Assisted Births Quiz Q & A (June 2010)

1. Name three types of birth which could be described as ‘assisted deliveries’.
A. Caesarean section, forceps delivery, ventouse (or kiwi cup) delivery


2. Describe two indications for instrumental vaginal delivery
A. Fetal compromise, fetal distress, maternal exhaustion, maternal cardiac condition requiring minimising exertion/valsalve manouevre, lack of progress, maternal exhaustion


3. What is an episiotomy, and why is it sometimes performed prior to an instrumental delivery?
A. Episiotomy = surgical incision (cut!) through the perineum – performed to enable the instruments to be applied to the baby’s head more accurately/easily

4. Name three people who might be in the room at the time of an instrumental delivery
A. Mum (!), Dad, birth partner, midwife, obstetrician, paediatrician, student midwife


5. Why is it normal practice to empty the woman’s bladder prior to an instrumental vaginal delivery?
A. To minimise the risk of causing bladder damage. Could also say to avoid a full bladder complicating the birth


6. State three reasons why a baby might be delivered by caesarean section
A. Placenta praevia, transverse lie, previous caesarean, multiple pregnancy, maternal medical history, failed induction of labour, fetal compromise, lack of progress in labour, placental abruption

7. Jane’s baby is going to be born by caesarean section, and her doctor is discussing the procedure with her in order to gain her consent. As part of this the risks of the procedure should be discussed with her – name three possible risks.
A. Heavy bleeding, infection, thrombosis (blood clots), damage to baby etc


8. You are caring for a woman on the postnatal ward who had a caesarean section three hours ago. When is the right time for her to start offering her baby a feed?
A. Erm.... as soon as possible, skin to skin and feeding should be initiated as soon as possible


9. What is the main responsibility of the scrub nurse/midwife in theatre during a caesarean section
A. In short, the instruments. The scrub helps set up prior to the start of the surgery, checks the instruments prior to the surgery, passes the surgeon instruments etc as required, and checks that everything passed to the surgeon leaves the surgical field (and is not left behind!)


10. Julie’s first baby was born by caesarean section. What is the likelihood that her caesarean scar will rupture during her second pregnancy or labour?
A. Data on this varies, but the most commonly cited statistic is about 0.5%


BONUS QUESTION
What does VBAC stand for, and what proportion of VBAC attempts are successful?
A. Vaginal Birth After Caesarean – and about 80% are successful