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Prenatal / Midwife > Page 1 of objectives > Flashcards

Page 1 of objectives Flashcards

1
Q

Basics of hormonal regulation of menstrual cycle

  • LH
  • FSH
  • Estrogen
  • Progesterone
A
  • LH is released from pituitary
  • Surges at ovulation
  • Leads to release of oocyte
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2
Q

Basics of hormonal regulation of menstrual cycle

  • LH
  • FSH
  • Estrogen
  • Progesterone
A
  • FSH is released from the pituitary
  • Surges at ovulation
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3
Q

Basics of hormonal regulation of menstrual cycle

  • LH
  • FSH
  • Estrogen
  • Progesterone
A
  • Estrogen is released from the ovary
  • Rises during follicular phase; peaks right before ovulation
  • Causes thickening of endometrium of uterus
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4
Q

Basics of hormonal regulation of menstrual cycle

  • LH
  • FSH
  • Estrogen
  • Progesterone
A
  • Progesterone is released from the granulosa cells of the corpus luteum that contained the oocyte
  • At its lowest at ovulation; rises and peaks during luteal phase, prepping for a fertilization
  • If no fertilization, levels fall and endometrial lining is shed, 14 days after ovulation
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5
Q

General maternal physiologic changes in pregnancy:

Hematalogic

A
  • Hematocrit will drop due to dilution
  • Also, pregnancy is a hypercoagulable state
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6
Q

General maternal physiologic changes in pregnancy:

Cardiovascular

A
  • Cardiac output rises 30-50%
  • Maternal heart rate rises by 15 to 20 beats/min
  • Systolic and diastolic blood BP typically fall early in gestation and are about 5 to 10 mmHg below baseline in the second trimester. In the third trimester, blood pressure gradually increases and may normalize to nonpregnant values by term.
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7
Q

General maternal physiologic changes in pregnancy:

Respiratory

A
  • Chronic respiratory alkalosis
  • May get unilateral nasal polyp, called nasal granuloma gravidarum
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8
Q

How is pregnancy diagnosed?

A

The diagnosis of pregnancy is based on the presence of any of the following:

●Detection of human chorionic gonadotropin (hCG) in blood or urine

●Identification of pregnancy by ultrasound examination

●Identification of fetal cardiac activity by Doppler ultrasound

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9
Q

GTPAL system

A

G = number of pregnancies; twins counts as one pregnancy

T = number of term births (has reached at least 38 weeks; each twin counts as a birth)

P = number of preterm births (20 weeks to 37 weeks)

A = number of abortions/miscarriages (less than 20 weeks)

L = number of living children

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10
Q

Calculate estimated date of delivery (EDD) based on LMP

A
  • EDD is 280 days from the onset of the last menstrual period (LMP) and 266 days from date of conception
  • Naegele’s rule: Subtract 3 months, add 7 days to first day of LMP
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11
Q

What is the role of folic acid in fetal development?

What is the current recommendation regarding folic acid supplementation?

A
  • Folic acid supplementation decreases the occurrence of neural tube defects (e.g. spina bifida, anencephaly) and is recommended for women planning pregnancy or capable of becoming pregnant
  • Recommendation is supplement containing 0.4 mg to 0.8 mg of folic acid daily
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12
Q

What is Chadwick’s sign?

A

Bluish discoloration of the cervix from venous congestion, usually visible by 8-10 weeks.

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13
Q

What is the recommended frequency of prenatal visits?

A
  • Every 4 weeks until 28 weeks
  • Every 2 weeks from 28-36 weeks
  • Every week from 36 weeks-delivery
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14
Q

What is the recommended weight gain during pregnancy?

A

Depending on weight prior to pregnancy…

…underweight (BMI < 18.5): 28-40 lbs

…normal weight (BMI 18.5-24.9): 25-35 lbs

…overweight (BMI 25-29.9): 15-25 lbs

…obese (BMI 30+): 11-20 lbs

(ACOG)

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15
Q

What are the screening tests (mother and fetal) of the first trimester?

A
  • First trimester screen: u/s for fetal nuchal translucency, plus hCG and PAPP-A
    • 10-14 weeks
  • Asymptomatic bacteriuria
    • 12-16 weeks
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16
Q

What are the screening tests (mother and fetal) of the second trimester?

A
  • Quad screen (AFP, hCG, estriol, inhibin A): Down syndrome risk, trisomy 18 risk, neural tube defect risk
    • 15-18 weeks
  • Anatomy ultrasound
    • 18-20 weeks
  • Gestational diabetes (glucose tolerance test)
    • 24-28 weeks
17
Q

What are the screening tests of the third trimester?

A
  • Group B strep vaginal and rectal swab
    • 35-37 weeks
18
Q

Amniocentesis:

  • indication
  • timing
A

Fetal genetic studies (followup to noninvasive testing): 15-17 weeks

Fetal lung maturity (infrequent; prior to semielective but medically indicated birth): 32-39 weeks

19
Q

What is chorionic villus sampling?

When is it done?

Why is it done?

A
  • small samples of the placenta are obtained for prenatal genetic diagnosis
  • generally in the first trimester after 10 weeks of gestation
  • Optional, but maybe advanced maternal age, genetic risk factors, anomaly seen on u/s
20
Q

What are the FDA pregnancy safety categories?

21
Q

When can doppler detect fetal HR?

A

10-12 weeks

22
Q

When is fetal movement usually first detected?

A

The initial perception of fetal movement occurs at 18–20 weeks’ gestation in primiparous patients and as early as 14 weeks’ gestation in multiparous patients.

23
Q

When is RhoGam given?

A

To Rh negative pregnant women whose fetus is or may be Rh positive, give RhoGam

  • At 28 weeks

AND

  • Whenever there is maternal hemorrhage, risk of maternal hemorrhage, or suspected maternal hemorrhage

AND

  • Within 72 hours of delivery of an Rh positive infant
24
Q

Fetal biophysical profile

A

Criteria for the biophysical profile test

  • *Nonstress test:** 2 points if reactive
  • *Fetal breathing movements:** 2 points if one or more episodes of rhythmic breathing movements of ≥30 seconds within a 30-minute observation period
  • *Fetal tone:** 2 points if one or more episodes of extension of a fetal extremity or fetal spine with return to flexion.
  • *Amniotic fluid volume:** 2 points if a single pocket of fluid is present measuring at least 2 cm by 1 cm
  • *Fetal movement:** 2 points if three or more discrete body or limb movements within 30 minutes of observation

0 points are assigned for any criteria not met.

8/10 or 10/10 = good

Prenatal / Midwife (2 decks)

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