exam prep

Question 1

What are the twelve determinants of health (WHO)

Answer 1

• Aboriginal status
• Early life factors that impact childhood development
• Education
• Employment and working conditions
• food and security
  _gender
• health services
• housing
• income and its distribution
• social safety net
• unemployment and employment security

Question 2

define preterm labor (PTL)

Answer 2

regular uterine contractions occuring after 20 weeks of gestation and before 37 weeks gestation that cause progressive cervical dilation.

incidence 13% in US; 8.2% in Canada

Question 3

infant morbidity related to pretermaturaly born neonates is ____%

Answer 3

75-80%

Question 4

preterm births continue to rise despite advances in technology and risk assessment T/F

Answer 4

true

Question 5

list factors that contribute to the rise of preterm births

Answer 5

• increase in multiples (due to advanced maternal age and use of ART)
• increase in obstetric interventions (medically indicated labor and/or csection)
• increase in the use of ultrasound-based estimates of gestational age

Question 6

list etiological factors that contribute to PTL

Answer 6

behavioural/psychosocial factors
neighbourhood characteristics
environmental exposures
medical conditions
infertility treatments
genetics
biologic factors

Question 7

list social factors contribute to PTL and love birth weight

Answer 7

poverty
limited maternal education
young maternal age
unmarried status
inadequate prenatal care

Question 8

does Hx of preterm labor increase the risk of preterm labor and in birth in subsequent pregnancies?

Answer 8

YES

Question 9

List RISK FACTORS for PTL by the society of obstetricians and gynaecologists of canada

Answer 9

mulitple gestation
preterm rupture of memebranes
polyhydramnios
antepartum hemmorrhage
intra-abdomenal Sx
tobaccco coke use
severe maternal infection
physical or emotional trauma

Question 10

what is the key element in improving outcomes for both the mother and her preterm infant?

Answer 10

early recognition of preterm labor symptoms

Question 11

List the signs of PTL

Answer 11

menstrual cramps
painful or painless contractions
backache
pelvic pressure
diarrhea
urinary frequency
increased vaginal discharge

Question 12

List the recommendations for BC caregivers for gestational age/viability and level of intervention.

Answer 12

< 23 wks: DO NOT RESUSCITATE and provide palliative care
23 wks: Discourage resuscitation and intensive care
24 wks: Provide intensive care or palliative care
25 wks: provide intensive care with option of palliative care

Question 13

definitive diagnosis of preterm labor is made based on _______ accompanied by _______ and _______

Answer 13

REGULAR UTERINE ACTIVITY
CERVICAL EFFACEMENT
DILATION

Question 14

list diagnostic relation of cervical length to the risk of preterm birth, measured by trans vaginal ultrasound

Answer 14

cervical length of 1.5 cm is associated with a high risk for preterm birth
cervical length of 3 cm is associated with a NEGATIVE predictive value for delivering less than 34 weeks

Question 15

Define fetal fibronectin

Answer 15

fetal fibronectins are proteins that are found in fetal membranes and decidua during pregnancy and found in vaginal secretion up to until 22 weeks gestation, then not again until within 2 weeks of onset of labor