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Questions and Answers
At what point is a pregnancy considered preterm?
Which component is NOT part of a biophysical profile?
What is indicated by a green color in amniotic fluid?
Which method is used to assess fetal lie and attitude?
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What does the term 'gravid' refer to in pregnancy terminology?
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What does the abbreviation 'PPROM' stand for?
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What is the expected fetal movement count in a 2-hour observation period?
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When should a woman seek immediate medical attention regarding fetal heart rate?
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What is a common risk associated with PROM (premature rupture of membranes)?
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What is indicated by the term 'amniotic fluid index (AFI)'?
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What is the purpose of intermittent auscultation during labor?
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Which condition is likely indicated by variable deceleration in fetal heart rate?
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At what point during labor is a woman typically in Stage 1?
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What does a vasovagal response in a laboring woman typically indicate?
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What type of bacteria is associated with potential risks to the baby if Group B strep is present?
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What is the recommended course of action if there is a late deceleration in fetal heart rate?
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What can a thick cervix indicate during labor?
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How frequently should a fetus's heart rate be typically assessed at 32 weeks?
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What is the primary concern with a cord prolapse situation during delivery?
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What does a fetal heart rate of 156 bpm at 32 weeks gestation indicate?
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What condition is indicated by the presence of seizures during pregnancy?
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What is a potential risk when a mother with blood type O has a baby with blood type A or B?
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Which test determines if blood exchange has occurred during pregnancy complications?
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What does the presence of fetal fibronectin in plasma indicate?
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What is the recommended use of Betamethasone during pregnancy?
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Which condition is characterized by the detachment of the placenta from the uterine wall?
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Which of the following is most likely to occur if a mother presents chronic conditions before 20 weeks of gestation?
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What is the consequence of a cord prolapse during labor?
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What is the outcome of a pregnancy loss at less than 20 weeks gestation?
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What is the main action of Nifedipine during pregnancy?
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Study Notes
Pregnancy
- Term pregnancy: 40 weeks
- Preterm pregnancy: 37 weeks
- Last menstrual period (LMP): Delivery date is approximately 9 months and 7 days from the first day of the LMP.
Gravida and Para
- Gravida: Number of pregnancies
- Para: Number of live births
- Abortion: Number of abortions or miscarriages
Ultrasound
- Dating: Determine gestational age
- Placement: Identify the location of the placenta
- Abnormalities: Detect any abnormalities in the fetus or placenta
Biophysical Profile
- Assesses five fetal parameters:
- Fetal breathing
- Fetal movement
- Fetal tone
- Amniotic fluid volume (AFV)
- Fetal heart rate (FHR)
- A score of 8 or 10 indicates a healthy fetus
- A score of 6 or less indicates fetal distress
Leopold's Maneuver
- Used to identify:
- Fetal presentation: Which fetal part is presenting (e.g., head, buttocks)
- Fetal lie: The orientation of the fetus's long axis (e.g., longitudinal, transverse)
- Fetal attitude: The fetal posture (e.g., flexed, extended)
- Degree of descent: How far the presenting part has descended into the pelvis
- Expected location of the point of maximal intensity (PMI)
Amniotic Fluid
- Clear: Normal
- Green: Fetal distress
- Yellow: Infection
- Ferning: Sterile speculum examination obtains fluid for microscope analysis of amniotic fluid
Bloodshow
- Indicates early labor pains
- Pain location and intensity: Pain is often felt in the lower back, abdomen, and groin.
False Labour (Braxton Hicks)
- Irregular contractions that are not as intense or painful as true labor contractions
- Duration: Can last 20 minutes or longer
- Cervical change: No cervical dilation or effacement
Effacement
- Thinning of the cervix
- Low thin cervix: Cervical tissue is thinned and soft.
- Bitation: Thick cervix has not started thinning
Urinalysis
- Used to assess for infection, ketones, protein, and glucose
Amniotic Membrane Rupture (PROM)
- Preterm premature rupture of membranes (PPROM): The membranes rupture before 37 weeks of pregnancy
- Premature rupture of membranes (PROM): The membranes rupture before the onset of labor
Artificial Rupture of Membranes (ARM)
- Performed to induce labor
Fetal Monitoring
- Important for detecting fetal stress or problems during labor
-
Mom Position:
- Towel under hip
- Right hip higher than left hip
-
Methods:
- Intermittent auscultation: Using Doppler to listen for fetal heartbeat for low-risk pregnancies
- Continuous fetal monitoring: Using electronic devices to monitor fetal heartbeat and contractions
Fetal Heart Rate (FHR)
-
Normal FHR range: Between 110 and 160 beats per minute
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Accelerations: Short-term increases in FHR. Considered a good sign
-
150 bpm for >15 seconds at 32 weeks
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10 bpm for >10 seconds at 32 weeks
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Decelerations: Drops in FHR. May not always be a cause for concern.
- Early Decels: Gradual decrease in FHR that mirrors contraction. Not cause for concern.
- Late Decels: Gradual decrease in FHR after contraction has begun. Cause for concern.
- Variable Decels: Sudden drops in FHR lasting less than 30 seconds. Cause for concern.
-
Reposition Mom:
- Move to a side-lying position
- Change hands and knees position
- Chest position
Prolapsed Cord
- Definition: A condition where the umbilical cord protrudes through the cervix before the baby is born.
- Intervention: Reposition mother to take pressure off the cord.
Group B Streptococcus (GBS)
- Effects: Can cause serious infection in newborns but not in mothers
- Testing: Screened between 35 and 37 weeks
-
Treatment: If positive:
- Penicillin G 5,000,000 units IV bolus followed by 2,500,000 units every 4 hours
- Clindamycin 975 mg IV every 8 hours
Stages of Labor
- Stage 1: Dilation and effacement (0 - 10 cm), cervix opens and thins.
- Stage 2: Pushing and birth - starts at 10cm and ends with the delivery of the baby.
- Stage 3: Delivery of the placenta
- Stage 4: First 2 hours after the birth of the baby.
Potential Complications
-
High Blood Pressure (Hypertension):
- Mild: Systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg.
- Severe: Systolic blood pressure ≥ 160 mmHg or diastolic blood pressure ≥ 110 mmHg.
- Chronic: Present before 20 weeks gestation
- Gestational: Present after 20 weeks gestation.
- Preeclampsia: High blood pressure and protein in the urine.
- Eclampsia: Severe preeclampsia that includes seizures.
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HELLP syndrome: Severe preeclampsia with:
- Hemolysis
- ELevated liver enzymes.
- LPow platelets
Premature Labor
- Fetal fibronectin (FFN): Glue found in plasma that can indicate premature labor
-
Medications:
- Nifedipine (Adalat): Calcium channel blocker that stops contractions.
- Betamethasone: Glucocorticoid that helps fetal lung development.
Miscarriage and Stillbirth
- Miscarriage: Loss of a pregnancy before 20 weeks of gestation
- Stillbirth: Loss of a pregnancy after 20 weeks of gestation
Glucose
- Glucose administration: Often given after birth if the mother is not symptomatic or at risk (e.g., gestational diabetes)
ABO Incompatibility
- Risk: If the mother is blood type O and the baby is blood type A or B.
- Presentation: May result in jaundice.
Fetal Distress
- Definition: A critical condition that occurs when a fetus does not receive adequate oxygen during labor
- Causes: Can be caused by cord compression, placental abruption, or uterine rupture.
Placental Abruption
- Premature detachment of the placenta from the uterine wall
Uterine Rupture
- Tear in the uterine wall
Prolapsed Cord
- Definition: A condition where the umbilical cord protrudes through the cervix before the baby is born.
- Cause: Can be caused by a short cord, a low-lying placenta, or a breech presentation.
Kleinhauer-Betke (KB) Test
- Used to determine if blood exchange (fetal-maternal hemorrhage) has occurred
- Importance: To assess for fetal blood in the maternal circulation during the second trimester
McRoberts Maneuver
- Procedure: Bringing the mother's legs to her abdomen to dislodge the baby's shoulder from behind the pubic bone
- Use: Used in cases of shoulder dystocia (the baby's shoulder is stuck behind the pubic bone)
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Description
This quiz covers key concepts related to pregnancy duration, fetal assessment techniques, and crucial parameters like fetal movement and heart rate. It includes important definitions such as gravida and para, as well as methods like ultrasound and Leopold's Maneuver. Test your knowledge on these essential topics in maternal and fetal health.
