babyyy Flashcards
prenatal care-how many visits?
1-28 wks= every mnth
28-36 wks= every 2-3 wks
36 wks until delivery=every week
Nageles rule
LMP-3mnth +7 dyas + 1 yr
ex. if LMP is Aril 14th 2011, then EDC will be Jan 21 2012
embryo
fertilization to 8 wks
fetus
8 wks till birth
previable
<24 wks
preterm
24-37
term
37-42
what are you looking for during prenatal visits?
fetal movement, vaginal discharge +/- bleeding, abdominal crapms or UC
leackage of fluid or signs of ROM
dysuria
blurred vision, HA, rapid weight gain, edema
objective findings
weight, fundal height, BP, edema,
dipstick urine protein and glucose
fetal heart tones (heard after 10-12 wks)
Fundal hieght
measured w/ tape measure from the top of the pubic symphysis to the top of the fundus
at 12 wks, FH?
at the pubic syphysis
at 16 wks? FH?
midway btw the pubic and umbilicus
at 20 wks fh?
at the umbilicus
at 20-32 wks
height above the pubic symphsis should equal GA in wks
nutrition for pregos
increased by 300 kcal/day
Iron and folate supplementation is recommentd
weight gain through out pregan
normal: 25-35 lbs for the entire pregan
first trimester wieght gain
3-5 lbs total
second trimester weight gain
0.5lb/wk
third trimester weight gain
1 lb/wk
prenatal labs initial visit
H/H, type, Rh, antibody screen
cystic fibrosis
papsmear, UA, urine culture, sickle prep
glucose
what infectious agents do you need to watch for?
rubella titier, VDRL for syphilis, HBsAG, VZV, PPD,HIV
what are some baby sceends that need to be done in the first trimester?
nuchal thickness, PAPP-A, hcG
+: increased nuchal thickness, decreased PAPPA, significanglty increased HCG
down syndrome, trisomeies
16-20 wks labs
Quad screen (HCG, AFP, estradiol) to test for Down, Edward’s and neural tube defects
Offer MSAFP
US at 18-20 wks
26-28 wks screening
DM! rf or not
RhoGam if pt Rh -
CXR if PPD +
34-38 wks screening
CBC, VDRL, cervical chlamydia and gonorrhea
**group B streptococcus culture at 35-37 wks
when can you visulaize a normal prg?
when BHCG is > 1800-2– (transvag US)
when BHCG is >3500-5000 (see transabdominal US)
**discrimatory zone
discrimatory zone cut off?
if HCG levels are above cut off an dIUP is not visualized- strong likelihood of an ectopic or other abnormal pregnancy
what are the estrogen components of OCP?
ethinyl estradiol or mestrol
progesterone compoentne of OCP
19-nortestosertone, including norethindrone acetate, norethindrone, levonorgestrel, ethynodiol diacetate, desogestrel, norgestimate, DL-norgestrel, gestodene, and drospirenone
what population has the most use for the minipills
lactating women and those older than 40
contraceptive advnatages
Less benign breast disease, iron deficiency anemia, and pelvic inflammatory disease as well as fewer ovarian cysts
- Protection against ectopic pregnancy, reduced risk of ovarian and endometrial cancer, reduced dysmenorrhea and menorrhagia,
- and improvements in hirsutism, acne, and symptoms of endometriosis. -Oral contraceptives also may protect against rheumatoid arthritis
disadvantages of OCP
increased risk of thromboembolic ddz, abnormal lipids
-possilbe increased risk of breasat cancer, and rarely, HTN, cholelithiasis, benign liver tumores
Adverse effects of OCP
missed periods, intermenstural bleeding
bloating, acne, N, HA wieght gain
norplant systemt
levonorgestrel
ADR: menstrual irregularity, HA, wieght gain
transdermal patch?
not effective in women who weiht more than 200 lbs
absolute contraindication of an IUd?
- current prego
- undiagnosed vaginal bleed
- acture infx
- past alpingitis
- suspected gynecologic malignancy
relative CI for IUD
nulliparity, previous ectopic preg or STD, mult sex partners, severe dysmenorrhea, uterina apbnormalites, anemia, vavluar heart dz,
young age
