Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PATHO OB > Preterm and Postterm > Flashcards

Preterm and Postterm Flashcards

1
Q

neonates who are born too small

A

Low birthweight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

neonates born too early

A

preterm or premature birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

weight of LOW birthweight

A

1500-2500g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

weight of VERY LOW birthweight

A

500-1500g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

weight of EXTREMELY LOW birthweight

A

500-1000g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

classification of:

  • small for gestational age (SGA)
  • large for gestational age (LGA)
  • appropriate for gestational age (AGA)
A

SIZE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

classification of:

  • preterm (early, late)
  • term (early, late)
  • postterm
A

AOG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Birthweight BELOW the 10th percentile for gestational age

A

small-for-gestational age (SGA)/
fetal growth restriction/
intrauterine growth restriction (IUGR)

IUGR: fetus inside the mother
SGA: fetus already delivered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Birthweight ABOVE the 90th percentile for gestational age

A

large-for-gestational age (LGA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

weight between the 10th and 90th percentiles

A

Appropriate-for-gestational age(AGA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

born before 37 completed weeks

A

preterm/ premature birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

> 42 weeks

A

postterm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

37-42 weeks

A

term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

39- 40 6/7 weeks

A

Late term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

37-38 6/7 weeks

A

Early term

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

34-36 weeks

A

Late preterm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

<33 6/7 weeks

A

Early preterm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

causes of preterm birth

A
  • spontaneous preterm labor
  • PPROM
  • multifetal pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

contributing factors of preterm birth

A
  • pregnancy factors
  • lifestyle factors
  • genetic factors
  • periodontal disease
  • interval between pregnancies
  • prior preterm birth
  • infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

4 major causes of spontaneous preterm labor

A
  1. uterine distention
  2. maternal-fetal stress
  3. premature cervical changes
  4. infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

TRUE/FALSE

2 examples of uterine distention are multifetal pregnancy and hydramnios

A

TRUE

examples of uterine distention

  • multifetal pregnancy
  • hydramnios
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

leads to premature loss of uterine quiescence due to the release of:

  • CAP
  • GRP
  • stretch induced potassium channel TREK-1
  • maternal release of corticotropin release hormone and estrogen
A

Uterine distention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Early uterine distention releases maternal CRH and estrogen which enhances the expression of myometrial _________.

A

CAP (contractions associated protein)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

levels of __________ are INCREASED with stretch to promote myometrial contractility

A

GRP (gastrin releasing peptides)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

This can inhibit uterine contractility

A

GRP antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

this is UPREGULATED during gestation and DOWNREGULATED in labor

A

stretch induced potassium channel- TREK 1

Upregulated- gestation
downregulated- labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

these 2 hormones can further enhance the expression of myometrial CAP genes

A

corticotropin releasing hormone (CRH)

estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

true/false

increase cortisol and estrogen can lead to loss of uterine quiescence

A

TRUE

INCREASE cortisol and estrogen can lead to loss of uterine quiescence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

true/false

one potential mechanism for stress-induced preterm labor is PREMATURE DEACTIVATION of the placenta-adrenal endocrine axis

A

FALSE

one potential mechanism for stress-induced preterm labor is PREMATURE ACTIVATION of the placenta-adrenal endocrine axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Activation of WHAT AXIS yields rising maternal serum levels of placental derived corticotropin-releasing hormone (CRH)

A

Plancenta-adrenal endocrine axis

- Activation of this axis yields rising maternal serum levels of placental derived corticotropin-releasing hormone (CRH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

This hormone raises adult and fetal steroid hormone production and promotes early loss of uterine quiescence

A

Placental derived CRH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

True/false

early rise in serum estriol concentrations is noted in women with subsequent preterm labor

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

stretch-induced potassium channel

A

TREK-1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

true/false

premature labor onset precedes premature cervical remodeling

A

false

premature cervical remodeling precedes premature labor onset

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Cervical dysfunction

Cervical dysfunction of either of these parts is the underlying cause

A

cervical dysfunction of either the EPITHELIA or STROMAL EXTRACELLULAR MATRIX is the underlying cause.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Mechanical competence of the cervix can be reduced

A

Cervical dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

genetic mutations in components of collagen and elastic fibers or protein required for their assembly

A

Cervical dysfunction

genetic mutations in components of collagen and elastic fibers or protein required for their assembly- example of reduced mechanical competence of the cervix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

genetic mutations in components of collagen and elastic fibers or protein required for their assembly are risk factors for what conditions

A
  • cervical insufficiency
  • PPROM
  • preterm birth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Source/ mode of transmission of intrauterine infection

A
  1. TRANSPLACENTAL TRANSFER of maternal systemic infection
  2. RETROGRADE FLOW of infection into peritoneal cavity via fallopian tubes
  3. ASCENDING INFECTION with bacteria from vagina and cervix
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

most common entry route of Intrauterine infection

A

Ascending infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

true/false

This anatomical arrangement provides passageway for microorganisms: the lower pole of the fetal membrane– Decidual Junction is contiguous with the Cervical Canal Orifice

A

TRUE

This anatomical arrangement provides passageway for microorganisms: the lower pole of the fetal membrane– Decidual Junction is contiguous with the Cervical Canal Orifice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

the ascending microorganisms colonize these parts where they may enter the AMNIOTIC SAC

A

the ascending microorganisms colonize the CERVIX, DECIDUA, and possible the MEMBRANES where they may enter the AMNIOTIC SAC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Category of infection:

bacterial vaginosis

A

Category I

!!! REMEMBER: BDAF !!!
Bacterial vaginosis- category I
Decidual infection- category II
Amniotic infection- category III
Fetal systemic infection- category IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Category of infection:

decidual infection

A

Category II

!!! REMEMBER: BDAF !!!
Bacterial vaginosis- category I
Decidual infection- category II
Amniotic infection- category III
Fetal systemic infection- category IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Category of infection:

amniotic infection

A

Category III

!!! REMEMBER: BDAF !!!
Bacterial vaginosis- category I
Decidual infection- category II
Amniotic infection- category III
Fetal systemic infection- category IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Category of infection:

Fetal systemic infection

A

Category IV

!!! REMEMBER: BDAF !!!
Bacterial vaginosis- category I
Decidual infection- category II
Amniotic infection- category III
Fetal systemic infection- category IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Microbes associated with preterm birth

A

Gardnerella vaginalis
Fusobacterium spp.
Mycoplasma hominid
Ureaplasma urealyticum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Spontaneous rupture of membranes before 37 completed weeks or before labor onset

A

PPROM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Major predisposing events of PPROM

A
  • intrauterine infection
  • oxidative stress-induced DNA damage
  • premature cellular senescence
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Associated risk factors of PPROM

A
  • lower socio-economic status
  • BMI of <19.8
  • nutritional deficiencies
  • cigarrette smoking
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what is the BMI that is considered a risk factor of PPROM

A

BMI: <19.8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

pathophysiology of PROM

increased apoptosis markers in amnion will lead to _____

A

increased apoptosis markers in amnion will lead to CELL DEATH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

pathophysiology of PROM

increased proteases will lead to _________

A

increased proteases will lead to WEAK AMNION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

most important risk factor of preterm birth

A

prior preterm birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

gum inflammation due to anaerobic microorganism

A

Periodontal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

True/false

antibiotic prophylaxis is recommended to prevent preterm birth in women with preterm labor and intact membranes

A

FALSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

normal hydrogen peroxide-producing lactobacillus predominant vaginal floral is replaced by anaerobes

A

Bacerial vaginosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

etiology/microbes of bacterial vaginosis

A
  • Gardnerella vaginalis
  • Mobiluncus species
  • Mycoplasma hominis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Vaginal pH of bacterial vaginosis

A

> 4.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

vaginal discharge of bacterial vaginosis

A

homogenous; amine odor when mixed with KOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

vaginal epithelial cells heavily coated with bacilli “clue cells”

A

Bacterial vaginosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Gram staining of bacterial vaginosis

A

show few white cells along w/ mixed flora as compared with the normal predominance of lactobacilli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

scoring used for gram staining in bacterial vaginosis

A

nugent score

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

bacterial vaginosis is clinically assessed by _______

A

bacterial vaginosis is clinically assessed by AMSEL CRITERIA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

management of bacterial vaginosis

A

Metronidazole 500 mg BID for 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

etiology of Periodontitis

A
  • Fusobacterium nucleatum

- Capnocytophaga spp.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Management of Periodontitis

A
  • teeth cleaning and polish,
  • deep root scaling and planning,
  • plus metronidazole
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

regular contractions before 37 weeks associated with cervical discharge

A

Preterm Labor
-regular contractions before 37 weeks associated with cervical discharge

Symptoms that are empirically associated with impending preterm birth:

  • contractions with pelvic pressure
  • menstrual-like cramps
  • watery vaginal discharge
  • lower back pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Cervical changes in preterm labor

A
  • asymptomatic cervical dilatation after midpregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

true/false

prenatal cervical examinations in asymptomatic women are neither beneficial nor harmful

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

glycoprotein produced by:

  • hepatocytes
  • fibroblasts
  • endothelial cells
  • fetal amnion cells
A

fetal Fibronectin (fFn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

high concentrations in Maternal blood and amniotic fluid

A

fetal Fibronectin (fFn)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

function as:

  • INTERCELLULAR ADHESION during implantation
  • maintenance of PLACENTAL ADHERENCE to uterine decidua
A

fetal Fibronectin (fFn)

74
Q

true or false

fetal Fibronectin (fFn) is detected in cervico-vaginal secretions before membrane rupture was possible marker for preterm labor.

A

TRUE

fetal Fibronectin (fFn) is detected in cervico-vaginal secretions before membrane rupture was possible marker for preterm labor.

75
Q

value of POSITIVE fetal Fibronectin (fFn)

A

> 50ng/mL

76
Q

Positive fetal Fibronectin (fFn) as early as ________ is a powerful indicator of subsequent preterm birth

A

18-22 wks

77
Q

true/false

value of cervical length to predict preterm birth is ONLY for high-risk women

A

TRUE

value of cervical length to predict preterm birth is ONLY for high-risk women

78
Q

true/false

Routine cervical UTZ has NO ROLE in screening of normal risk pregnant women

A

TRUE

Routine cervical UTZ has NO ROLE in screening of normal risk pregnant women

79
Q

mean cervical length at 24 weeks AOG

A

35mm

80
Q

women with previous preterm birth should undergo cervical length UTZ at what AOG?

A

between 16-24 wks AOG

81
Q

length of shortened cervix

A

<25mm

82
Q

true/false

shortened cervix (<25mm) is NOT correlated with another subsequent preterm birth before <35 wks

A

FALSE

shortened cervix (<25mm) is correlated with another subsequent preterm birth before <35 wks

83
Q

done emergently when cervical incompetence is recognized in women with threatened preterm labor

A

Rescue cerclage

84
Q

Consider cerclage with these following conditions

A
  • singleton pregnancy
  • prior spontaneous preterm birth <34 wks
  • cervical length: <25mm
  • AOG: <24 wks
85
Q

a history of vaginal leakage of fluid

A

PPROM

86
Q

Sterile speculum examination: (+) gross vaginal pooling of amniotic fluid, clear fluid from the cervical canal

A

PPROM

87
Q

used for the confirmation of PPROM

A

Ultrasound

  • to assess the amniotic fluid
  • identify the presenting part
  • estimate gestational age
88
Q

pH testing of PPROM

A

alkaline= 7.1-7.2

89
Q

Conditions that gives a false positive result for the diagnosis of PPROM

A

false positive results:

  • semen
  • blood
  • antiseptic
  • bacterial vaginosis
90
Q

Management for PPROM

<24 wks

A

(E/I, S, A, T)

E/I= Expectant management/ Induction of labor
S= Single corticosteroid course
A= Antimicrobials
T= Tocolotyics (no consensus)
91
Q

Management for PPROM

24-31 wks

A

(E,S,A, T + G,M)

E= expectant management
S= single corticosteroid course
A= Antimicrobials
T= Tocolotyics (no consensus) 
M=Magnesium sulfate (neuroprotection)
G= Group B streptococcal prophylaxis
92
Q

Management for PPROM

32-33 wks

A

(E,S,A + G)

E= expectant management
S= single corticosteroid course
A= Antimicrobials 
G= Group B streptococcal prophylaxis
93
Q

Management for PPROM

>34 wks

A

(I,G,S)

I= Induction of labor/ planned delivery
G= Group B steptoccoccal prophylaxis
S=single corticosteroid course (up to 36 6/7 wks)

94
Q

given to the patient to prevent cerebral palsy for neonates

A

Magnesium sulfate

  • given at 24- 31 wks to women at risk of imminent preterm delivery
  • 6g bolus over 2-30 mins followed by infusion of 2g/hr for at least 12 hours.
  • threatened preterm delivery from 24th-27 6/7 wks.
95
Q

Used to detect infection for preterm labor with INTACT membranes

A

Amniocentesis

-not routinely recommended

96
Q

true/false

Antimicrobials is recommended if will be used solely to prevent preterm labor

A

FALSE

Antimicrobials is NOT recommended if will be used solely to prevent preterm labor. It is used for ONLY for infection treatment

97
Q

currently recommended prophylaxis to preterm labor with intact membrane ONLY within RESEARCH protocols

A

cervical pessaries (arabin pessary)

98
Q

reasonable management for women facing poor pregnancy prognosis due to cervical dilatation (painless) at mid-gestation

A

Emergency or rescue cerclage

with appropriate counseling

99
Q

This agents do not markedly prolong gestation but may delay delivery in women for up to 48 hours

A

tocolytic agents

100
Q

may allow transport to an obstetrical center with higher level neonatal care

A

tocolysis to treat preterm labor

101
Q

permit time for a course of corticosteroid therapy

A

tocolysis to treat preterm labor

102
Q

6 Classification of Tocolysis

A
  1. Beta adrenergic receptor agonist
  2. Magnesium sulfate
  3. Prostaglandin inhibitors
  4. Ca++ channel blockers
  5. Atosiban
  6. Nitric Oxide donors
103
Q

reduce intracellular ionized calcium levels and prevent activation of myometrial contractile proteins

A

Beta adrenergic receptor agonist

104
Q

Ritodine, Terbutaline, Isoxuprine

A

Beta adrenergic receptor agonist

105
Q

side effects of Beta adrenergic receptor agonist

A
  • pulmonary edema
  • volume overload
  • arrhythmia
  • myocardial ischemia
106
Q

in a sufficiently high concentrations, it can alter myometrial contractility (indirect tocolytic)

A

Magnesium sulfate

107
Q

may inhibit labor

A

Calcium antagonist

108
Q

dosage of magnesium sulfate

A

4g IV loading dose followed by a continuous infusion of 2g/hr

109
Q

this tocolytic agent is ineffective and potentially harmful.
Prolonged use: fetal bone thinning and fractures

A

Magnesium sulfate

110
Q

has a dual role of tocolytic effect + neuroprotective

A

Magnesium sulfate

111
Q

MOA: inhibits prostaglandin syntheses or by blocking their action on target organs

A

Prostaglandin inhibitors

112
Q

indomethacin

A

Prostaglandin inhibitors

113
Q

has a side effect of Patent Ductus Arteriosus

A

Prostaglandin inhibitors

Side effects: (PONI)

  • Patent ductus arteriosus
  • Oligohydramnios
  • Necrotizing enterocolitis
  • Intraventricular hgg.
114
Q

act to inhibit calcium entry through the cell membrane channels thus decreasing uterine contractility

A

Calcium channel blockers

115
Q

one of the primary drugs used for tocolysis

A

Calcium channel blockers

116
Q

Nifedipine

A

Calcium channel blockers

117
Q

the combination of these 2 drugs for tocolysis is potentially dangerous

A

Nifedipine + MgSO4

Nifedipine enhances the neuromuscular blocking effect of Mg++, which can interfere with PULMONARY AND CARDIAC FUNCTION

118
Q

Nona-peptide oxytocin analogue

A

Atosiban

- Nona-peptide oxytocin analogue is an oxytocin receptor antagonist (ORA)

119
Q

competitive antagonist of oxytocin-induced contractions

A

Atosiban

120
Q

only drug formulated for preterm labor

A

Atosiban

121
Q

true/false

Atosiban is the true tocolytic agent while other drugs promoting tocolysis is just their side effect

A

TRUE

122
Q

not effective and causes MATERNAL HYPOTENSION

A

Nitric Oxide donors

123
Q

Nitroglycerine

A

Nitric Oxide donors

124
Q

Nifedipine

A

Calcium channel blockers

125
Q

Ritodine, Terbutaline, Isoxuprine

A

Beta adrenergic receptor agonist

126
Q

indomethacin

A

Prostaglandin inhibitors

127
Q

Atosiban

A

Nona-peptide oxytocin analogue

128
Q

drug used for lung maturation

A

corticosteroids

129
Q

corticosteroids used for the management of preterm labor with intact membranes

A

Bethamethasone (12mg every 24 hrs x 2 doses)

Dexamethasone (6mg every 12 hrs x 4 doses)

RESCUE DOSE: single course of corticosteroid given to women whose prior course was administered at least 7 days previously and who are <34 wks AOG

130
Q

what is the management?

Patient admitted at 30 wks and you gave her steroids as a management. Patient came back after a week and labored at 31 wks.

A

give rescue dose of corticosteroids

131
Q

although frequently prescribed, this management is rarely indicated

A

Bed rest

132
Q

done if the cause of preterm labor with intact membrane is due to cervical incompetence

A

Emergency or rescue cerclage

133
Q

true/false

Parenteral beta antagonist prevent preterm birth for at least 48 hrs facilitating maternal transport and giving steroids

A

False

Parenteral beta AGONISTS prevent preterm birth for at least 48 hrs facilitating maternal transport and giving steroids

134
Q

Management of preterm labor with intact membranes

A
  • Amniocentesis (detect infection)
  • Corticosteroids (lung maturation)
  • MgSO4 (prevent cerebral palsy in neonates)
  • Antimicrobials (infection treatment)
  • Bed Rest
  • Cervical Pessaries (for research only)
  • Emergency or rescue cerclage
  • Tocolysis (treat preterm labor)
135
Q

fetal tachycardia especially with ruptured membranes is suggestive of _______

A

SEPSIS

- fetal tachycardia especially with ruptured membranes

136
Q

ACOG recommends these drugs to prevent neonatal group B streptococcal infection for women in preterm labor

A

Penicillin G or Ampicillin IV every 4-6 hours until delivery for women in preterm labor

137
Q

True/false

preterm newborns have germinal matrix bleeding that can extend to more serious intraventricular hgg.

A

TRUE

preterm newborns have germinal matrix bleeding that can extend to more serious intraventricular hgg.

Cesarean delivery to obviate trauma from labor
and vaginal delivery to prevent these complications has not been validated

138
Q

True/false

Some evidence supports that intrapartum ALKALEMIA may intensify some of the neonatal complications usually attributed to preterm delivery

A

FALSE

Some evidence supports that intrapartum ACIDEMIA may intensify some of the neonatal complications usually attributed to preterm delivery

139
Q

newborn with recognizable clinical features indicating a pathologically prolonged pregnancy

A

Postmature

140
Q

True/false

Postmature is reserved for a specific clinical fetal syndrome

A

TRUE

141
Q

preferred expression for an extended pregnancy

A

Postterm or Prolonged pregnancy

postdates- should be an abandoned term to call postterm pregnancy, because the real issue in many postterm pregnancies is “post-what dates?”

142
Q

42 complete wks (294 days) or more from the first day of LMP

A

Postterm

143
Q

Difference of postmature and postterm/prolonged pregnancy

A

Postterm/prolonged pregnancy: pertains to the AOG

Postmature: fetal features of post-maturity

144
Q

True/false

In postterm pregnancy, the baby will either be growth-restricted or macrocosmic

A

TRUE

In postterm pregnancy, the baby will either be GROWTH-RESTRICTED or MACROSCOMIC

145
Q

Maternal/Perinatal

Adverse _________ outcomes associated with postterm are the ff:

  • fetal macrosomia
  • oligohydramnios
  • preeclampsia
  • CS: dystocia, fetal jeopardy
  • shoulder dystocia
  • postpartum hgg.
  • perineal lacerations
A

Adverse MATERNAL outcomes associated with postterm:

  • fetal macrosomia
  • oligohydramnios
  • preeclampsia
  • CS: dystocia, fetal jeopardy
  • shoulder dystocia
  • postpartum hgg.
  • perineal lacerations
146
Q

Maternal/Perinatal

Adverse _________ outcomes associated with postterm are the ff:

  • stillbirth
  • post-maturity syndrome
  • NICU admission
  • meconium aspiration
  • neonatal convulsions
  • hypoxic-ischemic encephalopathy
  • birth injuries
  • childhood obesity
A

Adverse PERINATAL outcomes associated with postterm

  • stillbirth
  • post-maturity syndrome
  • NICU admission
  • meconium aspiration
  • neonatal convulsions
  • hypoxic-ischemic encephalopathy
  • birth injuries
  • childhood obesity
147
Q

wrinkled patchy peeling skin

A

Post-maturity syndrome

148
Q

long thin body, wasting

A

Post-maturity syndrome

149
Q

open eyed, alert

A

Post-maturity syndrome

150
Q

appears old and worried

A

Post-maturity syndrome

151
Q

long nails

A

Post-maturity syndrome

152
Q

true/false

Placental Dysfunction: the concept that post-maturity stems from placental insufficiency has persisted despite an absence of morphological or significant quantitative findings of placental degeneration

A

TRUE

Placental Dysfunction: the concept that post-maturity stems from placental insufficiency has persisted despite an absence of
morphological or significant quantitative findings of
placental degeneration

153
Q

Consequence of cord compression associated with oligohydramnios

A
  • Antepartum fetal jeopardy

- Intrapartum fetal distress

154
Q

Management for one or more prolonged decelerations on CTG

A

emergency CS

155
Q

In Fetal distress/ Oligohydramnios, findings are consistent with ___________ as the proximate cause of the non-reassuring tracings

A

Fetal distress/ Oligohydramnios:

Findings are consistent with CORD OCCLUSION as the proximate cause of the non-reassuring tracings

156
Q

Meconium released into an already reduced amnionic fluid volume results in thick, viscous meconium

A

Meconium Aspiration Syndrome

157
Q

True/False

STILLBIRTHS were LESS common among growth-restricted infants who were delivered at 42 weeks or beyond

A

False

STILLBIRTHS were MORE common among growth-restricted infants who were delivered at 42 weeks or beyond

158
Q

True/False

1/3 of the postterm stillbirths were growth restricted

A

TRUE

1/3 of the postterm stillbirths were growth restricted

159
Q

Complications of Postterm

A
  1. Oligohydramnios
  2. Macrosomia
  3. Medical and obstetrical complications (hypertension, diabetes, prior CS)
160
Q

AFI of Oligohydramnios

A

<5cm

161
Q

Although growth velocity SLOWS at 37 weeks, most fetuses continue to gain weight leading to ____

A

Macrosomia

162
Q

TRUE/FALSE

Pregnancy should not be allowed to continue past 37 weeks

A

FALSE

Pregnancy should not be allowed to continue past 42 weeks

163
Q

bishop score of unfavorable/undilated cervix

A

Bishop score of <7

2-fold higher CS rate for “dystocia”

164
Q

ACOG concluded that ___________ gel can be used safely in postterm pregnancies→dilate

A

ACOG concluded that PROSTAGLANDIN GEL (PGE2 and PGE1) can be used safely in postterm pregnancies→dilate

165
Q

Cervical length of ______ determined by TVS was predictive of successful induction

A

Cervical length of 3cm OR LESS determined by TVS was predictive of successful induction

166
Q

Decreased the frequency of postterm pregnancy

A

Sweeping or stripping of the membranes

167
Q

True/false

Stripping did not modify the risk for cesarean delivery, and maternal and neonatal infections were not increased

A

TRUE

Stripping did not modify the risk for cesarean delivery, and maternal and neonatal infections were not increased

168
Q

Important in predicting successful postterm pregnancy induction

A

Station of the vertex

if station is TOO HIGH, induction may NOT be successful

169
Q

TRUE/FALSE

Antepartum interventions are indicated in cases of postterm pregnancies

A

TRUE

Antepartum interventions are indicated in cases of postterm pregnancies

170
Q

41 wks w/ FAVORABLE cervix (soft, effaced, anterior in position)

A

Induce labor

171
Q

41 wks w/ UNFAVORABLE cervix

A

Antepartum fetal testing

172
Q

42 wks, whether cervix is favorable or not

A

Labor is generally induced

173
Q

41 0/7 wks, uncomplicated

A

Consider:

  • fetal surveillance
  • membrane sweeping
  • labor induction
174
Q

41 0/7 wks, complicated (Hypertension, Oligohydramnios, Decreased fetal movement)

A

Labor induction

175
Q

42 0/7- 42 6/7 wks

A

Labor induction

176
Q

True/False

Usage of labor induction methods (Prostaglandins, etc.) will depend on AOG

A

True

Usage of labor induction methods (Prostaglandins, etc.) will depend on AOG

177
Q

this test is done prior to induction

A

Contraction stress test

if (-): start induction
if (+): CS

178
Q

Aids in identification of thick meconium stain

A

Amniotomy

  • Aids in identification of thick meconium stain
  • aspiration may cause severe fetal pulmonary dysfunction and neonatal death
179
Q

Further reduction in fluid volume following amniotomy can enhance the possibility of _________

A

Further reduction in fluid volume following amniotomy can enhance the possibility of CORD COMPRESSION

180
Q

Can provide more precise data concerning FHR and uterine contractions after membrane rupture

A

placement of scalp electrode and intrauterine pressure catheter

181
Q

management when CPD is suspected or uterine dysfunction evident and has thick meconium staining

A

CS delivery

PATHO OB (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions