Pregnancy Complications

Question 1

Preeclampsia

Answer 1

Inadequate albumin (protein) in the blood causes fluid to leak from blood cells, resulting in reduced blood volume, hemocoricontraction, and sometimes generalized edema

Question 2

How does preeclampsia effect the kidneys?

Answer 2

It reduces blood flow to kidneys which triggers rise in Bp

-blood flow to uterus is reduced, leads to fetal growth restriction

-severe hypertension leads to microthrombi (tiny clots) to form

-microthrombi stretch the filtering slits in kidneys so late protein molecules skip through, leading to protein uria

Question 3

Early signs of preeclampsia

Answer 3

High hematocrit
Hypertension
Protein in urine
Lab work that shows elevated liver enzymes
BUN
Uric acid

Question 5

Sever preeclampsia
Microthrombi

Answer 5

Microthrombi can do significant harm to other parts of the body

Impairs circulation to liver (causes epigastric pain)

Severe preeclampsia and liver involvement may develop HELLP syndrome

Hemolysis, elevated liver enzymes, low platelet counts

Question 6

Turner syndrome
Symptoms?
Treatment?

Answer 6

Chromosomal disorder in which a female is born with only one X chromosome

Symptoms:
Short stature
Delayed puberty
Infertility
Heart defects

Treatment: hormone therapy

Question 7

Tay-sachs disease

Answer 7

Rare inherited disorder that destroys nerve cells in the brain and spinal cord

Tay-sachs disease is typically found in people with certain ancestry as Eastern European Jews

Question 8

Tay-sachs disease symptoms

Answer 8

Slow development appears around 6 months
Symptoms progress until they lead to death often around age 4

No cure

Question 10

Which drug can be used to treat early diagnosis of ectopic pregnancy?

Answer 10

Methotrexate

Question 11

How does methotrexate work?

Answer 11

Inhibits folic acid metabolism thus inhibiting DNA synthesis and cell division so embryo does not develop further and is reabsorbed

Question 12

Methotrexate

Answer 12

Drug used to treat early diagnosis of ectopic pregnancy.

Question 13

Teratogen

Answer 13

Any substance that can harm the fetus or cause fetal anomalies is called a teratogen

Question 15

Question
26
of 50
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During pelvimetry, a primigravida is found to have a diagonal conjugate of 10 cm. Based on this information, the midwife would expect her labor to be:

Answer 15

prolonged, with failure of the head to engage

Question 16

All of the following birth defects could be detected by genetic screening,

Answer 16

-autosomal abnormalities

-neural tube defects

-thalassemia

Question 17

Alpha-fetoprotein

Answer 17

is a protein produced by the fetal liver and yolk sac during pregnancy, and its levels can be measured in the mother’s blood or amniotic fluid to screen for certain fetal abnormalities and cancers.

Question 18

contraindications to labor induction,

Answer 18

-invasive cervical carcinoma

-unexplained vaginal bleeding

-active genital herpes infection

Question 19

A woman suffering from eclampsia may experience:

Answer 19

Oliguria

Question 20

What is oliguria

Answer 20

Low urine output

Question 21

Dyspareunia

Answer 21

Painful intercourse

Question 22

the following are associated with S.G.A. babies

Answer 22

-visual and hearing defects

-cognitive disabilities

-poor infant growth and development

Question 23

What is a s.g.a baby

Answer 23

Small for gestational age

Question 24

•A possible reason for induction of labor would be:

Answer 24

chorioamnionitis

Question 25

Risk of Respiratory Distress Syndrome (RDS) is slight whenever the concentration of lecithin in amniotic fluid is at least how many times greater than sphingomyelin?

Answer 25

two times

Question 26

Proteinuria

Answer 26

Proteinuria = presence of excess protein in urine • Normal: Trace to +1 on dipstick may occur due to stress or dehydration • Concerning: ≥ +2 on dipstick or ≥ 300 mg in 24-hour collection

Question 27

Proteinuria Management Includes:

Answer 27

• Further lab evaluation • Close monitoring of BP & symptoms • Possible referral or consultation depending on severity

Question 28

AFP / MSAFP What is MSAFP and why is it important in pregnancy?

Answer 28

• Screened at 15–20 weeks, ideally around 16–18 weeks • High levels → Possible neural tube defects (e.g., spina bifida) • Low levels → Possible chromosomal issues (e.g., Down syndrome) • Abnormal results → Follow-up with ultrasound and possibly amniocentesis

Question 29

AFP Normal Range (approx.):

Answer 29

• 10–150 ng/mL (varies with gestational age & lab) • Often reported as MoM (Multiples of the Median): • Normal: 0.5–2.0 MoM • 2.5 MoM = high • < 0.5 MoM = lo

Question 30

What is an iatrogenic complication?

Answer 30

• A complication caused by medical treatment or provider action • Can be due to: • Medications • Interventions (e.g., unnecessary induction) • Surgery or procedures • In pregnancy/birth: May include infection, hemorrhage, trauma, or cascade of interventions • Highlights the importance of evidence-based, minimal-intervention care

Question 31

When an incomplete miscarriage occurs:

Answer 31

some fetal or placental parts are passed, but some remain inside

Question 32

Can syphilis pass through the placenta from mother to baby?

Answer 32

Yes

Question 33

Placenta percreta occurs when:

Answer 33

chorionic villi invade through the entire uterine wall to the serosa layer

Question 34

Two compounds found in cigarettes are especially harmful during pregnancy; these two toxins account for most smoking-related complications in pregnancy:

Answer 34

nicotine and carbon monoxide

Question 35

Constipation can be treated with:

Answer 35

increased water, exercise, and natural sources of iron

Question 36

What is polyhydramnios and why does it matter in pregnancy?

Answer 36

Polyhydramnios = excessive amniotic fluid • Diagnosed by ultrasound: • AFI > 24 cm or single pocket > 8 cm • Can be mild, moderate, or severe

Question 37

Causes of polyhydromanios

Answer 37

Idiopathic (most common) • Maternal diabetes • Fetal anomalies (e.g. GI or neural tube defects) • Twin-to-twin transfusion (in multiples)

Question 38

Risks of polyhydromanios

Answer 38

Preterm labor, malpresentation, cord prolapse, PPH

Question 39

What is oligohydramnios and why is it important?

Answer 39

Oligohydramnios = too little amniotic fluid • Diagnosed by ultrasound: • AFI < 5 cm or deepest pocket < 2 cm

Question 40

Causes of oligohydroamnios

Answer 40

Post-term pregnancy • Ruptured membranes • Placental insufficiency • Fetal renal anomalies (e.g. renal agenesis)

Question 41

Risks of oligohydroamnios

Answer 41

Cord compression, fetal distress, IUGR, joint contractures

Question 42

Management of oligohydroamnios

Answer 42

Monitor with NSTs/BPP • Hydration may help • Consider delivery if severe or term

Question 43

What is hyperreflexia and why is it significant in pregnancy?

Answer 43

Hyperreflexia = overactive or exaggerated reflexes • Assessed using deep tendon reflexes (e.g. patellar) • Can be a sign of CNS irritability

Question 44

CNS irritability

Answer 44

the condition where a person experiences heightened sensitivity and easily becomes agitated or frustrated, often due to issues with the brain's processing and regulation.

Question 45

Hyperflexia causes

Answer 45

May indicate severe preeclampsia • Often accompanied by clonus, headache, visual changes • Increases risk of seizures (eclampsia)

Question 46

Hyperflexia management

Answer 46

Monitor closely • May require magnesium sulfate for seizure prophylaxis

Question 47

What is clonus and why is it important in pregnancy?

Answer 47

Clonus = rhythmic, involuntary muscle contractions following a sudden stretch • Tested by rapidly dorsiflexing the foot and observing for twitching or beats In Pregnancy: • Sign of neuromuscular irritability • Often associated with severe preeclampsia • Presence of clonus = increased risk of eclampsia • May prompt treatment with magnesium sulfate

Question 48

What is a hydatidiform mole and why is it significant?

Answer 48

A type of gestational trophoblastic disease • Abnormal fertilization → nonviable pregnancy with proliferating trophoblastic tissue • Two types: • Complete mole: no fetal tissue, only abnormal placental tissue • Partial mole: some fetal parts + abnormal placenta

Question 49

Signs of hydatidiform mole

Answer 49

Very high hCG • Rapid uterine growth • Vaginal bleeding • “Grape-like clusters” seen on ultrasound • Hyperemesis gravidarum more common

Question 50

Management of hydatidform mole

Answer 50

Uterine evacuation (D&C) • Monitor hCG until undetectable • Avoid pregnancy for 6–12 months (risk of choriocarcinoma)

Question 51

What is gestational hypertension?

Answer 51

• New-onset elevated blood pressure after 20 weeks gestation • ≥140/90 mmHg on two occasions at least 4 hours apart • No proteinuria or signs of organ dysfunction

Question 52

Management of gestational hypertension

Answer 52

• Temporary diagnosis—may progress to preeclampsia • Resolves by 12 weeks postpartum • Requires close monitoring of BP, urine, and symptoms Management: • Lifestyle and activity modifications • Antihypertensive meds if BP ≥160/110 • Regular NSTs/BPPs to monitor fetal well-being

Question 53

What is chronic hypertension in pregnancy?

Answer 53

• High blood pressure diagnosed before 20 weeks gestation or • Known hypertension before pregnancy • BP ≥140/90 mmHg Key Points: • Persists beyond 12 weeks postpartum • Increases risk of: • Preeclampsia • IUGR • Placental abruption • Preterm birth Management: • Monitor closely throughout pregnancy • Medications: Labetalol, Nifedipine, Methyldopa • Regular growth ultrasounds and NSTs

Question 54

Oliguria

Answer 54

Oliguria is a condition where urine output is abnormally low, usually less than 400 mL per day in adults.

Question 55

What are common causes of oliguria in pregnancy and postpartum?

Answer 55

• Dehydration • Pre-eclampsia/eclampsia (kidney involvement) • Hemorrhage or blood loss • Urinary tract obstruction • Acute kidney injury (due to sepsis or toxins) • Severe infection (sepsis

Question 56

What does Etiology mean?

Answer 56

Etiology is the study or cause of a disease or condition.