[CLMD] The Normal Pregnancy; Antepartum care [Moulton] Flashcards
What percent of pregnancies are unplanned?
49%
What is an excellent supplementation to start at least 1 month prior to conception to prevent neural tube defects?
Folic acid
What population of mothers need extra attendion prior to conception?
Diabetic pts
What are some normal findings in pregnancy that would otherwise be considered pathologic?
- Systolic murmurs
- Palmar erythema
- Spider angiomas
- Linea nigra
- Striae gravidarum
- Chadwicks sign
What do you give to Rh (-) patients?
When?
Rhogam
28 weeks
Is pregnancy a hypercoagulable or hypocoagulable state?
Hypercoagulable
What are some major things to do during the first prenatal visit?
- Confirm pregnancy and viability
- Estimate gestational age and due date
- Potential genetic counseling
- Discuss teratology (meds)
When can hCG be first detected in the serum?
6 to 8 days after ovulation
In the first 30 days of a normal pregnancy, hCG doubles every ____ days
In the first 30 days of a normal pregnancy, hCG doubles every 2.2 days
What is the hCG level when the gestational sac is seen?
Around how many weeks?
hCG = 1500-2000 IU/L
5 weeks
What is the most accurate length to measure for determining the due date?
During which trimester?
Crown rump length
First trimester
Who needs genetic counseling?
35 or older pts.
Previous child/FH of birth defects
Multiple fetal losses
Exposure to teratogens
Abnormal ultrasound findings
What are the two diagnostic methods for prenatal diagnosis of chromosomal abnormalities?
Chorionic villus sampling
Amniocentesis
What are the two major sex linked disorders?
Duchenne muscular dystrophy
Fragile X syndrome
What are the screens included in the FIRST TRIMESTER?
Maternal age
Fetal nuchal translucency (NT) thickness
Maternal b-hCG
PAPPA-A
*PAPPA CAN GET HER PREGNANT FIRST
What is included in the SECOND TRIMESTER SCREENING?
Triple screen:
b-hCG, estriol and maternal alpha fetoprotein (AFP) markers
What do you use to identify open neural fetal defects?
AFP
What technique is HIGHLY specific and used to dectect genomic trisomies?
Noninvasive prenatal testing
Cell-free fetal DNA
What is the MOST VULNERABLE stage for teratogenic effect?
Day 17 to day 56
What are 6 major categories of the most common teratogenic agents?
Alcohol
Antianxiety
Antineoplastic
Anticoagulant
Anticonvulsants
Which anticoagulant drug crosses the placenta?
Which anticoagulant drug does NOT cross the placenta?
Coumadin
Heparin
What is the rule of thumb to use for radiation exposure and risk?
Less than 5 rads of exposure = no risk
Why do pregant women frequently experience N/V?
Relaxation of esophageal sphincter by progesterone
How much should a baby move every 2 hours?
10 movements every 2 hours
What is a nonstress test (NST)?
Either reactive or non reeactive results
Reactive= 2 accelerations of at least 15 beats above baseline lasting 15 seconds during 20 min of monitoring
Nonreactive = didn’t not get above results
What do you do if your pregnant pt gets a nonreactive nonstress test (NST)?
Get a contraction stress test (CST)
How do you conduct a contraction stress test (CST)?
Give oxytocin to establish at least 3 contractions in a 10 min period
If late decelerations are noted with the majority of contractions, the test is POSITIVE and delivery is warrented
What scores on the components of the reassuring biophysical profile guidelines are:
Reassuring
Equivocal
Nonreassuring
Reassuring = 8-10
Equivocal = 6
Nonreassuring = 4 or less
What biophysical variables are included in the components of biophysical profile?
- Non stress test
- Fetal breathing movements
- Fetal movement
- Fetal tone
- Amniotic fluid volume
