FA - Obstetrics

Question 1

Prenatal diagnostic testing during initial visit:

Answer 1

-Heme: CBC

Question 2

First trimester screening:

Answer 2

PAPP-A, NT, beta-hCG then consider need for CVS

Question 3

Prenatal diagnostic testing b/n 15-22wks:

Answer 3

msAFP or quad screen (AFP, estriol, hCG, inhibin A) then consider need for amniocentesis

Question 4

Prenatal diagnostic testing b/n 18-20wks:

Answer 4

U/S for full amniotic screen

Question 5

Prenatal diagnostic testing b/n 24-28wks:

Answer 5

1hr GTT for gestational diabetes screen

Question 6

Prenatal diagnostic testing b/n 28-30wks then w/in 72hrs PP:

Answer 6

RhoGAM for Rh (D) antigen neg, Rh (D) antibody negative, Rh (D) antigen positive father or unknown

Question 7

Prenatal diagnostic testing b/n 35-37wks:

Answer 7

GBS culture; repeat CBC

Question 8

Elevated msAFP (>2.5 MoMs) associated with:

Answer 8

• Open NTD (e.g. ancephaly, spina bifida)
• Abdominal wall defects (gastrochisis, omphalocele)
• Multiple gestation
• Incorrect gestational dating (t/f ALWAYS r/o FIRST with u/s)
• Fetal death
• Placental abnormalities

Question 9

Reduced msAFP

Answer 9

• Trisomy 21 and 18
• Fetal demise
• Incorrect gestational dating

Question 10

Quad screening markers for Trisomy 18:

Answer 10

“Still UNDERage at 18” t/f:

• Low AFP
• Low estriol
• Low hCG
• Low Inhibin A

Question 11

Quad screening markers for Trisomy 21:

Answer 11

“2up and 2 down”

• Low AFP
• Low estriol
• High hCG
• High Inhibin A

Question 12

Use of amniocentesis > 16 wks?

Answer 12

Genetics

Question 13

Use of amniocentesis > 24 wks?

Answer 13

Anemic status of fetus

Question 14

Use of amniocentesis > 36 wks?

Answer 14

L:S ratio to determine need for steroids b4 delivery (evaluate fetal lung maturity)