Exam 2: Labor and Birth at Risk Questions with Correct Solutions Rated A+

Preterm Labor This is defined as cervical changes and uterine contractions occurring between 20-37 weeks of pregnancy Preterm Birth This is defined as any birth that occurs before the completion of 37 weeks gestation Spontaneous ______________ preterm births occur after an early initiation of the labor process Indicated ___________ preterm births occur as a means to resolve maternal or fetal risk related to continuing the pregnancy Preterm Birth -Non-Caucasian race -Low socioeconomic status -Chronic stress -Smoking -Substance abuse -Periodontal diseases These are all risk factors for what? Fibronectin Fetal ___________ is a glycoprotein found in plasma during fetal life. The presence of this during the late second and early third trimesters of pregnancy are related to placental inflammation 30 mm Women whose cervical length is more than ____ mm are unlikely to give birth prematurely even if they have symptoms of preterm labor 20 - 37 weeks Symptoms of uterine contractions or cramping between ____ and ____ weeks gestation should be directed toward telling the woman that these symptoms are indications of possible preterm labor Tocolytics Preterm Labor Medications ___________ are medications given to arrest labor after uterine contractions and cervical changes have occurred Brethine (terbutaline) Preterm Labor Medications This medication reduces myometrial contractility by decreasing the affect of calcium on muscle activation. Side Effects: anxiety and nervousness, fetal tachycardia, pulmonary edema Magnesium Sulfate Preterm Labor Medications This medication is commonly used because of the familiarity of its use with treatment of preeclampsia Side Effects: Hypotonia in the infant 5 - 8 mg/dl Preterm Labor Medications The therapeutic level for magensium sulfate is what? Prostaglandin Synthesis Inhibitors (Indomethacin) Preterm Labor Medications These drugs are also called NSAIDs. They inhibit the synthesis of prostaglandins, which is needed for uterine contractions Ductus Arteriosus Preterm Labor Medications One of the major fetal side effects of prostaglandin synthesis inhibitors is the premature closure of what structure in the infant? Calcium Channel Blockers Preterm Labor Medications These drugs decrease the flux of extracellular calcium across the cell membrane. The most common example is Nifedipine Antenatal Glucocorticoids Preterm Labor Medications These drugs are given as IM injections to accelerate fetal lung maturity 4 cm Labor that has progressed to a cervical dilation of ____ cm is likely to lead to an inevitable preterm birth Intrauterine fetal demise Preterm birth or the presence of congenital anomalies or genetic disorders incompatible with life are major reasons for this Premature Rupture of Membranes This term describes the spontaneous rupture of the amniotic sac and leakage of amniotic fluid beginning before the onset of labor at any gestational age Chorioamnionitis This term describes infection of the amniotic cavity, which is the most common maternal complication of preterm PROM Dystocia This term describes a long, difficult, or abnormal labor. It is the second most common indication for cesarean birth Dysfunctional _____________ labor is described as abnormal uterine contractions that prevent the normal progress of cervical dilation, effacement, or descent Hypertonic Uterine Dysfunction Uterine Dysfunction Characterized by an increase in the frequency and a decrease in the intensity of contractions. The resting tone of the uterus is increased (The uterus does not relax between contractions), thereby inhibiting blood flow to the uterus. Hypotonic Uterine Dysfunction Uterine Dysfunction Characterized by a decrease in contractions to less than two contractions per ten minutes, with intensity less than 25 mm Hg; therefore uterine pressure is insufficient to provide enough force for cervical dilatation and fetal descent. Prolonged Latent Phase Labor Anomalies this happens if the latent phase lasts longer than 20 hours in a woman having her first baby, or more than 14 hours in women who have already had a baby in the past. (Give the mother Demoral to rest, have them ambulate, ensure hydration, amniotomy, ptosin) Prolonged Active Phase Labor Anomalies this happens if the active phase lasts longer than 12 hours, roughly equivalent to 0.5 cm/hr which is half as fast as the normal 1 cm/hr. (Happens with a very large baby. If the baby isn’t large, it is something related to the uterus. C section if baby is too big)