1. Pain relief in labour – from the list, choose the best mode for the following patients. Each option may be used once, more than once or not at all.

Possible Answers

For each of the questions below, select the answer which is most appropriate. Each option can be used once, more than once or not at all.

a.) A multiparous woman, who has had one previous Ventouse delivery, is on all fours on the floor in the second stage of labour. The fetal head is at +2 station, direct OA position.

Choose from one of the following answersA EntonoxB EpiduralC General anaesthesiaD PethidineE SpinalF None: support onlyG Transcutaneous electrical stimulation (TENS)H Water

b.) A woman is being induced in labour in her first pregnancy. She found the artificial rupture of the membranes (ARM) very painful and wants analgesia that will last her through all stages of her labour.

Choose from one of the following answersA EntonoxB EpiduralC General anaesthesiaD PethidineE SpinalF None: support onlyG Transcutaneous electrical stimulation (TENS)H Water

c.) A nulliparous woman has twins: first twin is cephalic and second is breech. She has been using Entonox for several hours, but wants something more effective. She is 8 cm and the presenting twin is in the right occipito-posterior position.

Choose from one of the following answersA EntonoxB EpiduralC General anaesthesiaD PethidineE SpinalF None: support onlyG Transcutaneous electrical stimulation (TENS)H Water

d.) A nulliparous woman is fully dilated and is going for a trial of instrumental delivery in theatre. She has no analgesia currently and the baby is presenting OT at station 0 to the spines. The CTG is suspicious.

Choose from one of the following answersA EntonoxB EpiduralC General anaesthesiaD PethidineE SpinalF None: support onlyG Transcutaneous electrical stimulation (TENS)H Water

e.) A woman needs immediate delivery for cord prolapse at 3 cm dilated. The fetal heart is present, but the tracing (CTG) is pathological.

Choose from one of the following answersA EntonoxB EpiduralC General anaesthesiaD PethidineE SpinalF None: support onlyG Transcutaneous electrical stimulation (TENS)H Water