81. A) Pregnancy, Antepartum care

Question 1

Fundal height in pregnancy, give measurements,

Answer 1

umbilicus- 22 (20) weeks
xiphisternum- 37/38 weeks
abdomen/Pubic symphsis 12 weeks

Question 2

what is the GTPAL format?

Answer 2

G- total no of pregnancies of ANY gestation
T- no of term infants delivered
P- premature infants delivered
A- abortionds, induced and spontaneous
L- living children

Question 3

for each pregnancy what information should you get?

Answer 3

obtain the year, location, mode of delivery, duration of labor, sex, gestational age, birth weight,
and complications of every pregnancy, SAME father?

Question 4

neagles rule?

Answer 4

1st day of LMP + 7 days - 3 mo

if cycle >28days, add no of days to EDD

Question 5

Symphysis Fundal Height: if baby is large for dates?

Answer 5

miscalculation of dates
multiple gestations
polyhydramnios
Large gestional age- familial, DM
fibroids

Question 6

Symphysis Fundal Height; if baby is small for dates?

Answer 6

oligohydramnios
IUGR
fetal demise
dates miscalculation

Question 7

what to assess at each antenatal visit?

Answer 7

Record estimated GA
• history of present pregnancy: fetal movements, uterine bleeding, leaking, cramping
• physical exam: BP, weight gain, thyroid exam, SFH, Leopold’s maneuvers (T3) for lie, position,
and presentation of fetus
• investigations: urinalysis for glucosuria, proteinuria; fetal heart rate starting at 12 wk using
Doppler U/S- should be about 140

Question 8

medications and pregnancy. What analgesics are preferred?

Answer 8

acetaminophen (paracetamol) prefereable to ASA (Aspirin (Acetylsalicylic Acid) or ibuprofen.

Question 9

what is the MOA of aspirin

Answer 9

Acetylsalicylic acid belongs to the group of acidic nonsteroidal anti-inflammatory drugs with analgaesic, antipyretic and anti-inflammatory properties. Its mechanism of action is based on irreversible inhibition of cyclo-oxygenase enzymes involved in prostaglandin synthesis.

Acetylsalicylic acid also inhibits platelet aggregation by blocking thromboxane A2 synthesis in platelets. Thus, it is used for various vascular indications at doses of in general 75 to 300 mg daily.