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Comps > Antepartum > Flashcards

Antepartum Flashcards

1
Q

pregnancy signs and symptoms that may be caused by something other than pregnancy

A

presumptive signs of pregnancy

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2
Q 
pregnancy signs and symptoms:
abdomen enlargement
uterine enlargement
fetal outline palpation
ballottement
uterus shape change
piskacek's sign
hegar's sign
goodell's sign
chadwick's sign
BH ctx
positive pregnancy test
A

probable signs of pregnancy

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3
Q

pregnancy signs and symptoms:
FHT heard by fetoscope or doppler
sonographic evidence of pregnancy
palpation of fetal movement

A

positive signs of pregnancy

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4
Q

differential dx for pregnancy

A

leiomyoma
ovarian cyst
pseudocyesis

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5
Q

average duration of human pregnancy

A

280 days

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6
Q

prior to placental formation in pregnancy, progesterone is released by the:

A

corpus luteum

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7
Q

chorionic villi develop from:

A

the outer wall of the blastocyst

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8
Q

chorionic villi blood pertains to the:

A

fetus

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9
Q

umbilical cord has ___ artery(s) and ____ vein(s)

A

1 vein, 2 arteries

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10
Q

umbilical arteries carries _________ blood from ______ to ________

A

deoxygenated blood from fetus to placenta

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11
Q

umbilical vein carries ___________ from ____________ to ___________

A

oxygenated blood from placenta to fetus

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12
Q

implantation occurs ____ days after fertilization

A

6-7

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13
Q

oxygen and glucose are transported across the placenta via:

A

facilitated perfusion

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14
Q

the trophoblast eventually becomes the:

A

placenta

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15
Q

________ system changes in pregnancy may cause:
increased chest diameter (5-6 cm) / decreased residual volume
mild respiratory alkalosis–> decreased PCO2
diaphragm level rise of 4 cm
nasal congestion
increased tidal volume/ minute ventilatory/ minute oxygen uptake
dyspnea

A

respiratory

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16
Q

________ system changes in pregnancy may cause:
dilation of renal calyces, pelvis and ureters–> UTI
decreased bladder tone
increased renal blood flow 35-60%
decreased renal threshold for glucose, protein, water-soluble vitamins, calcium, hydrogen ions
increased GFR 40-50%
increased renin-angiotensin-aldosterone system–> Na+/water retention, resistance to pressor effect of angiotensin II, maintenance of normal BP

A

GU/Renal

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17
Q

pregnancy can be considered a ____________ state because _________ and ___________ increase in pregnancy

A

hypercoaguable

fibrinogen (factor I) and factors VII-X

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18
Q

diastolic BP is ______ in 1st and 2nd trimesters due to development of new vascular beds and peripheral tone relaxation (progesterone) which results in decreased flow resistance

A

lower

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19
Q

prolactin levels are 10x _______ in pregnancy

A

higher

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20
Q

pituitary gland _________ by 100% in pregnancy

A

enlarges

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21
Q

thyroid gland _________ in size in pregnancy

A

increases

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22
Q

TSH does/does not cross the placenta?

A

does not

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23
Q

thyroid-stimulating immunoglobulins and TRH do/ do not cross the placenta?

A

do

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24
Q

adrenal glands double serum ________ levels in pregnancy

A

cortisol

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25
Q

adrenal glands remain their size but increase _________ that produces glucocorticoid in pregnancy

A

zona fasciculata

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26
Q

pancreas experiences hypertrophy and hyperplasia of the __________ in pregnancy

A

B cells

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27
Q

pregnancy causes _________ resistance as a result of placental hormones especially hPL

A

insulin

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28
Q

recommended weight gain for pre-pregnancy BMI < 18.5

A

28-40 lbs at rate of 1 lb/wk

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29
Q

recommended weight gain for pre-pregnancy BMI 18.5-24.9

A

25-35 lbs at rate of 1 lb/wk

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30
Q

recommended weight gain for pre-pregnancy BMI 25-29.9

A

15-25 lbs at rate of 0.6 lb/wk

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31
Q

recommended weight gain for pre-pregnancy BMI >30

A

11-20 lbs total at rate of 0.5 lb/wk

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32
Q

average pregnancy weight gain

A

28 lbs

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33
Q

protein metabolism is __________ in pregnancy

A

increased

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34
Q

carb metabolism is altered in pregnancy causing blood glucose levels to be 10-20% _____ in pregnancy

A

lower

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35
Q

number of times woman has been pregnancy regardless of outcome

A

gravida

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36
Q

number of pregnancies carried to 20th wk gestation or delivery on infant weighing > 500 gm regardless of outcome

A

para

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37
Q

woman who has never been pregnancy

A

nulligravida

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38
Q

woman who has not carried a baby to 20 wks or 500 gm

A

nullipara

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39
Q

woman who is pregnancy for the first time

A

primigravida

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40
Q

woman who has carried a pregnancy past the 20th wk or who is currently pregnancy for the first time and is carrying past the 20th wk

A

primipara

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41
Q

woman pregnant two or more times

A

multigravida

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42
Q

woman who has carried two or more pregnancies past the 20th wk or has delivered an infant weighing >500 gm

A

multipara

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43
Q

woman who has given birth 7x or more

A

grand mulipara

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44
Q

TPAL

A

Term (>37 wks)
Premature (20-36.6 wks or 500-2499 gm)
Abortions (<20 wks or <500 gm)
Living

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45
Q

calculation based on 28-day menstrual cycle assuming average length of pregnancy to be 280 days or 10 lunar months

A

Naegele’s Rule

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46
Q

Order of Leopold’s maneuvers

A 
Lie
Presentation
Position
Attitude
Variety
EFW
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47
Q

hormone responsible for bleeding gums in pregnancy

A

estrogen

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48
Q

BP decrease in supine hypotensive syndrome is a direct result of:

A

decreased cardiac output

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49
Q

increased respiratory rate due to changes in CO2 threshold in pregnancy is due to increase in this hormone

A

progesterone

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50
Q

dependent edema in pregnancy is associated with:

A

maternal obesity

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51
Q

normal change in pregnancy of the cervix to a bluish hue

A

Chadwick’s sign

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52
Q

softening of the isthmus of the cervix

A

Hegar’s sign

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53
Q

softening of the cervix during pregnancy

A

Goodell’s sign

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54
Q

at term, the uterus weighs _____ gm with a ___ L volume

A

1100 gms with 5 L volume

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55
Q

breasts develop _________ follicles during pregnancy

A

Montgomery’s

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56
Q

pelvis shape found in 23.5% of white and 50% of nonwhite women that favors posterior position of the fetus and is adequate size for vaginal birth due to large size

A

Anthropoid

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57
Q

pelvis shape commonly known as the male pelvis found in 32.5% of white and 15.7% of nonwhite women that is a heavy, heart-shape that leads to increased posterior positions, dystocia, and operative births

A

Android

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58
Q

pelvis shape commonly known as a female pelvis found in 41-42% of women with a good prognosis for vaginal birth

A

Gynecoid

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59
Q

rare pelvic type that occurs in less than 3% of women that has a poor prognosis for vaginal birth due to short anterior-posterior (AP) diameter

A

Platypelloid

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60
Q

longitudinal axis of fetal head is ___ cm

A

11 cm

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61
Q

fetal shoulder width is ___-___ cm

A

12-15

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62
Q

the effect of flexion is to change the longitudinal axis from 11 cm to smaller diameter of ___ cm

A

9.5 cm

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63
Q

inlet transverse diameter is much _______ at ___ cm than the anteroposterior diameter

A

wider at 13.5 cm

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64
Q

the least diameter of the pelvis is the ____ plane

A

mid

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65
Q

the pelvic inlet conjugate we can measure clinically is:

A

diagonal

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66
Q

normal/adequate pelvic diagonal conjugate measurement _____ cm

A

11.5

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67
Q

transverse (“interspinous”) diameter of the midplane which is the smallest of the pelvis

A

10 cm

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68
Q

anteroposterior diameter of the midplane

A

11.5 cm

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69
Q

the pubic arch angle should be at least ____ degrees

A

90

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70
Q

second trimester screening a.k.a. multiple marker screening is performed between ___-___ weeks

A

15-20

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71
Q

2nd trimester screening a.k.a. multiple marker screening detects:

A

neural tube defects, trisomies 18 and 21

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72
Q

triple genetic screen includes:

A

MSAFP, estriol, hCG

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73
Q

quad genetic screen includes:

A

MSAFP, estriol, hCG, inhibin A

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74
Q

1st trimester screening is performed between ___-___ weeks

A

10-13

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75
Q

serologic testing for pregnancy-associated plasma protein (PAPP-A) ad hCG, an U/S exam to measure nuchal translucency and the mother’s age are combined to calculate risk for trisomies 18 and 21

A

first trimester screening

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76
Q

results of 1st and 2nd trimester screening are combined to increase accuracy of detecting trisomy 21

A

combined 1st and 2nd trimester screening

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77
Q

serologic screening test on mother analyzes the small amount of DNA that is released from the placenta into the bloodstream of the mother; screens for aneuploidy (trisomies 13, 18, 21) and problems with sex chromosomes
can be performed as early as 10 weeks

A

cell-free DNA testing

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78
Q

sidewalls that extend from the upper anterior angle of the sacrosciatic notch to the ischial tuberosities should be:

A

straight

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79
Q

Vit B6 dose for N+V in pregnancy

A

pyridoxine (Vit B6) 25 mg BID or TID PO

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80
Q

doxylamine dose for N+V in pregnancy

A

12.5 mg BID or QID with Vit B6 PO

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81
Q

metoclopramide dose for N+V in pregnancy

A

5-10 mg q6-8 hrs PO

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82
Q

promethazine dose for N+V in pregnancy

A

25 mg q4 hrs per rectum

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83
Q

rubella vaccine should be given at least ___ weeks prior to conception

A

4

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84
Q

normal score for BPP (in absence of oligohydramnios)

A

8-10

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85
Q

equivocal score for BPP which indicates repeat testing

A

6

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86
Q

abnormal score for BPP that requires immediate further evaluation

A

4 or less

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87
Q

thyroid hormones availability _________ by 40-100% in pregnancy

A

increase

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88
Q

Reasons for decreased _________ pool in pregnancy:
placental transfer to the fetus
increased loss due to increased GFR
increased loss due to increased renal blood flow

A

iodine

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89
Q

____________ deficiency can lead to:
miscarriage
stillbirth
preventable mental retardation

A

iodine

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90
Q

N+V has been associated with alterations in _________ hormones

A

thyroid

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91
Q

a foreign tissue from the same species but with a different antigenic makeup

A

semiallograft

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92
Q

Inflammation at the maternal-placental interface is most marked in which trimesters?

A

1st and 3rd

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93
Q

most common contributor to the classification of pregnancy dermatoses called Atopic eruption of pregnancy (AEP)

A

eczema of pregnancy

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94
Q

sensation of “prickly heat” experienced by some women in pregnancy is related to:

A

eccrine sweat gland activity

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95
Q

alterations in skin pigmentation during pregnancy are thought to be related to:

A

effects of estrogen and progesterone on melanocytes

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96
Q

A separate placental lobe attached by blood vessels to the main placenta

A

Succenturiate

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97
Q

structure that adheres to the endometrium and leads to the decidual reaction

A

blastocyst

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98
Q

During implantation, the products of conception attach to the maternal endometrium via invasion by the:

A

blastocyst

99
Q

At approximately 4-5 days after fertilization, the morula reaches the uterine cavity and becomes the:

A

blastocyst

100
Q

hormone of pregnancy stimulates the corpus luteum to continue to function

A

hCG

101
Q

pregnancy hormone that has thyroid stimulating (TSH)- like properties

A

hCG

102
Q

hormone that is lowest during the 1st trimester and increases to baseline levels in the 2nd trimester and 3rd trimester.

A

TSH

103
Q

pre-eclampsia may cause __________ fetal growth

A

assymetric

104
Q

maternal position that enhances water excretion

A

side-lying

105
Q

When blood vessels run from the umbilical cord between the amnion and chorion through the membranes to the placenta

A

Velamentous cord insertion

106
Q

During placentation, trophoblastic tissue invades the maternal spiral arteries causing:

A

Disruption of elastic and muscular properties in the vessel wall

107
Q

Macrobid can cause hemolysis in person with:

A

G6PD deficiency

108
Q

med associated with gastroschisis if taken in 1st trimester

A

Sudafed (psuedoephedrine)

109
Q

Terb may cause:

A

pulmonary edema

110
Q

2nd trimester dating U/S is accurate within +/- ____ days

A

10

111
Q

Naegele’s Rule

A

LMP + 7 days

subtract 3 months

112
Q

most sensitive traditional screening test for Down Syndrome

A

integrated screen

113
Q

Appropriate genetic screening tests to discuss and offer at 8 wk prenatal appt

A

inegrated screen and CF screen

114
Q

screening test has the lowest detection rate for Down Syndrome

A

triple screen

115
Q

preferred test to offer to women who desire to screen for both Down Syndrome and neural tube defects (NTD)

A

quad screen

116
Q

95% accurate for detecting Down Syndrome in the fetus

A

integrated screening

117
Q

screening that should be offered to all women at the first prenatal visit and is usually done via a blood draw.

A

CF screening

118
Q

Meiosis results in daughter cells that have:

A

23 chromosomes

119
Q

Nuchal translucency measures thickness of the nape of the neck that is due to:

A

excess accumulated fluid

120
Q

Protein secreted by the trophoblast

A

Pregnancy-associated plasma protein A (PAPP-A)

121
Q

Imprinting affects gene expression through:

A

epigenetic control

122
Q

encapsulated tumor that contains hair, teeth, bone, or other tissue

A

Ovarian teratoma

123
Q

Alpha fetoprotein (AFP) levels in maternal serum is used to screen for:

A

neural tube defects

124
Q 
Indications for \_\_\_\_\_\_\_\_\_:
placenta previa
age >40 years
substance abuse
antiphospholipid  antibody syndrome
cyanotic heart dx
chronic HTN
GDM requiring insulin
hemoglobinophathies
Preeclampsia
hyperthyroidism, poorly controlled
renal dx
hx of stillbirth
seizure disorder, poorly controlled
sickle cell dx
lupus
abnormal maternal serum screening
IVF
cholestasis
late-term/post-term pregnancy
multifetal gestation
pemphigoid gestonis
abruptionin current pregnancy
congenital abnormalities
decreased FM
IUGR
oligo
poly
umbilical cord abnormalities
A

NST

125
Q 
Indications for \_\_\_\_\_\_\_\_\_:
placenta previa
age >40 years
substance abuse
antiphospholipid  antibody syndrome
cyanotic heart dx
chronic HTN
GDM requiring insulin
hemoglobinophathies
Preeclampsia
hyperthyroidism, poorly controlled
renal dx
hx of stillbirth
seizure disorder, poorly controlled
sickle cell dx
lupus
abnormal maternal serum screening
IVF
cholestasis
late-term/post-term pregnancy
multifetal gestation
pemphigoid gestonis
abruption current pregnancy
congenital abnormalities
decreased FM
IUGR
oligo
poly
umbilical cord abnormalities
A

NST

126
Q 
Risk Factors for \_\_\_\_\_\_\_\_\_:
pelvic inflammatory disease
STI
therapeutic abortion followed by infection
endometriosis
previous pelvic surgery
failed BTL
tube scarring
menstrual reflux/hormonal alteration of tube motility
A

ectopic pregnancy

127
Q

Questions:
Have you felt need to Cut down on drinking?
Have people Annoyed you by criticizing your drinking?
Have you ever felt bad or Guilty about drinking?
Have you ever had a drink in the morning to steady nerves or get rid of hangover (Eye opener)?

A

CAGE Screening Tool

128
Q

Questions:
Tolerance: How many drinks can you hold
Worried: Have close friends/family worried/complained about your drinking?
Eye-openers: Do you sometimes have a drink in the morning when you first get up?
Amnesia: Has anyone told you about something you did you don’t remember when drunk?
Cut down: Do you sometimes feel the need to cut down on drinking?

A

TWEAK Screening Tool

129
Q

Percentage of women who gave birth in 2016 who smoked in pregnancy

A

7.2%

130
Q

Age group with highest prevalence of smoking in pregnancy (10.7%)

A

20-24

131
Q

Ethnicity with highest prevalence of smoking in pregnancy (16.7%)
Ethnicity with lowest prevalence of smoking in pregnancy (0.6%)

A

highest: Non-Hispanic American Indian/Alaskan Native
lowest: Non-Hispanic Asian

132
Q 
Complications of \_\_\_\_\_\_\_\_\_\_\_\_:
stillbirth
preeclampsia
abruption
previa
spontaneous abortion
ectopic pregnancy
PROM
IUGR
preterm birth
SGA
A

smoking in pregnancy

133
Q 
Infant effects of \_\_\_\_\_\_\_\_\_\_:
low birth weight
small head circumference
shorter length
irritability
hyperactivity
tremors
high-pitched cry
excessive sucking
A

cocaine/meth use in pregnancy

134
Q 
Maternal effects of \_\_\_\_\_\_\_\_\_\_\_\_:
migraines
seizures
PROM
abruption
HTN crisis
spontaneous abortion
preterm labor
A

cocaine/meth use in pregnancy

135
Q

parvovirus spreads through:

A

respiratory secretions

136
Q

rubella spreads through:

A

respiratory secretions

137
Q 
Effects of \_\_\_\_\_\_\_\_\_\_:
IUGR
cataracts
retinopathy
heart defects (PDA)
hearing impairement
A

congenital rubella syndrome

138
Q

Adults with CMV are usually:

A

asymptomatic

139
Q

Without antiretrovirals, HIV has _____% chance of transmission to infant in pregnancy

A

15-45%

140
Q

With antiretrovirals, HIV has _____% chance of transmission to infant in pregnancy

A

1%

141
Q

zika virus can cause:

A

microcephaly and severe brain damage

142
Q 
Causes \_\_\_\_\_\_\_\_\_\_\_ growth restriction:
tobacco
alcohol
Dilantin (phenytoin)
cocaine
heroin
congenital infections
chromosomal abnormalities
A

Symmetric

143
Q

Causes of ___________ growth restriction:
reduced nutrition to fetus
uteroplacental perfusion abnormalities

A

Asymmetric

144
Q

process in which a needle is inserted under real-time U/S through the maternal abdomen and then into the umbilical cord so that blood can be aspirated or blood/meds can be given to fetus

A

cordocentesis

145
Q

most common used drug in pregnancy

A

nicotine

146
Q

____% of pregnancies where FHT are heard will continue to term after early bleeding

A

90%

147
Q 
Diff Dx for \_\_\_\_\_\_\_\_\_:
ectopic
implantation bleeding
threatened abortion
cervicitis
cervical polyps
vaginitis
trauma/intercourse
disappearing twin
autoantibody/autoimmune disorder
A

1st trimester bleeding

148
Q

____% of women have low-lying placenta in 1st trimester

A

30%

149
Q

elevated maternal _____ is associated with:
neural tube defects
multiple gestations
placental abruption

A

serum alpha-fetoprotein (AFP)

150
Q

pair of genes for each characteristic inherent in an individual

A

genotype

151
Q

a sensitized Rh negative mother does not need:

A

Rhogham

152
Q

cervical cerclage is done after ___-___ weeks and is 80-90% successful

A

12-14 weeks

153
Q

treatment for syphilis in pregnant women

A

benzathine pen G 2.4 million units I x 1 dose

154
Q

treatment for BV in pregnant women

A

metronidazole 500 mg PO BID x 7 days
OR 250 mg PO TID x 7 days
OR clindamycin 300 mg PO BID x 7 days

155
Q

treatment for trichomoniasis in pregnant women

A

metronidazole 2 gm PO x 1 dose

156
Q

symmetric growth restriction usually becomes evident in:

A

midpregnancy

157
Q

symmetric growth restriction is due to conditions that reduce:

A

cell size and number

158
Q

90% of ectopic pregnancies are assocated with B-hCG levels less than ______ IU/L

A

6500

159
Q

treatment for chlamydia in pregnancy women

A

azithromycin 1 gm PO x 1 dose
OR amoxicillin 500 mg PO TID x 7 days
(alternatives: Erythromycin)

160
Q

___-____% of pregnancies are ABO incompatible

A

20-25%

161
Q

mother Rh negative with negative antibody titer is a ____________ pregnancy

A

unsensitized

162
Q

mother Rh negative with positive antibody titer (> 1:4) is a ____________ pregnancy

A

sensitized

163
Q

Management for unsensitized pregnancy:

A

Draw ABO/D group and antibody titer at 1st visit
Repeat antibody screen at 28 wks
Give RhoGAM at 28 wks
If infant Rh+, give RhoGAM after delivery

164
Q

Management for sensitized pregnancy:

A

Seek consultation or transfer care
Follow fetus with U/S
Follow titers to assess need for amniocentesis

165
Q

positive induration of PPD skin test for no-risk persons

A

15 mm

166
Q

Preeclampsia is defined as:

A

HTN plus proteinuria (>300 mg per 24 hr urine or >1+ on dipstick or PCR > 0.3 mg/dL)

167
Q

Preeclampsia can be diagnosed w/o __________ if one of these is present:
thrombocytopenia
impaired liver function (LFTs double normal)
serum creatinine > 1.1
pulmonary edema
cerebral/visual disturbances

A

proteinuria

168
Q

Preeclampsia w/ severe features is defined as:

A 
preeclampsia with addition of:
BP > 160/110
thrombocytopenia
impaired liver function (LFTs double normal)
serum creatinine > 1.1
pulmonary edema
cerebral/visual disturbances
169
Q

IDA in 2nd trimester is most likely due to:

A

blood volume expansion

170
Q

microcytic, hypochromic, low Hgb indicates:

A

IDA

171
Q

megaloblastic anemia is due to low:

A

folic acid

172
Q

postpartum diabetes screening is the ___ hr ___ gm OGTT

A

2 hr 75 gm

173
Q

women at high risk for gonorrhea/chlamydia should be screened at:

A

1st prenatal visit and 3rd trimester

174
Q

Laboratory testing for HIV commonly includes:

A

ELISA followed by Western Blot

175
Q

appropriate time in pregnancy to draw an antibody screen for ALL women

A

at 1st prenatal visit

176
Q

lab test used for the routine prenatal antibody screen

A

indirect coombs

177
Q

a woman with hx of syphillis treated 10 years ago will have _________ VDRL/RPR titer at 1st prenatal visit

A

normal

178
Q

RhoGAM may be given via:

A

IM or IV

179
Q

Taking Sudafed in pregnancy is most concerning in the _____ trimester

A

1st

180
Q

substances considered to be teratogenic must have:

A

stage-sensitive effect depending on time of exposure during pregnancy

181
Q

the goal of treatment for opioid addiction in pregnancy is:

A

maintenance

182
Q

Teratogens that affect which organ can cause damage at any time during pregnancy?

A

the brain

183
Q

class of antibiotics associated with fetal cardiovascular defects and/or oral cleft defects

A

sulfanomides

184
Q

direct effect of nicotine on the fetus

A

neurotransmitter sytem changes

185
Q

drugs that exert effects on growth or development in the second or third trimesters

A

fetotoxic agents

186
Q

dyspnea is most commonly experienced during which trimesters?

A

1st & 3d

187
Q

physiology of shortness of breath in pregnancy:

A

secondary to awareness of hyperventilation and decreased CO2

188
Q

physiologic factor that influences respiration in late pregnancy

A

increased subcostal angle

189
Q

best advice for heartburn during pregnancy

A

avoid beverages with meals

190
Q

most appropriate lab test to order when evaluating a pregnant woman for Restless Leg Syndrome

A

serum ferritin

191
Q

Pemphigoid Gestationis (PG) may spread to:

A

palms and soles

192
Q

Pregnant women abusing substances may be more willing to disclose their substance use if:

A

they are routinely screened using a screening tool like Audit-C

193
Q 
Associated with \_\_\_\_\_\_\_\_\_\_\_\_:
post-maturity syndrome
cord compression
uteroplacental insufficiency
fetal growth restriction
dehydration
congenital abnormalities (renal agenesis, Potter's syndrome)
viral diseases
PPROM
use of indomethacin as tocolytic
A

oligohydramnios

194
Q

TSH levels __________ during the first trimester when hCG levels are high

A

decrease

195
Q

___________ associated with:
2nd trimester bleeding
PTB
PPROM

A

circumvillate placenta

196
Q

Most common problem with succenturiate lobe placenta

A

retained placenta after birth

197
Q

“Battledore” placenta

A

marginal insertion

198
Q
  • placental vessels are vulnerable to rupture and compression during labor and birth
  • rupture can cause rapid fetal exsanguination
  • life threatening fetal hemorrhage
A

velamentous cord insertion

199
Q

condition when the velamentous vessels cross over the cervical os

A

vasa previa

200
Q 
Risk Factors for \_\_\_\_\_\_\_\_\_\_:
placenta previa
multifetal gestation
hx of ART
obesity
smoking
A

velamentous cord insertion and vasa previa

201
Q

___________ associated with:
PTB
FGR
perinatal morbidity/mortality

A

velamentous cord insertion

202
Q

placental implantation is anchored to the myometrium instead of the decidua (endometrium)

  • -attached to myometrium
  • -incidence increasing d/t inc in Cesareans & ART/IVF
  • -attaches to scarred or damaged uterus
  • -more common in people with placenta previa
A

placenta accreta

203
Q

placental implantation that invades the myometrium

–can be life threatening

A

placenta increata

204
Q

placental implantation that extends through the myometrium & serosa and attaches to adjacent maternal organs
–can be life threatening

A

placenta percreta

205
Q 
Associated with \_\_\_\_\_\_\_\_\_\_\_\_:
fetal structural anomalies
multifetal gestation (monozygotic twins, twin-to-Twin Transfusion Syndrome)
diabetes
fetal infection
fetal chromosomal abnormalities
A

polyhydramnios

206
Q

the fetus is at greatest risk with ___________ maternal CMV infection

A

primary

207
Q

listeriosis can be acquired through eating:

A

soft cheeses

208
Q

Risk of fetal transmission for parvovirus B19 is ___-___%

A

30-50%

209
Q

Toxoplasmosis infection in pregnancy is often:

A

asymptomatic

210
Q

If a woman contracts varicella infection 4 days prior to giving birth, the newborn needs:

A

varicella-zoster immune globulin

211
Q

Hep C transmission in labor may promoted by:

A

Prelabor ROM

use of internal monitors

212
Q

elective Cesarean delivery should be offered to a woman who is human immunodeficiency virus (HIV) positive based on:

A

viral load

213
Q

The greatest risk of CMV transmission to the fetus occurs with a primary infection during:

A

1st trimester or early 2nd trimester.

214
Q

Fifth’s Disease is caused by which virus:

A

parvovirus B19

215
Q

After pregnant woman’s known exposure to Fifth’s disease, midwife should order:

A

serum parvovirus IgM and IgG

216
Q

processed foods such as pate, hummus, wieners, and sliced deli meats can cause infection of:

A

listeriosis

217
Q

Woman most likely to pass Hep B to fetus is positive for:

A

Hepatitis B surface antigen (HBsAg) positive and

Hepatitis B e-antigen (HBeAg) positive

218
Q

infection that has the potential to cause fetal anemia, hydrops fetalis, or fetal death

A

parvovirus B19

219
Q

condition that may cause fetal deafness, cataracts, and cardiac defects

A

rubella

220
Q

garden work puts woman at risk for contracting:

A

toxoplasmosis

221
Q

if woman’s partner is exposed to Zika, they should:

A

abstain from all sex or use condoms for remainder of pregnancy

222
Q

swollen lymph nodes, fatigue and sore throat are symptoms of:

A

CMV

223
Q

fetal fibronectin (fFN) test best predicts those women who will:

A

not give birth in the next 2 weeks

224
Q 
Risk Factors for \_\_\_\_\_\_\_\_\_\_:
age <17 or >35
genetic variants
BMI < 19.8
Low SES
short pregnancy interval < 18 mo
substance abuse
smoking
FGR
congenital abnormalities
infection
isoimmunization with hydrops
life stress
history of PTB
low weight gain
AA race
pregnant woman born preterm
prior cervical surgery
Mulleran tract abnormalities
short cervical length
polyhydramnios
multifetal gestation
HTN/HELLP
placenta previa
pyelonephritis
vag bleeding in > one trimester
ASB/lower UTI
peridontal disease
A

PTB

225
Q

Vaginal progesterone is most effective for women with a cervical length of ≤ ___ mm prior to ___ weeks gestation weeks.:

A

< 20 mm prior to 24 weeks

226
Q 
Risk Factors for \_\_\_\_\_\_\_\_\_\_\_:
prolonged ROM
prolonged labor
>4 vag exams
internal monitors
A

intra-amniotic infection

227
Q

nitrazine false positives:

A

BV, trich, blood, lube, semen

228
Q

fern false positives:

A

cervical mucus, semen

229
Q

vaginal pooling false positives:

A

vaginal infections, prelabor cervical ripening, semen

230
Q

asymptomatic bacteruria should be treated if colony count is > ___________

A

100,000

231
Q

gonorrhea treatment in pregnancy:

A

ceftriaxone (Rocephin) 250 mg IM x 1 dose
AND!!!
azithromycin (Zithromax) 1 g PO x 1 dose

232
Q

HSV treatment in pregnancy:

A

acyclovir 400 mg PO TID x 7-10 days
200 mg PO 5x/day x 7-10 days
valacyclovir 1 gm PO BID x 7-10 days

233
Q

classic test method for assessing ROM**

A

fern

234
Q

normal pH of vagina

A

4.5

235
Q

amniotic fluid pH

A

7.0-7.5

236
Q

GBS in urine is diagnostic at _______ colony count

A

10,000

237
Q

Macrobid and sulfonamides are contraindicated in women with:

A

G6PD deficiency

238
Q

trimethoprim (Bactrim, Septra) use with caution for UTI
ACOG: can be used safely in _____ trimester
in _____ trimester if no other abx available

A

safe in 2nd trimester

1st trimester only if no other abx

239
Q

fluoroquinolones
tetracycline
doxycycline
are __________ in pregnancy

A

contraindicated

240
Q 
Factors that decrease success of \_\_\_\_\_\_:
oligohydramnios
anterior placenta
engaged in pelvis
fetal back down (posterior)
maternal obesity
A

ECV

241
Q

ripe cervix= Bishop score of ___ or greater

A

8

242
Q

RDA for pregnancy (kcal and protein)?

A

2500 kcal/day and 60 g protein

243
Q

AFP is detected starting at ___ weeks

A

2nd trimester

Comps (6 decks)

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