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Patient Evaluation > Maternal Physiology / 
Normal Pregnancy and Prenatal Care
 / Imaging in Obstetrics > Flashcards

Maternal Physiology / 
Normal Pregnancy and Prenatal Care
 / Imaging in Obstetrics Flashcards

1
Q

Maternal Physiology

A

Pregnancy changes anatomy, physiology and biochemistry

Affects normal lab values

Affects medication dosing

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2
Q

Cardiovascular System 1 ?

A

As uterus enlarges, heart rotates

Apical impulse shifts laterally

Heart size increases by 12%

Blood plasma volume increases ~50%
-
Varies by 
Size of woman
Number of prior pregnancies
Number of fetuses
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3
Q

Cardiovascular System 2 ?

A

Cardiac output increases 40%

Stroke volume increases 25-30%

-Sensitive to maternal position
-Lateral recumbent
-Supine -they are compressing the vena cava
so lay on right or left side

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4
Q

Cardiovascular System 3 ?

A

Systemic arterial pressure decreases initially (until 24-28 weeks)

Venous pressure increases in legs

-Pressure on inferior vena cava and common iliac veins
-Edema
-Varicosities
feet swelling is normal but arms not so much

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5
Q

Cardiovascular System 4 ?

A

Blood flow distribution
Increased flow to uterus, kidneys, breast and skin - helps dissipate the heat

Strenuous exercise

  • Diverts blood flow to large muscles
  • Okay for conditioned mothers
  • For nonconditioned, can decrease uteroplacental perfusion to the fetus
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6
Q

Cardiovascular System 5 ?

A

90% of gravidas have systolic ejection murmurs

Increased CO

Decreased blood viscosity

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7
Q

Pulmonary System 1 ?

A

Engorgement of nasopharynx, larynx, trachea and bronchi

Increased vascular markings on CXR

Diaphragm elevates 4 cm - SOB

  • Reduced total lung capacity
  • ribs flare out a bit more ( look below too)

Increased thoracic circumference

Decreased total lung capacity

Increased tidal volume
-Decreased reserve and residual volume

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8
Q

Renal System 1 ?

A

Kidney lengths enlarge by 1-1.5 cms

Ureters elongate and widen - curve around uterus

Collecting system can contain 200 mL

  • Increased risk of UTI’s
  • hold more volume but increase risk of UTI

Back to normal 4 days postpartum

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9
Q

Renal System 2 ?

A

Blood flow to kidneys increases by 50-85% during first half of pregnancy, lower later

Urinary flow increases two-fold in LATE pregnancy when in lateral recumbent position ( compared to supine)

Medications cleared by the kidney faster

Half of pregnant women will have glucosuria sometime during pregnancy

-NL also contributes to UTI rate

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10
Q

Renal System 3 ?

A

Early in pregnancy, hormones contribute to increased urinary frequency

Bladder capacity actually enlarges

Later in pregnancy, frequency due to enlarged uterus (pressure)

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11
Q

Gastrointestinal System ?

A

Stomach pushed upward

Bowel pushed back, to sides and up

Increased salivation (due to nausea?)

Gums may hypertrophy, bleed
-hormones , or even OCP

Increased GERD, esp first trimester
-more gastrin being produced and esophageal peristalsis being decreased

Increased constipation in later months
-cause slower transit time of stool

Increased risk of gallstone formation
-cause of bile stasis , GB disease

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12
Q

Hematologic System 1 ?

A

Red cell mass expands by 33%, even more with iron supplementation

Greater plasma increase – anemia of pregnancy cause of dilution factor

Active transport of iron to fetus

Fetus generally not anemic, even if mother is severely anemic

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13
Q

Hematologic System 2 ?

A

WBC’s 5000-12,000 in third trimester
not infection

20,000-25,000 during labor is normal

Mainly polymorphonuclear cells

  • Basophils decrease slightly
  • Eosinophils unchanged

Platelet production increases, but so does consumption = thrombocytopenia
-Resolves with delivery

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14
Q

Skin: Hyperpigmentation ?

A

Linea nigra

Chloasma - “mask of pregnancy”

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15
Q

Skin: Striae gravidarum ?

A

“stretch marks”

Abdomen, breasts, thighs, buttocks

Decreased collagen adhesiveness and it just pulls apart

Genetic predisposition

No effective treatment

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16
Q

Skin continued ?

A

Spider angiomas

Palmar erythema- cause more heat through the hands trying to be released

Cutis marmorata - vasomotor instability

Hemorrhoids

Brittle nails with grooves (Beau’s lines)
-trauma to the body and the blood etc go else were causing this

Thickened hair (ends 1-5 months postpartum and shedding begins

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17
Q

Metabolism: Increased nutritional requirements ?

A

Rest more

Increased appetite (for some)

Pica (rare) - dirt

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18
Q

Metabolism: Weight gain ?

A

Uterus and contents ( fetus)

Breast enlargement

Blood and water volume 6.8L

Average weight gain is 27.5 lbs

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19
Q

Placenta ?

A

Purpose is physiologic exchange between fetal organs and maternal tissue

Oxygen and nutrients to fetus

CO2, urea, catabolites back to the mother

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20
Q

Placenta: Cotyledons ?

A

Cotyledons – 12-15 subunits of the placenta - tents of blood where the blood collects and during contraction they collapse

At height of contraction, cotyledons are mainly devoid of blood flow. In uterine tetany, fetal hypoxia develops

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21
Q

Placenta and Placental-Fetal Unit: Produces increasing amounts of steroids in late ?

A

first trimester

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22
Q

Placenta and Placental-Fetal Unit: Fetal adrenal cortex _______ than adult

A

larger

helps with fetal development and growth , maturation and delivery

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23
Q

Placental Secretions ?

A

Human chorionic gonadotropin- hCG

Properties similar to LH from pituitary

Alpha subunit common to all glycoproteins

Beta subunit is specific to the hormone

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24
Q

HcG secretions: Measurement of β-hCG detects pregnancy______ after fertilization ( qualitative)

A

6-12 days

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25
Q

HcG secretions: Levels peak at ______ gestation

A

60-90 days

then we look for quantitative and if it is still increasing and increasing then it could be ectopic

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26
Q

Placental Transport of Drugs: Few substances that won’t cross the “placental barrier” ?

A

Heparin

Insulin

these wont cross cause Too large of molecules

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27
Q

Umbilical Cord: Connective tissue of cord is called ?

A

Wharton’s jelly

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28
Q

Umbilical Cord: ___arteries, ___ vein twisted around each other

A

Two

one

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29
Q

Umbilical Cord: _______ carry blood from fetus to the mother

A

Arteries

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30
Q

Umbilical Cord: ____ returns blood to the fetus

A

Vein

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31
Q

Umbilical Cord: Average diameter ?

A

12 mm

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32
Q

Umbilical Cord: Average length ?

A

50-60 cms

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33
Q

Umbilical Cord: Nuchal loops around baby’s neck 25% of _________________ deliveries

A

spontaneous vertex

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34
Q

Umbilical Cord: Short cord related to _______________ maybe a shorter umbilical cord

A

oligohydramnios

not enough amniotic fluid

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35
Q

Umbilical Cord: True knots in __ of deliveries – can lead to fetal demise

A

1%

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36
Q

Umbilical Cord: At delivery, a portion of the cord should be kept for ?

A

cord blood gas sampling

more accurate then a APGAR score and it is preserved for several hours

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37
Q

Normal Pregnancy and Prenatal Care definition ?

A

Pregnancy defined as the physiologic process of a developing fetus within the maternal body

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38
Q

Gestational age is the amount of time since first day of ____

A

LNMP

(precedes fertilization by 2 weeks)

Assume a 28 day cycle

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39
Q

Gestational age expressed in ?

A

Expressed in completed weeks

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40
Q

__ weeks to term pregnancy

A

40

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41
Q

_________________ age is the age of the conception, calculated from time of implantation

A

Developmental/fetal

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42
Q

Naegele’s Rule calculates ?

A

estimated due date (EDD)

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43
Q

Naegele’s Rule ?

A

Add 7 days to first day of LNMP

Subtract 3 months

Add 1 year

Ex: First day of LNMP 5/1/15

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44
Q

Gestation: Divided into __ trimesters, each __ calendar months

A

3

3

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45
Q

Gestation: First trimester has two parts ?

A

Embryonic period

Fetal period

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46
Q

Embryonic period: ____weeks gestational age

A

2-10

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47
Q

Embryonic period: Most sensitive to ?

A

teratogens

  • *sometimes people dont know they preggo yet and still drink alcohol etc .
  • *
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48
Q

Fetal period: __ weeks after FDLNMP

A

10

8 weeks after fertilization

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49
Q

Nulliparous - ?

A

never pregnant

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50
Q

Primiparous - ?

A

first pregnancy

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51
Q

Multiparous - ?

A

delivered more than one child

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52
Q

Gravid = ?

A

pregnant

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53
Q

Gravida = ?

A

total number of pregnancies, regardless of outcome

delivered pregnancy or not

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54
Q

Parity= ?

A

number of births

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55
Q

Parity includes what type of births ?

A

full term

preterm

abortions

living children

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56
Q

Preterm births: Weighing ____ or more, at OR beyond __ completed weeks, alive or dead

A

500 g

20

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57
Q

Abortions: Ending before __ weeks, induced or spontaneous

A

20

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58
Q

Twins = ___ gravid event, but ___ parity

A

one

two

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59
Q

Ex: G2 P3 Ab 0 ?

A

(had twins once)

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60
Q

Ex: G2 T1 P0 A0 L1 ?

A

(currently pregant)

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61
Q

Live birth – ?

A

evidence of life

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62
Q

Infant: Live-born human, from moment of birth until ?

A

1 year of age

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63
Q

Preterm infant: Born at _____ completed weeks gestation

A

20 -37

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64
Q

Term infant: Born between ______ and ______ weeks

A

37 0/7 and 42 0/7

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65
Q

Postterm infant: Born after __ weeks

A

42

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66
Q

Large for gestational age (LGA) – aka ?

A

macrosomia - “big body”

Beyond 90th percentile

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67
Q

LGA baby are prone to ?

A

gestational DM are prone to this

cephalopelvic disproportion

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68
Q

Low-birth-weight infant – ?

A

2500 g or less

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69
Q

Abortion – based on age or weight: Expulsion of ____________________ with or without fetus

A

complete or partial placenta

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70
Q

Abortion – based on age or weight: Expulsion of fetus, alive or dead weighing less than _____ or less than __ completed weeks

A

500 g

20

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71
Q

Embryo –until __ weeks gestation

A

10

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72
Q

Fetus – ___ weeks

A

10+

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73
Q

Neonatal period ?

A

Birth to 28 days of life

Infant is a newborn, a neonate

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74
Q

Perinatal period: __ weeks gestation to 7 days of life

A

28

before and after birth

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75
Q

Pregnancy Symptoms and Signs: Nausea/vomiting

?

A

50% of pregnancies

2 weeks until 13-16 weeks

Small, frequent meals, emotional support

Extreme – Hyperemesis gravidarum

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76
Q

Pregnancy Symptoms and Signs: Mastodynia ?

A

Tingling to pain

Caused by hormones

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77
Q

Pregnancy Symptoms and Signs: Breast engorgement ?

A

Fullness, esp in primips ( first pregnancies)

Montgomery’s tubercles

Periareolar veins ( venous engorgement )

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78
Q

Pregnancy Symptoms and Signs: Colostrum secretion ?

A

As early as 16 weeks

variation of normal

79
Q

Pregnancy Symptoms and Signs: Fetal Movement ?

A

Perception of fetal movement – “quickening”

18-20 weeks in primips

14 weeks in multips ( recognize it earlier)

Not a reliable symptom

80
Q

Pregnancy Symptoms and Signs: Elevated basal body temperature ?

A

Progesterone causes a 0.5ᵒ F increase

81
Q

Pregnancy Symptoms and Signs: skin changes ?

A

Chloasma

Linea nigra

Striae

Spinder telangiectasia

82
Q

Chloasma ?

A

Darkening of forehead, bridge of nose, cheeks

Exacerbated by sunlight

83
Q

Linea nigra ?

A

Midline from umbilicus to pubis

Lightens somewhat after delivery

84
Q

Spider telangiectasia ?

A

Vascular stellate lesions

cheek or chest

85
Q

PUPPP aka ?

A

Pruritic Urticarial Papules and Plaques of Pregnancy

86
Q

Most common specific dermatosis of preg ?

A

PUPP

87
Q

Most common in primip and multiple gestation ?

A

PUPP

88
Q

PUPP description ?

A

Erythematous papule within striae

  • *itchy hive like lumpy within the straie and erythematous and late in the third trimester
  • *
89
Q

When does PUPP start ?

A

Usually starts late 3rd trimester

90
Q

Where does PUPP start ?

A

Starts on abdomen, spreads to extrem

91
Q

PUPP tx ?

A

Treat symptoms (pruritus) –low potency steroid cream

** use low potency steroid for the itch**

92
Q

Pregnancy Symptoms and Signs: pelvic organ changes ?

A

Chadwick’s sign

Hegar’s sign

Leukorrhea

Pelvic ligaments

Abdominal enlargement

Uterine contractions

93
Q

What is the Chadwick’s sign

?

A

Bluish discoloration of cervix and vagina

cause venous engorgement / congestion

94
Q

What is the Hegar’s sign

?

A

Widening and softening of body of uterus

Cervical softening and widening of os

Occurs at 6-8 weeks gestation ( early)

95
Q

What is the Leukorrhea ?

A

Vaginal discharge ( white , NL , just increased in amount)

96
Q

Pelvic Organ Changes: Pelvic ligaments ?

A

Relaxation of sacroiliac and pubic symphysis

97
Q

Pelvic Organ Changes: Abdominal enlargement ?

A

Good correlation between fundal measurement and gestational age ( checks fetal growth )

98
Q

Pelvic Organ Changes: Uterine contractions ?

A

Braxton-Hick’s – painless, tightening, pressure

Usually begin at 28 weeks

Often stop with walking, exercise

  • while true babe they get worse with exercise
  • not true labor, its like the uterus is getting ready
99
Q

Diagnosis: Fetal heart tones FHT’s ?

A

Handheld Doppler after10 weeks

Fetoscope after 18-20 weeks

100
Q

Diagnosis: Uterine size/Fetal palpation ?

A

Uterine enlargement or fetal parts/position

101
Q

Diagnosis: Imaging studies ?

A

Sonography

102
Q

Handheld Doppler after __weeks

A

10

103
Q

Fetoscope after_____ weeks

A

18-20

104
Q

Sonography ?

A

Crown-rump length (CR)

top of the head to the butt and very accurate at determine gestational age

105
Q

Diagnosis: Home pregnancy tests - qualitative ?

A

First voided morning urine sample

hCG (beta)

106
Q

Diagnosis: Urine pregnancy tests ?

A

In office, to confirm

Reliable, rapid, inexpensive

107
Q

Diagnosis: Serum pregnancy tests - quantitative ?

A

β-hCG – 6-12 days after conception

Used more for evaluating threatened abortion, ectopic and molar pregnancies

see if it is increasing or decreasing

108
Q

Uterine size: 8 weeks – ?

A

fundus at pubic symphysis

109
Q

Uterine size: 16 weeks – ?

A

midway between pubic symphysis and umbilicus

110
Q

Uterine size: 20 -22 weeks – ?

A

at umbilicus

111
Q

Uterine size: 18 weeks and up – ?

A

measure in cms from pubic symphysis to top of fundus

112
Q

Uterine size: After 36 weeks, ?

A

height may decrease as head descends into pelvis

** the baby drops and head goes into the pelvis **

113
Q

______ of pregnancies have complications

A

5-20%

114
Q

Prenatal care focuses on prevention and identification of ?

A

risk factors

115
Q

Evidence-based that prenatal care helps ? And IDs ?

A

Helps decrease complications

Identifies high-risk pregnancies for special care

116
Q

Prenatal Care: Ideally an evaluation occurs before conception ?

A

Identify risk factors

Discuss smoking, alcohol, teratogens

Discuss nutrition, exercise, vitamins

Start folic acid 3 months before conception

117
Q

Start folic acid __ months before conception

A

3

118
Q

Prenatal Hx: Obstetric history ?

A

Current symptoms

Outcomes of previous pregnancies

119
Q

Prenatal Hx: Medical history ?

A

Preexisting conditions such as :
diabetes, thyroid dz, HTN, epilepsy
Hx of blood transfusion

120
Q

Prenatal Hx: Surgical history ?

A

Previous abdominal, gynecologic procedures

Recurrent fetal losses
-cause cervical incompietnce, maybe it dilates to early

Previous Caesarean section

  • doesn’t always mean they will need another, VBACS
  • vaginal birth after c section

** ( cause we want to know about scar tissue) **

121
Q

Prenatal Hx: Family history ?

A

Diabetes, twinning, familial disorders

122
Q

Prenatal Hx: Social history ?

A

Tobacco, alcohol, contact with IVDU or other drug use

Exposures – workplace, home

123
Q

Prenatal Physical Exam: Complete PE at _____ visit ?

A

first

124
Q

Prenatal Physical Exam: Pelvic exam ?

A

Bony pelvis

Fundal height

Cervical length

Cervical os

125
Q

Pelvic exam: Bony pelvis ?

A

pelvimetry to assess for cephalopelvic disproportion (CPD).

inside of the pelvic rim measurements

Usually allow a trial of labor, though

126
Q

Pelvic exam: Cervical length?

A

3-4 cms average

127
Q

Pelvic exam: Cervical os?

A

nullip will be closed

multip may be partially open

128
Q

Prenatal Blood Tests on First visit ?

A

CBC - anemia

Blood group, Rh typing

Screen for antibodies against blood group antigens

VDRL/RPR

Hep B surface antigen

Antibodies to rubella and

HIV

Glucose challenge test (if hx of gest diabetes or risk factors for diabetes)

129
Q

Prenatal Blood Tests: Genetic screening - _________________ and maternal serum to screen for trisomy (21, 18 and 13)

A

Fetal nuchal translucency

130
Q

Prenatal Blood Tests: Genetic screening - Serum alpha fetoprotein (AFP) at _____ weeks to screen for open neural tube defects

A

15-18

131
Q

Prenatal Blood Tests: Genetic screening - Hemoglobin electrophoresis for ?

A

sickle cell, CF

132
Q

Prenatal Blood Tests: Genetic screening - Maternal serum testing – ?

A

whole panel!
more accurate

material serum is more comprehensive and less scary

133
Q

Prenatal Blood Tests: Invasive genetic testing -

A

Must be offered to all women, esp +35 or abnormal family hx or risk factors

Chorionic villus sampling at 9-13 weeks

Amniocentesis at 15-20 weeks

Complication rates are very low and detection for aneuploidy is +99%

134
Q

Chorionic villus sampling at_____ weeks

A

9-13

135
Q

Amniocentesis at ____ weeks

A

15-20

136
Q

Prenatal Tests: Urine testing ?

A

U/A with C&S

At EVERY visit – UA for

137
Q

Urine testing: Protein- ?

A

to assess kidneys

138
Q

Urine testing: Glucose ?

A

– though not usually significant unless gestational diabetes is present

139
Q

Urine testing: Ketones ?

A

– inadequate carb intake

140
Q

Prenatal Tests: Pap – at initial visit unless ?

A

normal exam in the past year

141
Q

Prenatal Tests: _________ – for high-risk patients ?

A

Tuberculin skin test

142
Q

Prenatal Tests: STDs ?

A 
Syphilis
Chlamydia
Gonorrhea
Herpes simplex virus - prophylaxis like acyclovir to keep it at bay if they delivery by vag. 
HIV
check prenatally to avoid transmission
143
Q

Prenatal Tests: Other infections ?

A

Trichomonas

Candidiasis – often asymptomatic

Bacterial vaginosis – can cause preterm labor, PROM, chorioamnionitis

G can cause eye injuries , premature labor ,

144
Q

Prenatal Visits: Standard schedule ?

A

Every 4 weeks from 0-28 weeks

Every 2 weeks from 28-36 weeks

Weekly after 36 weeks

145
Q

Prenatal Visits: Increased frequency depends on risk factors ?

A

Maternal conditions, age

Fetal complications

146
Q

Prenatal Visits: each visit ?

A 
Maternal weight gain
Blood pressure
Fundal height
Fetal heart tones
Edema
Fetal size and position
UA
147
Q

Maternal Weight Gain: Note ?

A

prepregnancy weight

148
Q

Maternal Weight Gain: Woman who is 15% or more below ideal body weight or of short stature is at risk for ?

A

small for gestational age (SGA) baby

149
Q

Maternal Weight Gain: ____________ – may have inadequate diet

A

Adolescents

150
Q

Maternal Weight Gain: ACOG recommends weight gain of ?

A

25-35 lbs

151
Q

Maternal Weight Gain: Obese women should gain ?

A

less (15-25 lbs) or risk of macrosomia (LGA)

152
Q

Maternal Weight Gain: Underweight women should gain more ?

A

(28-40 lbs)

153
Q

Blood Pressure should be taken while ?

A

sitting

154
Q

BP decreases _____ mm in 2nd trimester

A

5-7

155
Q

BP should go back to NL in ___ trimester

A

3rd

156
Q

BP Elevation may precede __________ ?

A

proteinuria

157
Q

Fundal Height Measured at each visit after ?

A

20 weeks

158
Q

Fundal Height: If measurement does meet expected amount by more than 2 (cms or weeks) then further evaluation of _______________________ is needed

A

fetal size and amount of amniotic fluid via US

159
Q

Fetal Heart Tones ?

A

Doppler

Fetoscope

Rate, rhythm
-110-160, higher rate earlier in pregnancy

Accelerations, decelerations of rate

160
Q

Edema: Note any _________ episodes of generalized edema

A

transient

161
Q

Edema: Leg edema in late pregnancy is ________

A

natural

162
Q

Edema: Edema of upper body – face and hands, esp with ↑ BP may be first sign of ?

A

preeclampsia

163
Q

Fetal Size and Position: After 26 weeks – ?

A

Leopold’s maneuvers

164
Q

Fetal Size and Position: Persistence of abnormal lie into late pregnancy suggests abnormality ?

If abnormal lie persists, consider ?

A

Abnormal placenta
Uterine anomaly
Need US

external version after 37 weeks
painful

165
Q

Third Trimester Evaluations: 1-hour glucose challenge test with a 50 g glucose load at _________ (all patients)

A

24-28 weeks

check 1 hr glucose

and CBC

166
Q

Third Trimester Evaluations: Group B streptococcus ?

A

Universal vaginal and rectal cultures at 35-37 weeks

if pos. give them PCN at labor

and CBC

167
Q

Group B Streptococcus: Antibiotics to mothers who ?

A

Have positive cultures

Delivered a prior neonate with group B strep infxn

Had group B strep bacteruria during current pregnancy

Have known risk factors for PROM, prematurity

Women with group B strep who are scheduled for C section before rupture of membranes do not need antibiotics

168
Q

Group B Streptococcus: __ of neonates exposed to group B strep develop symptoms

A

2%

so Treat mothers with antibiotics before labor

169
Q

Neonate sxs GBS ?

A

Group B Streptococcus

170
Q

GBS drug of choice ?

A

Pen G

Cefazolin if penicillin allergy and no hx of anaphylaxis with penicillin

171
Q

Other Issues of Prenatal Care ?

A

Bathing and swimming are permitted

Douching should be avoided

Smoking ↑ risk of IUGR, placenta previa, placenta abruption, preterm birth

Alcohol can cause FAS even with 2 oz/day
fetal alcohol syndrome

Exercise encouraged, esp yoga

172
Q

Immunization to pregnant women ?

A

killed, toxoid or recombinant vaccines okay. Encourage flu shot. NO live vaccines

**no live vaccinate like MMR, varicella **

173
Q

Intercourse in pregnant women ?

A

okay unless pain or bleeding occurs

174
Q

______ is permitted (auto, train, plane) in pregnant women

A

Travel

175
Q

Prenatal Care: Nutrition ?

A

balanced diet, prenatal vitamins

176
Q

Nutrition: 127 lbs prepregnant = ?

A

2300 kcal/day

177
Q

Nutrition: Additional ___ kcal during pregnancy

A

300

178
Q

Nutrition: Additional ___ kcal during breastfeeding

A

500

179
Q

Imaging in Obstetrics: Safe

Widely available ?

A

Primary modality is 2-D US

180
Q

Imaging in Obstetrics: Good for certain circumstances

Too costly for routine use ?

A

3D/4D US and MRI available

  • *good if you expect abnormality like cleft palate
  • *
181
Q

Imaging in Obstetrics: Limited use because of safety issues

May be necessary in some maternal conditions ?

A

CT

182
Q

Ultrasound Imaging options ?

A

Transabdominal or transvaginal probe

Choice depends on what is being evaluated

183
Q

US: cervix or early gestation choice ?

A

transvaginal

184
Q

US: fetus in 3rd trimester choice ?

A

trans abdominal

185
Q

First Trimester US Indications ?

A

Confirm intrauterine pregnancy
-and location so it is good for ectopics

Assess pelvic pain and bleeding

Estimate gestational age

Confirm viability ( HR)

Determine number of gestations

Genetic screening

Evaluate basic anatomy

Nuchal translucency - downs syndrome

Assess uterine and adnexal anomalies

186
Q

Second and Third Trimester US screens for ?

A

Fetal anomalies

Fetal growth – BPD, HC, AC,
femoral length

Fetal well-being (next slide)

Fetal lie and presentation

Placental anomalies

Cervical insufficiency

Gestational age

Number of gestations
Viability

**bi-parietal diameter for hypocephalus etc.
Head circumference and abdominal circumference **

187
Q

Fetal Well-Being: BPP ?

A

Biophysical profile (BPP)

4 US parameters and a nonstress test

Scored 0-10/10

188
Q

Fetal Well-Being: Fetal Doppler exam ?

A

Measure of speed that blood is moving in a vessel (artery or vein)

189
Q

US for Cervical Evaluation ?

A

Shape and length

Most helpful earlier in gestation

Can help determine risk for preterm labor

Determine need for progesterone or cerclage

190
Q

Non-stress test ?

A

two or more fetal HR accelerations peak at least 15 beats per minute above the baseline and last 15 seconds from baseline to baseline w/in 20 minute period w/ or w/o fetal movement discernible by the woman

191
Q

Amniotic fluid volume ?

A

A single 2 cm x 2 cm pocket is considered adequate of AFI greater than 5 cm

192
Q

Fetal breathing movements ?

A

One or more episodes of rhythmic fetal breathing movements of 30 seconds or more w/in 30 minutes

193
Q

Fetal movements ?

A

At least 3 discrete body or limb movements.

Episodes of continuous movement are considered as a single movement

194
Q

Fetal tone ?

A

One or more episodes of extension of a fetal extremity or trunk with return to flexion, or opening or closing of a hand

Patient Evaluation (29 decks)

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