Dx of Pregnancy and Prenatal Care Flashcards
During the first trimester, why is it not a good sign if the patient does not have fatigue, nausea, vomiting, or breast tenderness?
All of the those symptoms are a result of high hCG levels produced by the trophoblast. They usually disappear after the first trimester, however, if they disappear earlier it could be a sign of a poor pregnancy with possibility of an early abortion.
What is Chadwick’s Sign?
Bluish discoloration of the cervix, vagina, and labia resulting from increased blood flow. It is considered an indication of pregnancy.
What is Chloasma?
Hyperpigmentation of the face (tan or dark skin) resulting from pregnancy.
Difference between a qualitative aand quantitative b-hCG test.
Qualitative: used to determine only if a patient is pregnant or not.
Quantitative: used to monitor the progress of the pregnancy.
How is the estimated date of delivery (EDD) determined?
By the FDLNMP or the earliest fetal ultrasound.
FDLNMP is more reliable
How accurate is fetal ultrasound in determining EDD?
If performed during:
6-11 weeks gestation, accurate to within a week
12-20 weeks, accurate within 10 days
3rd trimester, accurate within 3 weeks
What is the difference between gestational age and embryological age.
Gestational age is usually 2 weeks older than embryologic age. This is because gestational age is based on FDLNMP and conception can occur up to 2 weeks after this.
What is considered a full term pregnancy?
37-42 weeks
How is ectopic pregnancy diagnosed?
Absence of intrauterine gestational sac on transvaginal ultrasound once the quantitative b-hCG level reaches 1500
When is the best time to start prenatal vitamins?
3 month prior to conception, drops risk of miscarriage by 50% compared to a patient that has not started them.
What is the normal prenatal visit schedule?
Every 4 weeks until week 28
Every 2-3 weeks from week 28-36
Every week from week 36 to delivery
What is an RPR test?
Rapid Plasma Reagin test:
test that looks for non-specific antibodies in the blood of the patient that may indicate that syphilis is present.
Why are TSH and urinalysis tests performed on the first prenatal visit?
TSH: hypothyroidism can lead to miscarriage
Urinalysis: asymptomatic bactiuria can lead to early labor
What is PAPP-A and why is it screened in the 1st trimester?
Pregnancy-associated plasma protein A: if it is lower than normal, there is a possibility of down syndrome.
(high Inhibin A, b-hCG and total hCG can also indicate down syndrome)
What kind of Ultrasound screen can indicate Down Syndrome?
Increased opacity of the Nuchal lucency.
What are the two Trisomy and Open Neural Tube Defect (ONTD) DIAGNOSTIC tests and when are they used?
They are used in advanced maternal age (35 or older).
Amniocentesis (15-20 weeks)
chorionic villi sampling (12-14 weeks)
What is Cell-Free Fetal DNA?
Analysis of fetal DNA in maternal serum. Non-invasive testing that can be done as early as 10 weeks to check for trisomy 21, 18, 13
What 4 labs are done at 24-28 weeks gestation?
CBC
Glucola Test for gestational diabetes
Rh phenotype (if negative give Rhogam)
Vaginal Culture
Most common time where Rh incompatibility can harm the fetus.
At the time of delivery
When is Rhogam administered?
In any Rh (-) mother at 28 weeks and post partum with an Rh(+) fetus.
Also with any trauma, amniocentesis, placental abruption, ectopic pregnancy, bleeding previa
When is group B strep culture done and if it is (+) when is it treated?
Done at 35-36 weeks and treated during labor.
Ampicillin: loading dose of 2g initially followed by 1g every 4 hours until delivery
Name the 4 tests to check for fetal well being.
Non-stress Test
Contraction Stress Test
Biophysical Profile
Cord Doppler Velocimetry
