Normal and Abnormal Pregnancy

Question 1

how long are the trimesters?

Answer 1

14 weeks each

Question 2

what is used to determine pregnancy duration?

Answer 2

last menstrual period

Question 3

what is Naegle’s rule for estimated due date?

Answer 3

add 7 days to last menstrual period
subtract 3 months

Question 4

what frequency should repeat prenatal visits be?

Answer 4

q 4 weeks until 28 weeks
q 2 weeks until 28-36 weeks
every week after 36 weeks

Question 5

in normal pregnancy, blood volume increases by ____-____%

Answer 5

40-45

Question 6

during which trimester does blood volume expand the most rapidly in?

Answer 6

2nd trimester

Question 7

the spontaneous termination of pregnancy before fetal viability

Answer 7

abortion

Question 8

ovulation may resume as early as _____ weeks after an early abortion

Answer 8

2

Question 9

what is the management for abortion? (2)

Answer 9

control bleeding
infection control

Question 10

during which trimester are abortions most common in?

Answer 10

1st trimester

Question 11

lack of embryonic/fetal development without cardiac motion on US without cervical dilation. Dx? management?

Answer 11

missed abortion

wait
misoprostol VS dilation + curettage

Question 12

lack of embryonic/fetal development without cardiac motion on US with incomplete uterine emptying. Dx? management?

Answer 12

incomplete abortion

misoprostol VS dilate + curettage

Question 13

lack of embryonic/fetal development without cardiac motion on US and complete evacuation of the uterus. Dx? management?

Answer 13

complete abortion

tissue testing + reassurance

Question 14

implantation of a fertilized egg in a location outside of the uterine cavity

Answer 14

ectopic pregnancy

Question 15

what is the leading cause of maternal death due to hemorrhage in the 1st trimester?

Answer 15

ectopic pregnancy

Question 16

any degree of glucose intolerance with onset or first recognition during pregnancy; does not exclude the possibility that unrecognized glucose intolerance may have antedated the pregnancy

Answer 16

gestational diabetes

Question 17

when should low and average risk women be screened for gestational diabetes?

Answer 17

24-28 weeks gestation

Question 18

what screening test is used for gestational diabetes?

Answer 18

1 hr oral glucose challenge

Question 19

what diagnostic test is used for gestational diabetes?

Answer 19

3 hr glucose tolerance test

Question 20

what levels in a 1 hr screening test are diagnostic of gestational diabetes?

Answer 20

fasting plasma BG > 126 and
1 hr plasma BG > 200

Question 21

what levels in a 3 hr test are diagnostic of gestational diabetes?

Answer 21

if 2/4 blood sugar are elevated

Question 22

how to optimize glucose control? (3)

Answer 22

monitor 4 times / day
consult dietician
exercise program

Question 23

what is the 1st line option to medically treat gestational diabetes?

Answer 23

insulin

Question 24

diagnosis of gestational diabetes warrants evaluation _____ to ensure resolution of disease. what test is used?

Answer 24

postpartum

2 hr glucose tolerance test

Question 25

when should a postpartum GTT be performed?

Answer 25

6-12 weeks postpartum

Question 26

classified as no proteinuria, onset over 20 weeks gestation, or an onset within 48-72 hours of delivery but resolved by 12 weeks post-partum

Answer 26

gestational hypertension

Question 27

what is the preeclampsia triad?

Answer 27

hypertension
proteinuria
edema

Question 28

what is one of the leading causes of maternal morbidity/mortality in the US?

Answer 28

preeclampsia

Question 29

when is preeclampsia known to occur?

Answer 29

during 1st pregnancies

Question 30

what is required to diagnose preeclampsia?

Answer 30

> 140/90 on two separate occasions after 20 weeks gestation
OR
160/110
AND proteinuria

Question 31

what must be present to diagnose preeclampsia without proteinuria? (5)

Answer 31

thrombocytopenia
renal insufficiency
impaired liver function
pulmonary edema
cerebral/visual symptoms

Question 32

what are the symptoms in the variant of severe preeclampsia?

Answer 32

HELLP

Hemolysis
Elevated Liver enzymes
Low Platelets

Question 33

what is the only treatment for preeclampsia?

Answer 33

delivery

Question 34

tonic-clonic seizure as a manifestation of preeclampsia. treatment?

Answer 34

eclampsia
magnesium sulfate + deliver

Question 35

what are the 3 mainstays of management of preeclampsia?

Answer 35

prevention of seizures
control hypertension
expedite delivery

Question 36

chronic hypertension with development of new onset proteinuria after 20 weeks gestation

Answer 36

chronic hypertension with superimposed preeclampsia

Question 37

what constitutes preterm delivery?

Answer 37

delivery < 37 weeks gestation or birth weight < 2500 g

Question 38

what grade is texas in terms of prematurity report card?

Answer 38

D

Question 39

transient state of tearfulness, anxiety, irritation, and restlessness that occur in the 1st week of postpartum and resolve by day 10

Answer 39

postpartum blues

Question 40

management for postpartum blues?

Answer 40

reassurance

Question 41

what is the treatment for postpartum depression?

Answer 41

antidepressants
supportive care

Question 42

what 2 psycho-related reactions are most common postpartum and typically last 2-3 months?

Answer 42

schizophrenia
bipolar

Question 43

treatment for postpartum psychosis?

Answer 43

hospitalization