normal antepartum quiz questions and answers pdf

Normal Antepartum Quiz Questions And Answers Pdf

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Pregnancy is considered late term from 41 weeks, 0 days' to 41 weeks, 6 days' gestation, and postterm at 42 weeks' gestation. Early dating of the pregnancy is important for accurately determining when a pregnancy is late- or postterm, and first-trimester ultrasonography should be performed if clinical dating is uncertain. Optimal management of a low-risk, late-term pregnancy should consider maternal preference and balance the benefits and risks of induction vs.

Compared with expectant management, induction at 41 weeks' gestation is associated with a small absolute decrease in perinatal mortality and decreases in other fetal and maternal risks without an increased risk of cesarean delivery. Although there is no clear evidence that antenatal testing beginning at 41 weeks' gestation prevents intrauterine fetal demise, it is often performed because the risks are low.

When expectant management is chosen, most experts recommend beginning twice-weekly antenatal surveillance at 41 weeks with biophysical profile or nonstress testing plus amniotic fluid index modified biophysical profile ; induction may be deferred until 42 weeks if this surveillance is reassuring.

Postterm pregnancy is defined as that lasting beyond days or 42 weeks' gestation. The clinical concerns surrounding late-term pregnancy include the risks and anticipated outcomes for expectant management vs.

Infants delivered at or beyond 41 weeks' gestation are at increased risk of meconium aspiration syndrome. Delivery beyond 42 weeks' gestation increases the maternal complications of postpartum hemorrhage, dystocia, and maternal infection i.

However, there is no difference in risk of maternal hemorrhage or infection at 41 weeks between expectant management and induction. Women with pregnancies lasting beyond 41 weeks' gestation should undergo twice-weekly antenatal testing until delivery. Do not schedule elective, non—medically indicated inductions of labor or cesarean deliveries before 39 weeks, 0 days' gestation. Avoid elective, non—medically indicated inductions of labor between 39 weeks, 0 days' and 41 weeks, 0 days' gestation unless the cervix is deemed favorable.

In most cases, the etiology of postterm gestation is not well understood. Known risk factors for postterm pregnancy are a previous postterm pregnancy, nulliparity, maternal age older than 30 years, and obesity. Inaccurate clinical dating may lead to the misdiagnosis of late-term or postterm pregnancy. The American College of Obstetricians and Gynecologists states that the estimated date of delivery may be determined by the last menstrual period if the patient has regular, normal menstrual cycles and has not used contraceptive hormones in the three months before the last menstrual period.

A review of all live births in the United States for the years and documents gestational age—specific patterns of perinatal morbidity and mortality, with a rise in stillbirths, perinatal deaths, and neonatal deaths at 41 weeks' gestation Figure 1. Rates of birth, stillbirth, neonatal deaths, and extended perinatal death in by gestational age. Reprinted with permission from Joseph KS.

The natural history of pregnancy: diseases of early and late gestation. A Cochrane review of 22 trials with a total of more than 9, women compared induction of labor at 41 weeks' gestation with expectant management. However, these findings occurred in the context of a minimal 0. A second systematic review confirmed a significant reduction in perinatal mortality in this population, with a number needed to induce of to prevent one perinatal death.

The fetal morbidity most clearly associated with late-term or postterm gestation is meconium aspiration syndrome, 15 , 21 , 22 which is more common at 40 and 41 weeks' gestation compared with 39 weeks' gestation. Meta-analyses have found no significant differences in neonatal intensive care unit admission or abnormal Apgar scores between induction at 41 weeks' gestation and expectant management. Possible neurologic risks have been associated with postterm delivery.

A Danish study of the National Birth Registry between and reported a small increase in the risk of epilepsy in the first year of life in postterm infants; the incidence rate ratio for epilepsy was 1.

Infants born at 42 weeks' gestation had a cerebral palsy prevalence of 1. Postterm pregnancies also have potential maternal risks. Delivery at 42 weeks' gestation is associated with an increased risk of postpartum hemorrhage, dystocia, and maternal infection i. A pregnant woman nearing term may be counseled about sweeping of the membranes as a possible measure to prevent late-term or postterm induction.

Number needed to treat sweep to prevent one induction was eight. If a pregnancy reaches 41 weeks and there are no medical indications for induction, the patient should be counseled about the benefits and harms of induction compared with expectant management. Thoughtful informed consent should include a discussion of maternal and fetal risks; the option of waiting for spontaneous labor; descriptions of induction methods; and the likelihood of successful induction based on clinical predictors, as well as the possible need for cesarean delivery if the induction fails or maternal or fetal conditions change.

Induction may be recommended for low-risk pregnancies at 41 weeks' gestation because it has been shown to decrease the risk of fetal perinatal mortality and morbidity.

Because the absolute risk of fetal morbidity in expectant management is low, especially in the setting of antenatal testing and monitoring, it is reasonable to wait until 42 weeks' gestation for induction if the patient prefers. There are few data comparing the effects of antenatal testing in late-term or postterm pregnancy, and no single method of antenatal testing has been shown to be superior.

Amniotic fluid index and nonstress test. Tone: One or more episodes of extension and flexion of fetal extremity or opening and closing of a hand.

A common practice is to start with a nonstress test and amniotic fluid index modified biophysical profile. If there is evidence of oligohydramnios, delivery should be advised. If the nonstress test is nonreactive, then a biophysical profile or contraction stress test is usually performed 33 ; however, some clinicians and patients may elect induction at 41 weeks' gestation or later in the setting of a nonreactive nonstress test.

When a four-quadrant amniotic fluid index is performed, oligohydramnios is defined as a total measurement of less than 5 cm. A positive contraction stress test or biophysical profile score of less than 6 is an indication for induction in this setting. Clinical factors for predicting a successful induction should be assessed by the clinician at 41 weeks' gestation. The Bishop score, which consists of fetal station and cervical effacement, dilation, consistency, and position, has been used to help predict favorability of induction.

A Bishop score greater than 6 is considered favorable. In , the total cesarean delivery rate in the United States reached a record high at However, induction alters the birth experience by adding medical interventions, and some women may prefer to wait for spontaneous labor.

The risks of waiting for the onset of spontaneous labor are low between 41 and 42 weeks' gestation e. We also used the evidence summary from Essential Evidence Plus. Search dates: September and May Already a member or subscriber? Log in. Reprints are not available from the authors.

Births: final data for Natl Vital Stat Rep. American College of Obstetricians and Gynecologists. ACOG committee opinion no Definition of term pregnancy. Obstet Gynecol. Maternal risk factors for postterm pregnancy and cesarean delivery following labor induction. Acta Obstet Gynecol Scand. Maternal obesity and labour complications following induction of labour in prolonged pregnancy.

Risk of recurrence of prolonged pregnancy. Recurrence of prolonged and post-term gestational age across generations: maternal and paternal contribution. Maternal and fetal genetic contributions to postterm birth: familial clustering in a population-based sample of , Swedish births. Am J Epidemiol. ACOG practice bulletin. Clinical management guidelines for obstetricians-gynecologists.

Number 55, September replaces practice pattern number 6, October Management of postterm pregnancy. J Obstet Gynaecol Can. Nielson JP. Ultrasound for fetal assessment in early pregnancy. Cochrane Database Syst Rev.

Comparison of gestational age at birth based on last menstrual period and ultrasound during the first trimester. Paediatr Perinat Epidemiol. Bottomley C, Bourne T. Dating and growth in the first trimester. A comparison of first trimester measurements for prediction of delivery date. J Matern Fetal Neonatal Med. A comparison of LMP-based and ultrasound-based estimates of gestational age using linked California livebirth and prenatal screening records.

Joseph KS. Nakling J, Backe B. Pregnancy risk increases from 41 weeks of gestation. Increased neonatal mortality among normal-weight births beyond 41 weeks of gestation in California. Am J Obstet Gynecol. Induction of labour for improving birth outcomes for women at or beyond term. Elective induction for pregnancies at or beyond 41 weeks of gestation and its impact on stillbirths: a systematic review with meta-analysis. BMC Public Health. Perinatal and maternal complications related to postterm delivery: a national register-based study, — Perinatal outcomes in low-risk term pregnancies: do they differ by week of gestation?

Induction of labor versus expectant management for post-date pregnancy: is there sufficient evidence for a change in clinical practice? Labor induction versus expectant management for postterm pregnancies: a systematic review with meta-analysis. Postterm delivery and risk for epilepsy in childhood. Cerebral palsy among term and postterm births. Maternal and obstetric complications of pregnancy are associated with increasing gestational age at term.

Postpartum hemorrhage: 11 critical questions, answered by an expert

Brown describes blood product replacement in severe PPH. Brown, MD Dr. Brown is Roy T. Brown serves as a speaker for Alere and Hologic and as an advisor for the Bayer Foundation and Ferring. We know the potentially tragic outcome of postpartum hemorrhage PPH : Worldwide, more than , women die every year as a result of PPH—one death every 4 minutes! Brown, MD.

Pregnancy is considered late term from 41 weeks, 0 days' to 41 weeks, 6 days' gestation, and postterm at 42 weeks' gestation. Early dating of the pregnancy is important for accurately determining when a pregnancy is late- or postterm, and first-trimester ultrasonography should be performed if clinical dating is uncertain. Optimal management of a low-risk, late-term pregnancy should consider maternal preference and balance the benefits and risks of induction vs. Compared with expectant management, induction at 41 weeks' gestation is associated with a small absolute decrease in perinatal mortality and decreases in other fetal and maternal risks without an increased risk of cesarean delivery. Although there is no clear evidence that antenatal testing beginning at 41 weeks' gestation prevents intrauterine fetal demise, it is often performed because the risks are low. When expectant management is chosen, most experts recommend beginning twice-weekly antenatal surveillance at 41 weeks with biophysical profile or nonstress testing plus amniotic fluid index modified biophysical profile ; induction may be deferred until 42 weeks if this surveillance is reassuring. Postterm pregnancy is defined as that lasting beyond days or 42 weeks' gestation.

midwife quiz questions

There are several risks to amniocentesis, including but not limited to miscarriage, infection, needle injury, and RH sensitization. The rate of miscarriage due to amniocentesis is between 1 in and 1 in The other complications listed are relatively rare.

A comprehensive collection of clinical examination OSCE guides that include step-by-step images of key steps, video demonstrations and PDF mark schemes. A comprehensive collection of OSCE guides to common clinical procedures, including step-by-step images of key steps, video demonstrations and PDF mark schemes. A collection of communication skills guides, for common OSCE scenarios, including history taking and information giving. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations.

In this section are the practice quiz and questions for maternity nursing and newborn care nursing test banks. Notable topics included in this nursing test bank include: nursing care of the pregnant mother obstetric nursing , labor and delivery, prenatal nursing care, antepartum, intrapartum, and postpartum nursing care, nursing care of patients with preeclampsia, placental and cord anomalies, cesarean birth , labor complications, postpartum depression and more. This is your first set of practice questions for maternity nursing.

Стратмор вытащил из-под ремня мобильник и набрал номер. - Ты блефуешь, Грег. - Вы этого не сделаете! - крикнул Хейл.  - Я все расскажу.

Учитель превратился в ученика. Однажды вечером на университетском представлении Щелкунчика Сьюзан предложила Дэвиду вскрыть шифр, который можно было отнести к числу базовых. Весь антракт он просидел с ручкой в руке, ломая голову над посланием из одиннадцати букв: HL FKZC VD LDS В конце концов, когда уже гасли огни перед началом второго акта, его осенило. Шифруя послание, Сьюзан просто заменила в нем каждую букву на предшествующую ей алфавите.

NCLEX-PN Practice Test Questions

4 comments

Steffen B.

Development happens quickly during the prenatal period , which is the time between conception and birth.

REPLY

Morgan W.

Maternity Nursing: Antepartum NCLEX Practice Questions #6 | 55 Once all questions are answered, you'll be prompted to click the "Quiz.

REPLY

Renzo T.

Passing the NCLEX-PN examination gives your state the authority to grant you a nursing license after the completion of a state approved school for practical nursing.

REPLY

Estelle S.

A woman is seen by you in clinic @ 18wks. She had a normal first trimester screen @. 12wks. a) What second trimester screening serum test.

REPLY

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