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BSNC 5000OB Final Exam Questions with Correct Answers

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BSNC 5000OB Final Exam Questions with Correct Answers

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BSNC 5000OB Final Exam Questions with
Correct Answers
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

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