Post-Term Pregnancy

Chapter 93 Post-Term Pregnancy




Clinical Case Problem 1 “I should have delivered by now.”


A 32-year-old primigravida visits your office at 40 weeks of gestation. A 12-week ultrasound examination was consistent with her last menstrual period (LMP). The pregnancy has been unremarkable. Her vital signs are normal. Her fundal height is 39   cm. Fetal heart tones are 140. The cervix is closed, thick, and high. She is concerned because today is her due date and she is not in labor.



Select the best answer to the following questions




1. Which of the following gestational ages is the earliest at which a post-term pregnancy can be diagnosed?


a. 39 weeks and 1 day

b. 40 weeks and 1 day

c. 41 weeks and 1 day

d. 42 weeks and 1 day

e. 43 weeks and 1 day

2. Which of the following is not a risk factor for post-term pregnancy?


a. primiparity

b. fetal anencephaly

c. male fetus

d. prior post-term pregnancy

e. all of the above are risk factors

3. The first day of her LMP was February 20. What is her best estimated date of confinement (EDC)?


a. October 20

b. October 27

c. November 20

d. November 27

e. December 27

4. What is the margin of error for an EDC determined by 12-week ultrasound study?


a. 3 days

b. 7 days

c. 14 days

d. 21 days

5. Which of the following is an appropriate management strategy for this patient?


a. 40-week induction (today)

b. 41-week induction

c. amniotomy

d. nonstress testing (NST) or biophysical profile (BPP) today



Clinical Case Problem 2 Managing a Post-Term Pregnancy


A 27-year-old G3P2002 presents at 41 weeks after an uncomplicated pregnancy. She declined early genetic testing. She is not contracting, and her cervix is 2/25%/−2. Fetal heart tones are reassuring.



6. You decide to manage this pregnancy expectantly. Which of the following is an appropriate antepartum surveillance strategy?


a. ultrasound examination for fetal weight

b. NST and BPP

c. umbilical artery velocimetry

d. all of the above

e. none of the above

7. Maternal complications of post-term pregnancy include increased incidence of all of the following except


a. labor dystocia

b. cesarean section

c. postpartum depression

d. third- and fourth-degree perineal lacerations

8. Fetal complications of post-term pregnancy include increased incidence of all of the following except


a. intrauterine fetal demise

b. meconium-stained amniotic fluid

c. umbilical cord prolapse

d. decreased umbilical artery pH at delivery

e. chorioamnionitis

9. Immediate and future complications for a post-term neonate include increased incidence of all of the following except


a. lower IQ scores later in life

b. decreased 5-minute Apgar scores

c. death within the first year of life

d. meconium aspiration syndrome

10. BPP is performed at 42 days. Which of the following is not a BPP scoring element?


a. NST

b. fetal breathing movement

c. fetal movement

d. fetal tone

e. polyhydramnios

11. She is in vertex position. Her BPP shows the following: nonreactive NST, one episode of arm extension and flexion, one episode of spinal extension and flexion, rhythmic breathing movement for 10 seconds, and an amniotic fluid index (AFI) of 4 cm with the deepest single pocket of fluid measuring 1   cm. What is her BPP score?


a. 0

b. 2

c. 4

d. 6

12. Which of the following would be considered a reactive NST?


a. 35 weeks: a 20-minute tracing showing two accelerations of 15 beats/minute lasting 15 seconds each, with a single 15-second variable deceleration

Related posts:

  1. Alcohol
  2. Pancreatic Carcinoma
  3. Urticaria Angioneurotic Edema
  4. Illustrated Review

Stay updated, free articles. Join our Telegram channel
Tags:
Oct 1, 2016 | Posted by in GENERAL SURGERY | Comments Off on Post-Term Pregnancy

Full access? Get Clinical Tree
Get Clinical Tree app for offline access