E2/L14 - Normal Pregnancy, Prenatal Care, Lab Changes

Question 1

1st Trimester Screening

Answer 1

1) Nuchal Translucency, hCG, PAPP-A, Nasal Bone Assessment

2) Cell-Free DNA, CVS

Question 2

2nd Trimester Screening

Answer 2

1) Triple: hCG, Estriol, maternal AFP
2) Quadruple: hCG, estriol, AFP, Inhibin A
3) Cell-Free DNA, Amniocentesis

Question 3

Detection of apoptosis of trophoblastic cells in maternal circulation; non-invasive; Test for chromosomal problems NOT NTD; only high risk pregnancies

Answer 3

Cell-free fetal DNA

- if elevated due Amniocentesis, CVS

Question 4

Best blood thinner to give

Answer 4

Heparin (class B)

Question 5

best antianxiety rx

Answer 5

Fluoxetine

Question 6

Detection of Neural Tube Defects

Answer 6

high AFP

Question 7

Normal Prenatal Office Visit Frequency

Answer 7

0-28 weeks: q 4wks
28-36 weeks: q 2 wks
36+: q 1wk until delivery

Question 8

When to start measuring uterine size?

Answer 8

20 weeks

Question 9

When do you feel first fetal movements?

Answer 9

Kick Counts @ 20 weeks (10 movements in 2hrs)

Question 10

Screening at 20 weeks

Answer 10

fetal survey U/S

Question 11

Screen at 28 weeks

Answer 11

Diabetes, Hb/Hct, RhoGAM, Tdap (27-36 wks)

Question 12

Screen at 35 weeks

Answer 12

Group B Strep

Question 13

Nonstress Test (NST)

Answer 13

Reactive (Normal) = 2 accels, 15 bpm above baseline for at least 15 seconds, during 20 minute period

Question 14

Contraction Stress Test (CST)

Answer 14

1) Give oxytocin
2) normal = 3+ contractions in 10 minutes
3) abnormal = late decels (positive test, delivery warranted)

Question 15

Biophysical Profile

Answer 15

1) NST
2) Fetal Breathing Movements
3) Fetal Movement
4) Fetal Tone
5) Amniotic Fluid Volume
Results: <4 consider delivery