12 teenage pregnancy Flashcards
(24 cards)
chlamydia screen
all sexually active age 24 and younger
AND sexually active over 25 at increased risk
preconception health care checklist
folic acid supplement - 400 mcg (1 mg in diabetes or epilepsy, 4 mg if previous child with NTD)
carrier screening if appropriate
screen infectious ds, immunize (rubella, varicella), toxo (avoid cat litter, garden soil, raw meat), counsel on avoiding other (CMV, pB19)
avoid toxins
treat medical ds, switch meds
s/s pregnancy
amenorrhea fatigue n/v breast changes urinary frequency softening of cervix (goodell's) and uterus (hegars) blue cervix (chadwick's)
FHT at 10-12 weeks
Movement at 18-20 weeks
calculate EDD
add year
subtract 4 months
add 1 week
calculate EGA
2 weeks less than LNMP but really just use the LNMP
rhogam
maternal rh -
give at 28 weeks or if any bleeding
first trimester vaginal bleeding
1/4 have bleeding
if significant, 25-50% chance miscarriage
ectropion
central part cervix appears red from mucuous producing endocervical epithelium prodruding form os, no clinical significance.
first trimester US dating
crown-rump length
within a week - keep EDD/EGA from LNMP
if greater than 1 week differnece, change to US
second trimester US dating
biparietal diameter, head circumfrence, abdominal circ, femur lenght (within 2 weeks)
if within 1 week from EDD/EGA, don’t change. If more than 1 week, change
third trimester US dating
cannot change EGA or EDD
use to determine SGA/LGA
HEEADSSS
home education/employment eating Activities Drugs Sexuality Suicide Safety
tx inevitable/incomplete abortion
expectant
surgical d/C
medical (cytotec)
rhogam
initial pregnancy labs
cbc rubella immunitiy hep b immunity blood type rpr hiv
tests for first trimester vaginal bleeding
cbc wet mount pcr g/c progesterone quantitative bHCG (with US or series)
normal bHCG
by expected date of menses, at or above 100 miu/ml
doubles every 48 hours for first 6-7 week s
transabdominal us at hcg > 5000
spontaneous abortion
pregnancy loss before 20 weeks
threatened abortion
bleeding before 20 weeks
inevitable abortion
dilated cervical os
incomplete abortion
some but not all uterine contents expelled
missed abortion
fetal demies without cervical dilation or uterine activity (often found on us without bleeding)
septic abortion
with infection
complete abortion
products of conception completely expelled
three most common causes of bleeding in early pregnancy
spontaneous abortion
ectopic pregnancy
idiopathic bleeding in viable pregnancy
