Preterm Labor

5 Questions | Total Attempts: 1481

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Preterm Labor

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Questions and Answers
  • 1. 
    A 33-year-old woman, G2P0101, at 18 weeks' gestation presents for routine prenatal care. She has a history of pre-term labor at 32 weeks with her previous pregnancy, and she is currently receiving vaginal micronized progesterone suppositories (100 mg) daily. Transvaginal ultrasound examination demonstrates a cervical length of 16 mm and the following finding (see the attached image). She denies painful contractions, leakage of fluid, or vaginal bleeding.    Which of the following is the most appropriate next step in the management of this patient?
    • A. 

      Place patient on bedrest

    • B. 

      Substitute 17-hydroxyprogesterone caproate for the micronized progesterone suppositories

    • C. 

      Perform a reduction amniocentesis

    • D. 

      Perform a cerclage

    • E. 

      Perform a D&C to empty the uterus

  • 2. 
    A 29-year-old G2P1001 with a twin gestation at 25 weeks presents to OB triage complaining of irregular uterine contractions and back pain. She also reports an increase in the amount of her vaginal discharge, but denies any "gush of fluid." She reports that in the morning she had some very light vaginal bleeding, but it has since resolved. She says that the babies have been active and moving as much as usual. She thinks that she may have overdone it with too much lifting as she has been rearranging the nursery to get it ready for the babies. She has no GI or urinary symptoms. She has had adequate PNC and denies any problems or complications with the pregnancy. On arrival to triage, she is placed on an external fetal monitor, which indicates uterine contractions every 2 to 4 min. She is afebrile and her vital signs are all normal. Her gravid uterus is nontender. The nurses call you to evaluate the patient. You decide to implement all of the following assessments EXCEPT which one?
    • A. 

      Sterile digital exam

    • B. 

      Intravenous hydration

    • C. 

      Bedside ultrasound

    • D. 

      Urinalysis and urine culture

    • E. 

      Rectovaginal swab for Group B Strep

  • 3. 
    A bedside ultrasound examination indicates that both fetuses are in the cephalic presentation and rules out the presence of a placenta previa. A sterile speculum exam is then performed, and a vaginal swab is obtained to perform a fern test on the vaginal discharge. The fern and nitrazine tests are negative. A subsequent digital exam indicates that the cervix is 50/2–3/−3. All of the following are appropriate next steps to manage this patient except
    • A. 

      Prep the patient for an emergent cesarean

    • B. 

      Administer tocolytics

    • C. 

      Administer bethamethasone

    • D. 

      Obtain a neonatal consultation

  • 4. 
      A 35-year-old G1P0 presents to her obstetrician’s office at 8 weeks gestation. She has a history of type I diabetes and is very concerned regarding the possible risks this illness may have on her fetus. As the patient’s physician, you tell her that all of the following are possible risks that can result from having diabetes in pregnancy except
    • A. 

      Fetal malformations

    • B. 

      First-trimester spontaneous abortions

    • C. 

      Macrosomia

    • D. 

      Preterm labor

    • E. 

      Cesarean section

  • 5. 
    The strength of using fetal fibronectin as a screening test for preterm labor is in its:
    • A. 

      Positive predictive value

    • B. 

      Specificity

    • C. 

      Negative predictive value

    • D. 

      Sensitivity

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