Diagnosis of Preg

Question 1

what is naegele’s rule?

Answer 1

lmp plus one year minus 3 months plus seven days - remember this is used to help calculate the EDC (estimated date of confinement aka due date)

Question 2

what is it called when the cervix begins to soften in the early stages of pregnancy? (IOW the cervix goes from feeling like cartilage to lips)

Answer 2

Hegar’s sign

Question 3

by what week of pregnancy does the fundus of the uterus become palpable above the pubic symphysis?

Answer 3

week 12

Question 4

describe the change in cervical mucus during pregnancy

Answer 4

goes from fernlike pattern to beaded/cellular pattern

Question 5

which hormone is responsible for the fernlike pattern of cervical mucus?

Answer 5

estrogen (increases sodium chloride)

Question 6

which hormone is responsible for the beadlike/cellular pattern of cervical mucosa?

Answer 6

progesterone (decreases sodium chloride)

Question 7

what happens to the vaginal mucosa color during pregnancy?

Answer 7

increase in blood flow causes vagina to appear dark bluish or purplish-red

Question 8

the bluish discoloration of the vaginal and cervical mucosa due to vascular congestion during pregnancy is called what?

Answer 8

chadwick’s sign

Question 9

first fetal movements felt by the mother are called what?

Answer 9

quickening

Question 10

what happens to maternal hair growth during pregnancy?

Answer 10

Prolonged anagen - the active growth phase of hair follicles.

Question 11

the fundal height at the level of the umbilicus if the equivalent of how many weeks gestation?

Answer 11

20 weeks

Question 12

why is it that the fundal height at 40 weeks tends to be less than at 36 weeks?

Answer 12

engagement and descent of fetal head accounts for this

Question 13

a gestational sac should be seen inside the uterus on TVU at which hcg level?

Answer 13

at least 1500 mIU/ml

Question 14

what is the role of hcg in early pregnancy?

Answer 14

supports the corpus luteum which produces progesterone which helps to support early pregnancy - remember, do NOT assay for hcg until a woman has missed her menstrual period

Question 15

hcg peaks at what week of gestation?

Answer 15

10 weeks

Question 16

for how long does hcg help to sustain the corpus luteum? what happens after this point in time?

Answer 16

first 7 weeks - after which point the placenta makes its own hormones to sustain the pregnancy

Question 17

if hcg levels are greater than 1500 but there is no evidence of intrauterine pregnancy via TVUS what should you begin to think?

Answer 17

ectopic pregnancy

Question 18

what is the preferred method to diagnose normal pregnancy? urine or plasma hcg

Answer 18

urine!

Question 19

at what time of day is best to collect urine for hcg levels? why?

Answer 19

early morning b/c hcg concentration is highest in the AM

Question 20

what are two situations in which a urine hcg will give you a false positive?

Answer 20

proteinuria and UTI

Question 21

what is the range of normal fetal heart rate?

Answer 21

110 to 160

Question 22

is early or late pregnancy ultra more accurate in establishing the EDD?

Answer 22

early

Question 23

an US done in T1 can vary by how many days in terms of predicting EDD?

Answer 23

approx. 4 days

Question 24

an US done in T2 can vary by how many days in terms of predicting EDD?

Answer 24

approx. 14 days

Question 25

an US done in T3 can vary by how many days in terms of predicting EDD?

Answer 25

approx. 21 days

Question 26

t or f: ultrasound measures the gestational age of the fetus

Answer 26

FALSE! u/s only measures the size of the fetus NOT the gestational age