OB 1 Kenobi

Question 1

What is the “count to 10 method?”

Answer 1

Perception of 10 fetal movements over 2 hours

or

Perception of 4 fetal movements over 1 hour (while mother is at rest)

Question 2

What testing should be done at 15-20 weeks gestation? (during 2nd trimester)

Answer 2

Invasive Dx Testing

• Amniocentesis (genetic material from amniotic fluid is extracted, risk of miscarriage is 0.6%)

Question 3

When does the baby drop in fundal height?

Answer 3

36-38 weeks

Question 4

Describe Hegar’s Sign

(normal pregnancy PE finding)

Answer 4

Softening of uterine isthmus

6-8 weeks gestation

Question 5

What is Nagele’s rule?

Answer 5

Used to calculate Expected Date of Confinement (EDC)

• Add 7 days to LMP
• Subtract 3 months

Question 6

Define 3rd trimester

Answer 6

29-40 weeks (12 weeks)

Question 7

When should a woman start taking prenatal vitamins?

Answer 7

3 months prior to conceiving

Question 8

Define post-term infant

Answer 8

Live born birth AFTER 42 weeks gestation

(perinatal mortality (death of fetus or neonate) increases as gestation advances beyond due date)

Question 9

At 12 weeks, what anatomical landmark is the fundal height?

Answer 9

pubic symphysis

Question 10

An US completed at the initial OB visit can do what 2 things?

Answer 10

• Establish/Confirm EDC
• Detect fetal heart activity at 5-6 weeks gestation

Question 11

How is gestational age calculated?

Answer 11

Age of fetus calculated from 1st day of LMP

(includes 2 weeks when woman is not pregnant)

Question 12

What murmur is seen in pregnancy and totally normal for pregnancy?

Answer 12

Systolic ejection murmur

Question 13

What is the total weight gain for pregnancy?

Answer 13

25-35 lbs

Question 14

Define neonate

Answer 14

Live born birth –> 28 days old

Question 15

Describe Goodell’s sign

(normal pregnancy PE finding)

Answer 15

Softening of cervix

4-6 weeks

Question 16

Define 2nd trimester

Answer 16

13 - 28 weeks (16 weeks)

Question 17

• Most home pregnancy tests are + by the time of a missed menses (+/- 1 week), HCG is approximately what??
• HCG is produced by what? Rises exponentially for how many weeks before it plateaus?
• Corpus luteum produces what hormone until how many weeks post-fertilization?

Answer 17

• 25
• placenta / 10 weeks
• progesterone till 6 weeks, then placenta takes over

Question 18

What happens to Tidal Volume, PO2, Expiratory Reserve, and PCO2 in pregnancy?

Answer 18

↑ TV & PO2

↓ Exp Reserve & PCO2

Question 19

What are 4 visible sxs of pregnancy?

Answer 19

• Linea nigra
• Melasma (>16 weeks = mask of preg)
• Leukorrhea
• Stretch marks

Question 20

How is Fetal age calculated?

Answer 20

Age of fetus calculated from time of implantation

(2 weeks less than gestational age) = actual fetus age

Question 21

How much folic acid supplementation is needed for low risk vs. high risk?

Most prenatal vitamins contain how much folic acid?

Answer 21

• Low risk: 0.4 mg
• High risk: 4 mg
• Vitamins: 1 mg

Question 22

Define 1st trimester

Answer 22

1 - 12 weeks (12 weeks)

Question 23

What happens to gastric motility, gallbladder empyting, GFR, plasma volume, and WBCs in pregnancy?

Answer 23

↓ gastric motility & delayed gallbladder emptying

↑ GFR, plasma volume, WBCs

Question 24

Define preterm infant

Answer 24

Born prior to 37 weeks gestation

Question 25

Define a fetus

Answer 25

9th week --\> birth

Question 26

Define an embryo

Answer 26

Fertilization --\> 8th week

Question 27

When is fundal height measured? When do cervical exams begin?

Answer 27

**Fundal H:** 20 weeks gestation **Cervical:** 37 weeks gestation

Question 28

What testing should be done at 16-18 weeks gestation (during 2nd trimester)?

Answer 28

**_Genetic Screening_** * **Quad screen:** maternal blood testing of AFP, HCG, Estriol, Inhibin A * **↑ AFP** = neural tube defects or multiple gestation * **Abnormal levels** of AFP, HCG, Estriol, AND Inhibin A **(all 4 tests)** = Trisomy 18 or 21

Question 29

What happens to CO, SV, and systemic vascular resistance in pregnancy?

Answer 29

↑ CO & SV ↓ SVR

Question 30

What testing is done at 10-12 weeks gestation (during 1st trimester)?

Answer 30

**_Invasive Dx Testing_** * **Chorionic Villus Sampling** (risk of miscarriage is 1%, extracts cells from placenta)

Question 31

What is "quickening" and how many weeks gestation does it occur?

Answer 31

First perception of fetal movement * Primigravida (18-20 weeks) * Multigravida (16-20 weeks)

Question 32

What are the frequencies of prenatal care visits? (4)

Answer 32

* Initial visit 6-8 weeks after LMP * Monthly until 28 weeks gestation * Bimonthly 28 weeks - 36 weeks gestation * Weekly 36 weeks until delivery

Question 33

Define an infant

Answer 33

Live born birth --\> 1 year old

Question 34

What are 2 abnormal findings on a UA for pregnancy?

Answer 34

Proteinuria Glucosuria

Question 35

What testing should be done at 11-13 weeks gestation (end of 1st trimester)?

Answer 35

**_Genetic Screening for Down Syndrome_** * **US** to assess nuchal translucency w/ ↑ fluid/thickening and absence of fetal nasal bone * **Maternal Blood Testing:** * ↑ HCG levels * ↓ PAPP-A (pregnancy associated plasma protein A

Question 36

In which trimester is the fetus most sensitive to teratogens?

Answer 36

1st trimester

Question 37

Fetal heart tones begin at what weeks gestation? What is used to evaluate them? How many bpm?

Answer 37

10-12 weeks gestation Hand held doppler 120-160 WNL

Question 38

What are 6 sxs of pregnancy?

Answer 38

* Amenorrhea * N/V (↑HCG, multiple gestation, molar preg) * Breast tenderness * Fatigue * Urinary freq/nocturia * ↑ incidence of UTIs

Question 39

How do you measure fundal height after 20 weeks gestation (from the umbilicus)

Answer 39

1 cm for each week

Question 40

Describe Chadwick's sign | (normal pregnancy PE finding)

Answer 40

Bluish cervix 8-12 weeks gestation

Question 41

At 20 weeks, what anatomical landmark is the fundal height?

Answer 41

Umbilicus

Question 42

What time is fetal movement greatest?

Answer 42

Night

Question 43

* beta HCG levels do what in a normal pregnancy? * What causes sxs in the 1st trimester?

Answer 43

* Double every 48 hours (normal) * Increase in HCG & progesterone causes nausea/vomiting