Antepartum

Question 1

Goal of prenatal care

Answer 1

Ensure a healthy baby and minimize maternal risk

Question 2

How much more likely is a baby to have a low birthweight if the mother does not receive prenatal care?

Answer 2

3x more likely

Question 3

How much more likely is a baby to die if the mother does not receive prenatal care?

Answer 3

5x more likely

Question 4

When is the ideal time for the first prenatal visit?

Answer 4

6-10 weeks

Question 5

How often should a pregnant woman be visiting the ob doctor throughout pregnancy?

Answer 5

Every 4 weeks up until 28 weeks, every 2 weeks between 28 and 36 weeks, and every week from 36-40 weeks

Question 6

Which prenatal visit will be the most comprehensive?

Answer 6

1st

Question 7

What information should be gathered for a woman’s prenatal history?

Answer 7

LMP, EDD, GA, G/P, G-TPAL, GYN history, STD history, medical/surgical history, genetic history, occupation, medications, if contraceptives were used, allergies, significant FOB health history, social profile

Question 8

What tests are run when bloodwork is done during the 1st prenatal visit?

Answer 8

Blood type, rubella titer, syphilis, hep b, HIV, CBC baseline, serum glucose

Question 9

Which immunizations are recommended during pregnancy?

Answer 9

Influenza, tdap(2nd or 3rd trimester), hep A and b, covid-19

Question 10

What is included in the physical examination at the first prenatal visit?

Answer 10

Vital signs, height/weight, head to toe assessment, pelvic and breast exam, ultrasound

Question 11

Which test is performed at every prenatal visit?

Answer 11

Urinalysis

Question 12

What is examined in the pelvic exam?

Answer 12

Vulva and cervix

Question 13

Is ultrasound dating or LMP dating for EDD more accurate?

Answer 13

Ultrasound

Question 14

why is folic acid important in pregnancy?

Answer 14

Prevents neural tube defects

Question 15

What is prescribed to decrease likelihood of preeclampsia in at risk women?

Answer 15

Low dose aspirin

Question 16

At 32 weeks pregnant, how often should prenatal visits be scheduled?

Answer 16

Every 2 weeks

Question 17

When is a late preterm baby born?

Answer 17

34 weeks to 36 6/7 weeks

Question 18

What is considered early term?

Answer 18

37 - 38 6/7 weeks

Question 19

What is considered full term?

Answer 19

39- 40 6/7 weeks

Question 20

What is considered late term?

Answer 20

41-41 6/7 weeks

Question 21

What is considered post term?

Answer 21

> 42 weeks

Question 22

Are twins/triplets considered as multiple para in the G/P system?

Answer 22

No

Question 23

What does G/TPAL stand for?

Answer 23

Gravida/term, preterm, abortion, living

Question 24

what type of history is gathered for prenatal visits after the first visit?

Answer 24

Interval history

Question 25

What things are assessed at prenatal visits following the first visit?

Answer 25

Vital signs, height, edema, fundal weight, FHR, fetal movement

Question 26

Why is it important to take vital signs at every prenatal visit?

Answer 26

To assess for preeclampsia

Question 27

Why is a fever of 101°f a concern in pregnancy?

Answer 27

Infection

Question 28

Why is sudden severe of continuous pain or cramping in the lower abdomen a concern in pregnancy?

Answer 28

Ectopic pregnancy, preterm labor, placental abruption, non-pregnancy causes such as: UTI or appendicitis

Question 29

why can bleeding or spotting from the vagina be a cause of concern for a pregnant woman?

Answer 29

Could be a spontaneous abortion, abruption, placenta previa, friable cervix, labor

Question 30

What can severe headaches or visual disturbances be a sign of?

Answer 30

Pre-eclampsia

Question 31

What can sudden, severe swelling of hands, feet, face, or generalized edema be a sign of?

Answer 31

Pre-eclampsia

Question 32

Why is persistent vomiting a concern?

Answer 32

Can cause a risk of dehydration

Question 33

4 or more uterine contractions per hour before 37 weeks can be a sign of____?

Answer 33

Preterm labor

Question 34

A continuous leaking of small amounts of fluid from the vagina or a gush or water from the vagina may be a sign of _____?

Answer 34

PROM

Question 35

What are 6 common discomforts of the first trimester?

Answer 35

Nausea/vomiting, urinary frequency increases, fatigue, breast tenderness, increased vaginal discharge, nasal stuffiness and nosebleed

Question 36

Common discomforts of pregnancy in the second and third trimesters

Answer 36

Heartburn, ankle/mild edema, faintness, dyspnea, carpaI tunneI syndrome, varicose veins, hemorrhoids, constipation, leg cramps, round ligament pain, backache-sciatica, SI joint, flatulence

Question 37

Fundal height at 10 weeks

Answer 37

An orange

Question 38

Fundal height at 12 weeks

Answer 38

A grapefruit

Question 39

Fundal height at 16 weeks

Answer 39

Midway between symphysis pubis and umbilicus

Question 40

Fundal height measurement at 22-34 weeks

Answer 40

Measurement in centimeters roughly corresponds with weeks' gestation

Question 41

Fundal height measurement at 38 weeks

Answer 41

@Xiphoid process

Question 42

Normal FHR range

Answer 42

110-160 bpm

Question 43

When can you hear the fetal heart rate on the ultrasound?

Answer 43

6-7 weeks

Question 44

When can the fetal heart rate be heard on the Doppler?

Answer 44

10-12 weeks

Question 45

When can a fetal heartbeat be heard with a fetoscope?

Answer 45

17-20 weeks

Question 46

When will mothers be able to feel the fetus moving?

Answer 46

~ 16 weeks

Question 47

How many fetal movements should be felt in 1 hour/2 hours?

Answer 47

4/10

Question 48

When can a noninvasive prenatal test be done to determine genetic abnormalities?

Answer 48

10 weeks (results in 5 days)

Question 49

When can an ultrascreen for chromosomal abnormalities be performed?

Answer 49

11 1/7 weeks to 13 6/7 weeks

Question 50

What can maternal serum alpha-fetoprotein indicate if it is too high/low at 15-20 weeks?

Answer 50

Chromosomal trisomies/NTDs

Question 51

When is the diabetes screen for gestational diabetes performed?

Answer 51

24-28 weeks (at the end of 2nd trimester)

Question 52

When would a 3 hour glucose tolerance test be performed?

Answer 52

If 1 hour glucose test is ≥ 140

Question 53

What lab screenings are done in the 2nd trimester?

Answer 53

Diabetes screen, hemoglobin/hematocrit, antibody screening for Rh neg patients, rhophylac (RhoGAM) administration

Question 54

What is one of the most important lab screening to be done in the third trimester?

Answer 54

Group B streptococcus culture

Question 55

Barriers to prenatal care

Answer 55

Financial, systemic, attitudinal, may not realize She's pregnant

Question 56

Types of prenatal tests

Answer 56

Nonstress test (nst), contraction stress test (CST), biophysical profile (bpp), ultrasound, Doppler ultrasound blood how assessment, chorionic villus sampling (CVS), fetal movement counts, alpha-fetoprotein screening, multiple marker screening

Question 57

What is considered a geriatric pregnancy?

Answer 57

≥ 35 yo

Question 58

What age is considered a young mom?

Answer 58

<16

Question 59

Can you confirm abnormalities with screening tests?

Answer 59

No. Only diagnostic tests can confirm abnormalities

Question 60

Which pregnancies are considered to be at risk?

Answer 60

Young/old mom, maternal diseases, Rh isoimmunization, previous poor pregnancy outcomes, suspected intrauterine growth restriction, post-dates pregnancy, multiple gestation

Question 61

What happens to fetal oxygenation during contractions?

Answer 61

Oxygenation stops

Question 62

What pattern of loss is observed in a fetus that is hypoxic?

Answer 62

FHR reactivity is lost, sucking stops, breathing movement stops, general movement stops, muscle tone is no longer detected

Question 63

When can muscle tone be detected?

Answer 63

7-8 weeks

Question 64

When can fetal movement be detected on an ultrasound?

Answer 64

8-9 weeks

Question 65

When can fetal breathing movement be detected on an ultrasound?

Answer 65

11-12 weeks

Question 66

When can sucking be seen on an ultrasound?

Answer 66

12-14 weeks

Question 67

When can fetal heart rate reactivity be detected?

Answer 67

28-32 weeks

Question 68

What is done in a nonstress test?

Answer 68

External fetal heart rate monitor observes fetal heart rate reactivity

Question 69

What is considered a reactive non-stress test?

Answer 69

Increase of 15bpm for 15 seconds with 2 episodes in 20 minutes

Question 70

Why is a contraction stress test used?

Answer 70

To determine how the fetal heart responds to uterine contractions that temporarily decrease placental blood flow

Question 71

What is the ideal result of a contraction stress test?

Answer 71

No fetal heart rate decelerations with 3 contractions lasting at least 40 seconds

Question 72

What are the 5 parts of a biophysical profile?

Answer 72

Fetal heart rate accelerations, fetal breathing movements, gross fetal movement, fetal tone, and amniotic fluid index

Question 73

What is the ideal range for amniotic fluid?

Answer 73

500-1000 mL

Question 74

What does a modified biophysical profile include?

Answer 74

Combination of a non stress test and an amniotic fluid index

Question 75

How does an ultrasound work?

Answer 75

Sound waves bounce off fetus and anatomical structures, creating a “picture”

Question 76

How does an ultrasound determine the fetal age?

Answer 76

Crown rump length

Question 77

what is an ultrasound used for in the second trimester?

Answer 77

Confirm due date, observe fetal anatomy, location of the placenta, multiple gestation, adjunct to amniocenteses

Question 78

What is an ultrasound used for in the third trimester?

Answer 78

Fetal growth and presentation, biophysical profile/amniotic fluid index, suspected intrauterine fundal development, adjunct to external version

Question 79

When will Doppler ultrasound umbilical blood flow studies be done?

Answer 79

Pregnant mothers with Hypertension, fetal growth restriction, placental insufficiency

Question 80

Why would an amniocentesis be performed in early pregnancy /late pregnancy?

Answer 80

Early: diagnose neural tube defects& Down’s syndrome Late: lung maturity Can also be used to test for intrauterine infections and hemolytic disease

Question 81

what lecithin/sphingomyelin ratio indicates lung maturity?

Answer 81

2:1

Question 82

What does a positive pg/pi test indicate?

Answer 82

Fetal lung maturity

Question 83

What is chorionic villus sampling used for?

Answer 83

Prenatal genetic diagnosis

Question 84

How is percutaneous umbilical blood sampling done?

Answer 84

Aspiration of fetal blood from the umbilical cord near the placenta

Question 85

What does umbilical blood sampling detect?

Answer 85

Blood disorders, acid-base imbalance, infection, or fatal genetic disease

Question 86

Which test predicts severe fetal anemia?

Answer 86

Delta OD 450 (middle cerebral artery doppler ultrasound study can also predict fetal anemia)

Question 87

How is the due date calculated using Nagaele’s rule?

Answer 87

LMP minus 3 months plus 7 days