Case 301 Medical history Primigravid patient, 35 years old, at 35 weeks’ gestation with normal pregnancy course, did a obstetric ultrasound examination, which is represented by images 1 and 2. Two weeks later, with 37 weeks' gestation, a new obstetric ultrasonography was made, which its images showed in images 3 and 4. Fetal heartbeats were present at a regular frequency. Fetal ultrasonography, axial section, at 35 week's gestation, with color Doppler.Fetal ultrasonography, longitudinal section, at 35 weeks gestation, with color Doppler.Fetal ultrasonography, axial section, at 37 weeks gestation, with color Doppler.Fetal ultrasonography, longitudinal section, at 37 weeks gestation, with color Doppler. Question:According to the clinical case and the images available, the correct diagnosis and its management are: Multiple umbilical cord loops, with no indication for cesarean delivery Umbilical cord procidency, which constitutes an indication for labor induction Velamentous cord insertion with medical indication for urgent cesarean delivery Multiple umbilical cord loops, with indication for cesarean delivery Test question Question:(Public tender for Administrative Technical Servants - 2011 - Obstetrical Physician Position - Lauro Wanderley University Hospital / ADAPTED) Caesarean is still frequently practiced in an abusive manner, while the forceps have been less used. Regarding cesarean operation and forceps, it is INCORRECT to state that: The main maternal indications for the use of forceps are: heart disease, pulmonary involvement, some neurological conditions, exhaustion, failure to progress and prolonged delivery. There are several indications of cesarean section. Among them, we can mention: umbilical cord prolapse, uterine rupture imminence, functional dystocia, anomalous presentations, placenta previa total center and circular cord diagnosed by ultrasonography. Although the cesarean section is considered a low risk and safe procedure, it is not risk free, since it can cause from urological lesions, infections, to maternal death. Placental acretism, placenta previa, chronic pelvic pain are possible complications in pregnant women with previous cesarean sections. The maternal conditions for applicability of the forceps include: completely dilated cervix, purse of the route water, and the middle and lower narrows compatible with cephalic volume. The fetal conditions are: alive concept, insinuated head and normal cephalic volume. Time is Up! Time's up
