OB/GYN Flashcards
What does Gravidity and Parity mean?
Gravidity: the number of times a women has ben pregnant
Parity: the number of pregnancies that led to a birth beyond 20 wks gestational age or an infant weighing >500g
(Term, preterm, aborted, living)
What is gestational age and what are the method to determine it? (5)
GA= # of wks and day measured from the first day of the LMP
Fundal height= umbilicus-20 weeks +2-3 cm/wks thereafter
Fetal heart tones (Doppler): typically 10-12 weeks
Quickening, or appreciation of fetal movement: occurs at 17-18 wk at the earliest
U/S: fetal crown-rump length at 6-12wk
—biparietal diameteer, femur length, and abdominal circumference (AC) 13 wks
What are the 2 methods of diagnosing a pregnancies?
B-HCG: standard
—produced by the placenta, peaks 100,000 mIU/mL by 10wks GA
—decrease throughout the second trimester;levels off in the third
—hCG levels doulbe appr every 48 every hours during early pregnancy
U/S: confirm an intrauterine pregnancy
—gestational sac is visible on TVUS by 5th wk GA
—b-HCG in range 1000-1500 mIU/mL
Weight gain recommendation based on prepreganancy weight?
Underweight (BMI <19.8): 25-40 lbs (12-18kgs)
Acceptable (BMI 19.8-26.0): 25-35 lbs (11-16kgs)
Overweight (BMI 26.1-29.0): 15-25 lbs (7-11kgs)
Severely overweight ( BMI >29.0) 10-20 lbs (5-9kgs)
Excessive gain >1.5 kg/month
Inadequate gain <1.0 kg/month
what are the guidelines for nutritional supplementation:
An addition 100-300 kcal/day; 500 kcal/day during breastfeeding
Folic acid supplements: 0.4 mg/day, or 4 mg/day for women w/ hx
Iron: starting at he first visit, 30 mg/day of elemental iron (150 mg iron su)
Calcium: 1300 mg/day <19 yo; 1000mg/day >19 yo
Vit D: 10micrograms or 400 IU/day
Vit B12: 2 micrograms/day
What happens for the following parameters in the cardiovascular system during pregnancy: HR, BP, SV, CO, PVD, PVR
HR: Gradually increase 20%
BP: gradually decrease 10% by 34 wks, then increases to prepregnancy values
SV: increases to max. At 19 wks, then plateaus
CO: Rises rapidly by 20%, then gradually increases an additional 10% by 28 wks
Peripheral venous distention: progressive increase to term
PVR: progresisive decrease to term
What happens for the following parameters in the pulmonary system during pregnancy: RR, TV, Expiratory reserve, Vital capacity, respiratory minute volume?
RR: unchanged Tidal Volume: Increases by 30-40% Expiratory reserve: Gradual decrease Vital capacity: Unchanged Respiratory minute volume: increases by 40%
What happens for the following parameters in the bloodsystem during pregnancy: volume, hematocrit, fibrinogen, electrolytes?
Volume: increase by 50% in second trimster
Hematocrit: decreases slightly
Fibrinogen: increases
Electrolytes: unchanged
What happens for the following parameters in the gastrointestinal system during pregnancy: sphincter tone, gastric emptying tome?
Sphincter tone: decreases
Gastric emptying time: increases
What organisms can cross the placenta?(9)
Toxoplasma Gondi Rubella HIV Varicella-zoster virus CMV Enteroviruses Treponema pallidum Listeria monocytogenes parvovirus B19
How often to pregnancy women go to the doctors during each trimester?
Weeks 0-28: every 4 weeks
Weeks 29-35: every 2 weeks
Weeks 36-birth: every wk
What testing is performed at the initial prenatal visit?
Heme: CBC, RH factor, type and screen
Infectious disease: UA and culture, rubella antibody titer, HBsAg, RPR/VDRL, cervical gonorrhea and chlamydia, PPD, HIV, Pap smear (to check for Dysplasia, consider HCV and varicella based on history
If indicated: HbA1c and sickle cell
Genetic screen: tag-Sachs Dx, cystic fibrosis
What tests are preformed during the prenatal visits from 9-14wks?
Offer PAPP-A + unchallenged transparency + free b-HCG +/- CVS
What tests are preformed during the prenatal visits from 15-22wks?
Offer maternal serum AFP or quad screen (AFP, estriol, bHCG, inhibin A) +/- amniocentesis
What tests are preformed during the prenatal visits from 18-20wks?
U/S for full anatomic screen
