Late Pregnancy Complications

Question 1

Labor (20-37 weeks) with cervical effacement & dilatation

Answer 1

Pre-term

Question 2

Contractions without cervical changes

Answer 2

Pre-term uterine contraction

Question 3

1 cause of neonatal morbidity/mortality.

Answer 3

Pre-term birth

Question 4

Risk factors for pre-term labor

Answer 4

Poor
<18 or > 40
Low pre-pg weight
Short interval between pgs (< 3months)
Poor weight gain during pg
Hx of abortion
Hx of previous complications of pgs
Smoking, Alcohol, infections...etc

Question 5

Pre-term labor treatment.

Answer 5

Bed rest (meh).
Corticosteroids (betamethasone 12 mg IM q 24 hrs x 2) to help fetal lung maturity up to 7 days.
Tocolytics (drugs to halt preterm labor..Nifedipine).

Question 6

When to use tocolytics

Answer 6

<5 cm dilation. 5 or more is therapy failure.

Question 7

When to give prophylaxis GBS abt?

Answer 7

Preterm birth where GBS status is positive or unknown.

Penicillin, clindamycin, cefazolin

Question 8

PROM?

Answer 8

Membrane ruptured before active labor

Question 9

Diagnosing PROM.

Answer 9

Nitrazine test (turns blue..alkaline pH)
Ferning
Pooling

Question 10

Signs of chorioamnionitis

Answer 10

Fever
Leuko
Tachy (mother or baby)
Uterine tenderness

Question 11

Causes of chorioamnionitis

Answer 11

E coli
GBS
(ascend from vagina)

Question 12

PROM + chorioamnionitis?

Answer 12

Deliver immediately regardless of GA

Question 13

Pg 40-42 weeks?

Answer 13

Postterm pg or Prolonged pg

Question 14

Most common cause of postterm pg?

Answer 14

Incorrect dating

Question 15

Dysmaturity

Answer 15

Complication of possterm pg.

Question 16

Complications of dysmaturity

Answer 16

From large fetal size

birth injury, labor problems, placenta insufficiency, oligohydramnios

Question 17

Treatment of postterm pg?

Answer 17

Induction (at 41)

CS

Question 18

RH Alloimmunization

Mother RH -
Baby RH +

Answer 18

Fetal RBCs move to mothers circulation (mostly during delivery or termination), cause mother to develop antibodies AGAINST baby.

Question 19

How to prevent mother RH sensitization?

Answer 19

Give RhIgG at 28. Can be given postpartum (72 hrs)

Question 20

Erythroblastosis fetalis

Answer 20

hemolytic anemia of baby (mothers antibodies cross placenta and attack baby RBCs)

Question 21

Measure what if mother is rH +.

Answer 21

Antibodies titers (<1:32 is ok)
Fetal cerebral artery with US (high blood flow indicates severe anemia)

Question 22

Intrauterine fetal death at or >20

Answer 22

Still Birth

Question 23

Dx of stillbirth

Answer 23

No cardiac activity on US or at birth

Question 24

Risk for recurrent stillbirth w/o known causes

Answer 24

1-2%