Maternal Health Risks and Complications Quiz
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Questions and Answers

What is a common risk factor for preeclampsia-eclampsia in adolescents?

  • Excessive weight gain
  • High maternal age
  • Maternal malnutrition (correct)
  • Uterine rupture

Which of the following is a risk associated with advanced maternal age?

  • Abortion (correct)
  • Low birth weight
  • Labor abnormalities
  • Adolescent pregnancy

What mode of conception is associated with higher risks for congenital anomalies?

  • Assisted reproductive technology (ART) (correct)
  • Natural family planning
  • Spontaneous conception
  • Intrauterine insemination

Which of the following is considered a danger sign during pregnancy?

<p>Vaginal bleeding (B)</p> Signup and view all the answers

What does a past history of complications in pregnancy indicate for future pregnancies?

<p>Higher risk for complications (D)</p> Signup and view all the answers

Which of the following could indicate danger signs that require immediate assessment?

<p>Decreased fetal movement (D)</p> Signup and view all the answers

What are the potential complications associated with the younger maternal age during pregnancy?

<p>Labor abnormalities (C)</p> Signup and view all the answers

What is an important aspect to assess during antenatal care history?

<p>Past history of obstetric complications (B)</p> Signup and view all the answers

What is the most common cause of antepartum fetal death?

<p>Asphyxia (D)</p> Signup and view all the answers

What percentage of antepartum fetal deaths is attributed to infections?

<p>5% (B)</p> Signup and view all the answers

Which fetal state lasts about 40 minutes and includes vigorous body movement?

<p>State 2F (D)</p> Signup and view all the answers

Which of the following complications contributes to antepartum fetal death?

<p>Maternal hypertension (A)</p> Signup and view all the answers

What percentage of antepartum fetal deaths is due to congenital malformations?

<p>15% (B)</p> Signup and view all the answers

In which fetal state would you expect to see continuous eye movement and increased variability?

<p>State IV (D)</p> Signup and view all the answers

Which factor can influence the fetal states of sleep and activity?

<p>Mother's nutrition (D)</p> Signup and view all the answers

What is the expected behavior of a fetus in State 1F?

<p>No acceleration of heart rate (A)</p> Signup and view all the answers

What is the purpose of the Medstar Clinical Guide and Synopsis?

<p>To serve as a revision tool for medical students (A)</p> Signup and view all the answers

Which guideline did the management plans primarily reference?

<p>FMOH Obstetrics management protocol (D)</p> Signup and view all the answers

Who contributed significantly to the preparation of the second edition?

<p>Graduating Class of Jimma University (C)</p> Signup and view all the answers

What aspect of the guide was notably improved in the second edition?

<p>Inclusion of more topics and updates (B)</p> Signup and view all the answers

What is strongly recommended for history and physical examination in OBGYN?

<p>Introduction to Obstetrics and Gynecology diagnosis by Dr. Asheber Gaym (A)</p> Signup and view all the answers

How has feedback influenced the second edition of the guide?

<p>By incorporating constructive criticism received from the previous edition (A)</p> Signup and view all the answers

What is the primary format of the guide's content?

<p>Case-oriented approach (B)</p> Signup and view all the answers

What communication method was provided for student feedback on the guide?

<p>Email address and Telegram bot link (A)</p> Signup and view all the answers

What percentage of anemia during pregnancy is caused by iron deficiency?

<p>75% (B)</p> Signup and view all the answers

What is the total body iron in women approximately?

<p>2.3g (D)</p> Signup and view all the answers

What factor can contribute to iron deficiency anemia in women?

<p>Short interpregnancy interval (B)</p> Signup and view all the answers

What is the first pathological change in iron deficiency anemia?

<p>Depletion of bone marrow, liver, and spleen iron stores (D)</p> Signup and view all the answers

Which of the following lab parameters would be expected in iron deficiency anemia?

<p>Low MCV (A)</p> Signup and view all the answers

In combination with iron deficiency, what can affect the morphology of RBCs?

<p>Folate/Vit B12 deficiency (D)</p> Signup and view all the answers

What happens to serum iron levels during the onset of iron deficiency anemia?

<p>They fall (B)</p> Signup and view all the answers

What additional iron is needed to support increased RBC mass, the fetus, and placenta during pregnancy?

<p>1g (6-7mg/day) (C)</p> Signup and view all the answers

What symptoms are commonly associated with acute cystitis?

<p>Urgency and dysuria (D)</p> Signup and view all the answers

Which urine test is preferred for diagnosing acute cystitis?

<p>Urine culture from a catheterized sample (D)</p> Signup and view all the answers

What colony count in urine indicates infection when using a catheterized specimen?

<p>102/mL (B)</p> Signup and view all the answers

Which antibiotic regimen is suggested for initial treatment of acute cystitis?

<p>3 days of treatment (A)</p> Signup and view all the answers

What is a significant risk associated with using amoxicillin and cephalexin?

<p>Causing diarrhea or monilial vulvovaginitis (C)</p> Signup and view all the answers

Which antibiotic has minimal effect on vaginal and bowel flora?

<p>Nitrofurantoin monohydrate (B)</p> Signup and view all the answers

Which antibiotics are generally effective against drug-resistant pathogens?

<p>Amoxicillin-clavulanic acid and TMP-SMX (D)</p> Signup and view all the answers

What is a common complication of recurrent infections in patients with acute cystitis?

<p>Need for longer courses of therapy (C)</p> Signup and view all the answers

What is the primary rationale for recommending LDA prophylaxis in preeclampsia?

<p>It decreases vasospasm and coagulation abnormalities. (C)</p> Signup and view all the answers

When should LDA prophylaxis ideally be started during gestation?

<p>Before 16 weeks. (D)</p> Signup and view all the answers

What is a significant risk reduction associated with LDA prophylaxis in pregnant women?

<p>It reduces the risk of preterm birth by 14%. (C)</p> Signup and view all the answers

Which condition is defined as the development of convulsions during pregnancy associated with preeclampsia?

<p>Eclampsia (A)</p> Signup and view all the answers

What percentage range represents the reported incidence of eclampsia in the western world?

<p>1 in 2000 to 1 in 3448 pregnancies (B)</p> Signup and view all the answers

What defines late postpartum eclampsia?

<p>Eclampsia occurring after 48 hours but before 4 weeks of delivery. (D)</p> Signup and view all the answers

Which of the following is NOT a maternal complication of preeclampsia?

<p>Uteroplacental insufficiency (D)</p> Signup and view all the answers

Which statement about eclampsia diagnosis is correct?

<p>Alternative diagnoses are necessary if seizure occurs shortly after delivery. (A)</p> Signup and view all the answers

Flashcards

What does MEDSTAR stand for?

MEDSTAR stands for Medical Students Targeted for Academic Research, a group of students who strive to create educational materials for medical professionals.

What's the purpose of the second edition of the Obstetrics and Gynecology clinical guide?

The second edition of the clinical guide and synopsis for Obstetrics and Gynecology focuses on providing a concise and updated reference for medical students.

How is the information in the OBGYN guide compiled?

The guide's content is primarily based on real-world clinical experiences and detailed scientific information from relevant textbooks.

What are the main sources for the management plans in the OBGYN guide?

The guide provides management plans based on official protocols from the Federal Ministry of Health (FMOH) and Jimma University.

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Which additional resources are suggested for further learning?

The authors recommend consulting specific resources like "Introduction to Obstetrics and Gynecology diagnosis" by Dr. Asheber Gaym and simplified format for history taking and physical examination from Jimma Medical Center.

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What are the key goals of the OBGYN guide?

The guide aims for readability and aims to help students revise effectively in a short period.

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How can readers provide feedback on the OBGYN guide?

The authors welcome feedback through the provided email address and Telegram bot link to improve future editions of the guide.

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Who is acknowledged specifically for their contribution to the book?

Special thanks are extended to Dr. Rajif Shawl for his role in coordinating and encouraging the creation of the clinical guide.

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Age extremes in pregnancy

A pregnancy where the mother is younger than 18 or older than 35. It carries increased risk of complications.

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Premature Rupture of Membranes (PROM)

Premature rupture of membranes (PROM) is the breaking of the amniotic sac before labor begins. It can lead to infections and premature birth.

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Preeclampsia

A condition marked by high blood pressure and protein in the urine during pregnancy. It can affect both mother and baby.

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Assisted Reproductive Technologies (ART)

The process of conceiving a child using assisted reproductive technologies (ART) like IVF or IUI.

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Hyperemesis Gravidarum (HG)

Excessive vomiting during pregnancy, leading to weight loss and dehydration.

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Threatened abortion

A pregnancy related complication causing bleeding before 20 weeks.

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Intrauterine Growth Restriction (IUGR)

A condition that occurs when the baby is underdeveloped or smaller than it should be for the gestational age.

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Teratogen

Any substance that can harm a developing fetus, for example alcohol, drugs, or certain infections.

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RBC mass increase during pregnancy

During pregnancy, the total red blood cell (RBC) mass increases by about 300 mg (25%), but this increase starts later in pregnancy.

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Hemoglobin and hematocrit levels after childbirth

Within 6 weeks after giving birth, hemoglobin and hematocrit levels usually return to normal, assuming there wasn't excessive blood loss during childbirth and the mother has sufficient iron stores.

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Prevalence of iron deficiency anemia in pregnancy

Iron deficiency anemia accounts for roughly three-quarters of all anemia cases during pregnancy.

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Iron requirements in pregnancy

Women normally have around 2.3 grams of total body iron. About 65% of this is found in red blood cells. During pregnancy, an extra 1 gram (6-7 mg/day) of iron is needed.

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Factors contributing to iron deficiency anemia in pregnancy

Poor diet, short intervals between pregnancies, and iron-deficient erythropoiesis can lead to iron deficiency anemia during pregnancy.

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First sign of iron deficiency anemia

The first change in iron deficiency anemia is depletion of iron stores in the bone marrow, liver, and spleen. This can take weeks or months, depending on the woman's iron levels.

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Iron deficiency anemia blood tests

A low serum iron level and a decreased transferrin saturation percentage are indicative of iron deficiency anemia. Total iron-binding capacity (TIBC) will increase as unbound transferrin rises.

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Iron deficiency + Folate/B12 deficiency

If iron deficiency is accompanied by folate or vitamin B12 deficiency, red blood cells will be normocytic (normal size) and normochromic (normal color).

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Acute cystitis

A common urinary tract infection (UTI) characterized by symptoms like frequent urination, painful urination, urge to urinate, lower abdominal pain, difficulty starting urination, and dribbling.

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Positive leukocyte esterase and nitrate tests in urine analysis

Presence of white blood cells (WBCs) and nitrates in the urine, which are indicators of a UTI.

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Urine culture from a catheterized sample

A urine sample collected using a catheter to minimize contamination from vaginal bacteria, providing a more accurate assessment of the UTI.

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Colony count greater than 10^2/mL in a catheterized urine sample

A colony count of more than 10^2 bacteria per milliliter in a catheterized urine sample is a strong indication of a UTI.

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Asymptomatic bacteriuria

A UTI that doesn't cause any symptoms, typically detected by urine testing.

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Treatment of acute cystitis and asymptomatic bacteriuria

Short courses of antibiotics are usually effective for UTIs, but single-dose therapy is less effective in pregnant women compared to non-pregnant patients.

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Oral antibiotics for UTI treatment

Oral antibiotics are the typical treatment for UTIs, and a 3-day course is often as effective as a longer regimen for initial infections.

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Longer course of therapy for recurrent UTIs

Longer courses of antibiotics are recommended for patients with recurrent UTIs to prevent repeated infections.

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Antepartum Fetal Death

Fetal death occurring before delivery, commonly caused by issues like oxygen deprivation, maternal complications, birth defects, or infections.

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Asphyxia

Lack of oxygen to the fetus, often linked to restricted growth or prolonged pregnancy.

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Maternal Complications

Mother's health issues impacting fetal development, like premature separation of the placenta, high blood pressure, or diabetes.

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Congenital Malformations & Chromosome Abnormalities

Birth defects or genetic problems affecting the fetus.

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Fetal Infections

Infections affecting the developing fetus, contributing to death in the womb.

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No Obvious Etiology

Fetal death without a clear cause, becoming more frequent with later stages of pregnancy.

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State 1F

A quiet sleep state in the fetus characterized by slow heart rate and limited movements.

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State 2F

An active sleep state in the fetus characterized by frequent movements, higher variability in heart rate, and eye movements.

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What is preeclampsia?

A condition during pregnancy characterized by high blood pressure and protein in the urine.

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What is low-dose aspirin (LDA) prophylaxis?

A medication used to prevent preeclampsia, often prescribed before 16 weeks of gestation.

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What is the rationale for LDA prophylaxis?

The theory that an imbalance in the ratio of TXA2 and prostacyclin contributes to the vasospasm and coagulation abnormalities in preeclampsia.

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What is eclampsia?

A serious complication of preeclampsia characterized by seizures or unexplained coma during pregnancy or the postpartum period.

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When should alternative diagnoses be considered for seizures after delivery?

Occurs when seizures occur after 48-72 hours postpartum or while receiving magnesium sulfate.

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What is late postpartum eclampsia?

Eclampsia that happens after 48 hours but before 4 weeks of delivery.

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When can eclampsia occur during pregnancy or postpartum?

Preeclampsia can develop before labor, during labor, or after delivery, with the majority of cases happening during labor.

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What is the relationship between preeclampsia and eclampsia?

Eclampsia is a more severe condition requiring immediate medical attention. Untreated preeclampsia can lead to serious complications including eclampsia.

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Study Notes

Clinical Guide and Synopsis - Obstetrics and Gynecology

  • Second Edition, December 2022
  • Prepared by the Graduating Class of Jimma University 2015 E.C (2022/23)
  • The guide is based on feedback and criticism from the previous edition.
  • It is written in a case-oriented approach, combining ward experience and detailed scientific information from textbooks.
  • Management plans are mainly from the FMOН Obstetrics management protocol and Jimma University OBGYN Management Guideline.
  • For further information regarding history and physical examination use the introduction to Obstetrics and Gynecology diagnosis by Dr. Asheber Gaym.
  • Jimma Medical Center OBGYN Department provides further information on history taking and physical examination.
  • The guide provides an email address and telegram bot link for feedback to aid in the future edition development.

Contents

  • The guide is divided into two sections: Obstetrics and Gynecology.
  • Each section is further subdivided into chapters.
  • The chapters cover antenatal care, fetal well-being assessment, fetal pulmonary maturity, HDP, antepartum hemorrhage, PROM, preterm labor, malpresentation, multifetal gestation, RBC alloimmunization, GDM, intrauterine growth restriction, and more topics within the sections.
  • A detailed list of topics within each chapter further elaborates the book's content.

Contributors

  • A list of contributors is included in the various sections.

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Description

Test your knowledge on the various risk factors and complications associated with pregnancy, specifically in adolescents and those with advanced maternal age. This quiz covers crucial topics such as antepartum fetal death, congenital anomalies, and important assessments during antenatal care. It's designed for those studying maternal health and obstetrics.

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