Risk Factors in Mother and Child Care
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Questions and Answers

Which of the following is NOT a biophysical risk factor for mother and child?

  • Low income (correct)
  • Nutritional status
  • Medical and obstetric disorders
  • Genetic considerations

    • What is the purpose of a Transvaginal Ultrasound?

  • To measure the circumference of the fetus' head
  • To assess the structure of the placenta
  • To identify potential fetal growth issues
  • All of the above (correct)

    • What is the typical gestation time frame for Chorionic Villus Sampling?

  • 6-8 weeks
  • 15-18 weeks
  • 20-22 weeks
  • 10-12 weeks (correct)

    • Which of the following is NOT a component evaluated during Amniocentesis?

    <p>Fetal heart rate (A)</p> Signup and view all the answers

    During Amniocentesis, which component indicates fetal lung maturity?

    <p>Lecithin-Sphingomyelin Ratio (B)</p> Signup and view all the answers

    Which test is conducted to assess the presence of fetal blood in the maternal bloodstream?

    <p>Kleihauer-Betke test (A)</p> Signup and view all the answers

    Why is a Left Recumbent Position recommended for Daily Fetal Movement Count?

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

    What is the main purpose of Nonstress Testing?

    <p>To monitor the fetus's heart rate response to movement (B)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of Class I heart disease?

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

    Which of the following is a potential consequence of Left-Sided Heart Failure during pregnancy?

    <p>Intrauterine fetal growth restriction (C)</p> Signup and view all the answers

    In which chamber of the heart does the blood from the systemic circulation enter?

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

    What is the primary cause of pulmonary edema in Left-Sided Heart Failure?

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

    During a Biophysical Profile assessment, a score of 6 indicates which of the following?

    <p>Suspicious, additional testing is required (C)</p> Signup and view all the answers

    Which of the following is NOT a contraindication for pushing during labor for women with heart disease?

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

    What is a common symptom of Right-Sided Heart Failure during pregnancy?

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

    Which of the following medications is typically prescribed for women with heart disease to manage high blood pressure?

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

    What is the purpose of a 50-g Glucose Challenge Test during pregnancy?

    <p>To screen for gestational diabetes (B)</p> Signup and view all the answers

    Which of the following conditions is associated with Right-Sided Heart Failure?

    <p>Pulmonary valve stenosis (B)</p> Signup and view all the answers

    What is the most common symptom associated with a pulmonary embolism?

    <p>Sudden onset of dyspnea (D)</p> Signup and view all the answers

    What is the recommended management for a patient with sickle cell anemia experiencing a crisis?

    <p>Provide pain management, oxygen, and hydration. (C)</p> Signup and view all the answers

    What is the primary cause of Iron-Deficiency anemia in pregnant women?

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

    During which phase of the pregnancy is a patient more likely to develop a pulmonary embolism?

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

    What is the most common method of transmission for Hepatitis A?

    <p>Fecal-oral route (D)</p> Signup and view all the answers

    What is the recommended management of a ruptured appendix in a pregnant patient in the late third trimester?

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

    What is the primary goal of treatment for a patient with gestational diabetes mellitus?

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

    What is the most significant risk associated with a woman contracting rubella during pregnancy?

    <p>Congenital birth defects (B)</p> Signup and view all the answers

    Which of the following is a risk factor for developing gestational diabetes mellitus?

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

    What is the primary method of transmission for tuberculosis?

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

    What is the recommended management for a pregnant woman with active tuberculosis?

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

    What is the most common symptom of a urinary tract infection in pregnant women?

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

    What is the recommended management for a pregnant woman with a urinary tract infection?

    <p>Encourage increased fluid intake. (A)</p> Signup and view all the answers

    What is the most significant risk factor for preterm labor in pregnant women with chronic renal disease?

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

    What is the primary difference between a pregnant woman with appendicitis and a pregnant woman experiencing morning sickness?

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

    Flashcards

    Biophysical Factors

    Factors related to genetics, nutrition, and medical history affecting mother and child.

    Psychosocial Factors

    Influences such as smoking, alcohol, drugs, and psychological state on pregnancy outcome.

    Sociodemographic Factors

    Factors like income, age, and access to prenatal care that affect mother and child's health.

    Environmental Factors

    External elements like radiation, chemicals, and pollutants impacting maternal and fetal health.

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    Transabdominal Ultrasound

    A non-invasive imaging method using sound waves to visualize the fetus through the abdomen.

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    Amniocentesis

    A procedure to collect amniotic fluid for testing fetal health, typically done between 15-18 weeks.

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    Daily Fetal Movement Count

    Monitoring baby's movements, expecting about 10 kicks per hour for assessing fetal health.

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    Nonstress Testing

    A test to evaluate fetal heart rate in response to movements and contractions.

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    Reactive Fetal Heart Rate

    Two accelerations of 15 bpm for 15 seconds.

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    Non-Reactive Fetal Heart Rate

    No fetal movements or low short-term variability.

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    Negative Contraction Stress Test

    Three contractions with good variability in 10 mins.

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    Positive Contraction Stress Test

    Late decelerations during contractions indicate increased risk for fetus.

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    Biophysical Profile Components

    Includes fetal reactivity, breathing, body movements, tone, and fluid volume.

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    Glucose Screening Test

    50-g glucose challenge between 24-28 weeks; high result leads to further testing.

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    Heart Disease Class I

    Uncompromised heart condition with no discomfort.

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    Mitral Valve Function

    Allows blood flow from left atrium to left ventricle.

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    Right Atrium Blood Source

    Receives blood from superior and inferior vena cava.

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    Signs of Left-Sided Heart Failure

    Includes pulmonary edema, orthopnea, and dyspnea.

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    Orthopnea

    Difficulty breathing when lying flat, often relieved by sitting up.

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    Thromboembolic disease

    Condition characterized by blood clots forming in veins, potentially leading to embolism.

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    Pulmonary embolism

    A blockage in a pulmonary artery caused by blood clots that travel to the lungs.

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    True Anemia

    Condition with hemoglobin levels less than 11g/dL due to inadequate red blood cells.

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    Iron-Deficiency Anemia

    A type of anemia caused by insufficient iron, leading to microcytic and hypochromic red blood cells.

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    Folic Acid-Deficiency Anemia

    Anemia resulting from insufficient folate, often seen in multiple pregnancies.

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    Sickle-Cell Anemia

    An inherited condition causing red blood cells to become sickle-shaped, leading to vessel blockage.

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    Urinary tract infection

    Infection in the urinary system marked by painful urination and frequent urges.

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    Chronic renal disease

    Long-term kidney dysfunction that may result in anemia and require dialysis.

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    Gestational diabetes mellitus

    Diabetes occurring during pregnancy due to insulin resistance, affecting fetal growth.

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    German measles (Rubella)

    Viral infection causing mild symptoms in mothers but severe risks to fetal development.

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    Human Immunodeficiency Virus (HIV)

    Virus that attacks the immune system, can be transmitted from mother to child.

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    Tuberculosis (TB)

    Infectious disease caused by Mycobacterium tuberculosis, affecting lungs and causing chronic symptoms.

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    Appendicitis in pregnancy

    Inflammation of the appendix, presenting as sharp abdominal pain, worsened in pregnant women.

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    Study Notes

    Assessment of Risk Factors in Mother and Child Care

    • Biophysical Factors:

      • Genetic factors, Nutritional status, Medical and obstetric conditions are assessed.

    • Psychosocial Factors:

      • Smoking, alcohol, caffeine, drug use, and psychological well-being are evaluated.

    • Sociodemographic Factors:

      • Low income, lack of prenatal care, age (especially adolescents), are important factors.

    • Environmental Factors:

      • Exposure to radiation, chemicals, and pollutants are considered.

    Screening Tests and Diagnostic Tests

    • Ultrasound:

      • Uses sound waves to examine the uterus.
      • Transvaginal ultrasound: inserted into the vagina, lithotomy position.
      • Transabdominal ultrasound: moved across the abdomen.

    • Chorionic Villus Sampling (CVS):

      • Tissue sample from the placenta.
      • Performed between 10-12 weeks to test for chromosomal abnormalities.

    • Amniocentesis:

      • Amniotic fluid collection (20 mL).
      • Possible at 15-18 weeks.
      • Evaluates:
        • Chromosomal abnormalities.
        • Blood incompatibility.
        • Fetal lung maturity.

    • Amniotic Fluid Analysis:

      • Color: analyzed for color (late pregnancy: slightly yellow).
      • Lecithin-Sphingomyelin Ratio (L/S): ratio of 2:1 indicates lung maturity (begins to form at week 24).
      • Phosphatidyglycerol (PG): Present in surfactant, mature at 35-36 weeks.
      • Bilirubin Determination: analyzed if blood incompatibility is suspected.

    • Magnetic Resonance Imaging (MRI):

      • Uses magnetic waves to assess the growing fetus.

    • Maternal Serum Alpha-fetoprotein (MSAFP):

      • Fetal liver product found in amniotic fluid and maternal serum.
      • Rises at 11 weeks gestation.
      • Assessed at 15 weeks.
      • Normal range (15 to 21 weeks) 10–150 ng/mL.

    • Percutaneous Umbilical Blood Sampling (PUBS):

      • Blood from the umbilical vein to analyze for incompatibility.
      • Kleihauer-Betke test for sensitization. Rho(D) immunoglobulin (RhIG) administered for high sensitization risk.

    • Fetoscopy:

      • Visual inspection using a fetoscope.
      • Possible at 16-17 weeks.
      • Used to confirm spinal column integrity, obtain tissue biopsies, or perform surgery.

    • Daily Fetal Movement Count (Kick Counts):

      • Consistent fetal movement count of about 10 per hour.
      • Performed in the left recumbent position after a meal.

    • Non-Stress Test (NST):

      • Measures fetal heart rate response to movement.
      • Reactive NST: 2 or more accelerations of 15 bpm for 15 seconds.
      • Non-Reactive NST: No fetal movements or low short-term variability.

    • Contraction Stress Test (CST):

      • Fetal heart rate analysis related to uterine contractions.
      • Negative CST: 3 contractions, 40-60 seconds long within a 10-minute period, and good variability.
      • Positive CST: Late decelerations, increased fetal risk.

    • Biophysical Profile (BPP):

      • Combines five parameters (reactivity, breathing movements, body movements, tone, amniotic fluid volume) to assess fetal well-being.
      • Scores:
        • 8-10: Fetus doing well.
        • 6: Suspicious, further testing needed.
        • 4: Fetus in jeopardy.

    • Glucose Screening Test:

      • 50-g Glucose Challenge Test between weeks 24-28.
      • If blood sugar is 140 mg/dL, a three-hour Glucose Tolerance Test is performed.
      • Fasting blood sugar levels expected, oral glucose solution.
      • Expected sugar values at 1 hr, 2 hr, and 3 hrs.

    Maternal Conditions at Risk

    • Pregestational conditions: Heart disease, high blood pressure, and other preexisting conditions.
    • Gestational complications: complications that arise during pregnancy.
    • High-risk labor and delivery: labor and delivery that presents challenges.
    • Combination of circumstances: multiple factors contributing to a high-risk situation.

    Maternal Heart Disease

    • Classification: Class I, II, III, and IV based on activity limitations.
    • Left-sided Heart Failure: Mitral stenosis, Aortic coarctation, compromised circulation, pulmonary edema, inadequate placental perfusion, intrauterine growth restriction, fetal mortality, possible need for anticoagulants like Heparin.
    • Right-sided Heart Failure: Pulmonary valve stenosis, congestion of systemic circulation, liver/spleen distension, uterus pressure, pain, distended abdominal vessels, ascites, edema.
    • Assessment: Exercise performance, cough, edema, jugular vein distention, vital signs, ECG, chest radiograph.
    • Management: Promoting rest, healthy nutrition, medication education (Digoxin, antihypertensives), avoidance of labor augmentation techniques (e.g., forceps, vacuum).

    Thromboembolic Disease

    • Causes: Venous stasis, hypercoagulation, vein damage.
    • Prevention: Avoid constrictive stockings, avoid sitting/standing in same position for extended periods.
    • Assessment (for PE): Chest pain, dyspnea, cough w/ hemoptysis, tachycardia, fainting.
    • Management: Doppler ultrasonography, bed rest w/ IV heparin for 24-48 hrs, oxygen therapy, ICU transfer.

    Anemia (Iron-Deficiency, Folate-Deficiency, Sickle Cell)

    • Iron-Deficiency Anemia: Microcytic and hypochromic, associated with low birth weight & preterm birth
    • Folate-Deficiency Anemia: Megaloblastic anemia, commonly with multiple pregnancy.
    • Sickle-Cell Anemia: Inherited hemolytic disease can block blood vessels & decrease blood flow to placenta, leading to low birth weight/fetal death.
    • Management: Dietary changes, iron/folic acid supplements, avoiding iron in certain circumstances, fluid intake, hydration, assessment and positioning of lower extremities, monitoring fetal health.

    Urinary Tract Infection

    • Assessment: Increased urination frequency with pain, pain/tenderness, raised temperature.
    • Management: Clean-catch urine sample, increased fluid intake, knee-chest position, frequent voiding, hygiene practices.

    Chronic Renal Disease

    • Assessment: Elevated creatinine levels.
    • Management: Dialysis if necessary, risk of preterm labor.

    Tuberculosis

    • Assessment: Chronic cough, low-grade fever, weight loss, chronic fatigue, hemoptysis, night sweats.
    • Management: Purified Protein Derivative (Mantoux) test if necessary. Isoniazid (INH) is common treatment.

    Appendicitis

    • Assessment: Differing presentation in pregnant vs. non-pregnant patients; varying pain intensity.
    • Management: Rest, liquid restriction, cesarean section for late-term pregnancies, laparoscopy for early pregnancies, consider rupture.

    Hepatitis

    • Assessment: Tenderness in liver area, dark yellow urine, jaundice.
    • Management: Prevention, sanitation measures.

    Gestational Diabetes Mellitus (GDM)

    • Assessment: Maternal hyperglycemia signs, enlarged uterus (large for gestational age), elevated blood sugar, age greater than 25 with glucosuria, recurrent infections, specific tests (50-g and 3-hr glucose tolerance).
    • Findings: Polyhydramnios, macrosomia, infant hypoglycemia.
    • Management: Balanced diet, insulin therapy.

    German Measles

    • Assessment: Rubella titer on first prenatal visit. Titer less than 1:8 indicates susceptibility.
    • Implications: Hearing impairments, cognitive/motor challenges, cataracts, cardiac defects, IUGR, and dental/facial clefts may arise.
      • Immunization concerns for pregnant women.

    HIV

    • Assessment: Placental transmission possible, breastfeeding may also transmit virus.
    • Management: Oral Zidovudine to minimize maternal-fetal transmission. Confirmation of HIV status for child by 4 months.

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    Description

    This quiz assesses key risk factors in mother and child care, focusing on biophysical, psychosocial, sociodemographic, and environmental aspects. It also covers important screening and diagnostic tests like ultrasound, chorionic villus sampling, and amniocentesis. Test your knowledge on how these factors and procedures impact maternal and child health.

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