Normal Pregnancy: Antepartum care Flashcards
When does a mom need to start takling folic acid to prevent NTD’s?
-1 month before conception
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?
- G1P1002
What do the 4 numbers after the P mean?
- FPAL
- Full term
- preterm
- abortions
- living
What does the G mean?
Gravidity
-how many times she’s been knocked up
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?
-G4P1123
What do Rh negative patients receive?
-Rhogam at 28 weeks ad anytime sensitization may occur
What lab value in preggo did he point out?
-hematocrit and hemoblobin decreased because of dilution at 30-34 weeks
when is the gestational sac seen and what is the mean hCG at that time?
- 5 weeks
- 1500 to 2000
What is Naegels rule?
- minus 3 month and 7 days from LMP
- that is the expected date of delivery
- only useful in patients with regular 28 day cycles
When can fetal demise be diagnosed?
-when the CRL > 5mm with absence of fetal cardiac activity
When does the neural tube close?
- at 28 days post conception
- remember 4 mg of folic acid
What do we look for in first trimester screeening?
-PAPP-A
What is associated with elevated BhCG and low PAPP-A?
-Down syndrome
What detects trisomies really well?
- Cell-free fetal DNA tests
- can be done in 1st or 2nd trimester
- does not test for open NTD’s
What does Thalidomide cause?
- Phocomelia
- they have paddle-like limbs
Which anticoagulant crosses the placenta?
- coumadin
- can cause spontaeous abortion
What anticoagulant does NOT cross the placenta?
-Heparin
Which anti seizure med do we not really use?
- valproate
- can give spina bifida
Which drug gives you t shaped uterus?
-DES
Why do hemorrhoids happen in preggo?
-increase in venous pressure in the rectum
at 28 weeks, what do we give Rh negative patients?
-Rhogam
At 35 weeks, what do we do for screeing?
- look for group B strep with vaginal culture
- treat in labor if positive
How many kicks should be there in 2 hours?
-10 movements
What is a nonstress test?
- can be either reactive or non reactive
- look at how many accelerations are over a time interval
What is a reactive NST?
- 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
What is a contraction stress test (CST)?
- 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
