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O&G > dg of early and late pregnancy > Flashcards

dg of early and late pregnancy Flashcards

1
Q

define pregq

A

phsyiological process in femals involed w/ the development of the femal sexual cell and course of growth of the embryo/fetus in maternal body

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2
Q

how long does pregnancy last for

A

9 months
40 weeks
280 days

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3
Q

pregnancy stages

A

early=2 weeks
mid= 13-27
late=27 weeks plus
term 37-42 weeks

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4
Q

3 trimesters of pregnancy

A

1st= 12 wks
2nd= 13-28wks
3rd=29-40wks

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5
Q

how to calculate the estimated due date

A

naegele’s rule

based on last menstrual period

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6
Q

naegel’s rule for april - dec

A

add7 days
minus 3 months
add one year

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7
Q

naegele’s rule jan0march

A

add 7 days

add 9 months

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8
Q

why is naegele;s rule innacurate

A

not everyone’s period cycle is 28 days

not everyone’s gestational period lasts 280 days

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9
Q

principles for dg

of early preg (1st trimester)

A

1) history & subjective symps
2) objective symps
3) immune tests
4) US

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10
Q

1) history & subjective symps of early preg

A

1) amenorrhea
2) morning sickness
3) urinary symptoms
4) breast sensation
5) fatigue

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11
Q

1) amenorrhea in early preg

A

1st and most important symp

other causes
- medications
chronic diseases
emtional tension

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12
Q

2)morning sickness in early preg

A

worst in the 6th week and stops after 12 wks

caused by

  • HCG
  • delayed gastric emptying
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13
Q

3)urinary symptoms

in early preg

A

frequency
nocturia

caused by increased pelvic circ
enlarged uterus increases pressure on the bladder

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14
Q

4) breast sensation in early preg

A

full
prickling sensation
pain

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15
Q

objective signs of early pregnancy

A

mastodynia
constipation(d/2 smooth muslce relaxing)
weight gain
pelvic changes

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16
Q

what is mastodynia

A

aka mastalgia is pain in the breast

caused by :
development of mammary duct and alveolar system

increased circulation and breast engorgment
+ larger breasts
+ darker areola

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17
Q

what are the pelvic changes in “dg of early pregnancy”

A

chadwick’s sign
vaginal sign
cervical sign
uterine sign

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18
Q

what is the chadwick sign in “dg of early pregnancy”

A

early preg sign 6-8 weeks

vagina and labia turn blue

d/2 accum of estrogen

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19
Q

what are the cervical signs of early pregnancy

A

softening and blue coloration

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20
Q

uterine signs of early pregnancy

A

enlarges and softens

  • hegar’s sign
  • palmar sign
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21
Q

hegars sign in “dg of early pregnancy”

A

*lower uterine segment above the cervix becomes so soft that when compressed between two fingers ( one abdominally other trans vaginally) its wall cannot be felt or feels extremely thin.

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22
Q

palmar’s sign in “dg of early

pregnancy”

A

rythmic uterine contraction elicited in bimanual exam at 4-8 wks

23
Q

imunological tests in “dg of early

pregnancy”

A

measure HCG made by placenta

hcg antigen detected in urine/blood 8-9 days after fertilization

24
Q

when do hcg levels peak in “dg of early

pregnancy”

A

2nd and 3rd months of pregnancy

Double every 2 days in 1st 10 wks

25
Q

list the types of ultrasonography in pregnancy

A

trans vaginal

abdominal

26
Q

when is the gestational sac seen on US in “dg of early

pregnancy”

A

5-6 wks after LMP
or 30-35 days gestation

by trans vaginal US

27
Q

when is fetal heart beat seen on US in “dg of early

pregnancy”

A

7th week

doppler can also be used

28
Q

when is fetus seen on US in “dg of early

pregnancy”

A

8th week

29
Q

describe a true gestational sac

A

eccentric locatino

round and regular shape

double ring sign

yolk sac and fetal pole

size increases 1mm/day

30
Q

significance of a pseudo GS

A

suggests ectopipc pregnancy

31
Q

describe a false gesyational sac

A

central location

irregular shape

absent double ring sign

absent yolk sac and fetal pole

lack of size increase

32
Q

what parameters are used to dg late pregnancy (2nd-3rd trimesters)

A 
symptoms]
general exam
abdominal exam 
vaginal exam 
US exam
33
Q

symptoms in late pregnancy

A
  • amenorrhoea
  • abdominal enlargement -loss of nausea and vom after 12 wks
  • reduced HCG after 12 wks
  • fetal movement after 20 wks
  • braxton hicks
  • palpation of fetal parts
  • fundal height
34
Q

what is fundal height

A

distance from the pubic bone to the top of the uterus measured in centimeters. After 20 weeks of pregnancy, your fundal height measurement often matches the number of weeks you’ve been pregnant.

35
Q

what is observed on gen exam in late preg

A

chloasma at the 24th week

increased breast enlargment

36
Q

define chloasma in “dg of late

pregnancy”

A

mask of pregnancy is a tan or dark skin discoloration d/2 hormone change

37
Q

abdominal exam in late pregnancy

inspection

A

inspection

  • striae
  • linea nigra( from xiphoid process to pubic symphisis)
38
Q

abdominal exam in late pregnancy

palpation

A

increased fundal hehight

ovoid shape uterus

braxtonhicks

active fetal movment:
20WKS

palpation of fetal parts 20WKS

39
Q

fundal height at 16 wks

A

betw/ pubic symphisis and umbilicus

40
Q

fundal height at 22-24 wks (5-6mo)

A

umbilical level

41
Q

fundal height at 28 wks (7mo)

A

between lower 1/3 and upper 2/3 of abdomen

42
Q

fundal height at 32nd wk (8mo)

A

upper and mid 3rd of abdomen

43
Q

fundal height at 36 wks (8-9mo)

A

at xiphoid cartilage

44
Q

what is then accepted variation of fundal height

A

plus or minus 2 cm

45
Q

what are braxton hicks contractions

A

painless tightening of the uterine muscles for 1-2 hrs preparing body for birth

No cervical changes

No rupture

46
Q

what is the purpose of palpation of fetal parts in “dg of late pregnancy”

A

1) dg pregnancy in late stage

2) ID fetal position, lie and presentation

47
Q

what is fetal lie

A

long axis of fetus in relation to long axis of mother

48
Q

types of fetal lie

A

longitudinal
- fetal and mother lies are parralell (vertex or breach)
transverse
- fetal lie crosses mother’s lie vertically (shoulder)

49
Q

what is fetal presentation

A

refers to the part of the fetus that first descends into the pelvis

head presentation
95%

breech presentatinon
3-5%

shoulder presentation

50
Q

indication for US investigation in “dg of late

pregnancy”

A

check amniotic fluid volume

  • oligoydromnious
  • polyhydromnious

determine fetal number( mx gestation)

assertain fetal anatomy ( birth defects)

assertain integrity of cervical canal

fetal organ anatomy ( doppler for heart defects)

view placental anatomy

51
Q

US fetal parameters in “dg of late

pregnancy”

A

HC: head circ

BPD: BIPARIETAL DIAMETER

AC: abdomincal circ

FL: femur length

52
Q

BPD

values in “dg of late
pregnancy”

A

1st TM: greater than 3 cm

28th wk (7 mo): 7cm

32nd wk (8mo): 8cm increaseing 0.2 cm / wk

53
Q

FL values in “dg of late

pregnancy”

A

2-3cm less than BPD

O&G (43 decks)

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