OB Exam 1 Flashcards
What is the goal of genetic counseling?
To identify risk
What’s the earliest genetic testing available?
Chorionic Villus Sampling; at 10-13 weeks
How is Chorionic Villi Sampling done?
Abdominal or vaginal; tissue sample of placenta
What does the patient need to do before Chorionic Villi Sampling?
Drink water and make bladder full
What are some risks of Chorionic Villi Sampling?
Spontaneous abortion, Fetal limb loss (especially prior to 9 weeks gestation), chorioamnionitis, rupture of membranes
What’s Amniocentesis?
Taking a sample of amniotic fluid to check genetic risk. Need enough fluid to test. Great for information purpose, but very high risk
When can amniocentesis be done?
15 weeks - birth
What are some risks of amniocentesis?
Infection, miscarriage, bleeding, rupture of membrane, fetal damage/death, bladder damage
What is Alpha-Fetoprotein (AFP) test?
Maternal blood testing; screening tool used to detect neural tube defects
When can AFP test be done?
15-18 weeks
What does low AFP level indicate?
Risk for Down Syndrome
What does high AFP level indicate?
Risk for neural tube defects or open abdominal defect
What is placenta previa?
When placenta implants in the lower segment of the uterus; may cover all or part of cervical opening
What happens if the cervical opening is covered by the placenta?
No vaginal delivery, no matter how much the placenta is covering the cervical opening
Why does painless vaginal bleeding occur in 3rd trimester with placenta previa?
As the cervix begin to dilate, placenta tears, which causes bleeding
What are some expected findings of placenta previa?
Painless, bright red vaginal bleeding during 2nd - 3rd trimester, higher than expected fundal height
Why is pelvic/vaginal exam contraindicated in placenta previa?
You don’t know where the placenta is before the ultrasound; we don’t want to perforate or separate the placenta because placenta = baby’s O2 supply.
we also don’t want to cause more bleeding
Can placenta previa patients ambulate how many times as they want closer to labor?
No. Strict bedrest
What’s placental abruption?
Premature separation of the placenta from the uterus; meaning that baby has lost their O2 supply
When does placental abruption occur?
After 20 weeks of gestation
What’s the leading cause of maternal death?
Placental abruption
What’s the biggest difference between placenta previa and placental abruption?
Placenta previa causes painless vaginal bleeding while placental abruption causes painful vaginal bleeding
What are some expected findings in placental abruption?
Sudden onset of intense localized uterine pain, profusely bleeding dark red blood, “board-like” abdomen, uterine tenderness, contractions with hypertonicity, fetal distress
What do contractions with hypertonicity mean and why is it bad for the fetus?
Uterine muscle squeezing constantly and not relaxing. More stress to the baby & decreased O2 and blood flow