Normal Pregnancy, Antepartum Care - Moulton Flashcards
what are some sex linked disorders?
Dx how?
DMD
Fragile X - #2 mental retards
Chorionic villus sampling or amniocentesis
Which anticoagulant crosses the placenta?
Which does not?
Coumadin
Heparin
What causes phocomelia?
Thalidomide
SAB or congenital malformations are as high as 50% in women who take what in 1st trimester?
Retinoids (accutane)
What levels of b-hCG and PAPP-A associated w/down’s?
What additional assessment can make this dx?
Elevated b-hCG and low PAPP-A
Nasal bone assessment to NT thickness (INCREASED)
When do leg cramps occur?
Last half of pregnancy
More frequent at night in calves
Crown rump length bw when can determine due date w/in 7 days?
6-11 weeks
How does Hct change in pregnancy?
Hb?
platelets?
Factors 7-10?
Dec 4-7%
Dec 1.5-2 by 30-34 wks
Slight decrease
Increase
Kick count can be done when?
Feel how many in 2 hour period?
Most active when?
28 weeks
10x
9pm-1am
What test is done at 20 weeks?
28 weeks?
35 weeks?
US
Screen for GD, RhoGAM if needed, admin Tdap
Screen for GrpB strep - treat in labor if +
When do you perform amniocentesis?
Chorionic villi sampling?
16-20 weeks
11 weeks, higher miscarriage rate
Radiation is dose dependent and what level of exposure carries NO risk?
Less than 5 rads
What is a reactive result for nonstress test (NST)?
2 accelerations of at least 15 beats above baseline lasting at least 15 seconds during 20 minutes of monitoring
Name some prenatal labs done at 1st visit
Laundry
CBC type and screen for Rh Syphilis HepB surface Ag HIV, gonorrhea, chlamydia DM UA
What tests are done at prenatal office visits?
BP BMI Urine protein Uterine size Fetal HR
Give some AR disorder laundry
Tay-Sachs
Sickle cell
thalassemia
CF - most common in whites
Contraction stress test is looking to establish what?
Give what?
What is a + test?
3 contractions in 10 min
Oxytocin
Late decelerations -> deliver baby
Fetal hydration syndrome is due to what?
How do they look?
Diphenylhydantoin (Dilantin)
Craniofacial abnormalities, growth Restriction, mental deficiency, CV anomalies
1st trimester screening includes what?
Maternal age
NT thickness (inc assoc w/chromosomal abnormalities)
B-hCG
PAPP-A
Noninvasive prenatal testing cell-free fetal DNA occurs when?
Tests what?
For what conditions?
9-10 wks (also 1st/2nd trimester) in high risk populations
Trophoblastic cells
Trisomy 13, 18, 21 but NOT NTD
Level above ____ IU/L considered positive?
25 - hCG
What is the most common teratogen?
Alcohol
When do prenatal office visits occur?
Every 4 weeks until 28 weeks
Every 2 from 28-36
Weekly until delivery
What is Naegels rule?
Need what?
Take LMP, minus 3 months, add 7 days and add 1 year to get expected delivery date
Regular 28 day periods
When to start folic acid supplementation?
Dose with no hx of NTD?
Dose w/Hx of NTD?
1 month before conception
0.4 mg
4 mg
When is the most vulnerable stage for teratology?
Day 17 - 56 post conception (organogenesis)
What 2nd trimester triple screen tests are used?
Quadruple?
B-hCG
Estriol
AFP
Same + Inhibin A
Give some AD disorder laundry
Tuberous sclerosis NF PCOS Muscular dystrophy Achondroplasia craniofacial synostosis
Total score of 8-10 of the biophysical profile indicates what?
6?
4 or less?
Reassuring
Deliver if pt is at term
Nonreassuring, consider delivery
What is gestational age?
of weeks bw 1st day of LMP and date of delivery
