A 28-Year-Old Woman, Gravida 1 Para 0, at 41 Weeks

question 8

Multiple Choice

A 28-year-old woman, gravida 1 para 0, at 41 weeks gestation comes to the hospital for antepartum fetal surveillance.  She has had less fetal movement than usual but no abdominal pain, leakage of fluid, or vaginal bleeding.  Blood pressure is 120/80 mm Hg.  The patient's pre-pregnancy BMI was 40 kg/m², and she has gained 20 kg (44 lb) during the pregnancy.  Her pregnancy has otherwise been uncomplicated.  Nonstress test shows a baseline fetal heart rate of 140/min, moderate variability, and no accelerations for >40 minutes.  Two contractions are observed on the tocodynamometer.  An episode of fetal heart rate decrease to 130/min began after the peak of a contraction and lasted for a minute.  Ultrasound shows a fetus in cephalic presentation, a loop of umbilical cord near the fetal neck, an estimated fetal weight at the 35th percentile for gestational age, and a single deepest pocket of amniotic fluid of 1 cm.  The biophysical profile results are shown below. Which of the following is the most likely cause of this patient's biophysical profile results?

• A)Fetal head compression
• B)Fetal sleep cycle
• C)Intraamniotic infection
• D)Nuchal cord
• E)Polyhydramnios
• F)Uteroplacental insufficiency

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Definitions:

Normalization Program

A process or initiative aiming to make certain practices, behaviors, or conditions accepted as normal within a society or group.

Legal And Human Rights

The body of law and principles that recognizes and protects the dignity, freedom, and inherent rights of all human beings.

Clinical Focus

Concentration on the assessment, diagnosis, treatment, and prevention of psychological disorders.

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The process of reducing reliance on large, centralized institutions for the treatment of individuals with mental illness, in favor of community-based services.