Answer to Question 1
4
1. Incorrect. Estriol is a form of estrogen produced by the fetus that is present in plasma at 9 weeks of gestation. Levels of salivary estriol have been shown to increase before preterm birth.
2. Incorrect. Irregular mild contractions that do not cause cervical change are not considered a threat.
3. Incorrect. The presence of fetal fibronectin in vaginal secretions between 24 and 36 weeks of gestation could predict preterm labor but has only a 20 to 40 positive predictive value. Of more importance are other physiologic clues of preterm labor, such as cervical changes.
4. Correct. Cervical changes such as shortened endocervical length, effacement, and dila-tion are predictors of imminent preterm labor. Changes in the cervix accompanied by regular contractions indicate labor at any gestation.
Answer to Question 2
2
1, 3, 4. Incorrect. Many cultural variations are found in prenatal care. Even if the prenatal care described is familiar to a woman, some practices may conflict with the beliefs and practices of a subculture group to which she belongs.
2. Correct. A concern for modesty is a deterrent to many women seeking prenatal care. For some women, exposing body parts, especially to a man, is considered a major violation of their modesty.
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