BC Preterm Labour

Question 1

Which of the following is an appropriate
indication for induction of labor?

a) post-dates 40 4/7 weeks gestation
b) Term pre-labor rupture of membranes
c) Maternal gestational diabetes at 37 weeks gestation
d) Previous Cesarean delivery at 40 weeks gestation
e) Estimated fetal weight of 4300 g.

Answer 1

Term pre-labor rupture of membranes

Question 2

Preterm delivery is defined as:

a) Delivery of an infant with a lecithin; sphingomyelin ratio < 2:1
b) Delivery of a low-birth-weight infant
c) Delivery of a very-low-birth-weight infant
d) Delivery at less than 37 weeks
e) Delivery at less than 40 weeks

Answer 2

Delivery less than 37wk

Question 3

Which of the following is the most important
complication of multiple pregnancies?

a) Abruptio placentae
b) Anemia
c) Hypertension
d) Postpartum hemorrhage
e) Prematurity

Answer 3

e)Prematurity

Question 4

A G2P1 patient at 32 weeks gestation presents with PPROM. Culture of the amniotic fluid reveals group B streptococcus. Which of the following statements regarding her diagnosis and subsequent management is most accurate:

a) The infant is preterm. Lung maturity should be assessed via phosphotidylglycerol measurement and betamethasone administered if the fetal lungs are deemed immature. The patient should be delivered by C/S 24 hours after administration of betamethasone
b) The patient has chorioamnionitis and the infant is likely to be immature. The mother should receive tocolytics and betamethasone to facilitate fetal lung maturity
c) The patient has chorioamnionitis. Delivery should be expedited and intravenous antibiotics begun.
d) The patient has chorioamnionitis. Intravenous antibiotics should be begun along with administration of tocolytics to attempt to abort labor and premature delivery
e) None of the above

Answer 4

c)The patient has chorioamnionitis. Delivery should be expedited and intravenous antibiotics begun.

Question 5

An appropriate delivery technique in a woman presenting at 36 weeks gestation with a placenta previa is generally:

a) Cesarean section
b) Vaginal delivery
c) Most dependent on the patient’s Bishop’s score of cervical readiness for delivery
d) None of the above
e) Cervical cerclage

Answer 5

a)Cesarean section

Question 6

Which one of the following is the most useful
interventions in preterm labor at 27 weeks’
gestation?

a) Magnesium sulphate bolus and then infusion
b) Intravenous hydration
c) Erythromycin orally for 1 week
d) Bed rest
e) Betamethasone injections

Answer 6

e) Betamethasone injections

Question 7

A 20-yo primigravid woman, at 31 wks’ gestation is admitted to the hospital because of intense uterine contractions every 1 to 2 minutes for the past 2 hours. The uterus is firm and tender. The FHR is 165/min. There is dark blood flowing from the vagina, and the cervix is completely effaced and 7 cm dilated. The vertex is at 0 station and fundal height is 30 cm.
For each pregnant patient, select the most likely cause of the findings

1) Abruptio placentae
2) Pyelonephritis
3) Incompetent cervix
4) Cervicitis
5) Placenta previa
6) Chorioamnionitis
7) Idiopathic preterm labour
8) Polyhydramnios
9) Fetal anomaly

Answer 7

g) Idiopathic preterm labour

Question 8

A woman, G1P1, consults the clinic at 10 weeks
of gestation. In obtaining her history, which of
the following is the most important risk factor for
preterm delivery?

a) She was treated for Chlamydia 6 months ago
b) She has a history of anorexia nervosa
c) Her first baby was born at 34 weeks
d) She is 36 years old
e) She works as a sales person in a department store

Answer 8

c)Her first baby was born at 34 weeks

Question 9

A 23-yo primigravid woman at 32 wks’ gestation is admitted to the hospital because of intense uterine contractions for 3 hours. Temp is 38.2C. The uterus is moderately tender on palpation and the FHR is 170/min. The cervix is 80% effected and 2 cm dilated; the vertex is at – 1 station. Fundal height is 31 cm. There is a watery vaginal discharge that tests (+ve) to nitrazine.

What is the most likely cause of these findings?

a) Abruptio placentae
b) Pyelonephritis
c) Incompetent cervix
d) Cervicitis
e) Placenta previa
f) Chorioamnionitis
g) Idiopathic preterm labour
h) Polyhydramnios
i) Fetal anomaly

Answer 9

f) Chorioamnionitis

Question 10

A G1P0 patient at 28 weeks gestation presents to the ER in preterm labor. If the decision is made to attempt to abort her labor, administration of all of the following might be indicated except:

a)Terbutaline
b)Magnesium sulfate
c)Ritodrine
D0Prostaglandin
e)Calcium-channel blocker

Answer 10

d)Prostaglandin