Prolonged Pregnancy Management Quiz

<p>It is considered irrelevant and should be avoided. (D)</p> Signup and view all the answers

<p>0.25% (A)</p> Signup and view all the answers

<p>More frequent and earlier ultrasounds (B)</p> Signup and view all the answers

<p>41.0 to 41.6 weeks (D)</p> Signup and view all the answers

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

<p>It has been shown to cause fetal hypoxia. (A)</p> Signup and view all the answers

<p>Nipple stimulation (C)</p> Signup and view all the answers

<p>Cervical ripening (B)</p> Signup and view all the answers

<p>It has no scientific evidence supporting its efficacy. (A)</p> Signup and view all the answers

<p>Bishop score (C)</p> Signup and view all the answers

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

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

<p>Pumping for 30 minutes on one side, then 30 on the other (D)</p> Signup and view all the answers

<p>Likelihood of successful induction of labor (D)</p> Signup and view all the answers

<p>Serious adverse effects such as fetal hypoxia (C)</p> Signup and view all the answers

<p>22.9% (D)</p> Signup and view all the answers

<p>It incorporates patient desires and concerns. (C)</p> Signup and view all the answers

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

<p>Increased subcutaneous fat (B)</p> Signup and view all the answers

<p>To minimize the risk of intrauterine fetal death (C)</p> Signup and view all the answers

<p>Both B and C (C)</p> Signup and view all the answers

<p>After 38 weeks gestation (B)</p> Signup and view all the answers

<p>Premature rupture of membranes (D)</p> Signup and view all the answers

<p>It is safe for GBS positive patients and their babies. (D)</p> Signup and view all the answers

<p>All of the above (D)</p> Signup and view all the answers

<p>Increased Wharton's jelly (C)</p> Signup and view all the answers

<p>Twice a week (C)</p> Signup and view all the answers

<p>There is no clear consensus (A)</p> Signup and view all the answers

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

<p>Short, thin umbilical cord (B), Decreased body weight (D)</p> Signup and view all the answers

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

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

<p>41-43 weeks (B)</p> Signup and view all the answers

<p>A G3p 1011 patient at 41 weeks with a non-reactive NST, a cervix of 370 minus two mid position, and soft. (A), A G4p3 patient at 41 weeks with a history of precipitous labor, who lives 45 minutes away from the hospital, and with a cervix of 490 minus one anterior and soft. (B), A patient with a bishop score of 66 and a partner going to Iraq who may never see this child again. (C)</p> Signup and view all the answers

<p>The effectiveness of elective induction of labor in reducing the risk of cesarean birth. (C)</p> Signup and view all the answers

<p>A bishop score less than five, intact membranes, and no regular contractions. (C)</p> Signup and view all the answers

<p>A bishop score less than five. (B)</p> Signup and view all the answers

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

<p>It reduces the need for cesarean birth by approximately 18.6%. (D)</p> Signup and view all the answers

<p>All of the Above. (D)</p> Signup and view all the answers

<p>A cervix that is thick, firm, and closed, with a low bishop score. (C)</p> Signup and view all the answers

<p>All of the above. (D)</p> Signup and view all the answers

<p>They are not as readily available as laminaria. (A)</p> Signup and view all the answers

<p>Cervical ripening prepares the cervix for labor, while labor induction initiates labor. (C)</p> Signup and view all the answers

<p>A scale used to evaluate the readiness of the cervix for labor. (D)</p> Signup and view all the answers

<p>All of the above. (D)</p> Signup and view all the answers

<p>To respect the patient autonomous decision and counsel them on the risks of continuing the pregnancy. (B)</p> Signup and view all the answers

<p>It explains why cervical ripening is necessary before induction of labor. (B)</p> Signup and view all the answers

<p>It is not supported by current evidence-based practices. (C)</p> Signup and view all the answers

<p>The HPA axis releases hormones that trigger the production of prostaglandins and estrogens. (A)</p> Signup and view all the answers

<p>Placental sulfatase deficiency leads to prolonged pregnancies due to low estriol levels. (B)</p> Signup and view all the answers

<p>Oligohydramnios (low amniotic fluid). (D)</p> Signup and view all the answers

<p>To decrease the statistically significant increase in stillbirth rates observed after 41 weeks. (C)</p> Signup and view all the answers

<p>Increased risk of preterm birth. (C)</p> Signup and view all the answers

<p>Increased fetal distress leading to meconium passage. (A)</p> Signup and view all the answers

<p>Progesterone inhibits uterine contractions, delaying labor onset. (D)</p> Signup and view all the answers

<p>Calcium deposits. (B)</p> Signup and view all the answers

<p>It can result in prolonged pregnancies due to disruption of the HPA axis. (C)</p> Signup and view all the answers

<p>Increased risk of oligohydramnios. (A)</p> Signup and view all the answers

<p>Increased fetal monitoring is recommended at 41 weeks, with delivery recommended by 42 weeks. (A)</p> Signup and view all the answers

<p>Reduced estriol levels. (C)</p> Signup and view all the answers

<p>Fetal macrosomia. (D)</p> Signup and view all the answers

<p>Decreased fetal oxygenation due to placental insufficiency. (A)</p> Signup and view all the answers

<p>While risks associated with post-term pregnancies exist, the optimal timing of labor before 41 weeks is still debated. (B)</p> Signup and view all the answers

<p>Obesity (A), History prior post term (B), Nulliparous (C), Genetic predisposition (D), AMA (E)</p> Signup and view all the answers

<p>Fetal macrosomia (A), Placental insufficiency (B), Induction without ripened cervix (C)</p> Signup and view all the answers

<p>Postpartum hemorrhage (A), Infection (B), Perineal trauma (C), Operative vaginal or Cesarean birth (higher risk) (D)</p> Signup and view all the answers

<p>Fetal postmaturity syndrome</p> Signup and view all the answers

<p>Long nails (A), Placental dysfunction (B), Thin body (C), Calcified/desquamination/peeling of skin (D), Absence of vernix or lanugo (E), Meconium stained nails or skin (F), Alert look (G)</p> Signup and view all the answers

<p>Hypoglycemia (A), Abnormal FHR patterns (B), Oligohydramnios (C), Meconium aspiration (D), Umbilical cord compression (E)</p> Signup and view all the answers

<p>Decreased production and storage of prostaglandin precursors (A), Decreased stimulation to form oxytocin receptors in myometrium (B), Placental estrogen deficiency or decreased prostaglandin release (C)</p> Signup and view all the answers

<p>Decreased diffusion of oxygen</p> Signup and view all the answers

<p>Placental sulfatase deficiency</p> Signup and view all the answers

<p>NST, BPP, modified BPP (B), 2x/week (C), Amniotic fluid index (D), 41 weeks (E)</p> Signup and view all the answers

<p>Amniotic fluid index</p> Signup and view all the answers

<p>80% (A), 41 weeks (B)</p> Signup and view all the answers

<p>Consider: 41 weeks (A), Recommend: 42 weeks (B)</p> Signup and view all the answers

<p>10-15% smooth muscle, the remainder connective tissue</p> Signup and view all the answers

<p>8 (A), 6 (B)</p> Signup and view all the answers

<p>Max 2 rounds or 2 hours (A), 30 minutes on 1 side (repeat on other side) (B)</p> Signup and view all the answers

<p>Produce contractions</p> Signup and view all the answers

<p>Not recommended</p> Signup and view all the answers

<p>Prostaglandin precursor</p> Signup and view all the answers

<p>Cervical ripening</p> Signup and view all the answers

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

<p>No recommended number (A), 1 cm (B), &gt; 38 weeks (C)</p> Signup and view all the answers

<p>Spotting (A), Accidental ROM (B), GBS positive (C)</p> Signup and view all the answers

<p>Dinoprostone (Cervidil) (A), Misoprostol (Cytotec) (B)</p> Signup and view all the answers

<p>Membranes intact (A), Bishop's score &lt; 5 (B), No regular contractions (C)</p> Signup and view all the answers

<p>Oxytocin (Pitocin)</p> Signup and view all the answers

<p>ROM (A), Bishop's score &gt; 5 (B)</p> Signup and view all the answers

<blockquote> <p>39 weeks (A)</p> </blockquote> Signup and view all the answers

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

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

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

<p>Neurologic state (A), Hematologic state (B), Movement (C), Heart rate/cardiac activity (D), Pulmonary development (E)</p> Signup and view all the answers

<p>Umbilical cord vessel function (size and shape) (A), Placental tissue aging/grading (B), Amniotic fluid volume (C)</p> Signup and view all the answers

<p>Fetal movement/kick counts</p> Signup and view all the answers

<p>CNS activity and muscle tone</p> Signup and view all the answers

<blockquote> <p>24 weeks (A)</p> </blockquote> Signup and view all the answers

<p>Without risk factors (A)</p> Signup and view all the answers

<p>No movement in 12 hours on a single day (A), Uncharacteristic decrease in movement (B), &lt; 10 movements in 12 hours on 2 consecutive days (C)</p> Signup and view all the answers

<p>Cardiotocographic or ultrasound assessment (NST, CST)</p> Signup and view all the answers

<p>Fetal non-stress test (NST)</p> Signup and view all the answers

<p>20 minutes (A), Semi-recumbent side-lying position (B)</p> Signup and view all the answers

<p>SNS and PSNS response</p> Signup and view all the answers

<p>Moderate variability (5-25 bpm)</p> Signup and view all the answers

<p>CNS maturity</p> Signup and view all the answers

<p>Low false negative (A), High false positive (B)</p> Signup and view all the answers

<p>Reactive</p> Signup and view all the answers

<p>Contraction stress test (CST)</p> Signup and view all the answers

<p>3 contractions in 10 minutes at least 40-60 seconds in duration (A)</p> Signup and view all the answers

<p>Semi-recumbent side-lying position</p> Signup and view all the answers

<p>Remain moderate and not drop during/after a contraction</p> Signup and view all the answers

<p>Loss of variability, decelerations beyond the end of contraction (A)</p> Signup and view all the answers

<p>High false positive rate (A), Low false negative rate (B)</p> Signup and view all the answers

<p>Negative</p> Signup and view all the answers

<p>Higher reassurance than an NST</p> Signup and view all the answers

<p>Auscultated acceleration test</p> Signup and view all the answers

<p>Biophysical profile (BPP)</p> Signup and view all the answers

<p>Fetal breathing movement (A), Amniotic fluid volume (B), Body and limb movement (C)</p> Signup and view all the answers

<p>8/8 or 10/10 (A)</p> Signup and view all the answers

<p>BPP</p> Signup and view all the answers

<p>Higher score: Lower risk, Lower score: higher risk (A)</p> Signup and view all the answers

<p>Amniotic fluid volume assessment</p> Signup and view all the answers

<p>3rd trimester (A)</p> Signup and view all the answers

<p>Amniotic fluid index (4 pocket measure) (A)</p> Signup and view all the answers

<p>Maximum/deepest ventricular pocket (single pocket measure) (A)</p> Signup and view all the answers

<p>Increases risk of stillbirth due to cord impingement</p> Signup and view all the answers

<p>Doppler velocimetry</p> Signup and view all the answers

<p>Transabdominal or transvaginal ultrasound (A)</p> Signup and view all the answers

<blockquote> <p>24 weeks (A)</p> </blockquote> Signup and view all the answers

<p>Hypertensive disorders (A), Heart disease (B), Diabetes (C)</p> Signup and view all the answers

<p>Umbilical artery (A), Fetal arterial circulation (MCA) (B)</p> Signup and view all the answers

<p>&lt; 3.0 (A), S:D ratio (B)</p> Signup and view all the answers

<p>Abnormal fetal growth (A), Poor placental perfusion (B)</p> Signup and view all the answers

<p>Absent diastolic flow</p> Signup and view all the answers

<p>Percutaneous umbilical blood sampling (PUBS)</p> Signup and view all the answers

<p>Genetic studies (A), Fetal therapy (blood transfusion = fetal anemia) (B), Tests for anemia, bleeding disorders, hemoglobinopathies, infection (C), Fetal blood gases (D)</p> Signup and view all the answers

<p>Amniocentesis for fetal lung maturity</p> Signup and view all the answers

<p>Phosphatidylglycerol (present) (A), Lecithin and sphingomyelin ratio (L:S ratio &gt; 2.0) (B)</p> Signup and view all the answers

<p>Equivalent</p> Signup and view all the answers

<p>Fetal tone (A), Fetal breathing movements (B), Fetal movements (C)</p> Signup and view all the answers

<p>Amniotic fluid volume</p> Signup and view all the answers

Refers to pregnancies from 37.0 to 38.6 weeks.

Defined as the duration from 39.0 to 40.6 weeks of pregnancy.

Refers to pregnancies completing from 41.0 to 41.6 weeks.

Describes pregnancies that go beyond 42 weeks (294 days).

Often used to denote pregnancies lasting 41-42 weeks.

The most common cause of prolonged pregnancy, often due to poor recall or irregular cycles.

A term meaning just past the due date, not useful for management.

Genetic predispositions can contribute to the likelihood of post term pregnancies.

A disorder linked to the X chromosome, affecting males more commonly due to their single X chromosome.

A condition where a fetus lacks a major part of the brain and skull, often leading to stillbirth or death shortly after birth.

The hypothalamic-pituitary-adrenal axis; a crucial system in regulating stress response and labor onset.

Hormone released from the hypothalamus that stimulates the pituitary to release ACTH.

Hormones that initiate labor by stimulating uterine contractions.

Excessively large fetal size, often complicating delivery.

Low amniotic fluid surrounding the fetus, which can lead to complications.

Aging of the placenta, which can lead to decreased function.

Increased likelihood of fetal death in later stages of pregnancy.

The ability of the fetus's heart to function properly, which can be assessed by Doppler studies.

The process of stimulating labor using medical methods rather than allowing it to commence naturally.

A condition where the newborn inhales a mixture of meconium and amniotic fluid into the lungs.

The smooth muscle layer of the uterus that contracts during labor.

Ultrasound tests that assess the blood flow in the fetal circulatory system.

Previous studies focusing on pregnancy outcomes without modern methods might be less reliable.

Areas of tissue death in the placenta that impact oxygen exchange.

Bleeding in the placental area can reduce oxygen supply to the fetus.

A loop in the umbilical cord that can cause complications for the fetus.

A gelatinous substance that cushions the umbilical cord.

A condition in newborns born after 42 weeks, showing signs of placental dysfunction.

Signs such as wrinkled skin and meconium staining in newborns after prolonged pregnancy.

Condition of low amniotic fluid, commonly occurring late in pregnancy.

Monitoring fetus health during late pregnancy to prevent adverse outcomes.

A technique to induce labor by separating membranes from the uterus.

Discussion regarding potential risks before performing the sweeping technique.

A test assessing fetal health by measuring heart rate, movement, and fluid.

Methods used to prepare the cervix for labor, including membrane sweeping.

Increased risks for both mother and fetus when pregnancy extends beyond 42 weeks.

Potential risk during membrane sweeping; rare but possible.

A scoring system to assess cervical favorability for induction of labor.

Using prostaglandins for cervical ripening before labor induction.

Methods like Foley catheters to open the cervix without drugs.

A device placed in the cervix to facilitate dilation before labor.

Seaweed rods used to swell and dilate the cervix mechanically.

Artificial devices to help in cervical dilation similar to laminaria.

A study examining elective induction effects on cesarean rates.

Percentage of births that occur via surgical delivery.

Death of a fetus or neonate close to the time of birth.

A pregnancy with no major complications affecting health.

Discussing induction options and decisions with patients.

A fetal heart rate test showing no significant accelerations.

Patients’ right to make their own healthcare decisions.

Gravida 3, Para 1-0-1-1: pregnancy history shorthand.

Methods used to induce labor without medical prescriptions, often discussed among patients.

Walking is reported by 43.3% of respondents and helps during labor progression.

Intercourse can help induce labor due to prostaglandins in semen and oxytocin release during orgasm.

10.9% of respondents reported using spicy food, but there's no evidence to support its effectiveness.

Nipple stimulation can help release oxytocin, prompting contractions but not reliably inducing labor.

Castor oil is used to encourage labor by stimulating bowel movements, potentially leading to uterine contractions.

Used as a prostaglandin precursor for cervical ripening; can pose risks like early membrane rupture.

Theoretically stimulates oxytocin secretion; more evidence is needed for its effectiveness.

Continuing pregnancy past 42 weeks can increase stillbirth and maternal complications; induction is recommended.

Prostaglandins help ripen the cervix and can initiate contractions, aiding labor induction.

Some herbs are used to induce labor but can have adverse effects; safety is not established.

Laxatives stimulate the bowel, which can provoke uterine irritation, but their use is controversial.

These herbs may lead to severe complications, including fetal health issues, and should be avoided.

A term describing a woman who has never given birth.

A condition where a fetus is significantly larger than average, often associated with prolonged pregnancy.

Risks for mothers include perineal trauma, postpartum hemorrhage, and infection.

Includes labor dystocia, meconium-stained fluid, and stillbirth.

A condition resulting from prolonged gestation with clinical features detected after birth.

Signs include long nails and meconium-stained skin at birth.

Induction should be considered at 41 weeks, recommended at 42 weeks.

Agents like misoprostol and dinoprostone used to prepare the cervix for labor.

NST tracks heart rate and movement; CST assesses heart rate during contractions.

A technique to assess blood flow in fetal circulation and placenta.

Aim for a negative result; indicates adequate fetal oxygenation during contractions.

Assessment of amniotic fluid volume in each quadrant of the uterus.

Includes fetal movement, tone, breathing, and amniotic fluid volume.

Condition where a newborn inhales a mixture of meconium and amniotic fluid.

Leads to hypoxemia, hypoxia, or asphyxia; affects fetal health progressively.

Method for assessing fetal well-being based on regular movements.

Signs in newborns include respiratory distress and abnormal breathing patterns.

Technique for sampling fetal blood from the umbilical cord for various tests.

Withdraws amniotic fluid to assess lung maturity via L:S ratio.

Conditions like diabetes, hypertension, or growth restrictions warrant closer monitoring.

Obesity and advancing age can increase risks of delayed pregnancy outcomes.

Monitor health to prevent adverse outcomes in prolonged pregnancy.

Reactive NST indicates a healthy fetus that responds to movement with heart variability.

A method to encourage contractions, assisting with labor onset.

Includes medical interventions like prostaglandins or mechanical methods for cervical ripening.