OB basics and prenatal care Flashcards
EDD
LMP, go back 3 months, add 7 days
Gravida
parity
G: # of total pregnancies
P: # of deliveries
P _ _ _ _
# of term infants # of premature deliveries # of abortions # of living children
frequency of prenatal visits
- initial visit 6-8 weeks after LMP
- examined every 4 weeks until 32nd week
- every 2 weeks up to 36 weeks
- weekly after
fundal ht checked first when
20 wks
check fetal hrt movement when
-nml rate
10 weeks
- 120 to 160 bpm
UA for what
glucosuria, ketonuria, proteinuria
what is quickening
first awareness of fetal movement; usually occurs 18-20 weeks in primigravida; 14-18 wks in multigravada
bleeding gums, profuse salivation, increasing varicositis, heartburn, hemorrhoids, fatigue
common complaints of PG
Advanced maternal age
35 y.o
chadwicks sign
6-8 weeks after conception
bluish cervix, vagina, labia due to venous congesion secondary to increase in estrogen
hegars sign
4-12 weeks after conception
softening of the uterine isthmus allowing palpation or compression of the connection between the fundus and cervix
ultrasound can detect fetal heart activity as early as when
5-6 weeks after LMP
what can indicate increased risk of trisomy 21
abnormally low PAPP-A and abnormally high free B-hCG
nuchal scan
-when
screen for trisomy 13, 18, 21, turner syndrome
- 10-13 weeks
b hCG peaks ..
- 100,000 by 10 weeks, decreases in 2nd trimester, then levels off in 3rd trimester
- it doubles every 48 hrs during early pregnancy
- ectopic
- monitor trophoblastic disease
- screen for fetal aneuploidy
get a quantitative b hCG when (3)
CVS advantage
- diagnostic or screening
adv: can be performed in 1st trimester, results back within 48 hrs
* * diagnositc not screening
CVS disadvantages
disadv: cannot be used in AFP testing for neural tube defects; infections, miscarriages, can get limb defects < 9wks
quadruple screen
15-18 wks; estriol, AFP, inhibin A, b hCG
CVS when. results when
10-13 wks; 48 hrs
amniocentesis when; results when
15-18 wks; 7 days
high AFP; %
risk of neural tube defects; 75-85%
estriol, AFP, and inhibin A shows risk for trisomy 21
high estriol and AFP, low inhibin A
decels
decrease in HR 15bpm or lasting over 15 seconds; or a slow return to baseline
biophysical profile
2 points each:
NST, amniotic fluid, gross fetal movements, fetal tone, fetal breathing
miscarriage risk of
- CVS
- amniocentesis
CVS: 0.7 - 1.3%
amniocentesis: 0.2-0.3%
glucose test
fasting, given 50 gms po. should be below 100.
1 hr: below 180
2 hr: below 155
3 hr: less than 140
what is CVS
biopsy of placental tissue to obtain chromosomal info about the fetus
which prenatal test for testing fetal lung development at 32 wks
amniocentesis
can a quadruple screen be used for a diagnostic diagnosis for trisomy 21
no
which Rh is bad and what can it lead to
negative. hemolysis of fetal Rh RBCs
indirect coombs test
test mom’s antibody production if she is negative
direct coombs test
test if fetal RBC have antibodies attached to them
% of population that is Rh negative
15%
3 things that increase risk for Rh problems
spontaneous abortion, therapeutic abortion, previous delivery with no Rhogam given
Rh antibody titer of what needs monitoring
1:16
does RBC or IgG cross the placenta
IgG
monitor Rh problems with what 2 tests
amniocentesis and ultrasounds
4 labs to get for the fetus in Rh pregnancies
fetal bilirubin, CBC, Hgb, U/S
give rhogam when
at 28 wks and within 72 hours of delivery; or trauma
+ CST vs - CST test
+ is bad; - is good
