BSNC 5000 OB Final Exam Questions
and Complete Solutions
Describe the psychosocial adaptation to pregnancy for mother, partner, sibling(s) and
other caregivers ✅Maternal/paternal adaptation: accepting the pregnancy →
identifying with the mother/father role → reordering personal relationships →
establishing a relationship with the fetus → preparing for childbirth
Sibling adaptation: concerns about losing their place in the family hierarchy
Other caregivers: grandparents can act as a family historian, experienced caregivers
can act as resource persons who share knowledge, any caregivers can provide support
to strengthen the family system and widen the circle of nurturance
Describe the stages of a healthy pregnancy and normal growth and development.
✅Ovum/pre-embryonic: conception until day 14
- Covers cellular replication, blastocyst formation, initial development of the embryonic
membranes, and establishment of the primary germ layer
Embryo: day 15 until 8 weeks after conception
- Most critical time in the development of the organ systems and the main external
features. Developing areas with rapid cell division are the most vulnerable areas to
malformation caused by environmental teratogens
Membranes, amniotic fluid, yolk sac, umbilical cord, placenta
Fetus: 9 weeks until pregnancy ends
- Refinement of structure until fetus reaches viability
Teratogens ✅Something that is going to affect the anatomical or the physiological
development of the embryo during the embryonic stage and/or the fetus during the fetal
stage
It can cause the termination of the pregnancy before it even happens (depends on type
of teratogen and severity of exposure, typically occurs during early days of pregnancy)
Examples: alcohol and tobacco products; environmental toxins, chemicals, radiation;
some prescription medications; maternal medical conditions; infections (TORCH)
Causes of developmental malformations ✅20-25%: genetic anomalies
5%: environmental factors (intrauterine infections, maternal metabolic disorders,
environmental chemicals, drugs, medications, radiation, etc.)
65-75%: multifactorial or unknown (ex. genetic + environmental)
,When is exposure to teratogens most severe ✅week 5 (embryonic period, weeks 3 to
8) as this is when all organ systems are being laid down
prior to embryonic period, there are no organ systems developing yet (just cellular
division), so there are no structural defects (however exposure can prevent implantation
to uterine wall)
List TORCH infections ✅Toxoplasmosis
Other symptoms such as syphilis, parvovirus, and Hep B
Rubella
Cytomegalovirus (CMV)
Herpes simplex virus (HSV)
Modes of transmission of TORCH infections ✅VERTICAL TRANSMISSION (mother to
baby in utero):
- transplacental transmission (maternal circulation --> placenta --> fetal blood supply)
(all except Hep B)
- contact with cervical or vaginal secretion during birthing process (syphilis, CMV, HSV,
Hep B)
- By breastmilk in premature and IUGR infants (CMV)
- During c-section where child is exposed to blood
Toxoplasmosis ✅a parasite acquired through undercooked meat or spores from cat
litter
treatment helps prevent passage through placenta, reducing rate of infection by up to
60%
Often causes hearing loss
Syphilis ✅bacterium
can cause hydrops fetalis
if mom is not treated: still birth 25%, neonatal death 14%, congenital syphilis 41%
if syphilis during pregnancy is untreated, 70-100% of neonates born will have
symptomatic congenital syphilis (hydropic and anemia with enlarged liver and spleen),
with fetal demise occuring in 40% of these pregnancies
Parvovirus B19 ✅Virus
, vertical transmission rate of 25-50%
Can cause hydrops fetalis, 13% spontaneous loss before 20 weeks gestation
transplacental transmission is approximately 30% and fetal death occurs in about 9% of
those affected
Hepatitis B ✅Virus
Too large to cross placenta, infection occurs via microtransfusion during labour, SVD or
C-section (contact with infectious secretions), 70-90% of time
Often no congenital effects on fetus... if fetus is exposed, shots are given to prevent
infection
Rubella ✅Virus
unvaccinated mother/mother with low antibody titre
first trimester infections cause congenital rubella syndrome in up to 85% of neonates
(heart defects, hearing loss, cataracts, developmental delays) --> non reversable
the risk for congenital abnormalities varies with the fetus's gestational age at the time
maternal infection occurs, ranging from diabetes mellitus, hearing loss, miscarriage, or
stillbirth
At what rubella titer # would the postpartum client receive an MMR or MMRV vaccine?
✅Anything less than 10
Cytomegalovirus ✅Virus
Transplacental, SVD, breast milk
Leading cause of non-genetic congenital hearing loss, can also cause defects to CNS,
GI, heart, placenta
can result in miscarriage, stillbirth, or congenital illness, yet most infected infants are
asymptomatic at birth and develop symptoms after the first year of life (hearing loss,
microcephaly, cognitive impairment, neuromuscular deficits, tooth enamel defect,
chorioretinitis)
Herpes Simplex Virus ✅Virus
Vertical transmission during SVD when mother has active infection/sores
