PRETERM -ANS module part2
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Mrs X, a 28-year-old primigravida has leaking of fl uid per vaginam for the past 3 h
at 32 weeks of gestation. Per speculum examination confi rms leakage of clear amni-
otic fl uid per vaginam. She is clinically stable with no signs of infection. Ultrasound
shows a singleton fetus in cephalic presentation, appropriate for gestation with nor-
mal liquor and Dopplers.
You are explaining her clinical situation to her. You would be correct to say that:
2) 5 A 26-year-old woman presents to the delivery suite with painful contractions and
vaginal bleeding. She is currently 35 weeks pregnant and abdominal examination shows
a tense uterus with an uneffaced cervix and vaginal bleeding.
Ms XY is 30/40 weeks pregnant in her fi rst pregnancy. She is in established preterm
labour, although not in advanced labour. The cause of preterm labour appears to be
an untreated E. coli UTI.
Ms XY is haemodynamically stable and apyrexial. Her lactate levels are 0.5.
Which treatment is most likely to improve neonatal outcome?
4) 4 A 20-year-old primigravida attends the day assessment unit at 23 weeks gestation
with increased vaginal discharge and abdominal discomfort. Abdominal examination
confirms a soft non-tender uterus, and vaginal examination reveals a soft cervix with no
bleeding or draining. Transvaginal scan shows a cervix of 1.5 cm length.
A 32-year-old second gravida came in preterm labour at 29 weeks of gestation. She
was administered the fi rst dose of antenatal corticosteroids, but she delivered just
after 6 h of the fi rst dose. It will be correct to tell her that the effect of the antenatal
corticosteroids in her case:
6) 3 A 22-year-old third gravida presents at 29-week gestation with leaking vaginal. On
examination, she is found to have regular uterine contractions, and her fetus is felt in
the transverse position. Cervix is found to be 4 cm dilated.
7) Hypoxic-ischaemic encephalopathy (HIE) is a rare neonatal condition that is a con-
sequence of intrapartum fetal oxygen deprivation. Which ONE of the following
statements is characteristic of neonates diagnosed with HIE?
8) 237. A 41-year-old woman is seen at 36 weeks of gestation. This is her first pregnancy,
and a plan for induction of labour at 39 weeks has been made. She is anxious
about induction of labour.
What intrapartum risk is increased for women in this age group who undergo
induction of labour compared with expectant management?
9) 233. A woman is admitted to the labour ward with intermittent lower abdominal pain
and is found to be in preterm labour. Her uterus is contracting three times in 10
minutes and the cervix is 4 cm dilated.
Until which gestational age should magnesium sulfate be offered?
10) 240. What is the most common cardiac adverse effect associated with the use of
11) 1 A 38-year-old second gravida with previous normal delivery at term presents at 26 weeks
gestation with leaking vaginal. She denies any pain or bleeding and examination shows a
soft non-tender uterus with no cervical changes. Pooling of liquor is seen in the posterior
fornix. Her antenatal period was otherwise normal and anomaly scan was also normal.
Ms XY is 32/40 weeks pregnant with a cervical cerclage inserted at 14/40. She
presents to the labour suite with a confi rmed diagnosis of PPROM.
Infl ammatory markers are normal. Ms XY is clinically well and demonstrates no
uterine activity. Which of the following treatment options are best suited to her?
13) 2 A 33-year-old primigravida attends the DAU at 33 weeks gestation complaining of
abdominal pain and leaking vaginal. On examination, she is noted to have regular
uterine contractions with partially effaced cervix.
A 23-year-old primigravida is in threatened preterm labour at 32 weeks of gestation.
As there is a possibility of imminent preterm birth, a decision to administer antena-
tal corticosteroids is taken. While explaining the rationale of this treatment to her,
all of the following statements are correct except that antenatal corticosteroids:
15) 234. A 26-year-old woman is seen complaining of regular contractions (one every 10
minutes) at 30 + 3 weeks of gestation. A speculum examination is performed
and the cervix appears long but slightly dilated. There is no history of ruptured
What investigation should be considered first in this situation?
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