NGR6342 EXAM 2 UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
Question:
What is fetal fibronectin (fFN)? Why is it used?
Answer:
- fFN is a fibronectin protein produced by fetal cells. It is found at the interface of the
chorion and the decidua (between the fetal sac and the uterine lining). It can be thought
of as an adhesive or "biological glue" that binds the fetal sac to the uterine lining.
- Fetal fibronectin is often present in vaginal discharge before week 22 of pregnancy.
Fetal fibronectin also begins to break down and can be detected in vaginal discharge
toward the end of pregnancy.
- If the health care provider is concerned about preterm labor, he or she might test a
swab of secretions near the cervix for the presence of fetal fibronectin between week
22 and week 34 of pregnancy.
- A (+) fFN test is a clue that the "glue" has been disturbed and you're at increased risk of
preterm labor.
- False-positive results are common
Question:
Preterm labor management: (Schuiling 809-810)
Answer:
-Treatment may include: (p809)
- Decrease activity
- Avoid sexual activity
- Avoid breast stimulation
- Increase hydration
- Bed rest
- Corticosteroids for fetal lung maturity
- Medications to relax uterine contractions
* PTL should not be suppressed
Question:
Treatment for Group B hemolytic strep in pregnancy
Answer:
- Women who test positive for GBS during pregnancy and for those with certain risk
factors for developing or transmitting GBS infection during pregnancy, IV antibiotics
are recommended at the time of labor.
- The administration of antibiotics to women before labor who are known to be
colonized with GBS is not effective in preventing early onset disease, as it has been
found that the GBS bacteria can grow back quickly.
- Pregnant women with GBS isolated from the urine at any time during the pregnancy
and those women who have had a previous infant with invasive GBS infection should
receive antibiotics during labor, and thereby do not require the routine GBS screening
at 35-37 weeks of gestation.
- Pregnant women who are not aware of their group B strep status should be given
antibiotics during labor if they develop preterm labor (less than 37 weeks gestation), if
they have membrane rupture for 18 hours or longer, or if they develop fever during
, labor.
- Penicillin or ampicillin are the recommended antibiotics
- Individuals who are penicillin-allergic may be given either: cefazolin, clindamycin, or
vancomycin.
- The administration of antibiotics has been shown to significantly decrease GBS early
onset infection in newborns; however, it does not prevent late onset GBS infection.
- If a pregnant carrier of GBS receives intravenous antibiotics during delivery, her baby
has a one in 4,000 chance of developing GBS infection. Without antibiotics, her baby has
a one in 200 chance of developing GBS infection.
Question:
Signs of retained placental fragments
Answer:
- fever
- a foul smelling discharge from the vaginal area.
- large pieces of tissue coming from the placenta.
- heavy bleeding.
- pain that doesn't stop.
Question:
State the average life span of an:
A) egg
Answer:
- The lifespan after ovulation is just 12-24 hours, maybe even less.
- Fertilization must take place within this timeframe.
- After this timeframe, the egg begins to degenerate and is no longer capable of being
fertilized.
- This seems like a very short window of time for conception to take place.
Question:
State the average life span of an:
B) sperm
Answer:
- prior to ovulation it can survive in the female reproductive tract for a few days, so the
few days before ovulation takes place are also considered fertile days
Question:
List the major contraindications to use of:
- Combined Oral Contraceptives
Answer:
- Thrombophlebitis or thromboembolic disorders
• Presence or history of DVT/pulmonary embolism)
• Presence or history of arterial thrombosis (MI, CVA) or prodromal conditions (e.g.
transient ischemic attack, angina pectoris).
• History of migraine with focal neurological symptoms
• Known predisposition for venous or arterial thrombosis, such as Activated Protein C
(APC) resistance, antithrombin-III deficiency, protein C deficiency, protein S deficiency,
hyperhomocysteinaemia and antiphospholipid antibodies
• Valvular heart disease with complications
CORRECT ANSWERS
Question:
What is fetal fibronectin (fFN)? Why is it used?
Answer:
- fFN is a fibronectin protein produced by fetal cells. It is found at the interface of the
chorion and the decidua (between the fetal sac and the uterine lining). It can be thought
of as an adhesive or "biological glue" that binds the fetal sac to the uterine lining.
- Fetal fibronectin is often present in vaginal discharge before week 22 of pregnancy.
Fetal fibronectin also begins to break down and can be detected in vaginal discharge
toward the end of pregnancy.
- If the health care provider is concerned about preterm labor, he or she might test a
swab of secretions near the cervix for the presence of fetal fibronectin between week
22 and week 34 of pregnancy.
- A (+) fFN test is a clue that the "glue" has been disturbed and you're at increased risk of
preterm labor.
- False-positive results are common
Question:
Preterm labor management: (Schuiling 809-810)
Answer:
-Treatment may include: (p809)
- Decrease activity
- Avoid sexual activity
- Avoid breast stimulation
- Increase hydration
- Bed rest
- Corticosteroids for fetal lung maturity
- Medications to relax uterine contractions
* PTL should not be suppressed
Question:
Treatment for Group B hemolytic strep in pregnancy
Answer:
- Women who test positive for GBS during pregnancy and for those with certain risk
factors for developing or transmitting GBS infection during pregnancy, IV antibiotics
are recommended at the time of labor.
- The administration of antibiotics to women before labor who are known to be
colonized with GBS is not effective in preventing early onset disease, as it has been
found that the GBS bacteria can grow back quickly.
- Pregnant women with GBS isolated from the urine at any time during the pregnancy
and those women who have had a previous infant with invasive GBS infection should
receive antibiotics during labor, and thereby do not require the routine GBS screening
at 35-37 weeks of gestation.
- Pregnant women who are not aware of their group B strep status should be given
antibiotics during labor if they develop preterm labor (less than 37 weeks gestation), if
they have membrane rupture for 18 hours or longer, or if they develop fever during
, labor.
- Penicillin or ampicillin are the recommended antibiotics
- Individuals who are penicillin-allergic may be given either: cefazolin, clindamycin, or
vancomycin.
- The administration of antibiotics has been shown to significantly decrease GBS early
onset infection in newborns; however, it does not prevent late onset GBS infection.
- If a pregnant carrier of GBS receives intravenous antibiotics during delivery, her baby
has a one in 4,000 chance of developing GBS infection. Without antibiotics, her baby has
a one in 200 chance of developing GBS infection.
Question:
Signs of retained placental fragments
Answer:
- fever
- a foul smelling discharge from the vaginal area.
- large pieces of tissue coming from the placenta.
- heavy bleeding.
- pain that doesn't stop.
Question:
State the average life span of an:
A) egg
Answer:
- The lifespan after ovulation is just 12-24 hours, maybe even less.
- Fertilization must take place within this timeframe.
- After this timeframe, the egg begins to degenerate and is no longer capable of being
fertilized.
- This seems like a very short window of time for conception to take place.
Question:
State the average life span of an:
B) sperm
Answer:
- prior to ovulation it can survive in the female reproductive tract for a few days, so the
few days before ovulation takes place are also considered fertile days
Question:
List the major contraindications to use of:
- Combined Oral Contraceptives
Answer:
- Thrombophlebitis or thromboembolic disorders
• Presence or history of DVT/pulmonary embolism)
• Presence or history of arterial thrombosis (MI, CVA) or prodromal conditions (e.g.
transient ischemic attack, angina pectoris).
• History of migraine with focal neurological symptoms
• Known predisposition for venous or arterial thrombosis, such as Activated Protein C
(APC) resistance, antithrombin-III deficiency, protein C deficiency, protein S deficiency,
hyperhomocysteinaemia and antiphospholipid antibodies
• Valvular heart disease with complications
