PKM Obstetrics lecture 1 - aa

Question 1

What is “preterm”?

Answer 1

less than or equal to 36 weeks 6 days

Question 2

What is “early term”?

Answer 2

between 37 weeks and 38 weeks 6 days

Question 3

What is “full term”?

Answer 3

between 39 weeks and 40 weeks 6 days

Question 4

What is “late term”?

Answer 4

41st week

Question 5

What is “post term”?

Answer 5

after 42 weeks

Question 6

the number of times that a woman has been pregnant regardless of outcome

Answer 6

gravidity

Question 7

What is parity?

Answer 7

the number of times a woman has given birth to a fetus of gestational age of 20 weeks or more regardless of whether the fetus was born alive or not

Question 8

Give the GxPx description of a woman who is currently pregnant and had a previous pregnancy that did not survive beyond 10 weeks

Answer 8

G2P0

Question 9

A woman who has never carried a pregnancy beyond 20 weeks

Answer 9

nulliparous

Question 10

A woman who has never been pregnant

Answer 10

nulligravida

Question 11

A woman in her first pregnancy

Answer 11

primigravida

Question 12

A woman with multiple pregnancies

Answer 12

multigravida

Question 13

A woman who has had four or more 20+ week pregnancies

Answer 13

grand multipara

Question 14

The parity does not take into account multiple gestations (e.g. twins).
T/F

Answer 14

True.

Question 15

Describe the GTPAL system of terminology.

Answer 15

• Gravidity – total # of pregnancies
• Term – total # of infants born at term (at or after 37 weeks)
• Preterm – total # born before 37 weeks and after 24 weeks
• Abortions – total # of spontaneous or induced abortions from impregnation to 24 weeks
• Living – total # of children currently living

Question 16

Using the GTPAL system, how would you chart a woman who has been pregnant one time with twins who were delivered at 35 weeks of gestation and survived?
What would be the abbreviation during her next pregnancy?

Answer 16

Now: G1T0P2A0L2

Next pregnancy: G2T0P2A0L2

Question 17

Name 4 presumptive signs of pregnancy.

Answer 17

~linea nigra
~chloasma
~mastodynia
~increased size & pigmentation of nipples; more prominent Montgomery tubercles

Question 18

Name 3 probable signs of pregnancy.

Answer 18

~Chadwick sign (purple cervix)
~Hegar sign (compressibility of uterine isthmus)
~Uterine souffle (auscultate bruit over placental attachment)

Question 19

Name 3 positive signs of pregnancy.

Answer 19

~fetal skeleton on radiograph
~fetal heart tones
~visible fetal cardiac activity on ultrasound

Question 20

When is hCG test usually positive (earliest)?

Answer 20

4-7 days after missed period

Question 21

When will the gestational sac be visible on ultrasound?

Answer 21

4-5 weeks

Question 22

When should fetal heart beat be detectable by ultrasound?

Answer 22

6 weeks

Question 23

Describe Naegele’s rule for determination of Estimated Due Date.

Answer 23

Subtract 3 months from the first day of the LMP, add 7 days and one year.
Example: LMP started 7/16/13
Subtract 3 months - 4/16/13
Add 7 days and one year - 4/23/14

Question 24

When can fetal heart tones be heard using Doppler?

Answer 24

10-12 weeks

Question 25

When can fetal heart tones be heart using fetoscope?

Answer 25

17-20 weeks

Question 26

When can amniocentesis be done?

Answer 26

after 15 weeks LMP

Question 27

When can chorionic villus sampling be done?

Answer 27

11-14 weeks LMP

Question 28

Chorionic villus sampling will not pick up neural tube defects.
T/F

Answer 28

True

Question 29

Increased maternal alpha fetoprotein may indicate what?

Answer 29

1. anencephaly
2. spina bifida/omphalacele/gastroschisis
3. placenta previa

Question 30

What is tested in first and second trimester for Trisomy 21?

Answer 30

Pregnancy-associated plasma protein A

Question 31

Elevated maternal serum estriol suggests what?

Answer 31

Maternal serum estriol - elevated levels suggest a viable fetus, a properly functioning placenta, and maternal well-being

Question 32

What is the “triple-screen” and when is it done?

Answer 32

16-18 weeks

alpha fetoprotein, beta-hCG, estriol

Question 33

What two things are performed at 26-28 weeks?

Answer 33

1. gestational diabetes screening

2. administer Rhogam if necessary for Rh incompatibility

Question 34

What test is done at 36 weeks?

Answer 34

Vaginal group B β-hemolytic strep culture to identify risk for strep sepsis in the newborn

Question 35

When should the fundal height be at the umbilical level?

Answer 35

20 weeks

Question 36

Where is the fundal height at 8 weeks?

Answer 36

pubic symphysis

Question 37

What is the ACOG recommended weight gain during pregnancy?

Answer 37

– BMI < 20 recommended gain of 30-40lbs
– BMI 20-25* recommended gain of 25-35 lbs
– BMI 25-30 recommended gain of 15-25 lbs
– BMI >30 recommended gain of 15lbs

*this is “normal” BMI

Question 38

What type of vaccine should be avoided in pregnant women? What are these vaccines?

Answer 38

live virus vaccines:

• -live attenuated influenza
• -measles
• -mumps
• -rubella
• -varicella
• -BCG (TB)

Question 39

What is the frequency of prenatal visits?

Answer 39

~Q4 weeks from 0 - 32 weeks
~Q2 weeks from 32 - 36 weeks
~Q1 week from 36 weeks - EDD
~weekly/daily after EDD