Paragraph Labeling 1
Cephalopelvic disproportion (CPD) in labour occurs when there is a mismatch between the size of the fetus and the dimensions of the maternal pelvis. The factors which mainly influence the outcome of the delivery can be summarized as the three “Ps” of the labour: passageway, passenger, and power of the uterus. The passageway component of this trinity has been investigated by pelvimetry which measures the maternal bony pelvic dimensions, with very little emphasis on its shape or pelvic floor muscles. During the last decades, the use of pelvimetry has been discouraged, but at present, no replacing methods to evaluate the maternal pelvis have been introduced. The benefits of vaginal deliveries are well known when no risk factors are present even after previous Cesarean section (CS). On the other hand, unplanned interventions during labour such as acute or emergency Cesarean sections as well as operative vaginal delivery increase both maternal and fetal morbidities as does a prolonged second stage of the delivery. The safety and the accuracy of the measurements obtained in pelvimetry have improved in the era of the MRI technology. It is also in the interest of the mother and her physician to minimize the number of unplanned interventions during labour.
Paragraph Labeling 2
The figure shows a flow chart of the 226 patients that were investigated. Pelvimetric measurements were found in all patients, as required by the inclusion criteria. In the spontaneous vaginal delivery group, 40% were nulliparous. Most of the nulliparous patients were sent to maternity clinics consultation because of suspected disproportion. In the multiparous group, 24% had delivered by CS and 37% by operative vaginal delivery. In the operative vaginal delivery group, 79% were nulliparous. Of the nine multiparous patients, six had delivered by CS in their previous pregnancy and two had had previous vaginal operative delivery.
Paragraph Labeling 3
The study investigated Caucasian women, that had been examined by X-ray or MRI pelvimetry during 2000–2008. The patients were sent to the hospital antenatal unit from their general health care. Eligibility criteria included that pelvimetric and fetal measurements had been recorded. In the operative delivery group, the criteria were as follows. There were no signs of fetal distress in cardiotocography, inertia was not diagnosed, and there was no malpresentation. Originally, 915 women were screened for possible inclusion, but 429 women were excluded because of breech presentation. A total of 486 patients with the fetus in the cephalic presentation were screened in the study, but those 234 women that went through elective or acute Cesarean section were excluded from the analysis.
Paragraph Labeling 4
The clinical indication for pelvimetry was breech presentation, or if the fetus was in cephalic presentation, the indication was suspected cephalopelvic disproportion in clinical examination. The findings that referred to CPD in clinical examination were clinically small pelvis, unengaged presentation, or suspected macrosomia. Pelvimetric measurements were found in all patients, as required by the inclusion criteria. There were 252 participants with fetal cephalic presentation delivered vaginally, of whom 184 women delivered spontaneously and 68 women went through operative vaginal delivery with vacuum extraction. Of this latter group of women, in 26 patients, the vacuum extraction was undertaken primarily because of fetal distress and inertia, and these patients were excluded from the final analysis, leaving 42 women in the operative vaginal delivery group. Thus, the total number of participants evaluated in the final stage of this study was 226.
- Find out today’s transcription audio from the learning folder you have received / Pick any OET Listening Audios / Listen to the short audios below.
- Get your headphone, pen, notebook and the device to play back the audio.
- Start playing back and listen carefully.
- As you listen to the audio, start writing down the conversations in the notebook.
- You will have to pause, stop, rewind and forward the playback head many times.
- Complete writing the transcription.
NB: When you play back large audio files, listen continuously till the end and write the transcription, leaving blank spaces whenever you fail to understand a particular word. After reaching the end of the audio, replay and fill the blanks.
Listen to the short audios below and, applying the paragraph labeling you have mastered by now, write the short labels of the audio in a word or in a few words.
Audio Labeling 1
Audio Labeling 2
Long-term care refers to a comprehensive range of medical, personal, and social services coordinated to meet the physical, social, and emotional needs of people who are chronically ill or disabled. A nursing home facility may be the best choice for people who require 24-hour medical care and supervision.
What Type of Care Do Nursing Homes Provide?
Nursing homes offer the most extensive care a person can get outside a hospital. Nursing homes offer help with custodial care — like bathing, getting dressed, and eating — as well as skilled care. Skilled nursing care is given by a registered nurse and includes medical monitoring and treatments.
Skilled care also includes services provided by specially trained professionals, such as physical, occupational, and respiratory therapists.
What Services Do Nursing Homes Offer?
The services nursing homes offer vary from facility to facility. Services often include:
- Room and board
- Monitoring of medication
- Personal care (including dressing, bathing, and toilet assistance)
- 24-hour emergency care
- Social and recreational activities
Read the case notes below and complete the writing task which follows.
You are a nurse at Nativity Infant Welfare Centre, North Dacosta. You visited this patient at home today for the first time, after a referral from the maternity hospital:
- Name: Chhean Lauva Hin
- Age: 38 years
- Occupation: Home duties
- Personal History – Recently migrated (1/2015) to Australia with husband and 3 children (survivors of 6 pregnancies) from Vietnam.
- Suffered 8 months imprisonment (both husband and wife) in connection with illegal immigration.
- Husband works in factory. Setting up a small import business with help of a government organization. Studying English at night school.
- Children (boy 13, boy 11, girl 7) all at school. Working hard to adjust.
- Strong family commitment to school/work/study/business.
- Increasing financial stability, debts are being paid back.
- No other family in Australia. Feeling like “being called back to Vietnam.”
- No operations/illnesses
- 6 normal pregnancies previously, birth weight of each baby approx. 2.8 kg.
- In-coordinate contractions and inadequate outlet-Cesarean section.
- Birth-weight 4 kg (probably result of recently improved diet/antenatal care).
- Circumstances not understood by patient; Language barrier / cultural differences.
- Mother sutures removed: suture lines healed.
- Baby: no jaundice; breast feeding satisfactory, normal weight gain.
- Mother and child discharged from hospital.
- 1st home visit
- Most time since operation depressed and in bed (reasons unclear, but suspect due to circumstances of operation).
- A strong desire to go back to own country. Fears of imprisonment.
- Physically well. Apparent resistance to medical intervention in hospital (language barrier).
- Understanding of reasons for Cesarean section.
- Fears of imprisonment
- Home help.
- Refer to social worker.
- Arrange management plan.
Using the information in the case notes, write a letter of referral to Hoa Tran, a Cambodian social worker with Romans Council. Introduce Mrs Hin and explain why you are referring her to the social worker. Discuss reasons for her depression and explain how you think Mrs Tran can help.
In your answer:
- Expand the relevant notes into complete sentences
- Do not use note form
- Use letter format
- The body of the letter should be approximately 180–200 words.