Antepartum Flashcards
pregnancy signs and symptoms that may be caused by something other than pregnancy
presumptive signs of pregnancy
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
probable signs of pregnancy
pregnancy signs and symptoms:
FHT heard by fetoscope or doppler
sonographic evidence of pregnancy
palpation of fetal movement
positive signs of pregnancy
differential dx for pregnancy
leiomyoma
ovarian cyst
pseudocyesis
average duration of human pregnancy
280 days
prior to placental formation in pregnancy, progesterone is released by the:
corpus luteum
chorionic villi develop from:
the outer wall of the blastocyst
chorionic villi blood pertains to the:
fetus
umbilical cord has ___ artery(s) and ____ vein(s)
1 vein, 2 arteries
umbilical arteries carries _________ blood from ______ to ________
deoxygenated blood from fetus to placenta
umbilical vein carries ___________ from ____________ to ___________
oxygenated blood from placenta to fetus
implantation occurs ____ days after fertilization
6-7
oxygen and glucose are transported across the placenta via:
facilitated perfusion
the trophoblast eventually becomes the:
placenta
________ 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
respiratory
________ 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
GU/Renal
pregnancy can be considered a ____________ state because _________ and ___________ increase in pregnancy
hypercoaguable
fibrinogen (factor I) and factors VII-X
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
lower
prolactin levels are 10x _______ in pregnancy
higher
pituitary gland _________ by 100% in pregnancy
enlarges
thyroid gland _________ in size in pregnancy
increases
TSH does/does not cross the placenta?
does not
thyroid-stimulating immunoglobulins and TRH do/ do not cross the placenta?
do
adrenal glands double serum ________ levels in pregnancy
cortisol
adrenal glands remain their size but increase _________ that produces glucocorticoid in pregnancy
zona fasciculata
pancreas experiences hypertrophy and hyperplasia of the __________ in pregnancy
B cells
pregnancy causes _________ resistance as a result of placental hormones especially hPL
insulin
recommended weight gain for pre-pregnancy BMI < 18.5
28-40 lbs at rate of 1 lb/wk
recommended weight gain for pre-pregnancy BMI 18.5-24.9
25-35 lbs at rate of 1 lb/wk
recommended weight gain for pre-pregnancy BMI 25-29.9
15-25 lbs at rate of 0.6 lb/wk
recommended weight gain for pre-pregnancy BMI >30
11-20 lbs total at rate of 0.5 lb/wk
average pregnancy weight gain
28 lbs
protein metabolism is __________ in pregnancy
increased
carb metabolism is altered in pregnancy causing blood glucose levels to be 10-20% _____ in pregnancy
lower
number of times woman has been pregnancy regardless of outcome
gravida
number of pregnancies carried to 20th wk gestation or delivery on infant weighing > 500 gm regardless of outcome
para
woman who has never been pregnancy
nulligravida
woman who has not carried a baby to 20 wks or 500 gm
nullipara
woman who is pregnancy for the first time
primigravida
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
primipara
woman pregnant two or more times
multigravida
woman who has carried two or more pregnancies past the 20th wk or has delivered an infant weighing >500 gm
multipara
woman who has given birth 7x or more
grand mulipara
TPAL
Term (>37 wks)
Premature (20-36.6 wks or 500-2499 gm)
Abortions (<20 wks or <500 gm)
Living
calculation based on 28-day menstrual cycle assuming average length of pregnancy to be 280 days or 10 lunar months
Naegele’s Rule
Order of Leopold’s maneuvers
Lie Presentation Position Attitude Variety EFW
hormone responsible for bleeding gums in pregnancy
estrogen
BP decrease in supine hypotensive syndrome is a direct result of:
decreased cardiac output
increased respiratory rate due to changes in CO2 threshold in pregnancy is due to increase in this hormone
progesterone
dependent edema in pregnancy is associated with:
maternal obesity
normal change in pregnancy of the cervix to a bluish hue
Chadwick’s sign
softening of the isthmus of the cervix
Hegar’s sign
softening of the cervix during pregnancy
Goodell’s sign
at term, the uterus weighs _____ gm with a ___ L volume
1100 gms with 5 L volume
breasts develop _________ follicles during pregnancy
Montgomery’s
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
Anthropoid
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
Android
pelvis shape commonly known as a female pelvis found in 41-42% of women with a good prognosis for vaginal birth
Gynecoid
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
Platypelloid
longitudinal axis of fetal head is ___ cm
11 cm
fetal shoulder width is ___-___ cm
12-15
the effect of flexion is to change the longitudinal axis from 11 cm to smaller diameter of ___ cm
9.5 cm
inlet transverse diameter is much _______ at ___ cm than the anteroposterior diameter
wider at 13.5 cm
the least diameter of the pelvis is the ____ plane
mid
the pelvic inlet conjugate we can measure clinically is:
diagonal
normal/adequate pelvic diagonal conjugate measurement _____ cm
11.5
transverse (“interspinous”) diameter of the midplane which is the smallest of the pelvis
10 cm
anteroposterior diameter of the midplane
11.5 cm
the pubic arch angle should be at least ____ degrees
90
second trimester screening a.k.a. multiple marker screening is performed between ___-___ weeks
15-20
2nd trimester screening a.k.a. multiple marker screening detects:
neural tube defects, trisomies 18 and 21
triple genetic screen includes:
MSAFP, estriol, hCG
quad genetic screen includes:
MSAFP, estriol, hCG, inhibin A
1st trimester screening is performed between ___-___ weeks
10-13
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
first trimester screening
results of 1st and 2nd trimester screening are combined to increase accuracy of detecting trisomy 21
combined 1st and 2nd trimester screening
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
cell-free DNA testing
sidewalls that extend from the upper anterior angle of the sacrosciatic notch to the ischial tuberosities should be:
straight
Vit B6 dose for N+V in pregnancy
pyridoxine (Vit B6) 25 mg BID or TID PO
doxylamine dose for N+V in pregnancy
12.5 mg BID or QID with Vit B6 PO
metoclopramide dose for N+V in pregnancy
5-10 mg q6-8 hrs PO
promethazine dose for N+V in pregnancy
25 mg q4 hrs per rectum
rubella vaccine should be given at least ___ weeks prior to conception
4
normal score for BPP (in absence of oligohydramnios)
8-10
equivocal score for BPP which indicates repeat testing
6
abnormal score for BPP that requires immediate further evaluation
4 or less
thyroid hormones availability _________ by 40-100% in pregnancy
increase
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
iodine
____________ deficiency can lead to:
miscarriage
stillbirth
preventable mental retardation
iodine
N+V has been associated with alterations in _________ hormones
thyroid
a foreign tissue from the same species but with a different antigenic makeup
semiallograft
Inflammation at the maternal-placental interface is most marked in which trimesters?
1st and 3rd
most common contributor to the classification of pregnancy dermatoses called Atopic eruption of pregnancy (AEP)
eczema of pregnancy
sensation of “prickly heat” experienced by some women in pregnancy is related to:
eccrine sweat gland activity
alterations in skin pigmentation during pregnancy are thought to be related to:
effects of estrogen and progesterone on melanocytes
A separate placental lobe attached by blood vessels to the main placenta
Succenturiate
structure that adheres to the endometrium and leads to the decidual reaction
blastocyst
During implantation, the products of conception attach to the maternal endometrium via invasion by the:
blastocyst
At approximately 4-5 days after fertilization, the morula reaches the uterine cavity and becomes the:
blastocyst
hormone of pregnancy stimulates the corpus luteum to continue to function
hCG
pregnancy hormone that has thyroid stimulating (TSH)- like properties
hCG
hormone that is lowest during the 1st trimester and increases to baseline levels in the 2nd trimester and 3rd trimester.
TSH
pre-eclampsia may cause __________ fetal growth
assymetric
maternal position that enhances water excretion
side-lying
When blood vessels run from the umbilical cord between the amnion and chorion through the membranes to the placenta
Velamentous cord insertion
During placentation, trophoblastic tissue invades the maternal spiral arteries causing:
Disruption of elastic and muscular properties in the vessel wall
Macrobid can cause hemolysis in person with:
G6PD deficiency
med associated with gastroschisis if taken in 1st trimester
Sudafed (psuedoephedrine)
Terb may cause:
pulmonary edema
2nd trimester dating U/S is accurate within +/- ____ days
10
Naegele’s Rule
LMP + 7 days
subtract 3 months
most sensitive traditional screening test for Down Syndrome
integrated screen
Appropriate genetic screening tests to discuss and offer at 8 wk prenatal appt
inegrated screen and CF screen
screening test has the lowest detection rate for Down Syndrome
triple screen
preferred test to offer to women who desire to screen for both Down Syndrome and neural tube defects (NTD)
quad screen
95% accurate for detecting Down Syndrome in the fetus
integrated screening
screening that should be offered to all women at the first prenatal visit and is usually done via a blood draw.
CF screening
Meiosis results in daughter cells that have:
23 chromosomes
Nuchal translucency measures thickness of the nape of the neck that is due to:
excess accumulated fluid
Protein secreted by the trophoblast
Pregnancy-associated plasma protein A (PAPP-A)
Imprinting affects gene expression through:
epigenetic control
encapsulated tumor that contains hair, teeth, bone, or other tissue
Ovarian teratoma
Alpha fetoprotein (AFP) levels in maternal serum is used to screen for:
neural tube defects
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
NST
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
NST
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
ectopic pregnancy
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)?
CAGE Screening Tool
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?
TWEAK Screening Tool
Percentage of women who gave birth in 2016 who smoked in pregnancy
7.2%
Age group with highest prevalence of smoking in pregnancy (10.7%)
20-24
Ethnicity with highest prevalence of smoking in pregnancy (16.7%)
Ethnicity with lowest prevalence of smoking in pregnancy (0.6%)
highest: Non-Hispanic American Indian/Alaskan Native
lowest: Non-Hispanic Asian
Complications of \_\_\_\_\_\_\_\_\_\_\_\_: stillbirth preeclampsia abruption previa spontaneous abortion ectopic pregnancy PROM IUGR preterm birth SGA
smoking in pregnancy
Infant effects of \_\_\_\_\_\_\_\_\_\_: low birth weight small head circumference shorter length irritability hyperactivity tremors high-pitched cry excessive sucking
cocaine/meth use in pregnancy
Maternal effects of \_\_\_\_\_\_\_\_\_\_\_\_: migraines seizures PROM abruption HTN crisis spontaneous abortion preterm labor
cocaine/meth use in pregnancy
parvovirus spreads through:
respiratory secretions
rubella spreads through:
respiratory secretions
Effects of \_\_\_\_\_\_\_\_\_\_: IUGR cataracts retinopathy heart defects (PDA) hearing impairement
congenital rubella syndrome
Adults with CMV are usually:
asymptomatic
Without antiretrovirals, HIV has _____% chance of transmission to infant in pregnancy
15-45%
With antiretrovirals, HIV has _____% chance of transmission to infant in pregnancy
1%
zika virus can cause:
microcephaly and severe brain damage
Causes \_\_\_\_\_\_\_\_\_\_\_ growth restriction: tobacco alcohol Dilantin (phenytoin) cocaine heroin congenital infections chromosomal abnormalities
Symmetric
Causes of ___________ growth restriction:
reduced nutrition to fetus
uteroplacental perfusion abnormalities
Asymmetric
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
cordocentesis
most common used drug in pregnancy
nicotine
____% of pregnancies where FHT are heard will continue to term after early bleeding
90%
Diff Dx for \_\_\_\_\_\_\_\_\_: ectopic implantation bleeding threatened abortion cervicitis cervical polyps vaginitis trauma/intercourse disappearing twin autoantibody/autoimmune disorder
1st trimester bleeding
____% of women have low-lying placenta in 1st trimester
30%
elevated maternal _____ is associated with:
neural tube defects
multiple gestations
placental abruption
serum alpha-fetoprotein (AFP)
pair of genes for each characteristic inherent in an individual
genotype
a sensitized Rh negative mother does not need:
Rhogham
cervical cerclage is done after ___-___ weeks and is 80-90% successful
12-14 weeks
treatment for syphilis in pregnant women
benzathine pen G 2.4 million units I x 1 dose
treatment for BV in pregnant women
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
treatment for trichomoniasis in pregnant women
metronidazole 2 gm PO x 1 dose
symmetric growth restriction usually becomes evident in:
midpregnancy
symmetric growth restriction is due to conditions that reduce:
cell size and number
90% of ectopic pregnancies are assocated with B-hCG levels less than ______ IU/L
6500
treatment for chlamydia in pregnancy women
azithromycin 1 gm PO x 1 dose
OR amoxicillin 500 mg PO TID x 7 days
(alternatives: Erythromycin)
___-____% of pregnancies are ABO incompatible
20-25%
mother Rh negative with negative antibody titer is a ____________ pregnancy
unsensitized
mother Rh negative with positive antibody titer (> 1:4) is a ____________ pregnancy
sensitized
Management for unsensitized pregnancy:
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
Management for sensitized pregnancy:
Seek consultation or transfer care
Follow fetus with U/S
Follow titers to assess need for amniocentesis
positive induration of PPD skin test for no-risk persons
15 mm
Preeclampsia is defined as:
HTN plus proteinuria (>300 mg per 24 hr urine or >1+ on dipstick or PCR > 0.3 mg/dL)
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
proteinuria
Preeclampsia w/ severe features is defined as:
preeclampsia with addition of: BP > 160/110 thrombocytopenia impaired liver function (LFTs double normal) serum creatinine > 1.1 pulmonary edema cerebral/visual disturbances
IDA in 2nd trimester is most likely due to:
blood volume expansion
microcytic, hypochromic, low Hgb indicates:
IDA
megaloblastic anemia is due to low:
folic acid
postpartum diabetes screening is the ___ hr ___ gm OGTT
2 hr 75 gm
women at high risk for gonorrhea/chlamydia should be screened at:
1st prenatal visit and 3rd trimester
Laboratory testing for HIV commonly includes:
ELISA followed by Western Blot
appropriate time in pregnancy to draw an antibody screen for ALL women
at 1st prenatal visit
lab test used for the routine prenatal antibody screen
indirect coombs
a woman with hx of syphillis treated 10 years ago will have _________ VDRL/RPR titer at 1st prenatal visit
normal
RhoGAM may be given via:
IM or IV
Taking Sudafed in pregnancy is most concerning in the _____ trimester
1st
substances considered to be teratogenic must have:
stage-sensitive effect depending on time of exposure during pregnancy
the goal of treatment for opioid addiction in pregnancy is:
maintenance
Teratogens that affect which organ can cause damage at any time during pregnancy?
the brain
class of antibiotics associated with fetal cardiovascular defects and/or oral cleft defects
sulfanomides
direct effect of nicotine on the fetus
neurotransmitter sytem changes
drugs that exert effects on growth or development in the second or third trimesters
fetotoxic agents
dyspnea is most commonly experienced during which trimesters?
1st & 3d
physiology of shortness of breath in pregnancy:
secondary to awareness of hyperventilation and decreased CO2
physiologic factor that influences respiration in late pregnancy
increased subcostal angle
best advice for heartburn during pregnancy
avoid beverages with meals
most appropriate lab test to order when evaluating a pregnant woman for Restless Leg Syndrome
serum ferritin
Pemphigoid Gestationis (PG) may spread to:
palms and soles
Pregnant women abusing substances may be more willing to disclose their substance use if:
they are routinely screened using a screening tool like Audit-C
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
oligohydramnios
TSH levels __________ during the first trimester when hCG levels are high
decrease
___________ associated with:
2nd trimester bleeding
PTB
PPROM
circumvillate placenta
Most common problem with succenturiate lobe placenta
retained placenta after birth
“Battledore” placenta
marginal insertion
- placental vessels are vulnerable to rupture and compression during labor and birth
- rupture can cause rapid fetal exsanguination
- life threatening fetal hemorrhage
velamentous cord insertion
condition when the velamentous vessels cross over the cervical os
vasa previa
Risk Factors for \_\_\_\_\_\_\_\_\_\_: placenta previa multifetal gestation hx of ART obesity smoking
velamentous cord insertion and vasa previa
___________ associated with:
PTB
FGR
perinatal morbidity/mortality
velamentous cord insertion
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
placenta accreta
placental implantation that invades the myometrium
–can be life threatening
placenta increata
placental implantation that extends through the myometrium & serosa and attaches to adjacent maternal organs
–can be life threatening
placenta percreta
Associated with \_\_\_\_\_\_\_\_\_\_\_\_: fetal structural anomalies multifetal gestation (monozygotic twins, twin-to-Twin Transfusion Syndrome) diabetes fetal infection fetal chromosomal abnormalities
polyhydramnios
the fetus is at greatest risk with ___________ maternal CMV infection
primary
listeriosis can be acquired through eating:
soft cheeses
Risk of fetal transmission for parvovirus B19 is ___-___%
30-50%
Toxoplasmosis infection in pregnancy is often:
asymptomatic
If a woman contracts varicella infection 4 days prior to giving birth, the newborn needs:
varicella-zoster immune globulin
Hep C transmission in labor may promoted by:
Prelabor ROM
use of internal monitors
elective Cesarean delivery should be offered to a woman who is human immunodeficiency virus (HIV) positive based on:
viral load
The greatest risk of CMV transmission to the fetus occurs with a primary infection during:
1st trimester or early 2nd trimester.
Fifth’s Disease is caused by which virus:
parvovirus B19
After pregnant woman’s known exposure to Fifth’s disease, midwife should order:
serum parvovirus IgM and IgG
processed foods such as pate, hummus, wieners, and sliced deli meats can cause infection of:
listeriosis
Woman most likely to pass Hep B to fetus is positive for:
Hepatitis B surface antigen (HBsAg) positive and
Hepatitis B e-antigen (HBeAg) positive
infection that has the potential to cause fetal anemia, hydrops fetalis, or fetal death
parvovirus B19
condition that may cause fetal deafness, cataracts, and cardiac defects
rubella
garden work puts woman at risk for contracting:
toxoplasmosis
if woman’s partner is exposed to Zika, they should:
abstain from all sex or use condoms for remainder of pregnancy
swollen lymph nodes, fatigue and sore throat are symptoms of:
CMV
fetal fibronectin (fFN) test best predicts those women who will:
not give birth in the next 2 weeks
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
PTB
Vaginal progesterone is most effective for women with a cervical length of ≤ ___ mm prior to ___ weeks gestation weeks.:
< 20 mm prior to 24 weeks
Risk Factors for \_\_\_\_\_\_\_\_\_\_\_: prolonged ROM prolonged labor >4 vag exams internal monitors
intra-amniotic infection
nitrazine false positives:
BV, trich, blood, lube, semen
fern false positives:
cervical mucus, semen
vaginal pooling false positives:
vaginal infections, prelabor cervical ripening, semen
asymptomatic bacteruria should be treated if colony count is > ___________
100,000
gonorrhea treatment in pregnancy:
ceftriaxone (Rocephin) 250 mg IM x 1 dose
AND!!!
azithromycin (Zithromax) 1 g PO x 1 dose
HSV treatment in pregnancy:
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
classic test method for assessing ROM**
fern
normal pH of vagina
4.5
amniotic fluid pH
7.0-7.5
GBS in urine is diagnostic at _______ colony count
10,000
Macrobid and sulfonamides are contraindicated in women with:
G6PD deficiency
trimethoprim (Bactrim, Septra) use with caution for UTI
ACOG: can be used safely in _____ trimester
in _____ trimester if no other abx available
safe in 2nd trimester
1st trimester only if no other abx
fluoroquinolones
tetracycline
doxycycline
are __________ in pregnancy
contraindicated
Factors that decrease success of \_\_\_\_\_\_: oligohydramnios anterior placenta engaged in pelvis fetal back down (posterior) maternal obesity
ECV
ripe cervix= Bishop score of ___ or greater
8
RDA for pregnancy (kcal and protein)?
2500 kcal/day and 60 g protein
AFP is detected starting at ___ weeks
2nd trimester
