1.What do you think would be the decision for referral made by the doctorin the MCH clinic? Explain your answer!2.Explain you should tocolysis be given the patient!3.What do they mean by ‘alarming sign’ in the case?Page 3Mrs. Dani returned three weekd later to the MCH clinic, complaining that she hasbeen having regular contraction for 8 hours. She noted to have uterine contractions every 7 to 8 minutes. She knows the baby is still moving, no water broke.Physical examination :Vital signs : within normal limitsObstetric examination :Leopold 1: A globular round hard mass is occupying the uterine fundus.Leopold 2: Small fetal parts detected on the left abdominal wall, on theright side a long- flat area of mass with higher resistance is detected on theright side.Leopold 3: Some soft mass is palpable above symphysis, and have somehow entered the pelvic inlet.Estimated fetal weight 2700 gramsContraction: once every 3 minutes, lasting 50 seconds, strong.Fetal Heart Rate: 152-160 beat per minuteVaginal examination :Vulva/ vagina: no abnormalitiesPortio: axial position, soft, effacement 80%Cervical dilatation: 9-10 cmAmniotic membrane: intactPresenting part: breech, sacrum on the right, station +2, no feet palpableAdmission test result with cardiotocography : fetal in good conditionAn hour later full dilatation is reached and as the baby’s buttock is bulging in the perineum.She was lead to bear down. There was no difficulty while delivering the shoulderwith lovset maneuver.A baby boy is born, weighing 2750 grams, 50 cm in length.1.How this delivery differs from normal delivery of occiput presentation?2.Explain the use partogram!3.What are the problems during labor!4.Explain your answer!5.What would be your management plan for this patient?EpilogueThe baby is sent to the perinatology unit.Both the baby and Mrs. Dani are dismissed in good condition.