Chapter 35

Question 1

Birth Trauma Risk Factors

Answer 1

Maternal age < 16 or > 35

Primigravida

Uterine dysfunction

Preterm or postterm labor

CPD

Oligohydramnios

Macrosomia

Multifetal gestation

Abnormal or difficult presentation

Obstetric birth techniques

Question 2

Soft-Tissue Injuries

Answer 2

Erythema and ecchymosis

Petechiae

Abrasions and lacerations

Edema

Forceps injury

Accidental lacerations

Subconjunctival or retinal hemorrhage

Caput succedaneum

Cephalhematoma

Subgaleal hemorrhage

Question 3

Skeletal Injuries

Answer 3

Skull fracture (linear fratures or indentations)

Clavicle fracture (bone most often fractured during birth)

Humerus or femur fracture

Question 4

PNS Injuries

Answer 4

Brachial plexus injury (Erb-Duchenne palsy, Upper plexus injury, Klumpke’s palsy, Lower plexus palsy)

Phrenic nerve injury (component of brachial plexus injury)

Facial paralysis (palsy)

Question 5

CNS Injuries

Answer 5

Intracranial hemorrhage

Subdural hematoma (present with apnea, unequal pupils, tense fontanel, seizures, and even coma)

Subarachnoid hemorrhage (occurs in term infants as a result of trauma and in preterm infants as a result of hypoxia)

Spinal cord injuries

Question 6

Congenital Anomalies of Infants of Diabetic Mothers

Answer 6

Most frequently occurring anomalies involve the cardiac, renal, musculoskeletal, and CNS

Macrosomia (can lead to dystocia)

Perinatal hypoxia

Respiratory distress syndrome

Hypoglycemia (less than 40 mg/dL and signs include jitteriness, apnea, tachypnea, and cyanosis)

Hypocalcemia and hypomagnesemia

Cardiomyopathy

Hyperbilirubinemia and polycythemia

Hyperinsulinemia

Question 7

Transplacental Infections

Answer 7

TORCH infections are infections that mothers have that are associated with congenital disorders

Question 8

TORCH Viruses

Answer 8

Toxoplasmosis, gonorrhea, syphilis, varicella-zoster, HBV, HIV, rubella, cytomegalovirus, herpes, parvovirus, enterovirus

Question 9

TORCH Bacterial Infections

Answer 9

GBS (leading cause of neonatal morbidity and mortality)

E. coli, S. aureus, listeriosis, chlamydia

Question 10

TORCH Fungal Infections

Answer 10

Cadidiasis

Question 11

Tobacco

Answer 11

Results in deficits in intellectual ability, emotional development, and behavior

Question 12

Alcohol

Answer 12

Fetal Alcohol Syndrome

Alcohol-related neurodevelopmental disorders

Alcohol-related birth defects

Question 13

Heroin

Answer 13

Causes prematurity

Withdrawal occurs in the majority of infants

Question 14

Methadone

Answer 14

Therapy of choice for heroin addiction

Question 15

Marijuana

Answer 15

Shortens gestation and a higher incidence of IUGR

Question 16

Cocaine

Answer 16

Recognized cause of placental abruption

Neonates do not experience withdrawal

Question 17

Methamphetamines

Answer 17

Higher incidence of placental abruption, preterm birth, and intrauterine growth restriction

Question 18

MDMA/Ecstasy

Answer 18

Toxic to nerve cells containing serotonin, causing long-term damage

Question 19

Caffeine

Answer 19

Pregnant women should not intake more than 200 mg/day

Question 20

SSRIs

Answer 20

Use should be determined by a risk-benefit analysis