Signs and symptoms that a pregnant woman should report immediately to her health care provider include: (Select all that apply.)

Choice A reason: A daily consumption of alcohol does not necessarily indicate a risk for alcoholism, although it is not recommended for pregnant women. Alcoholism is a chronic disease that involves physical and psychological dependence on alcohol, and it requires more than one criterion to be diagnosed.

Choice B reason: She will not be at risk for abusing other substances as well, unless she has a history or predisposition for substance abuse. Alcohol use during pregnancy does not cause other substance abuse problems, although it may co-occur with them.

Choice C reason: The fetus is not at risk for multiple organ anomalies, unless the mother consumes large amounts of alcohol during the first trimester of pregnancy. This can cause fetal alcohol syndrome (FAS), which is characterized by facial dysmorphia, growth retardation, and intellectual disability. However, FAS is rare and not related to moderate alcohol intake during the second trimester.

Choice D reason: The fetus is placed at risk for altered brain growth, as alcohol can cross the placenta and affect the developing nervous system of the fetus. Alcohol exposure during the second trimester can impair the formation and migration of neurons, leading to reduced brain size and function. This can result in learning difficulties, behavioral problems, and cognitive impairments in the child.

Choice A reason: Vibroacoustic stimulation is a technique that uses sound to stimulate the fetus and elicit a response. It is sometimes used in conjunction with the nonstress test (NST), not the CST. The NST measures the fetal heart rate (FHR) in response to fetal movement, while the CST measures the FHR in response to uterine contractions.

Choice B reason: A negative CST result means that the FHR does not show any late decelerations during at least three contractions in a 10-minute period. Late decelerations are decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends. They indicate uteroplacental insufficiency, which means that the placenta is not delivering enough oxygen and nutrients to the fetus. A negative CST result is reassuring and suggests that the fetus is well-oxygenated and can tolerate labor².

Choice C reason: The CST is not an invasive test, as it does not involve inserting any instruments or devices into the uterus or the fetus. However, it does require stimulating contractions, either by giving the pregnant woman oxytocin (a hormone that causes uterine contractions) or by having her rub her nipples (which also releases oxytocin). The contractions can be uncomfortable and may trigger preterm labor in some cases.

Choice D reason: The CST is not more effective than the NST if the membranes have already been ruptured. In fact, the CST is contraindicated (not recommended) in women who have ruptured membranes, as it can increase the risk of infection and bleeding. The NST is a safer and simpler alternative to the CST, as it does not require stimulating contractions. However, the NST may not be as reliable as the CST in detecting fetal compromise.