What maternal condition always requires delivery by cesarean section?
Partial abruptio placentae
Ectopic pregnancy
Eclampsia
Total placenta previa
The Correct Answer is D
Choice A reason: Partial abruptio placentae is not the correct answer, as it does not always require delivery by cesarean section. Partial abruptio placentae is a condition where the placenta partially separates from the uterine wall before the baby is born. This can cause bleeding, pain, and fetal distress. Depending on the severity of the condition, the gestational age, and the fetal status, the delivery may be vaginal or cesarean.
Choice B reason: Ectopic pregnancy is not the correct answer, as it does not require delivery by cesarean section. Ectopic pregnancy is a condition where the fertilized egg implants outside the uterus, usually in the fallopian tube. This can cause bleeding, pain, and rupture of the tube. Ectopic pregnancy is not viable and needs to be removed surgically or treated with medication. It cannot result in a live birth².
Choice C reason: Eclampsia is not the correct answer, as it does not always require delivery by cesarean section. Eclampsia is a severe complication of preeclampsia, a condition where the pregnant woman develops high blood pressure and protein in the urine. Eclampsia can cause seizures, coma, and death for the mother and the baby. The only cure for eclampsia is delivery of the baby, which may be vaginal or cesarean depending on the maternal and fetal condition.
Choice D reason: Total placenta previa is the correct answer, as it always requires delivery by cesarean section. Total placenta previa is a condition where the placenta completely covers the cervix, the opening of the uterus. This can cause painless bleeding, preterm labor, and fetal distress. Vaginal delivery is impossible and dangerous, as it can cause severe bleeding and damage to the placenta and the baby. Cesarean section is the only safe way to deliver the baby.
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Correct Answer is C
Explanation
Choice A reason: Low birth weight is not a common complication of GDM, as the fetus tends to grow larger than normal due to the excess glucose and insulin in the blood. Low birth weight is more likely to occur in infants of mothers with preexisting diabetes or other conditions that affect placental function.
Choice B reason: Preterm birth is a possible complication of GDM, as the increased fetal size and the risk of maternal hypertension or infection may induce labor before term. However, it is not the greatest risk for the fetus, as preterm infants can survive with proper care and treatment.
Choice C reason: Macrosomia is the greatest risk for the fetus of a mother with GDM, as it is defined as a birth weight of more than 4000 g or 8 lb 13 oz. Macrosomia can cause difficulties during labor and delivery, such as shoulder dystocia, birth trauma, or cesarean birth. It can also increase the risk of neonatal hypoglycemia, jaundice, or respiratory distress.
Choice D reason: Congenital anomalies of the central nervous system are not a common complication of GDM, as they usually occur in the first trimester of pregnancy, before GDM is diagnosed or develops. Congenital anomalies are more likely to occur in infants of mothers with preexisting diabetes or other genetic or environmental factors.
Correct Answer is A
Explanation
Choice A reason: A fetal heartbeat auscultated with a Doppler or a fetoscope is a positive sign of pregnancy, as it confirms the presence of a living fetus in the uterus. A Doppler is an electronic device that uses sound waves to detect the fetal heart rate, while a fetoscope is a stethoscope-like instrument that amplifies the fetal heart sounds. The fetal heartbeat can be heard as early as 10 to 12 weeks of gestation with a Doppler and 18 to 20 weeks of gestation with a fetoscope.
Choice B reason: Quickening is the first perception of fetal movement by the pregnant woman, usually felt between 16 and 20 weeks of gestation for first-time mothers and 13 to 16 weeks of gestation for experienced mothers. However, quickening is not a positive sign of pregnancy, as it can be subjective and mistaken for other sensations, such as gas, hunger, or muscle spasms².
Choice C reason: Morning sickness is a common symptom of pregnancy that involves nausea and vomiting, usually in the first trimester. However, morning sickness is not a positive sign of pregnancy, as it can be caused by other factors, such as food poisoning, stress, or medication.
Choice D reason: A positive pregnancy test is a probable sign of pregnancy, not a positive sign. A pregnancy test detects the presence of human chorionic gonadotropin (hCG), a hormone produced by the placenta, in the urine or blood of the woman. However, a positive pregnancy test does not guarantee a viable pregnancy, as it can be influenced by the timing, the quality, or the interpretation of the test. A positive pregnancy test can also occur in cases of ectopic pregnancy, molar pregnancy, or miscarriage.
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