OB New Test

What is Rh incompatibility and how is it treated?

Rh incompatibility occurs when an Rh-negative mother is carrying an Rh-positive fetus. Treatment includes administering Rho(D) immune globulin (RhoGAM) within 72 hours of potential exposure to fetal blood to prevent sensitization.

Q: What can cause maternal-fetal blood mixing leading to Rh incompatibility?

A: Trauma, amniocentesis, chorionic villus sampling, surgery, miscarriage, or delivery.

Q: What happens if an Rh-negative mother becomes sensitized?

A: Her immune system will attack Rh-positive fetal blood cells in future pregnancies, causing hemolytic disease of the newborn.

Q: What is ABO incompatibility?

When a type O mother carries a fetus with type A, B, or AB blood. Maternal antibodies may attack fetal RBCs, increasing risk of newborn jaundice.

Q: What are symptoms of placental abruption?

A: Sudden onset of abdominal pain, dark red vaginal bleeding, and a rigid, board-like abdomen.

Q: What defines gestational hypertension?

A: New onset of BP ≥140/90 after 20 weeks gestation without proteinuria.

Q: When does gestational hypertension become chronic hypertension?

A: If elevated BP persists beyond 12 weeks postpartum.

Q: What defines preeclampsia?

A: BP ≥140/90 with proteinuria (≥300 mg/24hr urine) after 20 weeks gestation.

Q: What are danger signs in preeclampsia that should be reported?

A: Visual disturbances, severe headaches, RUQ pain, nausea, vomiting, and facial/hand swelling.

Q: What is the therapeutic range for magnesium sulfate?

A: 4–7 mEq/L; signs of toxicity include decreased reflexes, respiratory depression, and low urine output.

Q: What is the antidote for magnesium sulfate toxicity?

A: Calcium gluconate.

Q: What is the purpose of a cerclage?

A: To prevent premature cervical dilation and pregnancy loss; it holds the cervix closed until the fetus reaches viability.

Q: What is used to change a transverse fetal lie?

A: External cephalic version (ECV), typically done around 36–37 weeks if no contraindications exist.

Q: What is meant by “decreased or shut off” in hypertonic labor?

A: Contractions may become ineffective, disorganized, and stop progressing labor.

Q: What is the fetal risk with prelabor rupture of membranes?

A: Increased risk of infection (chorioamnionitis) due to loss of protective barrier.

Q: What is the “turtle sign” and how is it managed?

A: Retraction of the fetal head after delivery due to shoulder dystocia; first action is McRoberts maneuver and suprapubic pressure.

Q: When would magnesium sulfate be questioned in labor?

A: If the patient has strong, regular contractions; it's meant to stop preterm labor or treat preeclampsia/eclampsia.

Q: What is done to the presenting part during a cord prolapse?

A: It is manually elevated off the cord to restore fetal circulation until delivery.

Q: What is labor dystocia?

A: Abnormally slow or difficult labor, often requiring transfer from a birthing center to a hospital.

Q: What is pelvic rest and its purpose?

A: Avoidance of vaginal intercourse and insertion; helps prevent preterm labor.

Q: What lab should be monitored during terbutaline therapy?

A: Blood glucose and potassium levels; terbutaline may cause hyperglycemia and hypokalemia.

What type of doctor specializes in high-risk pregnancies?

Q: What are risk factors for gestational diabetes?

A: Obesity, family history of diabetes, previous large baby, maternal age over 25

Q: How should women manage gestational diabetes?

A: Monitor blood glucose, follow a diabetic diet, exercise, possibly use insulin

Q: What needs to be assessed regarding fetal lungs in gestational diabetes?

A: Fetal lung maturity, especially surfactant production

Q: What is the recommended position for pregnant women with cardiovascular disease?

A: Left side-lying position

Q: What else is recommended to manage pregnancy with cardiovascular disease?

A: Frequent monitoring, cardiology consult, rest, possible hospitalization, increased fetal monitoring in 2nd trimester

Q: How can constipation be managed during pregnancy?

A: Eat high-fiber foods, stay hydrated, engage in moderate physical activity

Q: What beverage helps with iron absorption?

A: Vitamin C-rich drinks (e.g., orange juice)

Q: How is sickle cell disease inherited?

A: Both parents must pass on the sickle cell trait (autosomal recessive)

Q: What is the first sentence under "Tips for Reinforcing Family Teaching" (pg 339)?

A: “Make sure the woman understands the importance of follow-up care and treatment.”

Q: What is toxoplasmosis and what does it affect?

A: A parasitic infection from undercooked meat or cat feces; affects fetal brain and eyes

Q: When should the rubella and Varcella vaccine be given?

A: Postpartum (not during pregnancy)

Q: What type of delivery is safest for mothers with active herpes lesions?

A: Cesarean section (C-section)

Q: Can a baby exposed to HIV develop AIDS?

A: Not all babies exposed to HIV will develop AIDS

Q: What are the signs and symptoms of trichomoniasis?

A: Frothy yellow-green discharge, itching, burning, foul odor

Q: What are possible outcomes of teenage pregnancy?

A: Low birth weight, preterm labor, pregnancy-induced hypertension

Q: Why are teenage pregnancies higher risk?

A: Inadequate prenatal care, poor nutrition, social and economic challenges

Q: What is a risk after a molar pregnancy?

A: Choriocarcinoma (cancerous complication)

Q: How should a patient be managed after a molar pregnancy?

A: Avoid pregnancy for 1 year, monitor hCG levels, use reliable contraception

Q: What should be done if a woman presents with painless vaginal bleeding (possible placenta previa)?

A: Perform ultrasound; do not do vaginal exams