Quiz 15: Regionalised perinatal care

Please choose the one, most correct answer to each question or statement.

1. What is regionalised perinatal care?
   • All perinatal care in a town is provided in a single hospital.
   • All patients living in a community are delivered at the same clinic.
   • All perinatal care in a region is provided by a clearly defined health system.
   • The community must provide the money needed to run the clinics in that region.
2. What percentage of patients can usually be classified as low risk?
   • 10%
   • 20%
   • 35%
   • 60%
3. Most low-risk pregnant women should be:
   • Delivered in hospital
   • Delivered in a perinatal-care clinic
   • Delivered by a doctor
   • Delivered at home
4. A regional hospital which provides tertiary (specialist) care is also referred to as a:
   • Level 4 hospital
   • Level 3 hospital
   • Level 2 hospital
   • Level 1 hospital
5. How can a regional hospital assist the district hospital in that region?
   • By instructing the clinic to refer all patients with clinical problems directly to the regional hospital
   • By encouraging district hospitals to provide specialist care
   • By insisting that the district hospital care for all their own patients with clinical problems and, thereby, make the district hospital independent
   • By providing educational programmes for the staff in district hospitals
6. A district hospital can assist the perinatal-care clinic in that area by:
   • Sending doctors to care for the patients at the clinic
   • Providing the clinic staff with advice when asked
   • Reporting to the hospital superintendent any management errors made at a clinic
   • Offering to deliver 50% of their low-risk patients
7. How can the staff at a perinatal-care clinic improve communications with the referral hospital?
   • By writing good notes
   • By drawing up their own list of referral criteria
   • By making their own transport arrangements
   • By demanding that doctors from the district hospital assist with the antenatal-care clinics
8. A perinatal-care clinic is:
   • A clinic which provides antenatal care only
   • A clinic which provides both antenatal and postnatal care
   • A clinic which provides care during delivery as well as during the antenatal period and the puerperium
   • A clinic which provides care to women before, during, and after delivery, as well as to the infant during the first year of life
9. The midwife at a perinatal-care clinic should:
   • Only deliver patients if a doctor is present
   • Function as an independent nurse-practitioner (i.e. be responsible for all the clinical care given)
   • Only provide antenatal care
   • Should not communicate with traditional healers
10. A perinatal-care clinic should:
    • Always be close to a district hospital.
    • Be separate from a centre which provides primary healthcare.
    • Be acceptable to the local community.
    • Only be available in rural areas.
11. What is the role of the community in the management of a perinatal clinic?
    • The community should appoint the staff at the clinic.
    • The community should have no role in the management of the clinic.
    • The community should become involved with the running of the clinic.
    • The midwives should all come from the local community.
12. It is safer to deliver a patient at a perinatal-care clinic than at home because:
    • A doctor is always available at the clinic.
    • The clinic has the staff and facilities to manage most clinical problems.
    • Infection is commoner after a home delivery.
    • Postpartum haemorrhage cannot be prevented at a home delivery.
13. The referral criteria for each clinic:
    • Should be decided by the clinic staff and the community
    • Should be decided by the hospital staff
    • Should be decided by the doctor in charge
    • Should be decided by the senior medical and nursing staff at both the clinic and hospital
14. When clinic staff speak to a patient they should:
    • Not allow the patient to ask questions
    • Give her a detailed report on any clinical problem which has developed
    • Use simple language
    • Call her ‘Mommy’ as this shows that they are interested in her pregnancy
15. Patient notes at a perinatal-care clinic should:
    • Be kept by the clinic
    • Be written in the patient’s folder
    • Be recorded in a maternity case record which the patient keeps
    • Be written in detail both in the clinic folder and on the patient’s maternity case record.
16. What should be done to make the transfer of a patient from a clinic to hospital as safe as possible?
    • She should be transferred immediately.
    • Time should not be wasted by contacting the hospital by telephone.
    • The patient should be stabilised before transfer.
    • The patient should only be transferred when a doctor is available to accompany her.
17. What is an important danger to a woman during urgent transfer for hypertension in pregnancy from a clinic to a hospital?
    • Eclampsia
    • Dehydration
    • Postural hypotension
    • Motor vehicle accident
18. How is the maternal mortality ratio expressed?
    • As a percentage
    • Per 1000 deliveries
    • Per 10 000 deliveries
    • Per 100 000 live births
19. The maternal mortality rate in a developing country is usually:
    • 50 or more
    • 25–50
    • 10–25
    • Less than ten.
20. Which of the following will cause most maternal deaths in a developing country?
    • Haemorrhage
    • General anaesthesia
    • Thromboembolism
    • Acute pyelonephritis