USMLE forum
 
USMLE Forum
Step 1
Step 2 CK
Step 2 CS
Matching & Residency
Step 3
Classifieds
 
Archives
 
 
  <<   < *  Step 2 CK   *  >   >>  

* ob/gyn cms 4
 #842358  
  cs042016 - 06/30/17 16:59
 
  A 21-year-old primigravid woman at 41 weeks' gestation is admitted to the hospital in labor. Her pregnancy has been uncomplicated. Contractions occur every 3 minutes. The cervix is 100% effaced and 4 cm dilated; the vertex is at +1 station. The membranes rupture yielding moderately thick meconium-stained fluid. The fetal heart rate has a baseline of 130/min with variable decelerations lasting 45 seconds and decreasing to 60/min. Which of the following is the most appropriate next step in management?

External cephalic version
Forceps delivery
Amnioinfusion
Amniocentesis
Cordocentesis
 
Report Abuse

 
 

* Re:ob/gyn cms 4
#3342403
  cardio69 - 06/30/17 17:25
 
  Meconium is thick in labor " thick meconium-stained fluid" in order to down MAS, what u recommend to dilute of that?  
Report Abuse

* Re:ob/gyn cms 4
#3342404
  cs042016 - 06/30/17 17:54
 
  Amnioinfusion?
 
Report Abuse

* Re:ob/gyn cms 4
#3342919
  drerum - 07/08/17 16:06
 
  It's amnioinfysion  
Report Abuse

* Re:ob/gyn cms 4
#3342938
  airforce - 07/08/17 21:48
 
  y?
its already 41 weeks,
 
Report Abuse

* Re:ob/gyn cms 4
#3343214
  gpatrick21 - 07/12/17 17:48
 
  I'm thinking amnioinfusion as well.

Variable decelerations = Cord compression (VEAL CHOP). The first treatment for chord compression is repositioning the mother so that she's not on the cord. If this doesn't work, Amnioinfusion is the next best option. Picture it as re-inflating the bubble around the baby in order to get the pressure of its cord.

Other Answers:
- External rotation won't work because you've already punctured the membrane (i.e. deflated the balloon)
- Forceps delivery isn't the best option b/c a.) the cervix is only 4cm dilated and b.) cord compression is bad for baby.
- Amniocentesis/Cordocentesis = sampling fluid. This is sounding like an emergency = not the time to sample fluid.

Hope this helps. I haven't confirmed the answer, but it makes the most sense.
 
Report Abuse

* Re:ob/gyn cms 4
#3343474
  parmesh495 - 07/17/17 10:19
 
  i think Amnioinfusion is the answer  
Report Abuse

          Page 1 of 1          

[<<First]   [<Prev]  ... Message ...  [Next >]   [Last >>]

 
Logon to post a new Message/Reply
 
 
 

 

 

Google
  Web USMLEforum.com
 

Step 1 Step 2 CK Step 2 CS Matching & Residency Step 3 Classifieds
LoginUSMLE LinksHome