2nd Trimester Gestational Conditions

Question 1

Refers to the low
implantation of the
placenta

Answer 1

placenta previa

Question 2

4 degrees of placenta previa

Answer 2

low (low implantation of placenta)
marginal implantation (placenta previa marginalis)
partial (placenta previa lateralis)
total (placenta previa centralis)

Question 3

implantation in the lower rather than in the upper
portion of the uterus

Answer 3

low implantation of placenta

Question 4

the placenta edge approaches that of the cervical os

Answer 4

placenta previa marginalis

Question 5

implantation that occludes a portion of the cervical os

Answer 5

placenta previa lateralis

Question 6

implantation that totally obstructs the cervical os

Answer 6

placenta previa centralis

Question 7

placenta appears to have
been implanted correctly and occurs in about 10% of
pregnancies, most frequent cause of perinatal death from unknown cause

Answer 7

abruptio placenta or premature seperation of placenta

Question 8

degree of seperation of abruptio placenta

Answer 8

0-3

Question 9

No symptom of separation were apparent from maternal or

fetal side

Answer 9

0

Question 10

Minimal separation but enough to cause vaginal bleeding and

changes in maternal vital signs; no fetal distress or
hemorrhage occurs

Answer 10

1

Question 11

Moderate separation; there is evidence of fetal distress; uterus

is painful on palpation

Answer 11

2

Question 12

Extreme separation; without immediate interventions,

maternal shock and fetal death will result

Answer 12

3

Question 13

defined as one of the following:
1. One measurement of diastolic BP of 110 mmHg or more;
or
2. Two consecutive measurements of diastolic BP of greater
than 90 mmHg 4 hours or more apart

Answer 13

hypertension

Question 14

defined as one of
the following:
1. Twenty four hours urine
sample collection with a total
protein excretion of 300mg or
more; or
2. Random clean catch urine
specimen with a 2+ or more
reagent strip

Answer 14

proteinuria

Question 15

Is an idiopathic disorder of pregnancy characterized by
proteinuric hypertension.
* 2
nd largest cause of both direct maternal and perinatal
loss

Answer 15

pre-eclampsia

Question 16

classification of hypertensive disorders in pregnanct

Answer 16

gestational
pre-eclampsia
chronic hypertension
Pre-eclampsia superimposed on chronic
hypertension

Question 17

arising for the 1st
time after the 20th week of gestation in the absence
of proteinuria.

Answer 17

gestational hypertension

Question 18

hypertension associated with

proteinuria arising after 20th week of gestation.

Answer 18

proteinuria

Question 19

apparent prior to, in the 1st
half of, or persisting more than 6 weeks after pregnancy

Answer 19

chronic hypertension

Question 20

chronic hypertension may be complicated
by preeclampsia, evolution of other S/S of preeclampsia
after 20th week gestation.

Answer 20

Pre-eclampsia superimposed on chronic
hypertension

Question 21

A disorder characterized by three symptoms of
hypertension, edema and proteinuria appearing
after the 20th to 24 week of pregnancy and
disappearing 6 weeks after delivery.

Answer 21

PIH- pregnancy induced hypertension

Question 22

symptoms of PIH

Answer 22

hypertension, proteinuria, edema

Question 23

A test to assess the risk of
toxemia in pregnant women.
* A comparison of blood pressure
is made with the woman lying on
her left side and on her back.
* An excessive increase in blood
pressure when she rolls to the
supine position indicates
increased risk of toxemia.

Answer 23

roll over test

Question 24

drug to be administered to prevent convulsion

Answer 24

Magnesium Sulphate – prevents convulsions
2. Hydralazine [apresoline]: monitor BP
3. Diazepam [valium] : monitor BP
4. Diuretics: Rare; now it is considered inappropriate as it
further decrease circulating volume resulting in
decrease renal, cerebral and uterine perfusion
5. Blood volume expanders

Question 25

well-known variant of pre-eclampsia pregnancy complication. The syndrome was first described in 1982 as characterised by hemolysis (H), elevated liver enzymes (EL) and low platelet count (LP)

Answer 25

HELLP

Question 26

HELLP meaning

Answer 26

hemolysis, elevated liver enzymes, low platelet count

Question 27

is an obstetric complication that is frequently misdiagnosed at initial presentation. Many investigators consider the syndrome to be a variant of preeclampsia may also be first warning of preeclampsia and the condition is misdiagnosed

Answer 27

hellp syndrome

Question 28

levels in the syndrome are thought to be secondary to obstruction of hepatic blood flow

Answer 28

elivated liver enzymes

Question 30

has been attributed to increased consumption and/or destruction of platelets.

Answer 30

thrombocytopenia

Question 31

Laboratory Diagnostic Criteria for HELLP syndrome: hemolysis

Answer 31

Abnormal peripheral smear : spherocytes, schistocytes, triangular cells and burr cells Total Bilirubin level > 1.2 mg/dL Lactate dehydrogenase level > 600U/L

Question 32

EL diagnostic

Answer 32

Serum aspartate amino transferase level > 70U/L Lactate dehydrogenase level >600 U/L

Question 33

low platelet count diagnostic

Answer 33

Platelet count < 150 000/mm3

Question 34

appears to be the most reliable indicator of the presence of HELLP syndrome

Answer 34

platelet count

Question 35

class and count of platelet

Answer 35

class I, less than 50,000 per mm3 class II, 50,000 to less than 100,000 per mm3 class III, 100,000 to 150,000 per mm3

Question 36

When considering termination of gestation in a patient with HELLP, determine these 4

Answer 36

Gestational age.  Maternal and fetal conditions.  Fetal presentation.  Cervical maturity

Question 37

Management of labor and delivery timing of delivery –if > 34 weeks gestation,

Answer 37

deliver

Question 38

Management of labor and delivery timing of delivery –if < 34 weeks gestation,

Answer 38

administer corticosteroids, then deliver in 48 hours

Question 39

Precise diagnosis and early treatment with ___________- such as__________- may help achieve favorable maternal and perinatal results.

Answer 39

non-mineral corticosteroides , Dexamethasone