PMC High-Risk Pregnancy Considerations 2 — Questions and Answers
Question 1: A client at 28 weeks reports sudden severe headache, visual disturbances, and upper abdominal pain. What is the most appropriate action?
- Offer a scalp massage to relieve the headache
- Immediately refer her to emergency medical care (Correct answer)
- Reduce session pressure and monitor for 10 minutes
- Apply cold compresses to the forehead and continue
Correct answer: Immediately refer her to emergency medical care
Sudden severe headache with visual disturbances and upper abdominal pain are classic warning signs of severe preeclampsia or HELLP syndrome requiring emergency care.
Question 2: Which condition is characterized by the placenta partially or fully covering the cervical os?
- Placental abruption
- Placenta previa (Correct answer)
- Vasa previa
- Velamentous cord insertion
Correct answer: Placenta previa
Placenta previa occurs when the placenta implants in the lower uterine segment, partially or completely covering the cervical os.
Question 3: A prenatal massage therapist should avoid deep abdominal work in a client diagnosed with placenta previa because:
- It may stimulate uterine contractions and cause bleeding (Correct answer)
- The client may experience nausea from the pressure
- Deep work increases cortisol which harms the placenta
- Abdominal massage is always contraindicated after 20 weeks
Correct answer: It may stimulate uterine contractions and cause bleeding
Deep abdominal pressure can stimulate uterine activity and risk hemorrhage in placenta previa, where the placenta overlies the cervix.
Question 4: Gestational diabetes increases the risk of which neonatal complication at delivery?
- Meconium aspiration
- Neonatal hypoglycemia (Correct answer)
- Respiratory distress syndrome
- Neonatal jaundice from blood type incompatibility
Correct answer: Neonatal hypoglycemia
Infants of mothers with gestational diabetes are exposed to excess glucose in utero, causing fetal hyperinsulinism that leads to hypoglycemia after birth.
Question 5: When massaging a client with symptomatic varicose veins in the legs, the therapist should:
- Apply firm effleurage strokes directly over the varicosities
- Avoid direct pressure on varicose veins and work proximal to them (Correct answer)
- Use deep friction to improve local circulation
- Elevate the legs and apply cold hydrotherapy
Correct answer: Avoid direct pressure on varicose veins and work proximal to them
Direct pressure over varicose veins risks rupture or dislodgment of any associated thrombus; work proximal to the veins to encourage drainage safely.
Question 6: A client with a cervical cerclage (stitch) placed for cervical incompetence should avoid massage techniques that:
- Increase circulation to the lower extremities
- Stimulate uterine contractions or apply sacral pressure (Correct answer)
- Incorporate heat to the upper back
- Use side-lying positioning after 20 weeks
Correct answer: Stimulate uterine contractions or apply sacral pressure
Techniques that may stimulate uterine contractions—including deep sacral or lumbar pressure and certain acupressure points—are contraindicated with cervical cerclage.
Question 7: In a client with intrahepatic cholestasis of pregnancy (ICP), which symptom most commonly prompts her to seek massage therapy?
- Severe nausea and vomiting
- Intense itching, especially on the palms and soles (Correct answer)
- Facial swelling and puffiness
- Shortness of breath and heart palpitations
Correct answer: Intense itching, especially on the palms and soles
ICP classically presents with severe pruritus, particularly on the palms and soles, caused by bile acid accumulation under the skin.
PMC High-Risk Pregnancy Considerations 2
A client at 28 weeks reports sudden severe headache, visual disturbances, and upper abdominal pain.
What is the most appropriate action?