Normal Pregnancy Flashcards
What is the overall idea behind preconception care and what are two examples he gave?
Get mom as healthy as possible before getting pregnant.
EX. Starting folic acid a month before and make sure diabetes in under control before getting pregnant.
How do we define gravidity and parity and how can we break down parity?
Gravidity refers to the number of times a woman has been pregnant
Parity is the number of pregnancies that led to a birth at or beyond 20 weeks or a baby weighing more than 500 grams.
Break down parity to FPAL, how many were full term, pre term, abortions, and living currently.
What is considered a positive and negative hCG test and what should the hCG level be at time of expected next menses?
Above 25
Less than 5
100
At what weeks do we see gestational sac, fetal pole and here cardiac activity with TVUS?
5 weeks
6 weeks
7 weeks
What is naegel’s rule?
Estimating due date
From the start of last menstrual cycle, add 9 months and 7 days
Who do we send to genetic counseling?
Mom is 35 years and older
Any history of mental retardation
Any history of losing babies
Really any abnormality
4 most common presenting chromosomal disorders in live births?
Tuners, Klinefelter, balanced robertsonian translocations, autosomal trisomies/Down syndrome
Women 35 and older are at risk for which 3 trisomies and which one is most common?
13,18,21 (most common)
When should chromosomal studies be done for couples, most common class of spontaneous abortions, and most common single chromosome abnormality found in spontaneous abortions?
When a couple has had 3 or more SABs
Trisomy (16 most common)
45 XO
What are the two tests that can be done to determine the chromosomal abnormality?
Amniocentesis or chorionic villus sampling
What is the most common autosomal recessive gene in North America Whites that leads to an inherited disorder?
CF
What is the most common form of inherited mental retardation?
Fragile x syndrome
What are the 4 first trimester screening tests we can do for Down syndrome?
Maternal age
Fetal nuchal translucency thickness test
Maternal beta hCG
Pregnancy associated plasma protein A
What is indicative of chromosomal or congenital anomalies on the nuchal test?
Increased thickness
What about the two serum markers, what can they show us?
Elevated bHCG and low PAPPA can be indicative of trisomy 21
What is the most specific combo of results that indicates Down syndrome?
Elevated bHCG, low PAPPA, nuchal thickness and absent of nasal bone.
What are the two second trimester screenings and what are they trying to detect?
Triple screen: bHCG, estriol and maternal AFP trisomy 21
Quad screen: bHCG, estriol, maternal AFP and Inhibin A trisomy 21
What is noninvasive prenatal testing cell free fetal DNA and how elective is it?
Acquire dead fetal cells in moms circulation and the detection rate is very high for chromosomal abnormalities
Who gets cell free fetal DNA?
High risk patients like advanced maternal age, history of abnormal chromosomes, and US showing abnormalities suggestive of chromosomal abnormalities
What is FDA risk factor category A for pregnancy and breast feeding?
Controlled human studies show no evidence of risk in pregnancy
What is FDA B risk factor category for pregnancy and breast feeding?
Animal studies show no risk but there are no human studies
Animal studies show risk but human studies show no risk
What is c risk category for pregnancy and breast feeding?
No adequate studies
What is D risk category?
Good studies have in pregnant women have shown a risk.
But the benefit may outweigh the risk in emergency situations
Risk x category for pregnancy and breast feeding?
Contraindicated. Too much risk.
What info is Pregnancy 8.1 subsection required to post?
Risk and clinical considerations
Lactation 8.2 subsection?
Info about drugs while breastfeeding, amount of drug and potential effects to baby
What is the Reproductive 8.3 subsection required to say? 3 things.
How the drug will affect fertility, contraception recommendations while on the drug and need for pregnancy testing if applicable.
What is the most vulnerable time to teratogens and why?
Day 17 to 56
Organs are growing and developing
