PKM Obstetrics lecture 1 - aa Flashcards
What is “preterm”?
less than or equal to 36 weeks 6 days
What is “early term”?
between 37 weeks and 38 weeks 6 days
What is “full term”?
between 39 weeks and 40 weeks 6 days
What is “late term”?
41st week
What is “post term”?
after 42 weeks
the number of times that a woman has been pregnant regardless of outcome
gravidity
What is parity?
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
Give the GxPx description of a woman who is currently pregnant and had a previous pregnancy that did not survive beyond 10 weeks
G2P0
A woman who has never carried a pregnancy beyond 20 weeks
nulliparous
A woman who has never been pregnant
nulligravida
A woman in her first pregnancy
primigravida
A woman with multiple pregnancies
multigravida
A woman who has had four or more 20+ week pregnancies
grand multipara
The parity does not take into account multiple gestations (e.g. twins).
T/F
True.
Describe the GTPAL system of terminology.
- 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
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?
Now: G1T0P2A0L2
Next pregnancy: G2T0P2A0L2
Name 4 presumptive signs of pregnancy.
~linea nigra
~chloasma
~mastodynia
~increased size & pigmentation of nipples; more prominent Montgomery tubercles
Name 3 probable signs of pregnancy.
~Chadwick sign (purple cervix)
~Hegar sign (compressibility of uterine isthmus)
~Uterine souffle (auscultate bruit over placental attachment)
Name 3 positive signs of pregnancy.
~fetal skeleton on radiograph
~fetal heart tones
~visible fetal cardiac activity on ultrasound
When is hCG test usually positive (earliest)?
4-7 days after missed period
When will the gestational sac be visible on ultrasound?
4-5 weeks
When should fetal heart beat be detectable by ultrasound?
6 weeks
Describe Naegele’s rule for determination of Estimated Due Date.
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
When can fetal heart tones be heard using Doppler?
10-12 weeks
When can fetal heart tones be heart using fetoscope?
17-20 weeks
When can amniocentesis be done?
after 15 weeks LMP
When can chorionic villus sampling be done?
11-14 weeks LMP
Chorionic villus sampling will not pick up neural tube defects.
T/F
True
Increased maternal alpha fetoprotein may indicate what?
- anencephaly
- spina bifida/omphalacele/gastroschisis
- placenta previa
What is tested in first and second trimester for Trisomy 21?
Pregnancy-associated plasma protein A
Elevated maternal serum estriol suggests what?
Maternal serum estriol - elevated levels suggest a viable fetus, a properly functioning placenta, and maternal well-being
What is the “triple-screen” and when is it done?
16-18 weeks
alpha fetoprotein, beta-hCG, estriol
What two things are performed at 26-28 weeks?
- gestational diabetes screening
2. administer Rhogam if necessary for Rh incompatibility
What test is done at 36 weeks?
Vaginal group B β-hemolytic strep culture to identify risk for strep sepsis in the newborn
When should the fundal height be at the umbilical level?
20 weeks
Where is the fundal height at 8 weeks?
pubic symphysis
What is the ACOG recommended weight gain during pregnancy?
– 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
What type of vaccine should be avoided in pregnant women? What are these vaccines?
live virus vaccines:
- -live attenuated influenza
- -measles
- -mumps
- -rubella
- -varicella
- -BCG (TB)
What is the frequency of prenatal visits?
~Q4 weeks from 0 - 32 weeks
~Q2 weeks from 32 - 36 weeks
~Q1 week from 36 weeks - EDD
~weekly/daily after EDD
