A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. Which finding is most indicative that preterm labor is occurring?

The cervix is effacing and dilated to 2 cm

Irregular, mild uterine contractions are occurring every 15-30 minutes

Estriol is not found in maternal saliva

Fetal fibronectin is present in vaginal secretions

Answer and Explanation

The Correct Answer is A

A. The cervix is effacing and dilated to 2 cm. Cervical changes, including effacement and dilation, are the most definitive signs of preterm labor. Uterine contractions alone do not confirm preterm labor unless they result in cervical dilation, indicating that labor is progressing.

B. Irregular, mild uterine contractions are occurring every 15-30 minutes. Irregular contractions, known as Braxton Hicks contractions, can be common in pregnancy and do not necessarily indicate preterm labor. True preterm labor involves regular contractions that lead to cervical changes.

C. Estriol is not found in maternal saliva. The absence of estriol in maternal saliva does not confirm or rule out preterm labor. Salivary estriol testing is not a widely used or reliable diagnostic tool for determining the onset of preterm labor.

D. Fetal fibronectin is present in vaginal secretion. Fetal fibronectin (fFN) is a protein found in vaginal secretions between 22-34 weeks of pregnancy and can indicate a risk of preterm labor, but its presence alone does not confirm that labor is actively occurring. A positive fFN test means the patient may be at increased risk for preterm labor, but cervical changes remain the best indicator of actual labor.

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Correct Answer is C

Explanation

A. The patient will deliver a baby that is appropriate for gestational age. While cerclage helps prevent preterm birth, it does not directly influence fetal growth or ensure that the baby will be appropriate for gestational age (AGA). Factors such as maternal nutrition, placental function, and genetics play a larger role in fetal growth.

B. The patient will have a normal blood glucose throughout the pregnancy. Cerclage is performed to prevent cervical insufficiency and preterm birth, not to regulate blood glucose. Maintaining normal blood sugar levels is important for pregnancy outcomes but is unrelated to this procedure.

C. The patient will deliver after 38 weeks' gestation. The primary goal of a cerclage is to prevent preterm birth by reinforcing the cervix and allowing the pregnancy to progress to term. Women with a history of second-trimester pregnancy losses or cervical insufficiency benefit from this procedure to increase the likelihood of delivering at or near term.

D. The patient will gain less than 25 pounds during the pregnancy. Weight gain recommendations are based on maternal BMI and nutritional status, not the need for a cerclage. The procedure does not directly affect maternal weight gain.

A. Transverse fetal lie B. Preterm labor C. Severe preeclampsia D. Placenta Previa E. Placental abruption

Correct Answer is ["B"]

Explanation

A. Transverse fetal lie. A transverse fetal lie is related to fetal positioning and is not a direct complication of trauma. While maternal injuries can sometimes lead to abnormal fetal positioning, a car accident does not directly cause a transverse lie.

B. Preterm labor. Trauma, including a car accident, can trigger preterm labor due to stress, uterine irritation, or placental dysfunction. Uterine contractions may begin as a response to the injury, potentially leading to preterm birth.

C. Severe preeclampsia. Preeclampsia is not a direct result of trauma. It is a pregnancy-related hypertensive disorder that develops due to vascular abnormalities rather than external injury. A car accident does not increase the risk of preeclampsia.

D. Placenta previa. Placenta previa is a condition where the placenta covers the cervix, leading to painless vaginal bleeding, but it is not caused by trauma. It is a pre-existing placental abnormality rather than a complication of an auto accident.

E. Placental abruption. Trauma, such as a car accident, significantly increases the risk of placental abruption, where the placenta prematurely detaches from the uterine wall. This can cause vaginal bleeding, abdominal pain, and fetal distress, making it a critical complication to monitor for in a pregnant trauma patient.

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A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. Which finding is most indicative that preterm labor is occurring?

Nursing Test Bank

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