Maternal Care Flashcards
Iron supplementation decreases the prevalence of
anemia at delivery (Level A)
Iron deficiency anemia during pregnancy has been associated with an increased risk of (Level B):
– LBW
– Preterm delivery
– Perinatal mortality
1) What is asymptomatic bacteriuria?
2) Which organism is most commonly isolated.
3) Which organisms are considered contaminants?
1) > 100,000 cfu/mL of a single bacterial species
2) E. coli is most commonly isolated.
3) Lactobaccilli and Staphylococcus species (other than S. saprophyticus) may be presumed to be
contaminants
Which antibiotics are considered safe in pregnancy?
- Amoxicillin
- Ampicillin
- Clindamycin
- Erythromycin
- Penicillin
- Cephalosporins
Which antibiotics are typically avoided in pregnancy?
• Tetracyclines
• Nitrofurantoin*
• Sulfonamides*
* Prescribing sulfonamides or nitrofurantoin in the first trimester is still considered appropriate when no other suitable alternative antibiotics are available. During the second and third trimesters, sulfonamides and nitrofurantoin may be used as first-line agents for infections.
Gestational Diabetes increased risk of:
– Gestational hypertension – Preeclampsia
– Cesarean delivery
– 7-fold increased risk of developing diabetes later in life
When does gestational diabetes routine screening occur?
24-28 weeks (routine)
What is the initial glucose challenge test
- 50 g oral glucose load (glucose challenge test)
- > 135 or > 140 mg/dL*, goes to the 3-hour OGTT
- Note: > 190, > 90% abnormal 3-hour
Abnormal plasma blood glucose:
fasting? 1h? 2h? 3?
> fasting 95 mg/dL, 1h 180, 2h 155, 3h 140
Rubella antibody titer for initial prenatal screen
2001 – CDC. Interval to 1 month for pregnancy after rubella vaccine
Timing of GDM screening, high-risk vs routine
– Intake (if “high-risk”)
– Routine 24-28 weeks
Empiric treatment of asymptomatic bacteriuria? What antibiotics should be avoided?
- Seven-day course, cephalexin, 250 mg po QID
- Ampicillin should not be used − high rates of resistance
Indications for screening at “initial OB evaluation” (3)
- Prior history of GDM
- Known impaired glucose metabolism
- Obesity (BMI > 30)
All women of childbearing age should have how much folic acid supplementation
0.4 mg/day
Sonographic assessment of the pregnant abdomen between ___ and ____ weeks EGA?
Sonographic assessment of the pregnant abdomen between 16 and 20 weeks EGA (second trimester), in the absence of specific indications for a second-trimester ultrasound.
