Question

In which of the following instances should you insert your fingers into the pregnant patient's vagina?

- When there is limb presentation instead of the normal head presentation
- Prolapse of the umbilical cord
- In a breech birth
- In a vertex presentation

Answer 1

Insert fingers into a pregnant patient's vagina only for an umbilical cord prolapse, which requires immediate medical intervention. Breech presentations are often delivered by Caesarean section, and vertex presentations are optimal for a vaginal birth.

Step-by-step explanation:

The insertion of fingers into a pregnant patient's vagina should only be done in specific and medically necessary situations. You should insert your fingers if there is a prolapse of the umbilical cord, which is an obstetric emergency where the cord comes out of the vagina before the baby. This can cause cord compression and compromise fetal blood flow requiring immediate medical intervention. In other situations like limb presentation, breech birth, and vertex presentation, manual examination or intervention may be required, but typically under the guidance of a medical professional who is assessing the situation.

For instance, in fewer than 5 percent of births presenting as breech (buttocks or feet first), which may be a frank or complete breech, most are delivered by Caesarean section today. On the other hand, a vertex presentation, especially the occiput anterior vertex, is the most common and associated with the greatest ease of vaginal birth. During this presentation, the fetus faces the maternal spinal cord and the head enters the birth canal in an optimal position for vaginal birth.