Practice Quiz

CPM Certified Professional Midwife

Category - Labor, Birth, and Immediate Postpartum

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A G3P2 client at 38 weeks’ gestation has been in the second stage of labor for more than 3 hours. An epidural anesthesia has not been administered. A vacuum extraction is being considered. Which of the following assessment findings would signal that the extraction can be attempted?
  1. Amniotic membranes have already ruptured.
  2. Cervical dilatation of 8 cm.
  3. Fetal head is 2 cm above the ischial spines.
  4. Suspicion of cephalopelvic disproportion.
Explanation
Answer: A - Before vacuum extraction is attempted, the midwife should ensure that the client’s amniotic membranes have already ruptured. Other requirements include full dilatation of the cervix and the fetal head at the level of the ischial spines. There should be no suspicion of cephalopelvic disproportion. The bladder must be emptied by catherization or spontaneous voiding. A multiparous client without an epidural anesthesia is expected to complete the second stage of labor within one to two hours.
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