Maternal Infant Health - Final Exam

What is an episiotomy?

Surgical cut to widen the vaginal opening

Why are episiotomies no longer routine?

Increased risk of severe tearing and complications

What are the two types of episiotomy?

Midline (easier repair, higher tear risk) and mediolateral (less severe tearing, more painful)

What are routine postpartum care practices for the mother?

Uterine massage, pain control, bleeding monitoring, education, discharge planning

What are routine newborn care practices?

APGAR, weight/length, vitamin K, eye prophylaxis, Hep B vaccine, screenings

What is shoulder dystocia?

When the shoulders are stuck behind the pubic bone after the head delivers

What is the turtle sign?

Retraction of the baby’s head during delivery

What is the first-line maneuver for shoulder dystocia?

McRoberts maneuver

What are complications of shoulder dystocia?

Brachial plexus injury, hypoxia, fractures

What is perineal tearing?

Tearing of vaginal/perineal tissue during childbirth

What percentage of first births involve tearing?

About 90%

What increases risk of tearing?

Large baby, vacuum delivery, fast labor

What reduces tearing risk?

Perineal massage, warm compress, controlled pushing

What is pelvic floor injury?

Damage to pelvic support muscles and nerves

What symptoms result from pelvic floor injury?

Urinary incontinence, fecal incontinence, prolapse, pain

What is a major long-term complication of pelvic floor injury?

Pelvic organ prolapse

What is the role of doulas?

Provide emotional, physical, and advocacy support

How do doulas improve outcomes?

Reduce C-section rates and improve patient experience

What is gestational diabetes?

Diabetes that develops during pregnancy

What causes gestational diabetes?

Hormonal insulin resistance

What effect does gestational diabetes have on the baby?

Macrosomia, hypoglycemia, birth complications

What is macrosomia?

Birth weight greater than 4000 g

What is preeclampsia?

High blood pressure with organ damage after 20 weeks

What are symptoms of preeclampsia?

Headache, vision changes, swelling, high BP, protein in urine

What are severe features of preeclampsia?

Vision changes, RUQ pain, severe headache

What is the only cure for preeclampsia?

Delivery

What is HELLP syndrome?

Hemolysis, elevated liver enzymes, low platelets

What is placenta previa?

Placenta covering the cervix causing painless bleeding

What is placental abruption?

Premature separation of placenta causing painful bleeding

What is a key difference between previa and abruption?

Previa is painless, abruption is painful

What is postpartum hemorrhage?

Excessive bleeding after delivery

What are the 4 T’s of postpartum hemorrhage?

Tone, tissue, trauma, thrombin

What is Pitocin?

Synthetic oxytocin

Why is Pitocin given after birth?

To contract uterus and prevent hemorrhage

What else is Pitocin used for?

Inducing or augmenting labor

What is informed consent?

Patient understands risks, benefits, and alternatives before agreeing

What are the four components of informed consent?

Disclosure, understanding, voluntariness, capacity

What violates informed consent?

Coercion or lack of full information

What is the hierarchy of infant feeding?

Direct breastfeeding → pumped milk → donor milk → formula

What is exclusive breastfeeding?

Only breastmilk for first 6 months

What is recommended duration of breastfeeding?

At least 6 months exclusive, continue up to 2 years or more

What does breastmilk contain?

Antibodies, immune cells, nutrients, hormones

How does breastmilk composition change?

Adjusts to baby’s needs and time of day

What is colostrum?

Early milk rich in antibodies

What are benefits of breastfeeding for the baby?

Improved immunity, reduced SIDS, better digestion, lower disease risk

What are benefits of breastfeeding for the mother?

Reduced cancer, diabetes, heart disease, improved bonding

How does breastfeeding affect SIDS?

Reduces risk

What is dose-response in breastfeeding?

More breastfeeding leads to greater benefits

How do formula-fed babies sleep?

Sleep longer and deeper

Why can this be a concern?

Increased SIDS risk and less bonding

What is a major issue with formula marketing?

Aggressive promotion despite global health guidelines

What is a healthcare barrier to breastfeeding?

Lack of provider training in lactation

What are perinatal mood and anxiety disorders?

Depression, anxiety, PTSD around pregnancy

What percentage of women are affected?

About 1 in 5

What are symptoms of postpartum depression?

Sadness, anxiety, irritability, sleep disturbances

What are risk factors?

Hormonal changes, stress, lack of support

What are barriers to care?

Stigma, cost, access, childcare

What is EPDS?

Screening tool for postpartum depression

Why is screening important?

Many cases go undiagnosed

What is infertility?

Inability to conceive after 1 year (

What is the 1/3 rule in infertility?

1/3 male, 1/3 female, 1/3 both

What factors influence infertility?

Age, weight, stress, lifestyle, environment

What causes male infertility?

Low sperm count, abnormal sperm, infection, structural issues

What is a varicocele?

Enlarged veins in scrotum

What is retrograde ejaculation?

Semen enters bladder instead of exiting

What causes female infertility?

Ovulation issues, PCOS, endometriosis, implantation failure

What is implantation failure?

Embryo fails to attach to uterus

What is progesterone’s role in pregnancy?

Maintains uterine lining

What is IVF?

Fertilization outside the body

What is ICSI?

Injection of a single sperm into an egg

What is IUI?

Placement of sperm directly into uterus

What is ovulation induction?

Medication to stimulate ovulation

What is a major barrier to IVF?

High cost

How do fertility regulations differ globally?

U.S. less strict, other countries more regulated

What is miscarriage?

Pregnancy loss before 20 weeks

What percentage of pregnancies end in miscarriage?

About 26–30%

When do most miscarriages occur?

First trimester (~80%)

What is the most common cause of miscarriage?

Chromosomal abnormalities

What is a D&C?

Procedure to remove pregnancy tissue

What is stillbirth?

Fetal death at 20+ weeks

What were historical causes of infant death?

Infectious diseases

What are current major causes?

Prematurity and complications

What is SIDS?

Sudden Infant Death Syndrome

What reduces SIDS risk?

Breastfeeding and safe sleep

What increases SIDS risk?

Formula feeding and unsafe sleep

What is genetic selection?

Choosing traits or screening embryos

What is an ethical concern of genetic selection?

Creating “designer babies”

What is the ethical dilemma?

Where to draw the line between treatment and enhancement

What are benefits of paid parental leave?

Improved maternal recovery, bonding, infant health

What are downsides of paid parental leave?

Economic cost and workforce disruption