Normal Pregnancy: Antepartum care

Question 1

When does a mom need to start takling folic acid to prevent NTD’s?

Answer 1

-1 month before conception

Question 2

What will the G and P thing look like if a woman has given birth to 1 set of twins at term and both are living?

Answer 2

• G1P1002

Question 3

What do the 4 numbers after the P mean?

Answer 3

• FPAL
• Full term
• preterm
• abortions
• living

Question 4

What does the G mean?

Answer 4

Gravidity

-how many times she’s been knocked up

Question 5

Woman has given birth to one term infant, one set of preterm twins, and has had 1 miscarriage and 1 ectopic preggo… what are the G and P’s thing?

Answer 5

-G4P1123

Question 6

What do Rh negative patients receive?

Answer 6

-Rhogam at 28 weeks ad anytime sensitization may occur

Question 7

What lab value in preggo did he point out?

Answer 7

-hematocrit and hemoblobin decreased because of dilution at 30-34 weeks

Question 8

when is the gestational sac seen and what is the mean hCG at that time?

Answer 8

• 5 weeks

- 1500 to 2000

Question 9

What is Naegels rule?

Answer 9

• minus 3 month and 7 days from LMP
• that is the expected date of delivery
• only useful in patients with regular 28 day cycles

Question 10

When can fetal demise be diagnosed?

Answer 10

-when the CRL > 5mm with absence of fetal cardiac activity

Question 11

When does the neural tube close?

Answer 11

• at 28 days post conception

- remember 4 mg of folic acid

Question 12

What do we look for in first trimester screeening?

Answer 12

-PAPP-A

Question 13

What is associated with elevated BhCG and low PAPP-A?

Answer 13

-Down syndrome

Question 14

What detects trisomies really well?

Answer 14

• Cell-free fetal DNA tests
• can be done in 1st or 2nd trimester
• does not test for open NTD’s

Question 15

What does Thalidomide cause?

Answer 15

• Phocomelia

- they have paddle-like limbs

Question 16

Which anticoagulant crosses the placenta?

Answer 16

• coumadin

- can cause spontaeous abortion

Question 17

What anticoagulant does NOT cross the placenta?

Answer 17

-Heparin

Question 18

Which anti seizure med do we not really use?

Answer 18

• valproate

- can give spina bifida

Question 19

Which drug gives you t shaped uterus?

Answer 19

-DES

Question 20

Why do hemorrhoids happen in preggo?

Answer 20

-increase in venous pressure in the rectum

Question 21

at 28 weeks, what do we give Rh negative patients?

Answer 21

-Rhogam

Question 22

At 35 weeks, what do we do for screeing?

Answer 22

• look for group B strep with vaginal culture

- treat in labor if positive

Question 23

How many kicks should be there in 2 hours?

Answer 23

-10 movements

Question 24

What is a nonstress test?

Answer 24

• can be either reactive or non reactive

- look at how many accelerations are over a time interval

Question 25

What is a reactive NST?

Answer 25

• 2 accelerations of at least 15 beats above baseline lasting at least 15 seconds during 20 minutes of monitoring
• if test is nonreactive, further evaluation is warranted with a contraction stress test or biophysical profile

Question 26

What is a contraction stress test (CST)?

Answer 26

• give them oxytocin to establish at least 3 contractions in a 10 min period
• if late decelerations are noted with the majority of contractions the test is positive and DELIVERY IS WARRANTED