Maternal Risk Factors and Birth History

Question 1

What effects does chronic HTN have on mother?

Answer 1

⬆️vasospasm, ⬆️ CNS irritability, ⬆️risk convulsions, ⬆️ renal damage

Question 2

How does CMV affect the fetus during pregnancy?

Answer 2

Retinochoroidotis, seizures, coma, microcephaly, IUGR, Encephalopathy

Question 3

What effects does chronic HTN have on the fetus?

Answer 3

⬇️placental perfusion, low birth weight, preterm birth

Question 4

What effects does renal disease have on the mother and fetus?

Answer 4

Maternal- ⬆️renal failure
Fetal- ⬆️risk IUGR/SGA
⬆️risk preterm birth

Question 5

What effects does HSV have on the fetus?

Answer 5

Neonatal HSV, Hepatitis with jaundice, neurologic abnormalities

Question 6

What effects does Syphilis have on the fetus?

Answer 6

⬆️fetal demise
Congenital Syphilis
IUGR
Non immune Hydrops

Question 7

What is the leading cause of maternal-fetal morbidity and death in pregnancy?

Answer 7

Hypertensive disorders

Question 8

What is HELLP?

Answer 8

Hemolysis
Elevated Liver enzymes
Low platelets

Question 9

What effects does HIV have on the fetus?

Answer 9

30% chance of transmission from infected mother

Question 10

What effects does Chlamydia have on the pregnancy and fetus?

Answer 10

PROM, preterm labor, IUGR, chorioamnioitus, infertility

Conjunctivitis, pneumonia

Question 11

What effects does gonorroeae have on the pregnancy and fetus?

Answer 11

Pelvic peritonitis, PROM

Sepsis, meningitis, conjunctivitis

Question 12

What effect does Hepatitis B have on the fetus?

Answer 12

Eta abnormalities, intellectual disabilities, neonatal disease

Question 13

What effects does toxoplasmosis have on the fetus?

Answer 13

(Cat feces)
Earlier transmission more catastrophic
Neurologic, IUGR, microcephaly

Question 14

What causes thrombocytopenia in newborns?

Answer 14

⬇️platelets

Platelet destruction: Maternal autoantibodies, igG cfosses placebta and destroys fetal platelets

Neonatal conditions: infection, Rh incompatibility, thrombotic disorders, birth asphyxia, impaired platelet production

Question 15

How is amniotic band syndrome associated with amniotic fluids?

Answer 15

If amniotic fluid has been leaking (oligydramnios) deformation can occur

Question 16

What is olihydramnios?

Answer 16

Low amniotic fluid

Question 17

What conditions should be watched for with olihydramnios?

Answer 17

Fetal genitourinary or lung anomalies

Question 18

What is associated with polyhydramnios?

Answer 18

Chromosomal disorders, Gastrointestinal anomalies (fetus not swallowing fluid)

Question 19

What is polyhydramnios?

Answer 19

Too much amniotic fluid

Question 20

What is chorioamnionitis?

Answer 20

Infection of chorion, amnion and amniotic fluid. Usually associated with premature rupture of membranes

Question 21

What is biophysical profile?

Answer 21

NST, fetal breathing, gross body/limb movements, fetal tone and amniotic fluid
Lower number indicates asphyxia

Question 22

What is the significance of the biophysical profile?

Answer 22

8-10 normal
4-6 suspect chronic asphyxia and assess for delivery
0-2 strongly suspect chronic asphyxia and delivery indicated

Question 23

What does the alpha fetoprotein/triple quad screen indicate?

Answer 23

Performed at 15-20 weeks

Helps evaluate risk of the fetus to have abnormalities including trisomy 21 and neural tube defects

They involve all three tests with consideration of maternal age, weight, race and diabetes status

Question 24

What can an ultrasound diagnose?

Answer 24

Abnormalities of the fetus, placenta, amniotic fluid and uterus.

Monitors changes in anatomy and growth

Question 25

What is a normal baseline FHR?

Answer 25

10 min with 110-160 bpm

Question 26

What is variability in the FHR?

Answer 26

Absent variability- no range in HR detected Minimal variability- amplitude greater than undetectable but less that 5bpm Moderate variability- 6-25 bpm Marked variability- greater than 25 bpm

Question 27

What are decels?

Answer 27

Decrease in FHR in relationship to contractions Early- category 1, normal decrease over at least 30 sec then return to baseline (head compression) Late- category 3, fall in FHH during contraction and returns after contraction (uteroplacental insufficiency) Variable- a quick drop in FHR less than 15 bpm and lasts 15 seconds (cord compression)

Question 28

What is fetal tachycardia during labor?

Answer 28

Category 2 Greater than 160 bpm for 10 min or greater

Question 29

What is bradycardia during labor?

Answer 29

Category 2 or 3 Less than 110 bpm for 10 min or greater

Question 30

What impact on the neonate does abruptio placenta?

Answer 30

The placenta separated from the uterine wall causing bleeding Can cause loss of fetal heart tones, tachycardia, late or variable decels, decreased FHR variability Anemia, hypoxia, hypovolemia

Question 31

What impact does umbilical cord prolapse have on the neonate?

Answer 31

Life threatening to the fetus! Cord falls below the presenting part is compressed

Question 32

What impact on the neonate does Breech position have?

Answer 32

Fetal anomalies, preterm fetus, fetal asphyxia or death and multiple pregnancy

Question 33

What are some complications of a breech delivery?

Answer 33

Prolapsed/compressed cord, asphyxia, genital damage if make, CND injuries

Question 34

Shoulder Dystocia and impact on neonate

Answer 34

Birth injuries, hypoxic injury, permanent brain or spinal cord injury and intrapartum or neonatal death

Question 35

How do analgesics affect the fetus?

Answer 35

Decreased variability of the FHR, neonatal respiratory depression

Question 36

How does anesthesia affect the fetus?

Answer 36

Neonatal respiratory depression, reaches fetus approx 2 min after induction

Question 37

How do tocolytics affect the fetus?

Answer 37

They slow labor to help get magnesium or steroids to a preterm mom in labor. In turn helping the fetus to develop further along

Question 38

How does maternal hemorrhage affect the neonate?

Answer 38

Causes mother to be anemic, fatigued and hypotension making it harder to care for newborn. Also affects milk supply

Question 39

How does meconium affect the neonate?

Answer 39

Can be inhaled into lungs causing respiratory issues and infection

Question 40

How does placenta previa affect the neonate?

Answer 40

Implantation if the placebta in the lower part of the uterus near or over the cervical os. Common cause of bleeding in the 2nd trimester Perinatal mortality, fetal anemia, malpresentation, fetal growth restriction, prematurity, congenital malformations

Question 41

What impact do forceps and vacuum have on the neonate during delivery?

Answer 41

Clavicle fracture, facial palsy, scalp abrasions

Question 42

What impact does a c-section have in neonates?

Answer 42

Fetal compromise from anesthesia, preterm birth, TTN, PPHN, lacerations, bruising

Question 43

If a laboring mother, self reports repeated her when abuse and pregnancy, the nurse should suspect to see signs of neonatal abstinence syndrome within

Answer 43

? 24-72 hours