Antenatal Care Flashcards
What is the aim of antenatal care
- risk assessment
- health promotion
- medical\psyychological intervention
- plan for birth
Each trimester is ….. weeks
1st and 2nd: 14
3rd: 12
First trimester is from week … to week …
1-13
Second trimester is from week … to week …
14-27
Third trimester is from week … to week …
28 to 40
What are the laboratory tests that you will order for the first visit of antenatal care?
1- CBC - ABO - Rh typing
2- Urine (analysis\culture)
3- rubella, syphlis, HBV, HIV
4- Pap smear
CBC and platelet count measurement during antenatal visit, is important to:
Know Hb baseline, as in pre-eclampsia there’s is drop of platelet count.
Urine analysis and culture measurement during antenatal visit, is important to:
1- look for UTI (asymptomatic bacteruria)
2- measure glucose\protein (pre-eclampsia)
What are the complications of UTI in pregnant lady?
1- preterm labor
2- rupture of membrane
3- ascending infection (pyelonephritis)
For specific patients, there are other lab investigations, these are:
Chlamydia, gonorrhea, TSH, TB, DM
When to start treating patient for hypothyroidism during pregnancy?
Low T3, T4 - or - symptomatic
What is the role of US in first visit
1- dating 2- location 3- viability 4- number 5- check uterus\ovaries
When is the best time to do the first ultrasound
Between 7-9 weeks (fetal pool, gestational sac, crown lump lenght)
What are the methods used to confirm pregnancy?
1- HCG (blood or urine)
2- US (when HCG>1500)
What is the percentage of HCG to be positive in urine test?
> 25
When does blood test become positive
After 6-8 days of ovulation, before her next missed period
What is the HCG value at time of missed period?
100
How to differentiate between normal pregnancy, abortion and ectopic pregnancy using HCG?
During the first 30 days of pregnancy, HCG doubles every 2 days.
- US shows no fetus
- measure HCG and repeat after 2 days
- if double: normal - if no double: Ectopic\abortion
What is biochemical pregnancy
Pregnancy confirmed only by HCG and no US
how to determine gestational age in
- regular period
- irregular period
- Nealges rule (+7d-3m+1y)
- dating US
Dating US is only accurate in:
The first trimester (1 or 2 days error)
What is the error rate in 2nd and 3rd trimester?
- 2nd: 1w
- 3rd: 2\3 w
What are the methods for screening for common genetic disorders
- blood: triple & quadraple test - free fetal DNA
- US: nasal bone - NT - anomaly scan
What are the methods for diagnosis for common genetic disorders
Amniocentesis, CVS, cordocentesis
Which test of diagnosis for genetic abnormalities is usually done early, and which one is done late?
Early: amniocentesis
Late: CVS
From where is sample taken in amniocentesis, cvs, and cordocentesis
- amniotic fluid
- placenta
- Umbilical cord
What are the complications of cordocentesis?
Bleeding and IUFD
When to preform
- GDM screening
- GBS screening
- Rh titer
- 24 to 28w
- 35 to 37w
- 24 to 28w
What are the safe and unsafe vaccines during pregnancy?
- Dtap, HBV, flu
- live attenuated like MMR
What are the dates for
First, second, and third trimester US
- 12wks
- 20wks
- 32wks then as needed
What to look for in the 2nd trimester US?
Anomaly (conginital) - organs easily demonstrated
What to look for in 3rd trimester US?
- Growth scan
- Placental localization (no previa\accreta)
- fetal wellbeing
- presentation (cephalic\breach)
Nutritional assessemnt during pregnancy:
Calcium and iron
What is the average weight gain during pregnancy
12kg, more in underweight, less in overweight
What causes nausea & vomitting during pregnancy?
B-hcg (from 1st trimester to 20wks)
What causes heart burn in pregnancy
- Progestrone causes muscle sphincter relaxation
- HCG
What are the common symptoms of pregnancy
1- N&V 2- heart burn 3- constipation 4- hemorrhoid 5- leg cramps 6- backaches
Warning symptoms during pregnancy
Vaginal bleeding, headache, blurred vision, abdominal pain, decrease fetal movement, abnormal vaginal discharge
What is the minimum recommended visits for ANC?
4
Confirm, anomaly scan, plan delivery 28, time of delivery
