What are the weeks for - 1st trimester - 2nd - 3rd

- 1w to 13w+6d - 14w to 28+6d - >29

If fundal height is at the level of - umbilicus: - symphysis pubis: - xiphoid process: What is the probable gestation age?

- 20wks - 12wks - 38 which is higher than 40 due to engagement.

ANC Flashcards by Zahra Kalifa

Return visits in ANC

0-28w: once every month
28-36w: twice every month
>36: once till labor

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Decreasing no. Of ANC visits to 4 was associated with:

Not increase in AE

- decreased satisfaction

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pregnancy test results occur after

urine
blood:

Urine: 12-14d
Blood: 11d
From ovulation

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What could give false positive urinary pregnancy test results

Increase protein in the urine like in hematuira, IgM, proteinurea.
disease increasing HCG like choriocarcinoma
LH increasing disease

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Risk of Down syndrome increases in patients aged:

35 or older

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When to add +9 and when to subtract -3 from month for EDD

jan
feb
march
Add 9 months

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What is the naegler’s rule for EDD

LMP + 7d

+9m or -3m

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Full duration of pregnancy is

280days

40weeks

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What are the weeks for

1st trimester
2nd
3rd

1w to 13w+6d
14w to 28+6d
> 29

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Urine dipstick is done routinly in ANC to detect

protein

- glucose

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What are the indicators of gestational age:

Most accurate is US up to 13+6\7d

fetal heart rate (10-12w)
fetal movement (20w)
Fundal height

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If fundal height is at the level of

umbilicus:
symphysis pubis:
xiphoid process:

What is the probable gestation age?

20wks
12wks
38 which is higher than 40 due to engagement.

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Measurement of fundal height should be done:

Each visit

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Physiological oversized uterus

wrong dates

- twins

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Pregnancy during period of amenorrhea (lactation\contraception) can cause:
(Small - large uterus)

Small

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When to give women of Rh incompatibility (Anti-D) injection?

Week 28

- 24hrs-72 post-delivery.

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Anti-D given regardless of weeks is only in cases of:

abortion
miscarriage
amniocentesis
secretions
trauma

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What are the test to preform in the first visits:

Ultrasound
UA\UC
Blood test: [CBC, blood type, RH, Ab coomb’s, FBG, sickle cell, titers (rubella\hep\syphlis) ]

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Detection of asymptomatic bacteriurea should be at weeks …. to ……

12-16 weeks.

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What are the infections that we screen for in the first visit

1- rubella & vericella 
2- syphlis 
3- HIV 
4- chlymedia\gonorrhea 
5- hepatitis b

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What is the recommended dose of folic acid?

400 mcg

In which trimester should one start iron therapy

iron deficiency: 1st

- normal: 2nd

When is the peak of nausea and vomitting

7-8 weeks.

Medications used to reduce N&V

(B6 - B12 - B1)?

Known as Navidoxine (B6 + antihistamine)

In case of patient was at high risk of pre-eclampsia, she should start which medications?

Asprin

How to reduce the following symptoms in pregnancy - heartburn - constipation - hemorrhoid - Varicose

- meal spacing - increase water &fiber intake (don’t give normacol) - decrease constipation - wear compression socks

What are the risk factors for pre-eclampsia?

- Old >40 - Obese - prev\family hx of pre-eclampsia - nuliparity - multiples - 10yr interval - renal disease - HTN

How to screen pregnant patients for pre-eclampsia? “Method of screening”

- BP monitoring - Urinanlysis for protein At each routine visit

How to treat women with pre-eclampsia

- Anti-hypertension medications - Magnesium sulfate - fetal monitoring

What is the prophylactic measures recommended by USPSF?

Low dose asprin 81mg\d given at 12weeks.

Duration of prophylaxis therapy for pre-eclampsia?

12-28 weeks Optimally before 16 [continued until delivery]

Why prophylaxis therapy for pre-eclampsia (low dose aspirin) is not recommended in the first month of pregnancy?

Because of high risk for bleeding and abortion

When to call the presence of diabetes during pregnancy - gestational diabetes & when to call it - DM2

- Gestational: after 20 weeks. | - DM2: before 20 weeks

Screening for GD should be

- all patients: 24-28wks | - high risk: early in pregnancy

Which test is usually used in most patients for GD: | 1step or 2step

1 step.

What are the values of the 1 step OGTT test, that if “one of them” is exceeded the patient is diagnosed w\ gestational diabetes:

``` 1- give 75g of oral glucose 2- measure the following - FBG: 92 (5.1) - 1hr: 180 (10) - 2hr: 153 (8.5) ```

In which group of population is a 2step OGTT used?

In high risk (obese, previous GDM, DM)

When to preform Group B-strep test during pregnancy?

35-37weeks.

If B-Strep was positive during week 35-37 and patient is asymptomatic, what’s your next step

IV ampicillin during delivery.

What type of swab is taken for B-strep diagnosis?

Low Vaginal swab

What are the 3 tests done to identify Down’s syndrome in first trimester?

1- NT by US ( 10+4\7 to 13+6\7) “best at 12-13” 2- PAPPA protein 3- Free B-hcg Weighed by maternal age

What are the 4 tests done to identify Down’s syndrome in 2nd trimester?

- [low] Serum alpha-fetoprotein - [low] Estriol - [high] B-HCG - [high] inhibin A

What is NT

Fluid collection in the back of the neck

NT can identify

1- Down syndrome 2- Cardiac defect 3- diaphragm hernia 4- abdominal wall defect

Sensivity of First trimester tests in detecting down’s syndrome is:

82-87%

Sensivity of second trimester triple tests in detecting down’s syndrome is:

70%

Sensivity of First trimester quadruple tests in detecting down’s syndrome is:

81%

aminocentensis is preformed at ..... wks.

15-20wks

Chorionic villus sampling is preformed at ..... wks.

10 wks

Which test is higher at fetal loss | Amniocentesis or CVS

CVS

Post-term pregnancy is considered after

40 weeks

Air travel safety in pregnancy

4 weeks before due date.