Reproductive Health End of Trimester 2 CAT (MBOG 4223): labour and cord prolapse cases

Mount Kenya University · Department of Obstetrics and Gynaecology

Paper details

• Unit: Junior Clerkship in Reproductive Health, unit code MBOG 4223
• Sitting: End of Trimester 2 CAT. The scan has no printed date.
• Time and marks: 1 hour, 40 marks, 2 case questions
• Answers: written by OmpathStudy for revision. They are not the official MKU marking scheme.
• Topics tested: partograph, prolonged first stage and obstructed labour, caesarean section complications, breech presentation, umbilical cord prolapse.

Question 1. Mrs X in labour

Given: admitted at 14:00. Contractions 2 in 10 minutes, each 20 seconds. Head 5/5 above the brim, FHR 130/min. Cervix 2 cm, membranes intact, no moulding. BP 110/70, pulse 78, temperature 36.6 °C, urine 100 ml, protein and acetone negative. At 18:00: FHR 140/min, membranes ruptured with clear liquor, no moulding, cervix 5 cm, head 3/5 above the brim, contractions 3 in 10 minutes each 50 seconds, BP 105/70, pulse 80, temperature 37 °C.

(i) Plot the findings on the partograph (8 marks)

(ii) At 22:00 she is still 5 cm. Most likely diagnosis (1 mark)

(iii) Five complications of the diagnosis (5 marks)

(iv) Most appropriate management (1 mark)

(v) Five complications of the management in (iv) (5 marks)

Question 2. Mrs R, para 3+0 G4 at 38 weeks, liquor draining, lower abdominal pain, fundal content a hard ballotable mass, longitudinal lie, FHR 134 regular, presenting part firm and engaged

(i) What presentation is this? (1 mark)

(ii) Five complications of this presentation (5 marks)

(iii) On vaginal examination, a soft mass with a rope-like pulsatile structure next to it, cervix 6 cm. Diagnosis (1 mark)

(iv) Five risk factors for the rope-like structure in the vaginal canal (5 marks)

(v) Management (8 marks)