Antenatal Assessment & Care Flashcards
5 purposes of Prenatal Care
-Assess health status of mothers & fetus
-Monitor progress of pregnancy
-Early detection of at-risk mothers/ fetuses
-Promote self-care of pregnant women
-Provide holistic care to pregnant women & family members
how do you calculate Expected Date of Confinement (EDC)/ Delivery (EDD)?
What is the name of rule & any limitations?
EDC=LMP - 3 months + 7 days
Nagele’s rule
only accurate for women with 28 days cycle
What is the difference between Gravidity & parity?
Gravidity: no. of times a woman has been pregnant
Parity: no. of times a woman has given birth (alive/ dead), excluding abortions
ps 1st baby stillbirth –> G1P0+1
What is the use of fundal height?
important landmarks in assessing gestation:
To estimate period of gestation
symphysis pubis: 12 weeks
umbilicus: 20 weeks
xiphisternum: 36 weeks
Name of abdominal palpation technique
Leopold’s Maneuvers
(4 maneuvers in total)
Fetal heart rate normal range
110-160/ min, regular
What instruments are used for auscultation? Best position to hear fetal heart beat?
Doppler: 8-17 weeks
Fetal Stethoscope: 17-19 weeks
best heard at fetal spine near scapula
types of lab tests for vaginal examination
- vaginal & rectal swab culture for grpB streptococcus
- pap smear for cervical cytology
- culture as indicated
What are the things to observe at the cervix during vaginal examination?
- open or close? (1st time moms: oval shape; otherwise slit)
- thicken
- bluish discolouration (Chadwick’s sign)
- increased mucus
- any abnormal discharge/ bleeding
Describe bimanual examination & possible results
Lubricate index & middle finger, enter with palm facing sideways then rotate so it is facing upwards;
Move along the posterior wall of the vagina and locate the cervix and feel for smoothness, clots, mobility and firmness
Place fingers in the posterior fornix to lift the uterus whilst simultaneously pushing the fundus down by placing the left hand above the symphysis pubis.
for early pregnancy: softening of cervix (Goodell’s sign), softening of isthmus (Hegar’s sign)
List out 7 blood tests in antenatal assessment
CBC, ABO grouping, Rhesus factor (Rh), Rubella antibody, HepB surface antigen (HbsAg), Venereal disease (syphilis), Human Immunodeficiency Virus (HIV) antibody
antenatal urine tests are for?
glycosuria
proteinuria
ketone
What to do if anti-Rh antibodies is tested positive?
give Rh anti-D immunoglobulin injection (Rogan) within 12hrs after delivery
(prevents hemolysis in baby)
5 prenatal diagnosis for congenital abnormalities/ heredity condition
Biochemical screening
amniocentesis
chorionic villus sampling (CVS)
cordocentesis
fetoscopy
what is nuchal translucency
measure thickness of subcu translucency between skin & soft tissue overlying cervical spine
if increase in thickness (1tri: >3mm, 2tri: >6mm) –> Down’s syndrome