Antepartum care

Question 1

Above what beta-hCG level can a gestational sac be seen on ultrasound?

Answer 1

2000 mlU/ml

Question 2

How much does beta-hCG rise by in a normal pregnancy?

Answer 2

By at least 50% every 48 hours for the first 42 days

Question 3

What are the treatment guidelines for Rh-negative women?

Answer 3

300 micrograms RhoGam (Anti-D-immunoglobulin) is administered to D-negative, non-sensitized mothers prophylactically at 28 weeks gestation (after an indirect Coombs’ test) and within 72 hours of delivering an Rh-positive baby, following spontaneous or induced abortion, following antepartum hemorrhage and following amniocentesis or chorionic villus sampling. If the father is known to be Rh-negative, RhoGAM is not necessary.

Question 4

What are postterm pregnancies associated with?

Answer 4

Placental sulfatase deficiency, fetal adrenal hypoplasia, anencephaly and inaccurate/unknown dates.

Question 5

What is a bluish color of the cervix (Chadwick’s sign) an indication of?

Answer 5

Pregnancy - due to increased blood flow to the cervix

Question 6

How is estimated due date determined using 1st trimester ultrasound vs. LMP?

Answer 6

If the early ultrasound and reliable LMP dating is within one week, the LMP is used; if not the ultrasound dating is used.

Question 7

What fetal ultrasound measurement is the most accurate for predicting fetal weight?

Answer 7

Abdominal circumference

Question 8

What change in the systolic/diastolic ratio of the umbilical artery reflects increased vascular resistance?

Answer 8

A decrease in the S/D ratio (more diastolic pressure compared to systolic)

Question 9

What are contraindications to external cephalic version?

Answer 9

Ruptured membranes, abnormal fetal heart tracing, oligohydramnios

Question 10

What is a normal non-stress test result?

Answer 10

It is considered normal (reactive) if there are at least 2 accelerations of the fetal heart rate.

Question 11

How many centimeters of a discrepancy between a fundal height and gestational age should an ultrasound be obtained?

Answer 11

A discrepancy of 3 cm or more

Question 12

Of the minor blood type antibodies, what should be known about anti-Lewis, anti-Kell, and anti-Duffy antibodies?

Answer 12

Lewis lives, Kell kills, Duffy dies

Question 13

What do BPP scores indicate?

Answer 13

A BPP s core of 8 or 10 i s normal. A score of 0 to 2 dictates imminent delivery, because fetal asphyxia is probable. Scores of 4 to 6 require repeat testing and delivery if persistent.

Question 14

At how many weeks is Rho-gam usually given?

Answer 14

28-32

Question 15

At how many weeks is GBS screening done?

Answer 15

35-37