OB 1 Kenobi

Question 1

Define an embryo

Answer 1

Fertilization –> 8th week

Question 2

Define a fetus

Answer 2

9th week –> birth

Question 3

Define preterm infant

Answer 3

Born prior to 37 weeks gestation

Question 4

Define neonate

Answer 4

Live born birth –> 28 days old

Question 5

Define an infant

Answer 5

Live born birth –> 1 year old

Question 6

Define post-term infant

Answer 6

Live born birth AFTER 42 weeks gestation

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

Question 7

What is Nagele’s rule?

Answer 7

Used to calculate Expected Date of Confinement (EDC)

• Add 7 days to LMP
• Subtract 3 months

Question 8

How is gestational age calculated?

Answer 8

Age of fetus calculated from 1st day of LMP

(includes 2 weeks when woman is not pregnant)

Question 9

How is Fetal age calculated?

Answer 9

Age of fetus calculated from time of implantation

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

Question 10

In which trimester is the fetus most sensitive to teratogens?

Answer 10

1st trimester

Question 11

Define 1st trimester

Answer 11

1 - 12 weeks (12 weeks)

Question 12

Define 2nd trimester

Answer 12

13 - 28 weeks (16 weeks)

Question 13

Define 3rd trimester

Answer 13

29-40 weeks (12 weeks)

Question 14

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

Answer 14

↑ TV & PO2

↓ Exp Reserve & PCO2

Question 15

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

Answer 15

↑ CO & SV

↓ SVR

Question 16

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

Answer 16

↓ gastric motility & delayed gallbladder emptying

↑ GFR, plasma volume, WBCs

Question 17

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

Most prenatal vitamins contain how much folic acid?

Answer 17

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

Question 18

• 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 18

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

Question 19

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

Answer 19

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

Question 20

What are 6 sxs of pregnancy?

Answer 20

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

Question 21

What are 4 visible sxs of pregnancy?

Answer 21

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

Question 22

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

Answer 22

Systolic ejection murmur

Question 23

Describe Chadwick’s sign

(normal pregnancy PE finding)

Answer 23

Bluish cervix

8-12 weeks gestation

Question 24

Describe Hegar’s Sign

(normal pregnancy PE finding)

Answer 24

Softening of uterine isthmus

6-8 weeks gestation

Question 25

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

Answer 25

Softening of cervix 4-6 weeks

Question 26

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

Answer 26

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

Question 27

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

Answer 27

**_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 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

When should a woman start taking prenatal vitamins?

Answer 29

3 months prior to conceiving

Question 30

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

Answer 30

**_Invasive Dx Testing_** * **Amniocentesis** (genetic material from amniotic fluid is extracted, risk of miscarriage is 0.6%)

Question 31

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

Answer 31

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

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

What is the total weight gain for pregnancy?

Answer 33

25-35 lbs

Question 34

What are 2 abnormal findings on a UA for pregnancy?

Answer 34

Proteinuria Glucosuria

Question 35

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

Answer 35

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

Question 36

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

Answer 36

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

Question 37

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

Answer 37

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

Question 38

What is the "count to 10 method?"

Answer 38

Perception of 10 fetal movements over 2 hours **or** Perception of 4 fetal movements over 1 hour (while mother is at rest)

Question 39

What time is fetal movement greatest?

Answer 39

Night

Question 40

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

Answer 40

pubic symphysis

Question 41

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

Answer 41

Umbilicus

Question 42

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

Answer 42

1 cm for each week

Question 43

When does the baby drop in fundal height?

Answer 43

36-38 weeks