C/S and complications – ANS module part 2

C/S and complications - ANS module part 2

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1) 7. You are the on-call registrar for the labour ward and are about to perform a

Caesarean section for failure to progress at 4 em cervical dilatation. Thiswoman is

a primigravida and has a body mass index of351cg!m2.The consultant wants you

to make an incision that willrequire the least amount of analgesia and result in less

febrile morbidity, the shortest operating time, less operative blood loss, the lowest

risk ofwound infection and a shorter hospital stay.

Which incision will you chooset

A) Chemey incision

B) Joel-Cohen incision

C) Kustner incision

D) Maylard incision

E) Plannenstiel incision

2) 28. A25-year-old woman undergoes an emergency caesarean section (CS) at full dilatation,

following a failed instrumental delivery. Regarding CS at full dilatation, which of the

following is correct?

A) CS at full dilatation is associated with almost double the risk of intraoperative trauma

B) Frequency of constipation is higher at one year with CS at full dilatation

C) Increased maternal BMI increases the risk of CS at full dilatation

D) Risk of wound infection is higher with a CS at full dilatation than operative delivery

E) Women undergoing an operative vaginal delivery are less likely to report difficulty in conceiving and more likely to have a further pregnancy than those who undergo a CS

3) You have been asked by your consultant to write a patient information

lea et on caesarean section. You decide to include information on serious

and frequently occurring risks.

What is the incidence of ureteric injury at the time of caesarean section?

A) 0.003%.

B) 0.03%.

C) 0.3%.

D) 3%.

E) 30%.

4) 5) A 30-year-old had an emergency caesarean section in the second

stage for a persistent bradycardia 6 days ago. She now presents with

progressive abdominal distension, which was initially painless but has

become increasingly painful. The pain is localised mainly to the right

side. She is tachycardiac on examination and also pyrexial. What is the

most likely diagnosis?

A) Bowel obstruction from adhesions

B) Bowel perforation

C) Faeculent peritonitis

D) Infected haematoma

E) Ogilvie syndrome

5) During a primary caesarean section, at what point during the operation is a

bladder injury most likely to occur?

A) Closure of the uterine incision

B) Delivery of the baby

C) Dissection of bladder from the lower segment

D) During catheterisation

E) Entry into the peritoneal cavity

6) 58. What is the most common type of postoperative infection following an emergency

caesarean section?

A) Endometritis

B) Lower respiratory tract infection

C) Upper respiratory tract infection

D) Urinary tract infection

E) Wound infection

7) 80. What is the risk of bladder injury during caesarean section?

A) 0.001%

B) 0.005%

C) 0.01%

D) 0.05%

E) 0.1%

8) 57. Following surgery, how long should patients wait before they can shower?

A) 24 hours

B) 48 hours

C) 72 hours

D) 5 days

E) 7 days

9) Which of the following is least likely to be a complication of lower segment caesar-

ean section?

A) Anal sphincter injury

B) Bladder dome injury

C) Colonic perforation

D) Intra-abdominal haemorrhage

E) Transient tachypnea of the newborn

10) . A36-year-old woman is electi.velybooked for a Caesarean section for placenta

praevia She has a history of previous laparoscopic salpingectomy for an ectopic

pregnancy, and two emergency previous Caesarean sections for failure to progress.

Youare the senior registrar, operating the consultant's supervision. Atthe end of

the procedure, you notice a 1em tear in the bladder dome.

What isthe correct management intraoperatively and what is your advice

postoperatively?

A) interrupted non-absorbable sutures, catheter for 7 days and a cystogram

B) Continuous absorbable sutures, catheter for 7 days and a cystogram

C) Interrupted absorbable sutures, catheter for 7 days and a cystogram

D) Continuous non-absorbable sutures, catheter for 7 days and a cystogram

E) Interrupted absorbable sutures, catheter for 4 days and a cystogram

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