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Questions and Answers
What is a possible fetal complication of abruptio placenta or placenta previa?
What is a possible fetal complication of abruptio placenta or placenta previa?
What is a maternal implication of failure to progress in labor?
What is a maternal implication of failure to progress in labor?
What is a possible fetal complication of precipitous labor?
What is a possible fetal complication of precipitous labor?
What is a maternal implication of AIDS/STIs during pregnancy?
What is a maternal implication of AIDS/STIs during pregnancy?
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What is a fetal implication of premature rupture of membranes?
What is a fetal implication of premature rupture of membranes?
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What is a maternal implication of induction of labor?
What is a maternal implication of induction of labor?
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What is a fetal implication of premature rupture of membranes?
What is a fetal implication of premature rupture of membranes?
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What is a maternal implication of abruptio placenta or placenta previa?
What is a maternal implication of abruptio placenta or placenta previa?
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Which intrapartum risk factor is associated with a higher risk of fetal anoxia?
Which intrapartum risk factor is associated with a higher risk of fetal anoxia?
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What is the maternal implication of a prolapse of umbilical cord?
What is the maternal implication of a prolapse of umbilical cord?
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Which intrapartum risk factor is associated with a higher risk of chronic hypoxia?
Which intrapartum risk factor is associated with a higher risk of chronic hypoxia?
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What is the fetal implication of diabetes in pregnancy?
What is the fetal implication of diabetes in pregnancy?
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What is the purpose of the Maternal Fetal Triage Index (MFTI)?
What is the purpose of the Maternal Fetal Triage Index (MFTI)?
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Which intrapartum risk factor is associated with a higher risk of congenital anomalies?
Which intrapartum risk factor is associated with a higher risk of congenital anomalies?
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What is the maternal implication of preeclampsia?
What is the maternal implication of preeclampsia?
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Which intrapartum risk factor is associated with a higher risk of fetal hemorrhage?
Which intrapartum risk factor is associated with a higher risk of fetal hemorrhage?
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What is the fetal implication of postdates (greater than 42 weeks)?
What is the fetal implication of postdates (greater than 42 weeks)?
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Which intrapartum risk factor is associated with a higher risk of cesarean birth?
Which intrapartum risk factor is associated with a higher risk of cesarean birth?
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What is the primary focus of subsequent assessment in a prenatal care visit?
What is the primary focus of subsequent assessment in a prenatal care visit?
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What is a key maternal implication of abnormal presentation?
What is a key maternal implication of abnormal presentation?
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What is a key fetal implication of multiple gestation?
What is a key fetal implication of multiple gestation?
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What is a key maternal implication of hydramnios?
What is a key maternal implication of hydramnios?
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What is a key fetal implication of oligohydramnios?
What is a key fetal implication of oligohydramnios?
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What is a key maternal implication of meconium staining of amniotic fluid?
What is a key maternal implication of meconium staining of amniotic fluid?
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What is a key fetal implication of meconium staining of amniotic fluid?
What is a key fetal implication of meconium staining of amniotic fluid?
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What is a key risk factor that can impact medical decision-making during the present admission?
What is a key risk factor that can impact medical decision-making during the present admission?
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What is a key aspect of the initial assessment in a prenatal care visit?
What is a key aspect of the initial assessment in a prenatal care visit?
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What is a key factor that can place a woman in a high-risk category?
What is a key factor that can place a woman in a high-risk category?
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Study Notes
Risk Factors for Postpartum Hemorrhage
- Prolapse of umbilical cord: Maternal implication - fear for baby, cesarean birth, and emergent risk; Fetal implication - acute fetal hypoxia
- Fetal heart deceleration: Fetal implication - tachycardia, chronic asphyxic insult, and bradycardia; Maternal implication - fear for baby, and risk of cesarean birth, forceps, and vacuum
- Uterine rupture: Maternal implication - hemorrhage, cesarean birth, and hysterectomy; Fetal implication - fetal anoxia, fetal hemorrhage, and neonatal morbidity and mortality
Postdates (Greater than 42 Weeks)
- Maternal implication - anxiety, incidence of induction of labor, and cesarean birth; Fetal implication - post-maturity syndrome, risk of fetal-neonatal mortality, and risk of antepartum fetal death
Diabetes
- Maternal implication - risk of hydramnios, hypoglycemia or hyperglycemia, and preeclampsia; Fetal implication - risk of malpresentation, macrosomia, IUGR, RDS, hypoglycemia, polycythemia, and congenital anomalies
Preeclampsia
- Maternal implication - abruptio placenta, risk of seizures, and risk of stroke; Fetal implication - risk of small for gestational age baby, preterm birth, and mortality
Maternal Fetal Triage Index (MFTI)
- A five-level standardized method for assigning an acuity score to pregnant women presenting to the hospital for care
- Level 1 - stat; Level 2 - urgent; Level 3 - prompt; Level 4 - no urgent; Level 5 - scheduled or requesting a service
Premature Rupture of Membranes
- Maternal implication - risk of infection, preterm labor, and prolonged hospitalization; Fetal implication - perinatal morbidity, prematurity, and risk of respiratory distress syndrome
Induction of Labor
- Maternal implication - risk of uterine rupture, and length of labor if cervix not ready; Fetal implication - prematurity if gestational age not assessed correctly, and risk of hypoxia
AIDS/STIs
- Maternal implication - risk of additional infections; Fetal implication - risk of transplacental transmission
Abruptio Placenta/Placenta Previa
- Maternal implication - hemorrhage, uterine atony, and incidence of cesarean birth; Fetal implication - fetal hypoxia, acidosis, and perinatal mortality
Failure to Progress in Labor
- Maternal implication - maternal exhaustion, incidence of augmentation of labor, and incidence of cesarean birth; Fetal implication - fetal hypoxia, acidosis, and intracranial birth injury
Precipitous Labor (Less than 3 Hours)
- Maternal implication - perineal, vaginal, cervical laceration; Fetal implication - neonatal tentorial (brain) tears, trauma – neural or tissue, and cephalohematoma
Initial Assessment
- Abnormal symptoms or signs of potential problems; FHR status of uterine contractions
Subsequent Assessment
- Determining if there is any change from the most recently documented prenatal care visit or other evaluation; and determining any ongoing or newly developed risk factors that could impact medical decision making during the present admission
Factors that would Place a Woman in a High-Risk Category
- Physical conditions, mental health, psychosocial, cultural, and intimate partner violence; The nurse's ability to provide support and care
Abnormal Presentation
- Maternal implication - incidence of cesarean birth, incidence of prolonged labor, and incidence of fibroids; Fetal implication - incidence of placenta previa, prematurity, and risk of congenital abnormality
Multiple Gestation
- Maternal implication - uterine distention, risk of postpartum hemorrhage, risk of cesarean birth, and risk of preterm labor; Fetal implication - low birth weight, prematurity, and risk of congenital anomalies
Hydramnios
- Maternal implication - discomfort, dyspnea, and risk of preterm labor; Fetal implication - risk of esophageal or other high alimentary tract atresia, and risk of CNS anomalies
Oligohydramnios
- Maternal implication - maternal fear of "dry birth"; Fetal implication - incidence of congenital anomalies, incidence of renal lesions, and risk of IUGR
Meconium Staining of Amniotic Fluid
- Maternal implication - psychologic stress due to fear for baby; Fetal implication - risk of fetal asphyxia, and risk of meconium aspiration
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Description
This quiz assesses the risk of postpartum hemorrhage and its implications on maternal and fetal health, including cesarean birth, fetal heart deceleration, and acute fetal hypoxia.
