H & H NARM
What are the risks of cesarean section? correct answersLife-threatening sepsis, perforation of adjacent
organs, scarring of the uterine lining that can lead to abnormal placental implantation and hemorrhage
with subsequent childbearing, and development of adhesions between the uterus and other organs that
can cause problems later
Painless bleeding with intercourse is the prime symptom of _______ correct answersFibroids. These tend
to grow during pregnancy and are
benign.If they are internal they can cause reduced intrauterine space, disrupted placental implantation
and postpartum hemorrhage
What are some urgent warning signs of preeclampsia? correct answersPersistent headaches in
combination with visual
disturbances or epigastric (upper abdominal) pain - especially on the right side.
What problems might a woman who has had a cone biopsy encounter? correct answersScarring from
cone biopsy may retard
cervical dilation.
What precautions might a midwife want to take with her patient who has a history of LEEP procedure?
correct answersBecause LEEP has been linked to incompetent cervix
and premature labor, some midwives feel that they should check their patient for cervical changes
throughout pregnancy and that the patient should be carefully instructed regarding signs of premature
labor.
What time period does assessment become especially important in the pregnant woman? correct
answersDuring the last six weeks of pregnancy.At this point the midwife can identify certain factors
regarding the baby's position, growth rate and size and relate them to the mother's condition.
What components should a midwife include in prenatal care? correct answersKnowledge of nutrition,
exercise, non allopathic
,healing options of herbology or homeopathy and mind and body integration techniques like yoga and
meditation.
What conditions/diseases contraindicate home birth? correct answersPreexisting diabetes or
hypertension, thyroid disease
(hyperthyroidism), chronic lung disease, severe asthma, epilepsy, clotting disorders, congenital heart
disease (grades 2-4) and kidney disease
Which conditions arising in pregnancy
contraindicate home birth? correct answersRh- with antibodies, severe anemia unresponsive
to treatment, cancer and acute viral infections such as rubella, cytomegalovirus, toxoplasmosis, chicken
pox or herpes
What complications/conditions can prior use of an IUD cause during pregnancy? correct answersAnemia
due to excess menstruation; scarring
of the uterine lining which predisposes to ectopic pregnancy, irregular implantation of the placenta and
third stage hemorrhage.
Which vitamin might a woman who previously used oral contraceptives be deficient in? correct
answersFolic acid.
What complication should be ruled out if there is chronic brown bleeding? correct answersMolar
pregnancy
What condition might fatigue combined with dizziness or nausea beyond the first trimester indicate?
correct answersAnemia
What are the dangers of maternal diabetes during pregnancy? correct answersFetal demise after 36
weeks; 5x the normal incidence of
of fetal abnormalities; increased polyhydramnios; 30-50% higher incidence of preeclampsia; increased
incidence of prematurity and newborn respiratory difficulties.
,Scarring of the uterine lining predisposes a woman to what three things? correct answersEctopic
pregnancy, irregular implantation of the placenta and third-stage hemorrhage. Scarring can be caused by
a previous IUD, Pelvic Inflammatory Disease and Endometriosis
What are the classic symptoms of ectopic pregnancy and what is the window of rupture? correct
answersBleeding or spotting accompanied by nonrhythmic pain, as well as pelvic pain.Pain becomes
severe with rupture and may be referred to the shoulder area.The window of rupture is 10-13 weeks GA
When during pregnancy is a fetus' risk of vertical transmission of toxoplasmosis the greatest? correct
answersThe risk of being infected rises as the pregnancy progresses although the severity is the greatest
if contracted within the first trimester
What might you suspect if your patient reports painful vaginal sores paired with flu like malaise? correct
answersAn initial outbreak of herpes. If suspected
immediately do a visual inspection and take cultures. The cervix should always be cultured because
herpes at this cite can be asymptomatic.
What is the standard care for women who have active herpes lesions at the onset of labor? correct
answersA c-section is performed because neonatal infection can cause central nervous system damage
or death.
What are the dangers of thyroid disease during pregnancy? correct answersThyroid medication has the
potential for causing severe fetal complications. Hyperthyroidism can cause miscarriage, premature labor
and fetal anomalies. Untreated hyperthyroidism can lead to cretinism in the newborn.
What are the dangers of active tuberculosis during pregnancy? correct answersSlightly higher risk of
miscarriage and
premature labor
What are the dangers of chronic lung disease during pregnancy? correct answersThe mother is at risk for
pulmonary complications and the baby for fetal acidosis and hypoxia
What are the dangers of severe asthma during pregnancy? correct answersRespiratory infections and
stress may intensify attacks.
, Cardiopulmonary function could be reduced, affecting fetal growth and well being.Certain medications
used to treat asthma are contraindicated in pregnancy.
What are the dangers of epilepsy during pregnancy? correct answersAnticonvulsant drugs may cause
folic acid deficiency
which when treated with folic acid may cause seizures. The infant may develop deficiently of coagulation
factors.
What are the dangers of severe anemia during pregnancy? correct answersMaternal infection, prolonged
labor, hemorrhage, intrauterine growth restriction and hypoxia during labor
What are the dangers of congenital heart disease during pregnancy? correct answersThe increased
blood volume and weight
in pregnancy put strain on the impaired heart
What are the dangers of and signs of renal disease during pregnancy? correct answersDangers: Acute
renal failureSigns: Protein in the urine, hypertension, edema and elevated blood urea all before the 20th
week GA.
What are the dangers of extreme obesity during pregnancy? correct answersNearly two thirds of
extremely obese woman have
obstetrical complications including diabetes, hypertension, pyelonephritis, uterine dysfunction and
hemorrhage.
What are the dangers of tobacco use during pregnancy? correct answersIntrauterine growth restriction,
miscarriage, congenital heart disease, fetal hypoxia in labor, and sudden infant death syndrome
What are the dangers of malnutrition during pregnancy? correct answersIUGR, preeclampsia, maternal
or fetal
infection, stillbirth and dysfunctional labor.
What are the dangers of drug abuse during pregnancy? correct answersIUGR, fetal hypoxia, respiratory
distress syndrome, maternal malnutrition, infection, preeclampsia, dysfunctional labor and hemorrhage.
