Social History and Maternal Mortality

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Questions and Answers

How does smoking influence fetal growth?

Reduces birthweight in a dose-dependent manner (correct)

Has no significant effect on fetal growth

Enhances fetal nutrient absorption

Increases blood flow to the placenta

What is advised regarding alcohol consumption during pregnancy?

Moderate consumption is acceptable

Consuming low-alcohol beverages is safe

Occasional drinking is permissible

Complete abstinence is recommended (correct)

What is one possible risk factor for early delivery?

Chronic smoking during pregnancy

High maternal age

Previous obstetric complications

All of the above (correct)

What should be considered significant in maternal history assessment for chromosomal abnormalities?

Age-related risks and prior genetic screening Signup and view all the answers

How can younger women feel more comfortable discussing sensitive issues during pregnancy?

They are more inclined to converse with medical students and young doctors Signup and view all the answers

What is the maternal mortality rate increase for women with unemployed partners compared to those whose partners are employed?

Seven times higher Signup and view all the answers

Which demographic is suggested to have higher risks in requesting amniocentesis when presented with high-risk Down's syndrome screening results?

Married women Signup and view all the answers

What was reported as a significant contributing factor to social exclusion in maternal deaths for women under 20?

Social isolation Signup and view all the answers

Which of the following factors has been reported as an influence on decision making regarding post-mortem consent after stillbirth?

Mother's marital status Signup and view all the answers

What percentage of women whose deaths were reported in the 1997-1999 inquiries experienced domestic violence?

12 percent Signup and view all the answers

In terms of social support, whose voice is considered significant in decision making for married women after childbirth?

The husband Signup and view all the answers

How many deaths were reported among women under 20 years of age during the 1997-1999 evaluations?

18 Signup and view all the answers

What potential effects might a woman's social history have on her pregnancy?

Presence of obstetric complications Signup and view all the answers

Which of the following conditions is most likely associated with fetal growth restriction (FGR)?

Diabetes mellitus Signup and view all the answers

What is a significant risk associated with previous cervical incompetence?

Increased risk of late second trimester delivery Signup and view all the answers

Which genetic condition is least likely to lead to congenital abnormalities during pregnancy?

Balanced translocations Signup and view all the answers

In pregnant women who have experienced recurrent pregnancy loss, which factor is most critical to support during their subsequent pregnancies?

Psychological support Signup and view all the answers

What is the main concern regarding the use of the contraceptive pill in women with antiphospholipid syndrome?

Increased risk of thrombosis Signup and view all the answers

How does advanced maternal age primarily affect pregnancy?

Greater incidence of genetic disorders Signup and view all the answers

Which complication is commonly associated with monochorionic twins?

Fetal growth restriction in one twin Signup and view all the answers

What is the potential consequence of multiple first trimester terminations of pregnancy?

Higher likelihood of preterm delivery Signup and view all the answers

What maternal condition is related to an increased risk of stillbirth during pregnancy?

Diabetes mellitus Signup and view all the answers

What maternal history is important to document that may affect future pregnancies?

Previous gynaecological surgeries Signup and view all the answers

What maternal BMI is associated with the highest risk of fetal growth restriction?

BMI < 20 Signup and view all the answers

Which of the following conditions is NOT mentioned as increased risk due to maternal obesity?

Preterm labor Signup and view all the answers

Which maternal factor is most significantly linked to an increased risk of pre-eclampsia?

High maternal age Signup and view all the answers

What is the primary reason for weighing women during pregnancy who are underweight?

To assess fetal health in relation to potential perinatal outcomes Signup and view all the answers

In cases of known familial tuberculosis history, what action is recommended for the baby post-birth?

Offering repeated immunization Signup and view all the answers

Which maternal condition is NOT linked to risks associated with overweight status?

Decreased risk of gestational diabetes Signup and view all the answers

What is a key consideration when assessing risks for women with a BMI greater than 30?

Increased complexity of fetal assessments Signup and view all the answers

What fetal complication is directly linked to a mother's history of maternal weight concerns?

Fetal growth restriction Signup and view all the answers

When is it especially important to repeat weight measurements during pregnancy?

In underweight women with poor weight gain Signup and view all the answers

What was a significant factor in the modernization of maternity care according to the decline in perinatal mortality rates?

Increased hospitalization during pregnancy Signup and view all the answers

What was a major concern regarding new technologies in maternity care?

Their benefits to the entire population of women were not established Signup and view all the answers

How did consumer awareness impact maternal care practices in the 1980s?

It encouraged unproven methods to be accepted unquestioningly Signup and view all the answers

Which body is responsible for setting standards and strategies for maternity screening?

The National Screening Committee Signup and view all the answers

What change in maternity care is emphasized as part of the government's current approach?

Encouraging more home deliveries Signup and view all the answers

What trend regarding induction rates was observed in England and Wales from 1966 to 1974?

It rose significantly from 12.7% to 38.9% Signup and view all the answers

What aspect of pregnancy care has been subject to extensive scrutiny due to evolving medical practices?

The effectiveness of antenatal, intrapartum, and post-natal care Signup and view all the answers

What is a potential risk linked to a maternal age above 35 during pregnancy?

Higher risk of congenital heart defects Signup and view all the answers

What complication is associated with monochorionic twins during pregnancy?

Higher chances of intrauterine growth restriction Signup and view all the answers

What is a common risk associated with early delivery?

Increased likelihood of respiratory problems Signup and view all the answers

What does the abbreviation 'DHA' stand for in medical terms?

Docosahexaenoic acid Signup and view all the answers

Which abbreviation refers to 'fetal growth restriction'?

FGR Signup and view all the answers

Which of the following abbreviations is associated with 'cardiotocograph'?

CTG Signup and view all the answers

What does the abbreviation 'IVF' stand for?

In vitro fertilization Signup and view all the answers

Which abbreviation corresponds to 'electrocardiogram'?

ECG Signup and view all the answers

What is the meaning of the abbreviation 'hCG'?

Human chorionic gonadotropin Signup and view all the answers

What does the abbreviation 'GDM' signify?

Gestational diabetes mellitus Signup and view all the answers

Which abbreviation denotes 'anti-cardiolipin antibodies'?

aCL Signup and view all the answers

What indicates the need to investigate potential pregnancy problems before palpating the abdomen?

The presence of polyhydramnios Signup and view all the answers

What is the correct method for measuring the symphysis-fundal height (SFH)?

Measure from the top of the fundus to the symphysis pubis Signup and view all the answers

Which of the following is true regarding the symphysis-fundal height chart?

It reflects the gestational age of the fetus Signup and view all the answers

Which presentation of the fetus is characterized by the head being down?

Cephalic Signup and view all the answers

What should a practitioner note when feeling for the fundus during a physical examination?

Its location can indicate fetal distress Signup and view all the answers

What is indicated by a maternal BMI of less than 20 during pregnancy?

Increased risk of fetal growth restriction Signup and view all the answers

Why is it crucial to record known allergies during the maternal history assessment?

They help identify women at risk of poor weight gain and related outcomes. Signup and view all the answers

What condition can be influenced by a family history of congenital abnormalities?

Haemoglobinopathies Signup and view all the answers

What is one reason why measuring weight is important during the initial examination of pregnant women?

To assess risk for fetal growth problems Signup and view all the answers

For women with a BMI over 30, what is a significant risk during pregnancy?

Higher birthweight and increased perinatal mortality Signup and view all the answers

When may it be unnecessary to re-measure weight during pregnancy?

In normal-weight women without nutrition concerns Signup and view all the answers

What is the potential outcome if a family member has a tuberculosis history?

The baby may require immunization after birth Signup and view all the answers

Which of the following maternal characteristics is not linked to increased risks during pregnancy?

Regular exercise during pregnancy Signup and view all the answers

What complication can arise from an underweight woman’s poor weight gain during pregnancy?

Increased risk of fetal growth restriction Signup and view all the answers

What is a common challenge faced by obese pregnant women during fetal assessment?

Difficulty in ultrasound measurements Signup and view all the answers

What might make it challenging for healthcare providers to inquire about domestic violence during pregnancy?

Patients may be accompanied by abusive partners. Signup and view all the answers

Which of the following statements about smoking during pregnancy is correct?

Smoking can reduce birth weight in a dose-dependent manner. Signup and view all the answers

Why is it important for pregnant women to discuss their previous obstetric history?

It helps identify potential complications in the current pregnancy. Signup and view all the answers

What is the most effective way to ensure women can discuss sensitive issues during pregnancy?

Schedule appointments when partners cannot attend. Signup and view all the answers

What are the implications of alcohol consumption during pregnancy?

There are significant risks, including fetal complications. Signup and view all the answers

What is a critical aspect of gathering social history for pregnant patients?

Determining their partner's employment status. Signup and view all the answers

What factor most likely impacts the future pregnancies of women with a history of smoking?

Duration of smoking before pregnancy. Signup and view all the answers

What common misconception might exist regarding the effects of smoking during pregnancy?

Many believe smoking only affects the mother. Signup and view all the answers

Which of the following statements concerning drug and alcohol use during pregnancy is true?

Drug and alcohol use should be entirely avoided. Signup and view all the answers

What type of housing condition is often considered potentially problematic for pregnant women?

Occupying a flat with many stairs and no lift. Signup and view all the answers

What is the primary risk associated with ascending urinary tract infections in pregnant women compared to non-pregnant women?

Increased risk of pyelonephritis Signup and view all the answers

Which of the following factors can influence the accuracy of blood pressure measurement in pregnant women?

The method of deflating the cuff Signup and view all the answers

What is the significance of identifying persistent proteinuria or hematuria in pregnant women?

May indicate underlying renal disease Signup and view all the answers

In the late third trimester, how does the fundal height typically relate to gestational weeks?

It is approximately 2 cm less than the number of weeks Signup and view all the answers

What is one reason women are encouraged to report new or suspicious lumps during pregnancy?

Late-stage diagnosis often occurs in pregnancy Signup and view all the answers

Which examination method is noted as being as reliable as a physician's examination in detecting breast masses?

Self-examination Signup and view all the answers

What is a common misconception about nipple examination during breastfeeding?

It effectively indicates breastfeeding success Signup and view all the answers

Why might women in late pregnancy need assistance in positioning during abdominal examinations?

To avoid discomfort from a flat position Signup and view all the answers

What should be avoided when performing a formal breast examination?

Doing the examination without a chaperone present Signup and view all the answers

What is the suggested practice for measuring the abdomen of pregnant women?

Measurement should be reported rather than palpating only Signup and view all the answers

Study Notes

Maternal mortality rates are significantly higher for women with unemployed or unclassifiable partners, reaching seven times greater than those with employed partners (CEMACH 2003-2005).
Social exclusion was evident in nearly all deaths of women under 20 documented in the 1997-1999 CEMD, highlighting the impact of socioeconomic factors.
Married women are more likely to seek amniocentesis after high-risk Down's syndrome screening compared to unmarried women, indicating the influence of marital support on healthcare decisions.

Domestic Violence and Risk Factors

12% of maternal deaths reported from 1997-1999 involved domestic violence, emphasizing the need for sensitive inquiries in prenatal assessments.
Knowledge of relationship status (married or single) is crucial for understanding the support system of pregnant women, particularly post-birth.

Impact of Medical History on Pregnancy

Conditions such as antiphospholipid syndrome and cervical incompetence increase risks of pregnancy loss, requiring careful monitoring.
A history of recurrent pregnancy loss necessitates greater support during subsequent pregnancies.

Chronic Conditions Affecting Pregnancy

Diabetes may result in macrosomia and congenital abnormalities, while hypertensive disorders increase the risk of pre-eclampsia.
Renal disease can worsen and contribute to complications like preterm delivery, while epilepsy may lead to increased seizure activity during pregnancy.

Weight and Nutritional Considerations

BMI is a critical indicator of maternal health: underweight women (BMI <20) are at risk for fetal growth restriction, while obese women (BMI >30) face higher chances of gestational diabetes and perinatal mortality.
Weight gain during pregnancies is essential for both mother and baby; consistent monitoring is necessary, especially if initial measurements are concerning.

Family History and Genetic Considerations

Inquire about family histories related to congenital abnormalities and genetic disorders, as these may pose risks for current pregnancies.
Tuberculosis in family history can prompt immunization for the newborn post-delivery.

Addressing Substance Use

Smoking is linked to lower birth weights and increased risks of miscarriage and stillbirth, warranting intervention during pregnancy.
Complete avoidance of alcohol is advised due to undetermined safety during gestation.

Changes in Maternity Practices

Increased hospitalization and technological advancements in maternal care have shifted over time, but the efficacy of these practices is still being evaluated.
Coordination of research through the Cochrane Library has enabled more rigorous examination of maternity care practices and standards.

Importance of Confidentiality and Disclosure

Women should be provided opportunities to discuss sensitive issues like domestic violence in private, ensuring their safety and well-being.
The involvement of medical students might facilitate easier disclosures among younger patients.

Previous Obstetric History

Past pregnancies should be noted chronologically to identify complications and outcomes influencing current risks.
Key aspects from previous obstetric histories include termination types, complications faced, and their impact on future pregnancies.

Common Medical Abbreviations

2,3-DPG: 2,3-diphosphoglycerate, important in oxygen delivery.
AIDS: Acquired immunodeficiency syndrome, a severe immune disorder.
AFI: Amniotic fluid index, assesses amniotic fluid volume.
ACR: American College of Rheumatology, sets standards in rheumatology.
BMI: Body mass index, indicator of body fat based on height and weight.
BPP: Biophysical profile, evaluates fetal health via ultrasound.
DVT: Deep vein thrombosis, blood clot in a deep vein, critical in pregnancy.
EDD: Estimated date of delivery, predicts due date based on last menstrual period.
FGR: Fetal growth restriction, indicates inadequate growth of the fetus.
GDM: Gestational diabetes mellitus, glucose intolerance during pregnancy.
IOL: Induction of labor, medical or surgical initiation of labor.
MRI: Magnetic resonance imaging, non-invasive imaging technique.
PPH: Postpartum hemorrhage, excessive bleeding after childbirth.
SGA: Small for gestational age, refers to a baby with lower birth weight.

Screening for domestic violence involves discreet conversations during prenatal visits.
Social history includes smoking, alcohol, and drug use, affecting fetal development.
Previous obstetric history is vital for assessing risk factors in current pregnancy.
Maternal weight measured at the initial examination can identify risk for fetal growth restriction.
Family history of congenital abnormalities is crucial for genetic counseling.
Allergies should be documented as they may complicate pregnancy management.

Implications of Lifestyle in Pregnancy

Smoking negatively impacts birth weight and increases risks of stillbirth and neonatal death.
Alcohol consumption is discouraged; no established safe level exists during pregnancy.
Detailed assessments of maternal weight are essential, particularly if underweight (BMI < 20) or obese (BMI > 30).
Women with significant weight changes during pregnancy should be closely monitored to prevent gestational diabetes and hypertension.

Clinical Examination Techniques

Accurate measurement of blood pressure is important to monitor hypertension during pregnancy.
Urinary examination should include screening for asymptomatic bacteriuria, reducing urinary tract infection risks.
Abdominal examination involves measuring fundal height to assess fetal growth and potential complications.

Obstetric History and Physical Examination

Documenting pregnancies in chronological order assists in evaluating outcomes and risks.
Fundal height measurement typically correlates with gestational age, used to identify potential issues.
Each examination should include a chaperone for safety and encouragement of self-examination for breast lumps.

Key Considerations During Pregnancy Care

Healthcare providers should be vigilant about signs of mental health issues, especially in women with a history of psychiatric conditions.
Understanding the risks associated with conditions like diabetes or thromboembolic disease is critical for maternal-fetal health.
Ensure appropriate referrals and interventions based on identified risks during the prenatal period.

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Description

Explore the critical connections between social history and maternal mortality. This quiz highlights the impact of unemployment and social roles on women's health outcomes. Test your understanding of how socio-economic factors influence maternal health statistics.