RANZCOG question of the week.

A 30-year-old woman who is exclusively breastfeeding her 3-month-old baby asks about drinking alcohol at a family wedding next month. She does not usually drink. What is the most accurate advice, in line with Australian guidance?

A 26-year-old woman is on day 4 after a vaginal birth with a second-degree tear repaired by a junior doctor. She has a temperature of 39.8 °C, vomiting, watery diarrhoea, a diffuse blanching erythematous rash over the trunk and limbs, confusion and BP 84/48 mmHg. There is an offensive vaginal discharge, and the uterus is non-tender. The swab count after the repair was documented as one short. Blood cultures have been taken, fluids are running and IV antibiotics have been started. What is the most important next step?

During a spontaneous vaginal birth at term, the head delivers and restitutes. The midwife feels the umbilical cord tightly around the neck; it cannot be slipped over the head or loosened enough to slip over the shoulders. The fetal heart was normal throughout the second stage. What is the most appropriate management?

A 31-year-old woman had cell-free DNA screening at 10 weeks reporting low probability for trisomies and a male fetal sex. At the 20-week scan the singleton fetus has normal female external genitalia; the heart, brain, hands and growth are normal. There was no vanishing twin, and she has had no transplant or recent transfusion. Amniocentesis confirms a 46,XY karyotype. Which condition is most likely?