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Question ID 510

Title E ects of smoking on pregnancy and fetal outcome

Last revision 2016-10-16 11:36:46

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An Aboriginal woman has come to your practice for antenatal care. She is a smoker and
has the history of hypertension. She does not seem to be motivated to quit smoking.
Which of the following is not an e ect smoking on the fetus during pregnancy if she
continues to smoke?

A Still birth.

B Premature birth.

C Placental abruption.

D Hydrops fetalis.

E Spontaneous abortion.

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Option D is correct

E ects of tobacco smoking (active or passive) during pregnancy include:

Obstetric complications

Spontaneous abortion and miscarriage

Placental abruption (double the risk for smokers who consume more than 20 cigarettes a day)
Placenta praevia
Preterm birth (<37 weeks)
Pre-eclampsia
Premature rupture of membranes
Still birth
Ectopic pregnancy

Fetal complications

Low birth weight

Intrauterine growth restriction
Birth defects – limb reduction, club foot, oral clefts, eye defects, gastrointestinal defects and
many other less insigni cant anomalies

Childhood and adult life complications:

Sudden infant death syndrome (SIDS)

Developmental delay (at least at early stages of development)
Type II diabetes
Obesity
Hypertension
Decreased HDL
Nicotine dependence
Asthma, lower respiratory tract infections
Impaired academic performance and cognitive abilities
Conduct disorders, ADHD, antisocial behaviour

Hydrops fetalis is a serious fetal condition, de ned as abnormal accumulation of uid in two or more
fetal compartments, including ascites, pleural e usion, pericardial e usion, and skin edema.
Hydrops fetalis can be caused by the following conditions:

Hemolytic disease of the newborn

Severe anemia
Chromosomal abnormalities
Congenital heart disease

Smoking is not a cause of hydrops fetalis.

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Reference(s)
http://www.racgp.org.au/afp/2014/januaryfebruary/s (http://www.racgp.org.au/af
p/2014/januaryfebruary/smoking-in-pregnant-women/)
http://www.uptodate.com/contents/cigarette-smoking (http://www.uptodate.co
m/contents/cigarette-smoking-and-pregnancy)
http://emedicine.medscape.com/article/974571-overv (http://emedicine.medscap
e.com/article/974571-overview)

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