Obstetrics Fetal Positioning Quiz

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Questions and Answers

What does fetal 'engagement' refer to?

The transition of the fetus into the anterior position

The position of the fetal head in relation to the spine

When the widest presenting transverse diameter has passed through the pelvic brim (correct)

The contraction of the uterine muscles during labor

Which presentation indicates that the fetal head is down in the pelvis?

Breech presentation

Face presentation

Vertex presentation (correct)

Transverse presentation

What is the relationship of fetal head to spine termed as?

Engagement

Presentation

Attitude (correct)

Position

What does a normal fetal heart rate range from?

110-160 beats per minute Signup and view all the answers

Which denominator corresponds to a breech presentation?

Sacrum Signup and view all the answers

What does the term 'longitudinal lie' indicate about the fetus?

The fetus is lying parallel to the mother's spine Signup and view all the answers

What measurement corresponds with the palpation of the fetal head being '2/5 above the pelvic brim'?

Non-engaged fetal head Signup and view all the answers

What is the significance of the fetal heart rate being regularly auscultated at 130 beats per minute?

It is within the normal range for a fetus Signup and view all the answers

What is the definition of maternal mortality rate?

Number of maternal deaths that occur as a direct result of pregnancy per 100,000 live births Signup and view all the answers

What is included in critical elements of prenatal assessment?

Health history, physical examination, blood and urine tests Signup and view all the answers

What factors contributed to the high maternal mortality ratio in low-income countries?

Inadequate prenatal care and poor healthcare infrastructure Signup and view all the answers

Which of the following statistics indicates the risk of infant mortality?

Number of deaths of infants under one year of age per 1,000 live births Signup and view all the answers

At what gestational age is stillbirth defined?

After 24 weeks of pregnancy Signup and view all the answers

Which condition is NOT a primary cause of maternal deaths worldwide?

Heart disease Signup and view all the answers

What is the perinatal mortality rate defined by?

Stillbirths and deaths in the first week of life Signup and view all the answers

Which population has the highest risk of maternal mortality?

Adolescents and women in poorer communities Signup and view all the answers

What is the purpose of prenatal care?

To provide holistic care to pregnant women and their families Signup and view all the answers

Which component is NOT typically included in a prenatal health history assessment?

Nutritional habits Signup and view all the answers

What does the term 'Gravida' refer to?

A woman who is currently pregnant Signup and view all the answers

Which formula can be used to calculate the expected date of confinement (EDC)?

EDC = LMP - (3 months) + 7 days Signup and view all the answers

What does 'Para' indicate in obstetrics?

The number of times a woman has given birth to a child Signup and view all the answers

Which of the following statements about gravidity is correct?

G5 refers to a woman who has been pregnant five times Signup and view all the answers

What is NOT typically assessed as part of a woman's psychosocial health during prenatal care?

Nutritional deficiencies Signup and view all the answers

What does the term 'Nullipara' represent?

A woman who has never given birth Signup and view all the answers

What is a primary focus of the WHO's 2023 publication on maternal mortality?

Trends in maternal mortality from 2000 to 2020 Signup and view all the answers

Which organization provides guidelines for the management of hypertension in pregnancy?

National Institute for Health and Care Excellence (NICE) Signup and view all the answers

What is the relationship between maternal age and Down syndrome according to the literature?

Increased maternal age is associated with a higher risk of Down syndrome Signup and view all the answers

What document outlines diagnostic criteria for hyperglycaemia first detected in pregnancy?

WHO diagnostic criteria document Signup and view all the answers

In which publication would you find information on maternal and child health nursing practices?

Maternity women’s health care Signup and view all the answers

What is the primary complication associated with the medical method of legal abortion?

Uterine cramping Signup and view all the answers

Which type of placenta praevia completely covers the internal os?

Type IV (Total praevia) Signup and view all the answers

Which risk factor is commonly associated with abruptio placenta?

Advanced maternal age Signup and view all the answers

What clinical feature might indicate a complete abruptio placenta?

Massive vaginal bleeding with tense uterus Signup and view all the answers

Which of the following scenarios does NOT typically cause antepartum hemorrhage?

Normal vaginal delivery Signup and view all the answers

Which ultrasound finding is associated with abruptio placenta?

Retroplacental clots Signup and view all the answers

What is a potential long-term effect of the surgical method of abortion?

Chronic pelvic infection Signup and view all the answers

What should management for antepartum hemorrhage be based on?

Amount of bleeding and maternal-fetal conditions Signup and view all the answers

Which of the following describes Type I placenta praevia?

Lower placental edge encroaches onto lower segment Signup and view all the answers

Which condition describes fetal blood vessels lying over the internal os?

Vasa praevia Signup and view all the answers

What is assessed during the bimanual examination in early pregnancy?

Softening of the cervix Signup and view all the answers

What is measured in a complete blood picture to indicate anaemia?

Haemoglobin (Hb) Signup and view all the answers

What sign indicates a bluish discoloration of the cervix during examination?

Chadwick's sign Signup and view all the answers

Which blood test is used to check for Rhesus isoimmunization?

Rhesus factor test Signup and view all the answers

What precaution should be taken if the rubella antibody is negative?

Avoid contact with individuals with rubella Signup and view all the answers

What condition can proteinuria during urine tests indicate?

Kidney disease Signup and view all the answers

Which test helps in early detection of congenital abnormalities?

Ultrasonography Signup and view all the answers

What is a common method to assess fetal well-being during pregnancy?

Fetal heart rate monitoring Signup and view all the answers

Which sign indicates the softening of the cervix during pregnancy?

Goodell's sign Signup and view all the answers

Which condition may require testing for syphilis during blood testing?

Abortion Signup and view all the answers

What is indicated by the presence of ketones in urine tests during pregnancy?

Dehydration Signup and view all the answers

What does the non-stress test (NST) primarily assess?

Response of fetal heart rate to movement Signup and view all the answers

What clinical application does transvaginal ultrasound serve during pregnancy?

Determine fetal viability Signup and view all the answers

When should Rh anti-D immunoglobulin be administered if tested positive for anti-Rh antibodies?

Within 72 hours after delivery Signup and view all the answers

Study Notes

Antenatal Assessment & Care (Part I)

This is a lecture on antenatal assessment and care, part 1, for Bachelor of Science (Honours) in Nursing students.
The lecture date is September 13, 2024.

Learning Outcomes

Students will be able to discuss current trends in maternal and child health.
Students will be able to describe the purposes and essential components of prenatal care.
Students will be able to identify critical elements of prenatal assessment, including health history, physical examination, blood, and urine tests.

Vital Statistics

Birth rate: Number of live births per 1,000 population in one year.
Maternal mortality rate: Number of maternal deaths per 100,000 live births resulting directly from pregnancy, including the postpartum period.
Infant mortality rate: Number of infant deaths under 1 year of age per 1,000 live births.
Neonatal mortality rate: Number of infant deaths younger than 28 days per 1,000 live births.
Stillbirth: Birth of a baby with no signs of life after pregnancy (and/or weight ≥ 500 gm).
Perinatal mortality: Number of stillbirths and deaths in the first week of life.

Maternal & Child Health

In 2020, approximately 800 women died each day from preventable causes related to pregnancy and childbirth.
Over 95% of maternal deaths occur in low- and lower-middle-income countries.
In 2020, the maternal mortality ratio was 430 per 100,000 live births in low-income countries compared to 12 per 100,000 in high-income countries.
Maternal mortality is higher in rural areas, poorer communities, and adolescents.
Primary causes of maternal deaths worldwide include severe bleeding (mostly after childbirth), infections (usually after childbirth), high blood pressure during pregnancy, complications from delivery (e.g., obstructed labor), and unsafe abortion.

Prenatal Care

Purposes: Assess health status of mothers and fetus, monitor pregnancy progress, identify at-risk mothers or fetus, promote self-care of pregnant women, and provide holistic care to pregnant women and their family members.
Schedule: First antenatal visit and subsequent visits.

Prenatal Assessment

Key elements of prenatal assessment include health history, physical examination, blood tests, and urine tests.

Health History

Current pregnancy: Signs, symptoms, urine/blood test for hCG, first day of last menstrual period (LMP).
Reproductive history: Menstrual history, age at menarche, menstrual cycle regularity, number of pregnancies/abortions/living children, previous experience in pregnancy, labor, and puerperium, date of last Pap smear, and contraceptive history.
Past medical, surgical & personal history: Medical conditions, surgeries, medications, allergies, and personal history.
Family history: Genetic diseases, multiple pregnancies, hypertension, diabetes mellitus, tuberculosis, and psychiatric disorders.
Psychosocial health assessment: Mental and emotional wellbeing.

Physical Examination

Height, weight, vital signs, head-to-toe physical examination, abdominal examination, and vaginal/pelvic examination.
Specific measurements and findings during physical examinations are included.
Detailed methods of breast examination (inspection and palpation) are described.
Abdominal examination method (including inspection, palpation, and auscultation) is documented, alongside examples of Leopold's maneuvers for determining fetal presentation.
Details on how to determine fetal attitude, fetal lie, fetal position and engagement are included.

Blood Tests

Complete blood picture, ABO grouping, Rhesus factor (Rh), Rubella antibody, Hepatitis B surface antigen (HbsAg), Venereal disease – Syphilis, and Human Immunodeficiency Virus (HIV) antibody.
Specific details of how to interpret the results of these blood tests are also detailed.

Urine Tests

Glycosuria, proteinuria, and ketones.

Prenatal Care (Subsequent)

Subsequent prenatal assessments, including general condition, body weight and height, blood pressure, urine tests for protein and glucose, and abdominal examination are detailed.

Antenatal Check-up Schedule

A standard schedule for antenatal check-ups, including the gestational week and the frequency of routine check-ups, as well as other examinations to be performed each week is listed.

Antenatal Assessment & Care (Part II)

Learning outcomes for this part include discussing common antenatal tests, identifying risk factors for high-risk pregnancies, and describing nursing assessment and management for various complications.

Assessment of Fetal Well-being

Methods of assessing fetal well-being, such as fetal heart rate (FHR), non-stress test (NST), and cardiotocography (CTG), are included.
Additional methods and procedures for fetal wellbeing, such as ultrasonography, biochemical screening, amniocentesis, chorionic villus sampling (CVS), and cordocentesis.

Ultrasonography

Methods and clinical applications of ultrasonography in pregnancy are described.

Prenatal Diagnosis

Non-invasive and invasive prenatal diagnostic procedures are detailed, including methods and complications.
Data about gestational age, including 1st and 2nd/3rd trimesters is detailed.

Pregnancy at Risk

Specific types of high-risk pregnancies, including abortion, antepartum hemorrhage (APH), gestational diabetes mellitus (GDM), and pregnancy-induced hypertension (PIH), are discussed.

Abortion

Definition and classification of spontaneous and induced abortions.
Causes of abortion.
Nursing care management for threatened abortions, including bed rest, bleeding monitoring, and subsequent care.
Legal aspects, including management methods, and complications of induced abortions.

Antepartum Haemorrhage (APH)

Various types of APH (including placenta previa and abruptio placenta), causes, clinical features, diagnosis, and management strategies are described.

Gestational Diabetes Mellitus (GDM)

Risk factors, diagnostic criteria (OGTT), management strategies (diet control, medication, and monitoring), and potential complications for both mother and fetus are detailed.

Hypertension in Pregnancy

Classification of hypertensive disorders (gestational, pre-eclampsia, eclampsia, chronic hypertension, superimposed pre-eclampsia).
Diagnosis parameters for hypertension during pregnancy.
Causes and risk factors for different types of hypertension in pregnancy.
Potential maternal and fetal complications and management strategies for each type of hypertension.

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Description

Test your knowledge on key concepts related to fetal positioning and presentation in obstetrics. This quiz covers fetal engagement, heart rate, and alignments in the pelvis, helping you understand the critical aspects of prenatal care.