Cambodia Midwifery Exit Exam flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Naegele's rule

Estimated date of delivery = first day of last menstrual period + 7 days − 3 months + 1 year, giving 280 days or 40 weeks from the last menstrual period.

WHO 8-contact ANC model

Antenatal contacts at before 12 weeks, then 20, 26, 30, 34, 36, 38 and 40 weeks, replacing the earlier four-visit focused antenatal care schedule.

Symphysio-fundal height

Measurement in centimetres from the pubic symphysis to the uterine fundus; between 20 and 36 weeks it approximates gestational age in weeks within about 2 cm.

Tetanus toxoid in pregnancy

Two doses four weeks apart in the first pregnancy, then one dose in each later pregnancy, to reach five protected doses over the woman's lifetime.

Active first stage of labour

Regular painful contractions with cervical dilatation of at least 5 cm, the threshold used in the WHO Labour Care Guide to define active labour.

Partograph action line

In active labour, cervical dilatation of less than 1 cm per hour over 4 hours, or failure of descent, signals the need to reassess and refer.

Active management third stage

Intramuscular oxytocin 10 IU within one minute of birth, controlled cord traction, and uterine massage, which together reduce postpartum haemorrhage.

Normal fetal heart rate

A baseline between 110 and 160 beats per minute, auscultated for a full minute every 30 minutes in the first stage and every 5 minutes in the second stage.

Postpartum haemorrhage definition

Blood loss of 500 mL or more after vaginal birth, or 1000 mL or more after caesarean, or any loss causing haemodynamic instability; uterine atony is the commonest cause.

Kangaroo mother care

Continuous skin-to-skin contact with exclusive breastfeeding and early follow-up, the standard care for stable low-birth-weight newborns in low-resource settings.

Newborn vitamin K dose

One milligram given intramuscularly within one hour of birth, preventing haemorrhagic disease of the newborn in all babies.

Exclusive breastfeeding duration

Breast milk only, no water or other liquids, for the first six months, fed on demand at least 8 to 12 times in 24 hours.

Pritchard magnesium sulphate regimen

For eclampsia: 4 g intravenous plus 10 g intramuscular loading dose, then 5 g intramuscularly every 4 hours for 24 hours, with monitoring of reflexes and respiration.

Shoulder dystocia manoeuvres

Call for help, use McRoberts position with suprapubic pressure, then internal rotational manoeuvres; never apply fundal pressure or pull the baby's head.

Cord prolapse management

Call for help, elevate the presenting part with a gloved hand, place the woman knee-chest or Trendelenburg, and arrange immediate caesarean section.

Tranexamic acid in PPH

One gram intravenously given within 3 hours of birth reduces death from postpartum haemorrhage and is given alongside oxytocin and uterine massage.

Newborn resuscitation initial steps

Warm, dry, stimulate, position the head, clear the airway if needed, then give positive pressure ventilation at 40 to 60 breaths per minute.

Newborn chest compression ratio

Three compressions to one breath, using the two-thumb technique, started when the heart rate stays below 60 per minute after 60 seconds of effective ventilation.

Neonatal hypoglycaemia threshold

Blood glucose below 2.5 mmol/L (45 mg/dL); treat with early feeding or expressed breast milk and refer if the baby is symptomatic or the level persists.

Neonatal jaundice referral trigger

Any jaundice in the first 24 hours of life, jaundice reaching the palms and soles, or jaundice with poor feeding requires urgent referral for bilirubin measurement.

Lactational amenorrhoea criteria

Effective only when the woman is fully breastfeeding, has no vaginal bleeding, and the baby is under six months old; otherwise another method is needed.

Emergency contraception options

Levonorgestrel 1.5 mg orally within 72 hours of unprotected intercourse, or a copper IUD inserted within 5 days, which is the most effective method.

Postpartum IUD timing

A copper or hormonal IUD can be inserted immediately after birth, including during breastfeeding, and remains highly effective with no delay in return to fertility after removal.

WHO five moments hand hygiene

Before patient contact, before aseptic procedures, after body fluid exposure risk, after patient contact, and after contact with patient surroundings.

HIV post-exposure prophylaxis

Antiretroviral treatment started as soon as possible after exposure, ideally within 2 hours and no later than 72 hours, continued for 28 days.

Sharps disposal rule

Never recap needles by hand; place used sharps directly into a puncture-resistant container and replace the container when it is three-quarters full.

Option B+ for PMTCT

All HIV-positive pregnant and breastfeeding women start lifelong antiretroviral therapy regardless of CD4 count, the approach recommended by WHO and used in Cambodia.

Early infant HIV diagnosis

DNA PCR testing of HIV-exposed infants at about 6 weeks of age, repeated after weaning, with a final antibody test at 18 months to confirm status.

Informed consent elements

Capacity to decide, adequate information about risks, benefits and alternatives, and a voluntary decision, all documented in the health record.

Midwife scope in Cambodia

Antenatal, intrapartum, postpartum, newborn and family planning care; caesarean section and instrument-assisted birth are outside scope and require referral.

Cambodia health system tiers

Health centres serving about 10,000 people, district referral hospitals, and national hospitals, with the health equity fund covering costs for poor households.

Birth preparedness and readiness

Planning saving money, choosing a birth companion, arranging transport, identifying a referral facility, and learning danger signs during antenatal education.