PROM, PTL,& IUGR

Question 1

What is amniorrhexis?

Answer 1

Spontaneous rupture of membranes

Question 2

What is amniotomy?

Answer 2

Artificial or intentional rupture of membranes

Question 3

What is PROM or preterm rupture of membranes?

Answer 3

Spontaneous rupture of membranes before the onset of labor & past 37 weeks

Question 4

What is PPROM or premature preterm rupture of membranes?

Answer 4

Spontaneous rupture of membranes before the onset of labor & before 37 weeks gestation

Question 5

abnormal membrane physiology; cervical insufficiency; vaginal infection that ascends; nutritional deficiency can all be causes for what?

Answer 5

PROM or PPROM

Question 6

If a patient experiences PROM and has amniotic infection, bad fetal HR tracing, cord prolapse, or active labor what is the appropriate management?

Answer 6

Deliver the fetus

Question 7

What are the three test used to diagnose PROM?

Answer 7

Nitrazine paper test, Fern test, and Amnisure test

Question 8

What is a positive dx of PROM in the Nitrazine test?

Answer 8

paper will turn blue from amniotic fluid

Question 9

What is a positive diagnostic result of PROM in a fern test?

Answer 9

When sample is airdried it will “fern” on the slide

Question 10

This test for PROM is highly accurate & measures the placental alpha microglobulin-1 (PAMG-1)?

Answer 10

Amnisure

Question 11

If a patient is diagnosed with PPROM and is 34-36 weeks, what is the proper treatment?

Answer 11

Give GBS ABX and deliver baby

Question 12

If a patient is diagnosed with PPROM and is 32-33 weeks, what is the proper treatment?

Answer 12

1. Give corticosteroids
2. Give ABX
3. Deliver at 34 weeks

Question 13

What is a sudden leaking or gushing of fluid and fluid seen leaving the cervical os on pelvic exam?

Answer 13

PROM

Question 14

What are the parameters for preterm labor (PTL)?

Answer 14

> 20 weeks but <37 weeks

Question 15

This is defined as deliveries occurring from 20 weeks up to 37 weeks of gestational age?

Answer 15

Preterm delivery or preterm birth (same thing)

Question 16

These are risks to the fetus following what: Pulmonary hypoplasia, asthma, underdeveloped organs, lo birth weight, & feeding issues?

Answer 16

preterm delivery

Question 17

What is the lower limit of viability in a fetus born preterm (Weeks or weight in grams)?

Answer 17

24 weeks or 500 g

Question 18

Abnormal placenta, vaginal infections that ascend, diabetes; HTN; UTI; smoking; vitamin D deficiency, and thrombophilia’s are all risk factors for what occurring?

Answer 18

Preterm labor

Question 19

What are the 4 causes of preterm delivery?

Answer 19

Infection in mother
abnormal placental invasion
Psychological and physical stress
Uterine stretch

Question 20

This cause of preterm birth is from BV or cystitis and results in shortening of the cervix?

Answer 20

genital ascending infection

Question 21

This cause of preterm birth is due to poor trophoblasts invasion of the spiral arteries in the myometrium resulting in a poor vascular connection between placenta and mom?

Answer 21

Placental abnormalities (or abnormal placenta)

Question 22

What protein helps keep the uterus relaxed so it doesn’t sense stretch and expel the fetus?

Answer 22

parathyroid-related protein

Question 23

What can cause uterine stretch suppression malfunction and lead to preterm delivery?

Answer 23

• polyhydramnios, or too much amniotic fluid
• multiple gestations
• macrosomia, fat baby

Question 24

What is polyhydramnios

Answer 24

too much amniotic fluid

Question 25

What is macrosomia?

Answer 25

fetus that’s way too big; >4500g or 8Ib 13oz

Question 26

What is the warning sign patients should notice in PROM?

Answer 26

sudden gush or fluid or constant leakage from vagina

Question 27

Fluid leaking from your vagina, vaginal bleeding or pink discharge, N/V, contractions, back pain and pelvic pain are all warning sigs of what?

Answer 27

Preterm labor

Question 28

What two elements are required to diagnose preterm labor?

Answer 28

Documented uterine contractions & documented cervical change

Question 29

When assessing for preterm labor, what level of contractions are considered positive for the dx?

Answer 29

4 per 20 minutes or 8 per 60 minutes

Question 30

When assessing for preterm labor, what level of cervical change is considered a positive dx?

Answer 30

cervical effacement of 80% or cervical dilation of 2 cm or more

Question 31

If a patient is presenting in preterm labor but their membranes aren’t ruptured, what is the appropriate treatment?

Answer 31

Put pt in lateral decubitus
give IV fluid, GBS test, and magnesium sulfate to slow labor

Question 32

Definition of low birth weight?

Answer 32

less than 5 pounds, 8 ounces
can be perfectly healthy

Question 33

Definition of intrauterine growth restriction?

Answer 33

poor fetal growth during pregnancy and reduced size at birth due to pathological cause; fetus is <10th percentile

Question 34

What is fetal death between 20 weeks’ gestation and the onset of labor

Answer 34

intrauterine fetal demise

Question 35

What are the two classifications of IUGR?

Answer 35

Symmetrical - all parts of body are small
Asymmetrical - head and brain NL, rest of body is too small

Question 36

This fetal growth abnormality is caused by abnormal placental growth, thrombophilia’s, and infections like CMV or toxoplasmosis?

Answer 36

Intrauterine growth restriction

Question 37

If a fetus is suspected to be suffering from IUGR, how oftern is US indicatied?