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Midwifery > Antepartum 1 > Flashcards

Antepartum 1 Flashcards

1
Q

Wt gain if BMI < 19.8

A

28-40

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2
Q

Wt gain if BMI 20-26 normal

A

25-35

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3
Q

Wt gain if BMI 26-29 overweight

A

15-25

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3
Q

second trimester screening primarily detects what abnormalities

A

trisomy 18, 21 and neural tube defects

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4
Q

Wt gain if BMI >29 obese

A

= 15<!--= 15</p-->

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5
Q

Who needs complete genetic evaluation?

A

>35, personal hx, prev hx, family hx, abnormal screening

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6
Q

What produces AFP

A

yolk sac then fetal liver

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7
Q

why is AFP elevated in maternal blood 7 reasons

A

“leaking” from neural tube defect ventral wall defect Oligo renal abnormalities Ectopic inaccurate EGA Malpositioned placenta

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8
Q

AFP levels are dependent on what maternal characteristics? 5

A

Gestational Age Race Maternal Age Weight Diabetes

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9
Q

AFP results > 2.5 MOM can indicate?

A

Neural tube defect omphalocele anencephaly

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10
Q

What MOM is used for AFP in diabetic mom?

A

2.0 MOM

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11
Q

Decreased AFP can indicate…

A

Trisomy 21

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12
Q

What are the 4 markers in a Quad Screen?

A

AFP Uncongugated Estriol hCG DIA (dimetric inhibin A)

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13
Q

Quad markers for Trisomy 21

A
  • AFP down
  • estriol down
  • hCG up
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14
Q

Quad markers for Trisomy 18

A
  • hCG down
  • estriol down
  • AFP down
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15
Q

Preferred method of estimated gest age for AFP

A

BPD by sono

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16
Q

Gest age for AFP/Quad screen

A

15-20 weeks

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17
Q

1 Reason for abnormal multiple marker screen?

A

error in EGA

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18
Q

Clinical follow up to an abnormal AFP/Quad screen?

A

Ultrasound Possible Amnio if US technology poor

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19
Q

Gest age for amnio?

A

15-16 weeks

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20
Q

Presence of what in amniotic fluid indicates a minimal risk of RDS in the newborn?

A

PG even when L/S is <2

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21
Q

Birth rate

A

The number of live births per 1000 population

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22
Q

Birth

A

The complete expulsion or extraction from the mother of a fetus after 20 weeks gestation or weighing 500gms or more.

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23
Q

Fertility rate

A

the number of live births per 1000 females aged 15-44

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24
Q

Live birth

A

the term used to record a birth whenever the newborn at or sometime after birth breathes spontaneously or shows any other sign of life such as a heartbeat or definite spontaneous movements of voluntary muscles

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25
Q

Stillbirth (fetal death)

A

the absence of signs of life at or after birth

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26
Q

Neonatal death

A

Early – death of a liveborn neonate during the first 7 days after birth Late – death after 7 days but before 29days

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27
Q

Infant death

A

All deaths of liveborn infants from birth to 12 months

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28
Q

Abortus/Abortion

A

A fetus or embryo removed or expelled from the uterus during the first half of gestation – 20 weeks or less / less than 500gms

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29
Q

Maternal mortality ratio

A

The number of maternal deaths that result from the reproductive process, per 100,000 live births. (known also as maternal mortality rate or maternal death rate)

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30
Q

Term

A

Neonate born after 37 completed weeks

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31
Q

Preterm

A

A neonate born before 37 completed weeks

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32
Q

post term

A

a neonate born after the completion of 42 weeks

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33
Q

SGA

A

Infants whose weights are below the 10th percentile for their gestational age

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34
Q

LGA

A

Infants whose weights are above the 90th percentile for their gestational age

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35
Q

Gravida

A

A woman who currently is pregnant or she has been in the past, irrespective of the pregnancy outcome

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36
Q

Para

A

A woman who has completed a pregnancy to 20 weeks or more Parity is the completion of the pregnancy, not how many fetuses were delivered

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37
Q

Primipara

A

A woman who has been delivered only once of a fetus or fetuses born alive or dead with an est gestation of 20 weeks or greater

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38
Q

Nullipara

A

A woman who has never completed a pregnancy beyond 20 weeks gestation

39
Q

Multipara

A

A woman who has completed 2 or more pregnancies to 20 weeks or more

40
Q

Parturient

A

Woman in labor – “bringing forth”; about to give birth

41
Q

Advanced maternal age

A

35 or older at time of delivery

42
Q

Lightening

A

The fetal head descends to or through the pelvic inlet

43
Q

Folic Acid recommendations: normal

A

0.4mg (400mcg) daily

44
Q

Folic Acid recommendations: high risk

A

4mg daily Rx only

45
Q

Naegele’s rule

A

+7 days, - 3 months

47
Q

3 Goals of preconception counseling

A
  • Optimize the woman’s health
  • Minimize risks to her and the fetus and improve pregnancy outcome
  • Provide information necessary to make informed decisions about future reproduction
48
Q

parameters for One hour glucose test

A

50gms <130 (140)

49
Q

NAME THAT BONE

50
Q

NAME THAT BONE

A

ILIAC CREST

51
Q

NAME THAT BONE

A

ISCHIAL SPINE

52
Q

NAME THAT BONE

53
Q

NAME THAT BONE

A

PUBIC ARCH

54
Q

NAME THAT BONE

A

PUBIC BONE

55
Q

NAME THAT BONE

A

SACRAL PROMONTORY

56
Q

NAME THAT BONE

57
Q

NAME THAT BONE

A

SYMPHYSIS PUBIS

58
Q

IDENTIFY A

A

TRUE CONJUGATE - 11CM

59
Q

IDENTIFY B

A

OBSTETRICAL CONJUGATE - 10CM

60
Q

IDENTIFY C

A

DIAGONAL CONJUGATE - 12CM

61
Q

IDENTIFY D

A

ANTERIOR/POSTERIOR DIAMETER OF THE MIDPELVIS - 11.5CM

62
Q

Cessation of Menses - Presumptive, Probable or Positive sign of pregnancy?

A

Presumptive

63
Q

Maternal perception - Presumptive, Probable or Positive sign of pregnancy

A

Presumptive

64
Q

Breast Changes - Presumptive, Probable or Positive sign of pregnancy?

A

Presumptive

65
Q

Nausea & Vomiting - Presumptive, Probable or Positive sign of pregnancy?

A

Presumptive

66
Q

Perception of Fetal Movement - Presumptive, Probable or Positive sign of pregnancy?

A

Presumptive

67
Q

Vaginal/Cervical changes - Presumptive, Probable or Positive sign of pregnancy?

A

Presumptive

68
Q

Uterine size changes - Presumptive, Probable or Positive sign of pregnancy?

69
Q

Enlargement of abdomen - Presumptive, Probable or Positive sign of pregnancy?

70
Q

Fundal Height - Presumptive, Probable or Positive sign of pregnancy?

71
Q

Palpation of Fetus - Presumptive, Probable or Positive sign of pregnancy?

72
Q

Braxton Hicks Contractions - Presumptive, Probable or Positive sign of pregnancy?

73
Q

Biochemical Markers - Presumptive, Probable or Positive sign of pregnancy?

74
Q

Fetal Heart Tones - Presumptive, Probable or Positive sign of pregnancy?

75
Q

Palpation of fetal movement on exam - Presumptive, Probable or Positive sign of pregnancy?

76
Q

Ultrasound Visualization - Presumptive, Probable or Positive sign of pregnancy?

77
Q

Platypelloid Pelvis

A
  • Transversally wide, anteriorly wide
  • flattened shape
  • short sacrum that curves inwards, reducing the diameters of the lower pelvis
  • reduced AP diameter
  • problematic for birth
  • < 3%
78
Q

Android Pelvis

A
  • Female pelvis with masculine features
  • wedge or heart shaped inlet
  • prominent sacrum and triangular anterior segment
  • reduced pelvic outelt causes birth problems
  • 15-30% (more white women)
79
Q

Anthropoid Pelvis

A
  • oval shape
  • greater A/P diameter
  • straight walls
  • small pubic arch, large sacrosciatic notches
  • deep non-obstructed pelvis
  • 25-50% (more non-white)
80
Q
  • Gynacoid Pelvis
A
  • Normal female Pelvis
  • Inlet is oval with greater transverse diameter or round
  • Interior walls are straight
  • suprapubic arch is wide
  • sarum shows averave backward inclination
  • greater sciatic notch is well rounded
  • well proportioned and accommodates birth
  • 50 % of women
81
Q

Sensitivity

A

proportion of actual positives which are correctly identified as such

Rules IN

82
Q

Specificity

A

proportion of negatives which are correctly identified as such

rules OUT

83
Q

Cultural Competence - Level 1

A

Destructiveness

attitudes, policies and practices can be destructive to a culture.
Everyone should be mainstreamed

84
Q

Cultural Competence - Level 2

A

Incapacity

Biased, authoritarian system lacks the capacity to facilitate growth in culturally diverse groups. Lack cultural awareness skills
The dominant group is racially superior

85
Q

Cultural Competence Level 3

A

Blindness

“we are all human” approach wherein culture, ethnicity and race make no difference in how services are provided

86
Q

Cultural Competence - Level 4

A

Pre-competence

“cultural sensitivity” – there is a desire and attempt made to deliver services in a manner respectful of cultural diversity. There is awareness about the set of norms, value and beliefs associated with a particular group and how these affect group interactions and experiences.

87
Q

Cultural Competence - Level 5

A

Competence

Acceptance of and respect for cultural norms, patterns, beliefs and differences. Individuals accept the influence of their own culture in relation to other cultures and are willing to examine components of cross-culture interactions.

88
Q

Cultural Competence - Level 6

A

Proficiency

These individuals more beyond accepting, appreciating and accommodating cultural differences to developing skills to interact in culturally diverse settings. Motivated to develop culturally therapeutic approaches and hiring staff who are specialists in cultural competence.

89
Q

What can hCG tell you?

A
  • viability
  • intrauterine implantation
  • gestational age

especially when 2 values are under 10,000 and rise appropriately

90
Q

Unsafe Herbs

Abortifacients (4)

A
  • Rue
  • Tansy
  • Pennyroyal
  • High Vit C combined with Rose Hips
91
Q

Unsafe Herbs

Teratogens ( 3)

A
  • Caffeine infusions
  • Excess Sucrose
  • Quinine
92
Q

Herbs

Hormones

Uterine & Nervous System Stimulants (2)

A
  • Blue/Black Cohosh prior to Term
  • Ma Huang or Chinese Ephedra
93
Q

Herbs

Hormone Producing Effects

Estrogens

A
  • Licorice
  • Black Cohosh
  • Dong quai
94
Q

Herbs

Hormonal Effects

Progesteronic

A
  • Chaste tree berry
  • Wild Yam
95
Q

Toxic Herbs (9)

A
  • Chaparral
  • Germander
  • Jin Bu Haun
  • Lobelia
  • Ma Huang
  • Stephania
  • Magnolia
  • Yohimbe
96
Q

Recommended Herbs (11)

A
  • Red Raspberry leaf
  • Evening Primrose Oil
  • Peppermint
  • Cohosh: Blue & Black
  • Ginger Root
  • Nettles
  • Alfalfa
  • Chamomile Tea
  • Comfy
  • Dandelion Root
  • Echinacea

Midwifery (2 decks)

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