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Questions and Answers
Which condition is characterized by vaginal bleeding during the first half of pregnancy without cervical dilatation?
What is the most common site of ectopic pregnancy?
Which of the following diagnostic tests can help rule out ectopic pregnancy?
Which symptom may indicate a rupture in the case of ectopic pregnancy?
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RhoGAM is administered to which group of women experiencing bleeding during pregnancy?
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What is the initial treatment for an unruptured ectopic pregnancy that is 3.5 cm in size?
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What is a significant risk factor for fetomaternal hemorrhage (FMH)?
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Which symptom is most commonly associated with abruptio placentae?
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Which diagnostic test is specifically useful for detecting the presence of fetal hemoglobin in cases of fetomaternal hemorrhage?
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What is the primary intervention for a complete abruptio placentae with severe bleeding?
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What defines preeclampsia in a pregnant woman?
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When is eclampsia diagnosed in relation to pregnancy timelines?
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What is the blood pressure criteria for severe preeclampsia?
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What symptom is not typically associated with severe preeclampsia?
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Which laboratory finding is characteristic of HELLP syndrome?
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What is considered a diagnostic criterion for hypertension in pregnancy?
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What is a primary trigger for Disseminated Intravascular Coagulation (DIC)?
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Which laboratory abnormality is associated with DIC?
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What ultimately results from the coagulation process in DIC?
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What is a common symptom of DIC that distinguishes it from other conditions?
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Which treatment is specifically used to increase clotting time in DIC?
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What condition may lead to impaired swallowing reflex in newborns?
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Which labor type is characterized by rapid progression from onset to delivery, typically occurring within 3 hours?
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What can be a serious misconception regarding DIC's symptoms?
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What is a common consequence of an undelivered prolapsed umbilical cord during labor?
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What is a potential consequence of untreated DIC?
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Which replacement product is indicated for increasing fibrinogen levels in DIC management?
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What initial management step is required for a patient experiencing a prolapsed umbilical cord?
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Which scenario is NOT associated with premature rupture of membranes (PROM)?
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Which of the following is typically decreased in a DIC panel?
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What factor is commonly increased in a DIC panel, indicating fibrinolysis?
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In cases of Rh incompatibility, what is the primary purpose of administering RhoGAM?
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Which of the following is NOT a characteristic symptom of Rh disease in newborns?
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If a mother is Rh- and has an Rh+ partner, when should she receive the first dose of RhoGAM during her pregnancy?
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What does the acronym CHEAP TORCHES stand for in relation to congenital infections?
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What does nulligravida refer to in obstetric terminology?
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Which infection is NOT included in the CHEAP TORCHES acronym?
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What percentage of mothers with Rh incompatibility show an increased prothrombin time according to standard findings?
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What term is used to describe a woman who has never been pregnant?
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Which definition correctly describes 'multipara'?
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What does the term 'grand multipara' signify?
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Which term is associated with a pregnancy that results in the delivery of a fetus at or beyond 20 weeks gestation?
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What is the gestational period usually defined as?
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Which condition is commonly associated with polyhydramnios?
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What defines a nullipara?
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What does 'primigravida' indicate about a woman?
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Polyhydramnios can lead to which of the following complications?
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What is one outcome associated with polyhydramnios?
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Study Notes
Complications in Pregnancy
Spontaneous Abortion
- Vaginal bleeding in the first trimester can signal spontaneous abortion, ectopic pregnancy, gestational trophoblastic disease, or infection.
- Types of abortion:
- Threatened: Bleeding without cervical dilation.
- Inevitable: Bleeding with cervical dilation.
- Incomplete: Partial loss of conception products.
- Complete: All conception products lost before 20 weeks.
- Missed: Fetal death without loss of products.
- Septic: Abortion associated with infection.
- Diagnostic tests include pelvic examination, CBC, Rh factor, antibody screen, urinalysis, and ultrasound.
- Treatments involve suctioning, evacuation for incomplete abortions, and RhoGAM for unsensitized Rh-negative women.
Ectopic Pregnancy
- Occurs when a fertilized ovum implants outside the uterus, commonly in the fallopian tubes.
- Diagnosis involves vaginal exam, pregnancy tests, and transvaginal sonography.
- An increasing progesterone level above 22 ng/mL helps rule out ectopic pregnancy.
Symptoms and Treatment
- Early symptoms of pregnancy include amenorrhea, breast tenderness, and nausea.
- Rupture symptoms are unilateral abdominal pain, decreased hemoglobin, and shoulder pain.
- Treatment for unruptured ectopic pregnancies includes methotrexate or surgical options like salpingostomy.
Fetomaternal Hemorrhage
- Fetomaternal hemorrhage occurs without symptoms yet can lead to severe consequences if massive (> 30 mL) hemorrhage occurs.
- The Kleihauer-Betke test is used to assess fetal blood presence in maternal circulation.
Abruptio Placentae
- The placenta prematurely detaches from the uterus, often related to maternal hypertension or cocaine use.
- Symptoms include vaginal bleeding, a tender uterus, increased resting tone, and possible fetal distress.
- Treatment includes consultations, fluid resuscitation, and potential delivery.
Placenta Previa
- Occurs when the placenta implants over or near the cervical os, increasing the risk of bleeding.
- Diagnosis is made through ultrasound; digital examinations should be avoided to prevent hemorrhage.
Hypertensive Disorders of Pregnancy
- Hypertension: Defined by BP > 140/90. Can be chronic or transient without signs of preeclampsia.
- Preeclampsia: Hypertension with proteinuria and edema; severe cases see BP ≥ 160/110.
- Eclampsia: Preeclampsia with seizures.
- HELLP Syndrome: Involves hemolysis, elevated liver enzymes, and low platelets.
Disseminated Intravascular Coagulation (DIC)
- Triggered by conditions like abruptio placentae and eclampsia; involves both clotting and hemorrhage.
- Symptoms include bleeding, hypotension, and petechiae.
- Treatment focuses on the underlying cause and may include blood product replacement and anticoagulation therapy.
DIC Panel
- Test results indicate decreased clotting materials and prolonged clotting times.
- Essential markers include increased D-Dimer, decreased fibrinogen, and platelet counts.
Rh Incompatibility
- Occurs when an Rh-negative mother has an Rh-positive fetus, risking hemolytic disease.
- RhoGAM injections are utilized to prevent the mother's sensitization.
- Dosage is 300 µg at 26-28 weeks and post-delivery for Rh-negative women.
Congenital Infections (CHEAP TORCHES)
- CHEAP TORCHES acronym includes:
- Chickenpox, Hepatitis, Enteroviruses, AIDS, Parvovirus, Toxoplasmosis.
- Represents common causes of congenital infections that could affect fetal development.
Pregnancy Terms
- Gravida: Total number of pregnancies.
- Nulligravida: Woman who has never been pregnant.
- Primigravida: First pregnancy.
- Multipara: Multiple pregnancies.
- Term: Duration of pregnancy from 38 to 48 weeks.
Central Nervous System Anomalies
- Associated with impaired swallowing and cardiovascular issues, alongside factors like twin-twin transfusion syndrome and macrosomia.
Precipitous Labor
- Defined as delivery within ≤3 hours of labor onset, often linked with complications for the fetus like low Apgar scores and aspiration risks.
Management of Emergency Birth
- Prolapse of the umbilical cord can compromise fetal blood flow, necessitating immediate interventions such as C-section preparation.
Induction of Labor
- Indicated for conditions including diabetes and post-term gestation, involves methods like membrane stripping and oxytocin infusion.
Cesarean Section
- Performed under specific indications like fetal distress or dystocia, generally using regional anesthesia to minimize risks.
Fetal Presentation
- Variations include cephalic, breech, and shoulder presentations, which may complicate delivery processes.### Labor and Delivery Techniques
- Coaching the mother on effective breathing methods is essential; "pant like a puppy" is a recommended technique during crowning.
- Consideration of perineum integrity is crucial during delivery to minimize trauma.
- Episiotomy, though often avoided, may become necessary due to several factors:
- Fetal malposition may hinder safe delivery.
- Anticipating a larger baby's delivery increases risk.
- Shoulder dystocia can arise, preventing the anterior shoulder from passing below the symphysis pubis.
- Poor elasticity in perineal tissue can complicate delivery.
- Inadequate control over the mother’s expulsive efforts may necessitate an intervention.
Placental Delivery
- The placenta typically delivers within 5 to 30 minutes after the fetus has been born.
- Placental separation is initiated by the reduction in uterine size, leading to the detachment process.
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Description
Test your knowledge on complications during pregnancy, including spontaneous abortion and ectopic pregnancy. This quiz covers types of abortions, diagnostic tests, and treatment methods. Perfect for students in healthcare or medical fields.
