Antepartum

Question 1

hCG

Answer 1

• hormone secreted by placenta
• Helps maintain corpus luteum and progesterone production
• Found in urine assays as early as ONE week after conception

Question 2

Umbilical arteries

Answer 2

• 2 arteries in umbilical cord
• Carry fetal deoxygenated blood to the placenta
• Smaller in diameter than vein

Question 3

Umbilival vein

Answer 3

• 1 vein in umbilical cord

- Carries oxygenated blood from placenta to fetus

Question 4

Polyhydramnios

Answer 4

• excess amniotic fluid
• AFI >= 24
• Max vertical pocket >= 8
• Amniocentesis for AFI >= 35

Question 5

Oligohydramnios

Answer 5

• AFI <= 5

- Max vertical pocket < 2

Question 6

Organogenesis

Answer 6

• 3rd week after fertilization through week 8

Question 7

4th week of embryonic development

Answer 7

• partitioning of heart begins
• arm & leg buds form
• umbilical cord

Question 8

6th week of embryonic development

Answer 8

• head > body
• heart completely formed
• fingers and toes

Question 9

Presumptive signs of pregnancy

Answer 9

• Subjective
• Amenorrhea
• N/V
• breast tenderness
• fatigue
• increased BBT
• Chadwick’s sign

Question 10

Probable signs of pregnancy

Answer 10

• • pregnancy test
• Enlarged abdomen/uterus
• Piskacek’s sign
• Hegar’s sign
• Goodell’s sign

Question 11

Positive signs of pregnancy

Answer 11

• Fetal heart tones
• Sonographic evidence
• Palpation of fetal movement

Question 12

Naegele’s Rule

Answer 12

• subtract 3 months, + 7 days to first day of LMP, then + 1 year = EDD

Question 13

Hegar’s Sign

Answer 13

Softening of isthmus

Question 14

Chadwick’s sign

Answer 14

bluish color of cervix

Question 15

Goodell’s sign

Answer 15

Softening of cervix

Question 16

Corpus luteum

Answer 16

• responsible for progesterone secretion until placenta
• persists d/t hCG
• approx 12 weeks

Question 17

1st Trimester Psychology

Answer 17

• focus on physical changes & feelings
• ambivalence
• adjustment

Question 18

2nd Trimester Psychology

Answer 18

• More aware of fetus as a person
• acceptance
• period of radiant health

Question 19

3rd Trimester

Answer 19

• Concerned with baby’s needs
• Introversion
• Period of watchful waiting

Question 20

BMI <18.5

Answer 20

• underweight

- 28 to 40 lb weight gain suggested

Question 21

BMI 18.5 - 24.9

Answer 21

• Normal BMI

- 25 to 35 lb suggested weight gain

Question 22

BMI 25 - 29.9

Answer 22

• Overweight

- 15 to 25 lb suggested weight gain

Question 23

BMI >= 30

Answer 23

• Obese

- 11 to 20 lb suggested weight gain

Question 24

Implantation

Answer 24

• 6-7 days after fertilization

- usually in upper posterior wall of uterus

Question 25

How are oxygen and glucose transported across placenta?

Answer 25

Facilitated diffusion

Question 26

Noninvasive Prenatal Testing (NIPT)

cell-free DNA (cfDNA)

Answer 26

• 10 weeks and beyond
• Screens for: Trisomy 13, 18, 21
• Highest detection rate of Down Syndrome/Tri 21 (99%)

Question 27

First Trimester Screening

Answer 27

• between 10 and 14 weeks gestation
• Nuchal translucency + maternal PAPP-A and B-hCG
• screens for Trisomy 13, 18, 21
• DOES NOT SCREEN FOR NTD

Question 28

Low PAPP-A and high B-hCG is indicative of?

Answer 28

increased risk for Trisomy 21

Question 29

Second Trimester Screening (i.e. Quad Screen)

Answer 29

• 15 to 18 weeks
• AFP, hCG, uE3, DIA
• screens for NTD, Trisomy 18 & 21

Question 30

Chronic Villus Sampling

Answer 30

• diagnostic
• removes small sample of placenta
• can diagnose Trisomy 21
• CANNOT diagnose NTD
• between 10 and 14 weeks

Question 31

Amniocentesis

Answer 31

• 15 to 22 weeks
• diagnostic
• withdrawal of small amount of amniotic fluid, analyze for fetal DNA