Assessments Flashcards
Ss preeclampsia
HA
Visual
Epigastric
Edema
Proteinuria (kidney)
Increased uric acid in serum (kidney)
Decreased platelets
Increased reflexes
Glucose levels in different pregnancy phases
HypoG 1st trimester and labor/PP
HyperG 2nd and 3rd trimester
Characteristics and timeframe of GHTN
After 20 w
No proteinuria
140/90
Characteristics of preeclampsia
After 20 w
With proteinuria
140/90
Timeframe of chronic HTN
Before pregnancy/20 w
HELLP for severe preeclampsia
Hemolysis
Elevated liver
Low platelet
Antepartum testing
Fetal movement
Ultrasound
Doppler blood flow analysis
Amniotic fluid index
Biophysical profile
NST
5 types of miscarriages
Threatened (fine for now)
Inevitable (happening)
Incomplete (need to evacuate the rest)
Complete
Missed
Ss/dx for ectopic
Bleeding
Pain
Positive pregnancy test
HCG
Transvaginal US
Sign of placenta previa
Painless bright red bleeding
Accreta/increta/percreta
Accreta beyond normal boundary
Increta into myometeium
Percreta into adjacent organs
RF for placenta abruption
Trauma
HTN
Coke and smoke
Twins
Ss placenta abruption
Extreme pain
Contractions
Tenderness
Bleeding
No FHTS/fetal distress
High risk pre existing conditions
DM
Thyroid
CV
Anemia
Asthma
Lupus
SUD
Normal AFI (amniotic fluid index)
5 to 25 cm
NST (non stress test) frequency guidelines
2x weekly after 28 weeks
For DM and other high risk patients
Good BPP (biophysical profile) score
7 to 10
Ss PTL
20 to 37 w
Contractions
Cervical change
Discharge
Bleeding
Backache
Cramps
Also: GI issues, pressure at pelvis
3 most common RF PTL
Hx of PTL
Multiple gestation
Cervical/uterine structural problems
Predict PTB with…
Positive FFN
Short CL
Prior PTB
CL length indicating PTB risk
Less than 15mm
How do you measure CL?
Transvaginal ultrasound
Assessments for PTL
Cervical exam
ROM exam
Amnisure and fern
UTI and other infection screenings
Fetal monitor
Toco for uterine activity
When can you hear baby heart?
W12
When can you feel baby move?
W16-20
When does fetus gender become apparent?
W12
Prenatal genetic testing options
Maternal serum
Fetal ultrasound
Invasive: amniocentesis, chorionic villus
Maternal serum for…
Neural tube defects
Down
Trisomy
Fetal ultrasound for…
Heart
Gestational age
Growth
Anatomy
Disorders, cleft
Placenta
Well being
Predictive testing for…
HD
Cervix and vagina changes with pregnancy
Goodell (soft)
Chadwick (dark)
Leukorrhea drainage
Operculum (mucus plug)
CV changes with pregnancy
Hypertrophy
Heart pushed up
Increase blood volume
Murmur and palpitations
Increase pulse (10-15 bpm)
Increase clotting
Anemia / increased RBC size
Increased WBC
Respiratory changes with pregnancy
O2 needs increase
Ribs relax and widen
Elevated diaphragm leads to dyspnea
Renal changes with pregnancy
Frequency
UTI common
Nocturia
Increased GFR
Increased blood flow
Musculoskeletal changes in pregnancy
Lordosis
Center of gravity shift
Waddling
Relax and increase mobility pelvis
Abdominal muscle stretch and lose tone
Neuro changes in pregnancy
Carpal tunnel
Tension HA
Lightheaded
Hypocalcemia leads to tetany and cramps
GI system changes in pregnancy
Heartburn
Constipation
Gallstones more likely due to delayed emptying
Increase thirst and hunger
Hyperemesis
Hyperemic gums
Endocrine changes in pregnancy
Increased BMR
Heat intolerance
Larger thyroid
What is done in routine prenatal office visits?
FHTS
VS
Urine (protein, glucose)
Weight
Fetal movement
Fundal height
Education
Prenatal labs and tests
CBC
VDRL for syphilis
STD screening
Pap smear
Antibody titers for rubella and Hep B
Blood type
Glucose
UA
TB screen
TORCH screen
AFP for neural tube
GBS
HIV
What is done in the initial provider visit?
Total physical exam
Pap smear
Labs
UA and culture
US
Prenatal return visit schedule
qMonth 4-28W
GDM screen at 24-28w
q2week 28-36w
qWeek 36w to delivery
PP visit at 6 weeks or earlier
Preeclampsia effects on fetus
Hypoxia
IUGR
Abruption
The 5 parameters in the BPP (biophysical profile) test
Amniotic fluid volume
Fetal breathing movements
Fetal reactivity
Fetal movement
Fetal tone
