PBL 1

Question 1

What is Naegele’s Rule?

Answer 1

Based on 28 day menstrual cycle to calculate EDB

First day of LMP - 3 months + 7 days (if 28 day cycle)

Question 2

Why do cycle variations occur?

Answer 2

Due to the follicular phase of the menstrual cycle

Question 3

For LMP, what questions should you ask the client?

Answer 3

What was the flow and duration like? This could have been implantation bleeding if very light flow/spotting.

Question 4

How many babies are actually born on their due dates?

Answer 4

Less than 3%

Question 5

What is the gold standard for calculating EDB?

Answer 5

Ultrasound

Question 6

What is used to calculate GA in the first trimester? How accurate is it?

Answer 6

Crown-rump length. Accurate with 10mm-84mm. Do not use if under 10mm because it’s too small and leads to inaccuracies.

Question 7

When is the biparietal diameter measurement more accurate?

Answer 7

After 84mm

Question 8

When does ultrasound GA estimates become less accurate?

Answer 8

In the second trimester due to fetal variability

Question 9

What is the mean sac diameter?

Answer 9

Can be done at 5 weeks, the earliest possible test, measures length, width, and height of the fluid-filled sac, measured in mm to get GA in days, not as accurate as CRL

Question 10

What is part of the combined first trimester screening?

Answer 10

Pregnancy-associated plasma protein-A (PAPP-A)
Free beta human chorionic gonadotropin (B-hCG)
Combined with age and nuchal translucency

Question 11

What is part of the enhanced first trimester screening?

Answer 11

Combined first trimester screening

+

first trimester alpha-fetoprotein (AFP)
Placental growth factor (PGF)

Question 12

What is the criteria for a GDM diagnosis?

Answer 12

One hour glucose challenge test is greater than or equal to 11.1 mmol/L

&

2 hour 75g oral glucose tolerance test shows one or more levels are abnormal

Question 13

When is eFTS recommended?

Answer 13

11+0 to 13+6 weeks

Question 14

What does the presence of leukocytes and nitrites in urine indicate?

Answer 14

Possible UTI

Question 15

When is GBS screening done?

Answer 15

35-37 weeks GA and repeated at 41-42 weeks if the last swab was done more than 5 weeks ago.

Question 16

When are first fetal movements usually felt?

Answer 16

around 20-22 weeks

Question 17

What can impact the pregnant person’s perceptions of fetal movement?

Answer 17

Anterior placenta and sometimes adipose tissue

Question 18

Describe how a client should perform fetal movement counts

Answer 18

Starting at 26-32 weeks, take time to focus for 2 hours on your baby’s movements every day. At a minimum, your baby should produce no less than 6 movements in 2 hours. If you notice there are less or you feel a change in fetal movements, contact your midwife.

Important to note that your baby may be asleep when you begin counting movements. However, they likely will only sleep in chunks of 40 minutes segments. So, counting for 2 hours should be enough time to count movements.