Exam 1 part 2 Flashcards
total number of times a women has been pregnant
without regard to number of fetuses, including a current pregnancy
Gravida
number of births after 20 weeks whether alive or still birth
More than 1 fetus still equals only one birth
Para
Expanded system to include specific information about past pregnancies, deliveries and current number of children
GTPAL
T
Term infants > 37 weeks
P
preterm infants
A
abortions (spontaneous or therapeutic)
L
living children
pregnant more than 5 times
Grand multi gravida
means never given birth
Nuli para
pregnant for the first time
prima para
never been pregnant
nuli gravida
means pregnant for at least the second time
Multi gravida
underweight BMI
normal BMI
18.5-24.9
overweight BMI
25-29.5
obese BMI
> 30.0
morbidly obese
> 40.0
Total weight gain for BMI
28-40
total weight gain fro BMI 18.5-24.9
25-35
total weight gain for BMI 25.0-29.9
15-25
Total weight gain for BMI >30
11-20
How much does the fetus weigh
7-8
how much does the placenta weigh
1-2
how much does the amniotic fluid weigh
2
how much does the uterine mass weigh
2
how much does the blood volume weigh
2-4
how much do the breasts weigh
1-3
how much do the maternal fat stores weigh
7-8
when do you hear fetal heart tone
10-12 weeks
when do you see fetal movement
20 weeks
when is there cardiac visualization
4-8 weeks
!st trimester labs
ABO and rh antibody screen CBC STI panel Rubella Genetic screening Urinalysis/ culture
High frequency sound waves produced an image if tissue, organ, bone, air (based on density)
Ultrasonography
Ultrasonography done in the 1st trimester
transvaginal
ultrasonography that needs full bladder
transabdominal
Rate and volume of blood flow between the placenta and umbilical vessels
Used in adjunct to US in any trimester
Looks at blood flow changes in maternal-fetal circulation in order to assess placenta function
Umbilical artery Doppler flow
Doppler velocimetry
Indications of umbilical artery doppler flow
IUGR
HTN/pre eclampsia
Fetal cardiac anomaly
Detailes radiological evaluation maternal.fetal tissues, organs, and placenta when abnormalities are suspected
Interpretation doen by radiologist
Magnetic resonance imaging MRI
Indications of MRI
abnormal US of suspected anatomical malformation
Placental accreta
Assess the accumulation of fluid between spine and neck
Pregnancy associated plasma protein PAPP-A
Free beta-hCG
Nuchal translucency
when is a offered
at 11-13 weeks to all pregnant women
increased amount of fluid
risk abnormalities
genetic syndromes
birth defects
poor pregnancy
> 3mm fold
increase of trisomy 21
low levels of PAPP-A are associated with what
Trisomy 21
Aspiration small amount of placental tissue (chorion) for chromosomal, metabolic and DNA testing
Adjunct with US
Catheter placed through cervix/abdominal w/ US guidance then biopsy of tissue then Villi harvested and cultured for chromosomal analysis
Chronic Villus sampling CVS
indications of CVS
Detects fetal abnormalities
High risk mothers
risks of CVS
7% chance of fetal loss due to bleeding, infection, or rupture of membranes
10% chance of bleeding
Blood used to test for metabolic, hematologic disorders, fetal infection, and genetic
Adjunct with US
Needle inserted into umbilical vein or near parental origin then small fetal blood sample obtained
Percutaneous umbilical blood sampling PUBS
Indications of PUBS
after US detects anomaly
Fetal transfusion
Abdomen cramp or pain in first trimester
Possible threatened AB, UTI, appendicitis, ectopic pregnancy
Vaginal spotting to bleeding during 1st trimester
possible threatened abortion
Absent FHT in 1st trimester
Possible missed abortion
Dysuria, frequency, urgency during 1st trimester
Possible UTI
fever or chills during 1st trimester
possible infection
prolonged N/V during first trimester
Possible hyper-emesis gracidarium
>risk dehydration
Always assess what during follow up visits
BP Weight gain FHT Fundal height urinalysis
fetal heart rate
110-160 bpm
Measured form the top of the symphysis pubis to top of the uterine funds
Fundal height
when is the funds at the umbilicus
at 20 weeks
reasons why findings may differ for fundal height
Obesity
Uterine fibroids
poly- or oligo hydramnios
