14- pregnant Flashcards
are home pregnancy tests reliable?
yes
most home urine pregnancy tests are positive at concentrations of … and blood hcg tests are positive at….
≥ 25 mIU/mL. home
5 mIU/mL, blood
when is gestational sac and fetal pole visualized by transvaginal US?
gestational sac : 4-5 weeks’ gestation,
fetal pole : 5-6 weeks.
embryonic age (also called conceptional or developmental age)
which is calculated from the date of fertilization, or about 2 weeks after the first date of the LMP.
what risk factors would prompt a hep C screening in pregnant patients?
prison inmates, intravenous drug use, HIV-positive, multiple sexual partners, tattoos, elevated liver enzymes.
how many pounds to gain in pregnancy if normal weight, overweight, and obese
nl: 25-35
overweight: 15-25
obese: 11-20
neural tube closes by
4 weeks
should you avoid Hot tubs and saunas during the first trimester of pregnancy.
yes :(
what foods to avoid in pregnancy
Avoid raw eggs, unpasteurized milk or milk products, soft cheeses (such as feta, brie, veined, Camembert, and Mexican queso fresco), unwashed fruits or vegetables, raw fish, shellfish, and large, steak-like fish (such as shark, swordfish, king mackerel, and tilefish).
caffeine in pregnancy
Likely safe in moderate amounts
some observational studies showed miscarriage and low birth weight
fetal heart tones are usually first heard by Doppler fetoscope between …
10-12 weeks
should influenza vaccine be given to patients?
yes!
when is rhogam given
routine Rhogam immunization be given at 28 weeks’ gestation and within 72 hours after delivery as well as with any episodes of vaginal or intrauterine bleeding.
Prenatal maternal (“triple” or “quad”) serum screening consists of … and is done when?
alpha-fetoprotein (AFP),
human chorionic gonadotropin (hCG),
unconjugated estriol, and (only in the quad screen) dimeric inhibin A
15-21 weeks
Routine ultrasound for fetal anomalies is not recommended until
18-20 weeks’ gestation.
when is nausea in pregnancy common
beginning between the fourth and seventh week and resolving by the 20th week in most women.
tricks to help nausea in pregnancy
at frequent, small meals, avoid smells and food textures that cause nausea.
Solid foods should be bland tasting, high in carbohydrates, and low in fat.
Salty foods usually can be tolerated early in the morning, and sour and tart liquids often are tolerated better than water.
sensitivity of triple screen vs quad screen for down’s syndrome
triple- 69%
quad- 81%
risk factors for placenta previa
multiparous
are older (>35)
smoke
have had twins or a higher multiple pregnancy
have had previous uterine surgery/c-section
Marginal or incomplete previas are more or less likely to resolve than complete previas.
more likely to resolve
how and when should gestational diabetes be screened
24 to 28 weeks with a one-hour glucose tolerance test.
complications for baby for preeclampsia
preterm delivery, small for gestational age infants, and placental abruption
defintion of chronic HTN during pregnancy
Blood pressure elevation first detected before the 20th week of pregnancy that persists beyond 12 weeks postpartum.
gestational HTN
The presence of persistent systolic blood pressure of ≥140 mmHg and/or a diastolic blood pressure of ≥90 mmHg, without proteinuria, in a previously normotensive pregnant woman at or after 20 weeks of gestation.
preeclampsia definition
The presence of persistent systolic blood pressure of ≥ 140 mmHg and/or a diastolic blood pressure of ≥ 90 mmHg, with proteinuria of 0.3 grams or greater in a 24-hour urine specimen.
risk factors for preeclampsia
white,
nulliparous women
lower SES
younger (teenage and low twenties) and older (> 35 years) women.
Symptoms of Severe Preeclampsia
Visual disturbances, severe headache, right upper quadrant or epigastric pain, nausea, vomiting, decreased urine output
what week does fetus start breathing
week 27
gestational DM criteria
as the presence of two or more of the following serum glucose values:
Fasting serum glucose concentration ≥ 95 mg/dL
One-hour serum glucose concentration ≥ 180 mg/dL
Two-hour serum glucose concentration ≥ 155 mg/dL
Three-hour serum glucose concentration ≥140 mg/dL
pruritic urticarial papules and plaques of pregnancy (PUPPP)
papulovesicular lesions on the trunk and extremities
prurigo of pregnancy
excoriated areas on the trunk or limbs
pruritic folliculitis
rash may be centered around hair follicles and have an associated pustular appearance
treatment of itchy rashes during symptoms
topical steroid cream (low-potency) and lotion
parts of birth plan
- Comfort measures, including mobility, eating and drinking during labor, music, birth balls, etc.
- pain, including medications (oral, IV, epidural)
- Labor support: who will be present, use of a doula or professional labor support person, other children, childbirth education classes
- Newborn issues, including time with baby after birth, breastfeeding, rooming-in, preferences about whether or not to give formula, timing of routine prophylactic measures (Vitamin K, eye medication)
placental abruption symptoms and treatment
vaginal bleeding with associated abdominal pain, uterine contractions, and a non-reassuring fetal heart tracing.
Requires immediate medical treatment, as abruption can deprive the fetus of oxygen and cause heavy bleeding in the mother.
bacterial vaginosis
thin, clear or mildly colored discharge, often with a foul odor.
sometimes itching or dysuria, recent intercourse
Vaginal candiasis
itching in the vaginal and labial area with associated thick, whitish vaginal discharge.
Is common in pregnancy, is often associated with dysuria, and can be associated with recent sexual intercourse.
Management of Bacterial Vaginosis During Pregnancy
metronidazole
down syndrome signs
Flat facial profile Poor Moro reflex Excessive skin at nape of the neck Slanted palpebral fissures Hypotonia Hyperflexibility of joints Dysplasia of pelvis Anomalous ears Dysplasia of midphalanx of fifth finger Transverse palmar (Simian) crease
birth control and lactation
copper IUD- can be inserted immeditely
progesterone-only: after 6 weeks
estrogen and progesterone combo can suppress milk production- controversial
portpartum blues timing
up to 2 weeks, peak day 5
