Maternal Newborn Jeopardy

Prenatal/Labor

100

A systematic four-step abdominal palpation technique used to determine fetal position, presentation, and engagement in late pregnancy

Leopold's maneuvers

1. First Maneuver (Fundal Grip): Examiner palpates the fundus to determine which fetal part (head or breech) is located at the top.
2. Second Maneuver (Umbilical Grip):Examiner palpates the sides of the uterus with one hand on each side. This helps identify the fetal back (smooth and hard) and the limbs (bumpy and irregular).
3. Third Maneuver (Pawlik's Grip):Examiner palpates just above the pubic symphysis. This helps determine if the presenting part (head or breech) is engaged in the pelvis and how far it has descended.
4. Fourth Maneuver (Pelvic Grip):Examiner applies downward pressure on the fundus while palpating the presenting part with the index finger and thumb of the other hand. This confirms the presentation (head or breech) and engagement.

200

Which of the following prenatal tests are diagnostic?

GTT, CVS, HIV, Amniocentesis, DNA, GBS, Syphilis 

_{CVS, amniocentesis}

CVS (chorionic villus sampling) is a diagnostic test that provides a more definitive diagnosis of chromosomal abnormalities and some genetic disorders compared to screening tests.  A provider uses a thin catheter to access the placenta transcervically and transabdominally.

_{Amniocentesis is a non-routine test where a thin needle is inserted through the abdominal wall, guided by an ultrasound image. The needle is passed into the amniotic sac and a small sample of amniotic fluid is removed for analysis (NTDs, genetic testing for Trisomies)}

300

This stage of labor begins with the birth of the baby and ends with delivery of the __________

third; placenta

Stage 1: Starts with true labor and ends when 10 cm

Stage 2: Starts with pushing and ends with delivery of baby

Stage 3: Starts with the birth of baby and ends with delivery of placenta

Stage 4: Recovery

400

Please list 3 cardiovascular changes during pregnancy

Supine hypotension, stasis of blood in lower extremities, increased heart rate, cardiac hypertrophy, heart sounds/murmurs, increased plasma

500

Your patient is pregnant for the fourth time and is due in August. Her first pregnancy ended with twin boys at 34 weeks, the second was a miscarriage at 12 weeks, and the third pregnancy resulted in a girl at 38 weeks. All children are living. What is her GTPAL and G-P?

G = 4

T = 1

P = 1 (even though it's twins, it's 1 pre-term pregnancy)

A = 1 (miscarriage or planned abortion)

L = 3

G4P2

Gravida = total # of pregnancies

Para = total # of pregnancies > 20 weeks (book says 24)

Complications During Pregnancy/Labor

100

A pregnancy complication characterized by high blood pressure

Preeclampsia

200

This condition occurs when a fertilized egg implants outside of the uterine cavity

Ectopic pregnancy

300

This condition is a severe form of nausea and vomiting that can lead to dehydration and electrolyte imbalances

Hyperemesis gravidarum

400

This abnormality causes bright red bleeding with a normal FHR pattern

Placenta previa

Placenta previa: Implantation occurs over or near cervix; painless or with urine activity, normal FHR, bright red bleeding

Placental abruption: Separation of placenta from wall of uterus; dark red bleeding, painful, FHR changes (late decels = placental insufficiency)

500

Please list 4 potential birth risks/complications of diabetic mothers (GDM and/or Type 2 DM)

Macrosomia, shoulder dystocia, preeclampsia, polyhydramnios, preterm labor, congenital anomalies, fetal distress, stillbirth, neonatal death

Preterm Labor

100

This PTL medication is an anticonvulsant CNS depressant that interferes with calcium uptake in myometrium cells. This results in reduced muscular contraction, leading to smooth muscle relaxation.

Magnesium sulfate

200

Name of the medications used to slow or stop uterine contractions, typically to delay premature labor and allow more time for the fetus to mature

Tocolytics or tocolytic agents

Examples: Terbutaline, Magnesium Sulfate, Nifedipine

300

1. Why do we give antenatal glucocorticoids to moms in PTL?

2. Name one that is typically given

Accelerates fetal lung maturity; betamethasone or dexamethasone

400

Please list 4 signs/symptoms of PTL

Uterine contractions/abdominal cramping, diarrhea, low back ache, pelvic pressure, urinary frequency, SROM, bleeding and/or spotting

500

Please list 5 risk factors for PTL/birth

Previous PTB, short cervix, multiple gestation, PPROM, infections, smoking/substance abuse, low pre-pregnancy weight/poor maternal nutrition, stress/hormonal changes

Newborn Care

100

This occurs from blood accumulation between the scalp and skull due to ruptured blood vessels, often caused by trauma during delivery.

Cephalohematoma (DOES NOT cross suture lines); can be due to prolonged labor/use of medical devices

Caput Succedaneum - DOES cross suture lines; due to fluid accumulation under the scalp from pressure on the head during vaginal delivery; "cone shape"

200

A normal newborn condition that causes a bluish discoloration of the skin on their hands, feet and sometimes around the mouth

Acrocyanosis

300

1. This is the first secretion from the mammary glands after giving birth, also known as "liquid gold"

2. Please list 2 breastfeeding contraindications

1. Colostrum 

2. Maternal HIV, galactosemia, mother with active TB, maternal illicit drug use

400

Please list 4 newborn reflexes that should be present at birth

Moro, stepping, rooting, babinski, palmar, tonic neck (fencing)

500

This is the test/score given to newborns shortly after birth to determine how well they are adapting post birth. Please list out what the full acronym stands for.

APGAR score (completed at 1 and 5 minutes). Appearance, Pulse, Grimace, Activity, Respiration

Newborn at Risk

100

Jaundice is a condition characterized by the yellowing of the skin and eyes caused by high levels of _______ in the blood

bilirubin

200

LGA newborns are at risk for this birth complication during active pushing/labor

Shoulder dystocia

300

This condition is a breathing disorder that most often affects babies born before 28 weeks but can occur in any baby born before 37 weeks. It is caused by a lack of surfactant and underdeveloped alveoli.

Respiratory distress syndrome (RDS)

400

Which of the following symptom is NOT a sign of sepsis in a newborn?

Lethargy, irritability, hypertonia, pallor, clammy skin, tachycardia, jaundice

Hypertonia

s/s sepsis in newborns: hypotonia, lethargy OR irritability, tachycardia then bradycardia, pallor, clammy skin, temperature instability, jaundice, feeding intolerance

500

_ _ _ _ _ _ _ _ _  disease of the newborn is a blood disorder that occurs when a mother's immune system attacks her baby's red blood cells during pregnancy. It is prevented with an IM medication called _ _ _ _ _ _.

Hemolytic; RhoGAM