Utilize the GTPAL system to classify a woman who is currently 18 weeks pregnant.
This is her 4th pregnancy.
She gave birth to one baby vaginally at 26 weeks who died, experienced a miscarriage, and has one living child who was delivered at 38 weeks gestation.

The correct answer is choice D.

Choice A rationale:

This statement describes the second stage of labor, not the third. The second stage begins with full cervical dilation and ends with the delivery of the fetus.

Choice B rationale:

The third stage of labor does not end 48 hours after the delivery of the placenta. This choice is incorrect.

Choice C rationale:

While it’s important to ensure no placental fragments remain, the third stage of labor technically ends with the delivery of the placenta, not at this later point.

Choice D rationale:

This is the correct definition of the third stage of labor. It begins with the delivery of the fetus and ends with the delivery of the placenta.

The correct answer is choice D. Chronic alcohol use.

Choice A rationale:

Active herpes simplex infection during pregnancy can lead to neonatal herpes, which is a serious condition, but it does not cause the symptoms described.

Choice B rationale:

Chronic cocaine use during pregnancy can lead to premature birth and low birth weight, but it does not typically result in the specific symptoms described.

Choice C rationale:

Folic acid deficiency during pregnancy can lead to neural tube defects, which can cause a range of symptoms, but not the specific ones described.

Choice D rationale:

Chronic alcohol use during pregnancy can lead to Fetal Alcohol Syndrome, which includes slow growth, cognitive and intellectual deficits, and the facial abnormalities described.