6: Normal Pregnancy and Antepartum Care

Question 1

preconception care: what to discuss during a visit

Answer 1

1. risk assessment: drugs, tobacco, alcohol
2. promoting health: nutrition, folic acid, healthy weight
3. medical management: DM, HTN, etc.
4. psychosocial intervention: stress reduction

Question 2

when to start folic acid

Answer 2

at least 1 month prior to conceiving

Question 3

amount of folic acid to take w no hx NTD vs Hx child with a NTD

Answer 3

1. no Hx: 0.4 mg

2. Hx: 4.0 mg

Question 4

gravidity vs parity

Answer 4

gravidity: # of time woman has been pregnant
parity: # of times woman has given birth beyond 20wks / 500 gram infant

Question 5

GP details: FPAL

Answer 5

Full term, preterm, abortion, living children

Question 6

two times rhogam can be given if needed

Answer 6

1. At 28 weeks

2. anytime sensitization may occur: threatened abortion, amniocentesis, abdominal trauma

Question 7

gestational age

Answer 7

of weeks since first day of LMP

Question 8

list of pts that may want genetic counceling

Answer 8

1. 35+ yrs
2. FHx birth defects or genetic DO
3. previous child with undx MR
4. previous baby who died in neonatal period
5. multiple fetal losses
6. abnl serum marker screen
7. conanguinity
8. xposure to teratogens
9. abnl US findings
10. parent is a known carrier of a genetic disorder

Question 9

incidence of chromosomal disorder causing spontaneous abortion

Answer 9

50%

Question 10

incidence of trisomy 21 for non-advanced age vs women 45+

Answer 10

<35: 1 in 800

45+ 1 in 35

Question 11

major biochem cause of down syndrome

Answer 11

meiotic nondisjunction

Question 12

when should karyotype study be done for couples?

Answer 12

after 3+ spontaneous abortions

Question 13

MC class of spontaneous abortion vs MC single chromosomal abnlty that causes it

Answer 13

1. MC Class: autosomal trisomies

2. MC single cause: 45 XO

Question 14

MC gene carried in north american white

Answer 14

CF

Question 15

MC form of inherited MR

Answer 15

Fragile X syndrome

Question 16

teratogen

Answer 16

any afent of factor that can caue abnormalities of form or function in an exposed fetus

Question 17

thalidomide caused ___

Answer 17

phocomelia

Question 18

PLLR: pregnancy and lactation labeling rule

Answer 18

replaced the letter categories (A, B, C, D, X) for drugs during pregnancy - gives more details to assess benefit vs risk

Question 19

first sensation of fetal movement is called ___ and typically occurs around ___ weeks.

Answer 19

quickening; 20 weeks