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[18.1] B. The most common finding in a uterine rupture is a fetal heart rate abnormality, such as fetal bradycardia, deep variable decelerations, or late decelerations. The intrauterine pressure catheter has not been found to be helpful; sometimes it confuses the picture and may delay the diagnosis of uterine rupture. Immediate cesarean section is indicated for suspected uterine rupture.

118.2] A. Transverse lie is associated with the highest risk of cord prolapse because no part of the fetus is in the maternal pelvis to prevent the umbilical cord from entering the cervix. With the frank breech (hips Hexed and knees extended), the buttocks fill the pelvis and decrease the risk of cord prolapse.

[18.3] A. The supine position causes uterine compression on the vena cava, which decreases the venous return of blood to the heart, leading to supine hypotension. One important maneuver when encountering fetal heart rate abnormalities is a positional change, such as the lateral decubitus position. Oxytocin and epidural anesthesia both can decrease oxygen delivery to the placental bed.

[18.4| E. The first step in assessment of apparent fetal bradycardia is differentiating the fetal heart rate from the maternal pulse.

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