M3 Prtrm

Question 1

Early preterm AOG

Answer 1

before 33 6/7

Question 2

Late preterm AOG

Answer 2

34-36 weeks

Question 3

Early term AOG

Answer 3

37 0/7 to 38 6/7 weeks

Question 4

Term AOG

Answer 4

39-40 6/7 AOG

Question 5

Define AGA

Answer 5

10th-90th percentile of weight to AOG

Question 6

Define SGA

Answer 6

<10th percentile of wt to AOG

Question 7

Define LGA

Answer 7

> 90th percentile

Question 8

Define LBW

Answer 8

1500-2500 g

Question 9

Define VLBW

Answer 9

1000-1500 g

Question 10

Define ELBW

Answer 10

500-1000 g

Question 11

Signs and Symptoms of preterm labor (5)

Answer 11

WP LMP (When Po LMP?)
Watery Vaginal Discharge
Painful or Painless uterine contractions

Low back pains
Menstrual-like cramps
Pelvic Pressure

Question 12

Physical examination findings in preterm labor (3)

Answer 12

3Cs
Contractions, regular
Cervical Dilatation
Cervical Effacement

Question 13

What do you call the bulging of membranes into the endocervical canal and protruding at least 25% of cervical length; U or V shaped internal os

Answer 13

Funneling

Question 14

Cervical length at 24 weeks is ____

Answer 14

35mm

Question 15

Short cervix is defined as sonographic cervical length of

Answer 15

25mm and less

Question 16

Value for positive fetal fibronectin

Answer 16

> 50 ng/mL

Question 17

When is fetal fibronectin present in cervicovaginal secretions?

Answer 17

before 34 weeks

Question 18

Implication of negative fetal fibronectin

Answer 18

low probability of delivery within 7 to 14 days even with contractions.

Question 19

Indications of cervical cerclage

Answer 19

those with history of recurrent mid-trimester losses and with cervical insuffieciency

Women with short cervix found by sonography

Question 20

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

Answer 20

Rescue cerclage

Question 21

Major causes of preterm labor

Answer 21

(RUMI)
Ruptured membranes
Uterine distention
Maternal-fetal distress
Infection

Question 22

Microorganisms implicated in preterm birth (4)

Answer 22

Fruit GUM
Fusobacterium
Gardnerella vaginalis
Ureaaplasma urealyticum
Mycoplasma hominis

Question 23

True about preterm labor with intact membranes EXCEPT

a. managed much the same as PPROM
b. Delivery before 34 weeks is delayed
c. Amniocentesis to detect infection is recommended
d. Bed rest is the most prescribed intervention

Answer 23

C; no evidence to support routine amniocentesis to identify infection

Question 24

Single course corticosteroid therapy done during ___ weeks AOG.

Answer 24

24-34 weeks (33 6/7)

Question 25

The following contributes to significant decrease chance of pregnancy continuation to 28 weeks or beyond EXCEPT a. multiparity b. membranes extending beyond the external os c. cerclage before 22 weeks d. NOTA

Answer 25

A; nulliparity

Question 26

Sponataneous rupture of fetal membranes before 37 completed weeks is defined as

Answer 26

PPROM

Question 27

Major predisposing factor to preterm premature rupture of membranes

Answer 27

Intrauterine infection

Question 28

The following factors contribute to PPROM EXCEPT a. low socioeconomic status b. Nutritional Deficiencies c. Tall d. Cigarette Smoking

Answer 28

C; Short stature

Question 29

How is PPROM more than or equal to 34 weeks managed?

Answer 29

Proceed to delivery usually by induction of labor | GBS prophylaxis recommended

Question 30

The following is least appropriate management for PPROM at 24-31 weeks a. Expectant management b. GBS prophylaxis c. Tocolysis d. Antimicrobials

Answer 30

C; Tocolysis, no consensus

Question 31

The following is least appropriate management for PPROM <24 weeks a. Patient counseling b. Expectant management or induction of labor c. GBS prophylaxis d. Corticosteroids

Answer 31

D

Question 32

What is the only reliable indicator for the diagnosis of clinical chorioamnionitis?

Answer 32

FEVER

Question 33

What is the recommended tocolytic for PPROM?

Answer 33

Magnesium sulfate

Question 34

Antidote for Magnesium sulfate overdose

Answer 34

Calcium gluconate