B8-019 Maternal/Fetal Health

Question 1

within the first hour following delivery, what changes are occurring in the maternal cardiovascular system?

Answer 1

cardiac output and SV increase dramatically as blood from uterus reenters main circulation (autotransfusion)

(presents a problem for patients with preexisting CVD)

Question 2

main mechanism to prevent post-partum hemorrhage

Answer 2

uterine involutions

(myometrial muscles contract)

Question 3

fundus should be at the level of […] about 24 hours after delivery

Answer 3

umbilicus

Question 4

main cause of postpartum hemorrhage

Answer 4

uterine atony

(myometrium doesn’t contract like its supposed to)

Question 5

treatment for uterine atony

Answer 5

medications
uterine balloon tamponade
surgery to remove uterus

Question 6

it is normal for lochia to occur up to […] weeks postpartum

Answer 6

6

Question 7

pregnancy is a hypercoagulable state and remains elevated for […] weeks following delivery

Answer 7

12

(increases risk for PE or DVT after chidlbirth)

Question 8

hCG levels return to zero within […] weeks after delivery

Answer 8

2-4

Question 9

effects of estrogen and progesterone levels plummeting after delivery [2]

Answer 9

aids in lactation
may lead to hot flashes

Question 10

mean postpartum weight retention per pregnancy is […] lbs

Answer 10

11.8

Question 11

depression screening tool validated in pregnancy

Answer 11

Edinburgh Postpartum Depression Scale

(PHQ misses anxiety component)

Question 12

conditions that develop in pregnancy […] the risk for development of that condition later on in life

Answer 12

increase

(i.e., gestational diabetes increases risk of DM2, post partum depression increases risk of depression, etc)

Question 13

greatest incidence of new PPD occurs […] months postpartum

Answer 13

2-3

Question 14

WHO recommends initiation of breastfeeding within […] of life

Answer 14

1st hr

Question 15

WHO recommends exclusive breastfeeding within […] of life

Answer 15

6 months

Question 16

breast is composed of […] lobes

Answer 16

15-25

Question 17

when does mature milk appear after delivery?

Answer 17

3-7 days

Question 18

first milk secretions after delivery

Answer 18

colostrum

Question 19

death of a woman while pregnant or anytime within one year of pregnancy regardless of cause

Answer 19

pregnancy-associated death

Question 20

death of a woman while pregnant or anytime within one year of pregnancy from a pregnancy complication or chain of events related to pregnancy

Answer 20

pregnancy-related death

Question 21

death of a woman while pregnant or anytime within one year of pregnancy from a cause that is not related to pregnancy

Answer 21

pregnancy-associated but not-related death

(MVA)

Question 22

death of a woman while pregnant or anytime within one year of pregnancy due to a cause that could not be determined to be related to pregnancy

Answer 22

pregnancy-associated but unable to determine pregnancy relatedness

Question 23

number of pregnancy associated deaths per 100,000 live births

Answer 23

pregnancy associated mortality ratio (PAMR)

Question 24

number of pregnancy related deaths per 100,000 live births

Answer 24

pregnancy-related mortality ratio (PRMR)

Question 25

PAMR in the state of Kansas

Answer 25

56 deaths per 100,000 live births (SUD, obesity, and mental health contributed to deaths)

Question 26

PRMR in the state of Kansas

Answer 26

15 deaths per every 100,000 live births leading cause is CVD conditions

Question 27

when LMP is in question, [...] is the most accurate way to establish an estimated gestational age

Answer 27

first trimester US

Question 28

[T:F] soft cheese are safe in pregnancy if pasteurized

Answer 28

true

Question 29

recommended weight gain in pregnancy for someone with a BMI > 30

Answer 29

11-20lbs

Question 30

vaccine recommended between 27 and 36 weeks of pregnancy

Answer 30

Tdap allows for passive immunity to the fetus against pertussis

Question 31

lactogenenis can take up to [...] to occur postpartum

Answer 31

one week

Question 32

when should women resume exercise postpartum?

Answer 32

return gradual as is comfortable

Question 33

bedrest is contraindicated in the postpartum period due to increased risk of

Answer 33

thromboembolic event

Question 34

only nutrient missing in breastmilk

Answer 34

vitamin D (mom can take large amounts herself or give the baby the supplement)

Question 35

death while pregnant or within 42 days of pregnancy

Answer 35

maternal mortality

Question 36

any death while pregnant or within the year following

Answer 36

pregnancy associated death

Question 37

death due to a pregnancy related complication, or chain of events initiated by pregnancy

Answer 37

pregnancy related death

Question 38

ideal mechanism to stop a postpartum hemorrhage

Answer 38

improve contractility of the myometrium of uterus

Question 39

most likely cause of post partum hemorrhage

Answer 39

uterine atony