Q1 Passage of meconium occurs in 30-40% of all births .

True      False      Don't Know


Q2 Parents must be warned that the baby is likely to be born flat when thin meconium staining of the liquor is detected.

True      False      Don't Know


Q3 Expedition of delivery is necessary in the presence of thick meconium-stained liquor (MSL).

True      False      Don't Know


Q4 On delivery of the head of the baby in the presence of thick MSL suctioning of the meconium from the hypopharynx should be carried out.

True      False      Don't Know


Q5 Besides optimising ventilation, infusion of intravascular fluids for blood pressure support is often necessary in MAS with persistent pulmonary hypertension.

True      False      Don't Know


Q6 Chest Xray may be normal in meconium aspiration syndrome (MAS).

True      False      Don't Know


Q7

A sudden drop in oxygen saturation in a baby being ventilated for MAS is likely to be due to intraventricular haemorrhage.

True      False      Don't Know


Q8 Systematic review of trials on amnioinfusion of MSL at birth has shown a reduction in MAS and neonatal hypoxic ischaemic encephalopthy.

True      False      Don't Know


Q9 Routine endotracheal intubation at birth in vigorous term meconium- stained babies has not been found to be superior to routine resuscitation including oropharyngeal suctioning .

True      False      Don't Know


Q10

In the presence of persistent pulmonary hypertension in MAS supportive treatment including regular suctioning is important.

True      False      Don't Know


Q11

Surfactant lavage is a recognised therapy in MAS.

True      False      Don't Know


Q12

There is a higher incidence of cerebral palsy in meconium-stained infants.

True      False      Don't Know

 


 

 

 

 

 

 

 

 

 

 

 

 

Your Score is  point(s) !

 


Marking Scheme

Correct answer - Add 1 point
Wrong answer - Minus 1 point
DK/no answer - 0 point

 

 

 

Answers

Q1 Passage of meconium occurs in 30-40% of all births.

Ans : False. Incidence is about 10-15%.


Q2 Parents must be warned that the baby is likely to be born flat when thin meconium staining of the liquor is detected.

Ans : False. Thin meconium staining is rarely associated with increased morbidity and mortality .


Q3 Expedition of delivery is necessary in the presence of thick meconium-stained liquor (MSL).

Ans : True. Passage of meconium is associated with fetal hypoxia and acidosis .


Q4 On delivery of the head of the baby in the presence of thick MSL suctioning of the meconium from the hypopharynx should be carried out.

Ans : True. This is to reduce the amount of meconium that can be aspirated when the baby breathes at birth.


Q5 Besides optimising ventilation, infusion of intravascular fluids for blood pressure support is often necessary in MAS with persistent pulmonary hypertension.

Ans : True. Large fluid boluses are often necessary to maintain adequate blood pressure and effectiveness of inotropes which are often also needed will depend on an adequate intravascular volume.


Q6 Chest Xray may be normal in meconium aspiration syndrome (MAS).

Ans : False. Criteria for MAS include
1) Presence of thick meconium stained liquor
2) Compatible chest X'ray findings and
3) Signs of respiratory distress.
Respiratory distress in the presence of thick MSL without CXR findings may be due to other complications like aspyhxia.


Q7

A sudden drop in oxygen saturation in a baby being ventilated for MAS is likely to be due to intraventricular haemorrhage.

Ans : False. Most likely complication is pneumothorax.


Q8 Systematic review of trials on amnioinfusion of MSL at birth has shown a reduction in MAS and neonatal hypoxic ischaemic encephalopthy.

Ans : True. Ref: Hofmeyr, GJ. Cochrane Database of Systematic Reviews Issue 3, 2000 .


Q9 Routine endotracheal intubation at birth in vigorous term meconium- stained babies has not been found to be superior to routine resuscitation including oropharyngeal suctioning.

Ans : True. Ref: Halliday HL. Cochrane Database of Systematic Reviews Issue 3, 2000
.


Q10

In the presence of persistent pulmonary hypertension in MAS supportive treatment including regular suctioning is important.

Ans : False. Suctioning should be only instituted if and when necessary to minimise periods of instability
.


Q11

Surfactant lavage is a recognised therapy in MAS.

Ans : True. Both intratracheal instillation and lavage of surfactant have been found to be effective .


Q12

There is a higher incidence of cerebral palsy in meconium-stained infants.

Ans : True. Incidence is 4 per 1000 livebirths in contrast to an overall incidence incidence of 2 per 1000 LBs .

 


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