A nurse is caring for a client who is scheduled for a cesarean birth based on the fetal lungs having reached maturity. Which of the following indicates that the fetal lungs are mature?

Choice A reason: You can receive an influenza vaccination during pregnancy, as it is safe and recommended for pregnant women. The flu vaccine can protect you and your baby from serious complications of influenza, such as pneumonia, preterm labor, and low birth weight. The flu vaccine can also provide some immunity to your baby for the first few months of life. ¹

Choice B reason: You can receive the Tdap vaccine during pregnancy, as it is safe and recommended for pregnant women. The Tdap vaccine can protect you and your baby from tetanus, diphtheria, and pertussis (whooping cough). Pertussis can be very dangerous for newborns, as it can cause severe coughing, breathing problems, and even death. The Tdap vaccine can also provide some immunity to your baby for the first few months of life.

Choice C reason: You should not receive a varicella vaccine before you deliver, as it is not recommended for pregnant women. The varicella vaccine can protect you and your baby from chickenpox, which can cause serious complications such as skin infections, pneumonia, and birth defects. However, the varicella vaccine is a live vaccine, which means it contains a weakened form of the virus that can cause infection in some people. Therefore, it is not safe for pregnant women or their babies.

Choice D reason: You should not receive the rubella vaccine while breastfeeding, as it is not recommended for breastfeeding women. The rubella vaccine can protect you and your baby from rubella, which can cause serious complications such as miscarriage, stillbirth, and birth defects. However, the rubella vaccine is a live vaccine, which means it contains a weakened form of the virus that can cause infection in some people. Therefore, it is not safe for breastfeeding women or their babies.

Choice A reason: Infection is not a common cause of IUGR, as most infections do not cross the placenta and affect the fetal growth. However, some infections such as cytomegalovirus, rubella, or toxoplasmosis can cause congenital anomalies and IUGR.

Choice B reason: Previous preterm birth is not a direct cause of IUGR, as it does not affect the current pregnancy. However, it may indicate an underlying maternal or fetal condition that could increase the risk of IUGR, such as cervical incompetence, placental abruption, or preeclampsia.

Choice C reason: Utero-placental insufficiency is the most common cause of IUGR, as it reduces the blood flow and oxygen delivery to the fetus. It can result from maternal factors such as hypertension, diabetes, smoking, or drug abuse, or from placental factors such as placenta previa, placental infarction, or cord compression.

Choice D reason: Chronic hypertension is a risk factor for IUGR, as it can lead to utero-placental insufficiency and fetal hypoxia. However, it is not the only cause of IUGR, as other factors can also affect the placental function and fetal growth.