Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RGU 2 > Preconception Care > Flashcards

Preconception Care Flashcards

1
Q

When do most women have their first pregnancy visit?

A
  • at 8 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What % of pregnancies are unintended?

A

over 50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What should be on a preconception checklist?

A
  • When do you plan to get pregnant?
  • Discuss pregnancy expectations (average time to pregnancy is 6 months).
  • Discuss cycle lengths and ovulation.
  • “Fertile Days” (2 weeks prior to menses).
  • If already had a child, discuss pregnancy spacing.
  • PRENATAL VITAMINS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Are many doctors pushing long acting reversible contraception (LARC)?

A

YES because it is most effective.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

When should prenatal vitamins be taken?

A
  • ideally before conception
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

** What is the most important prenatal vitamin?

A
  • FOLIC ACID (400 ug)= decreases incidence of neural tube defects.
  • 1 mg if diabetes/epilepsy
  • 4 mg if prior Hx of neural tube defect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When does the neural tube normally close?

A
  • by day 28 after conception (6 weeks gestation or menstrual age).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 2 categories of neural tube defects?

A
  1. open (more common)

2. closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 3 important neural tube defects related to prenatal vitamin deficiency (folic acid)?

A
  1. spina bifida= failure of the neural tube to close properly, causing defects in the spinal cord and in the bones of the vertebrae.
  2. anencephaly= absence of a major portion of the brain, skull, and scalp.
  3. encephalocele= neural tube defect characterized by sac-like protrusions of the brain and the membranes that cover it through openings in the skull
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

*** What 3 questions should you ask yourself when a woman looking to get pregnant tells you a medical problem?

A
  1. How does the disease affect the pregnancy?
  2. How does the pregnancy affect the disease?
  3. Does the disease have any affect on the fetus? (i.e. do any disease elements cross the placenta, or does the disease affect the mother’s nutritional provisions to the fetus?)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How will DM affect the fetus?

A
  • the higher the Hgb A1C, the greater the risk of poor outcomes (spontaneous abortion, fetal demise, or congenital abnormalities).
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should you do for a diabetic pt looking to get pregnant?

A
  • control their blood sugar and do a full work up.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

*** What should you do for a woman with hypertension who is looking to get pregnant?

A
  • AVOID ACEs and ARBs
  • Beta blockers are safe :)
  • Surveillance of the patient should be increased
  • Blood pressure should be evaluated frequently
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What may beta blockers do?

A
  • decrease the amount of amniotic fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What must you do for an obese pt looking to get pregnant?

A
  • Evaluate and discuss the problem

- Optimize diet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What issues can obesity cause in getting pregnant, or to the fetus itself?

A
  • ovulatory disturbance
  • fetal loss
  • gestational diabetes
  • increased likelihood that the child will need to be delivered via caesarian
17
Q

Are some SSRI’s safe during pregnancy?

A

YES, but some are not

18
Q

Are some patients sometimes on an SSRI unnecessarily?

A

YES

19
Q

What is another option for pts with depression other than an SSRI during pregnancy?

A
  • psychotherapy
  • some patients are never aware of this option
  • some patients seek a way to reduce the medications that they are taking during pregnancy
20
Q

What carrier screening should be done for a woman looking to get pregnant?

A
  • sickle hemoglobinopathies
  • beta-thalassemia
  • alpha-thalassemia
21
Q

If a woman is an Ashkenazi Jew, what other panels should be run prior to conception?

A
  • CF (offered to every patient)
  • Tay Sach’s
  • Canavan
  • Familial Dysautonomia
22
Q

What are some other familial diseases that could be screened?

A
  • Fragile X

- 22q (DiGeorge)

23
Q

*** For what infectious diseases should you screen a women prior to conception?

A
  • HIV (opt out not in). Treatment can decrease risk pf transmission from 25% to around 8%
  • Syphilis
  • Hepatitis B (must immunize)
  • Rubella (German measles; must immunize)
  • Varicella (herpes virus)
  • Environmental Exposure
  • CMV
  • Parvovirus
  • Toxoplasmosis
24
Q

*** How can congenital syphilis present?

A
  • Hutchinson’s Triad= deafness, notched peg-shaped upper central incisors, and interstitial keratitis (inflammation of the cornea, which can lead to blindness).
  • mulberry molars
  • Du Bois sign= narrowing of the little finger
  • frontal bossing= prominent, protruding forehead
25
Q

Can infants can varicella from their mother?

A

YES, called Congenital Varicella Syndrome (CVS)

26
Q

How does CVS present?

A
  • hypertrophic skin
  • low birth weight
  • incomplete formation of the digits
  • cortical atrophy or dilated ventricles
  • mental retardation
27
Q

How does Congenital Rubella Syndrome (CRS) present if mother was not vaccinated, and become infected within the first 20 weeks of pregnancy?

A
  • sensorineural deafness (58% of patients)
  • eye abnormalities (especially retinopathy, cataract, and microopthalmia; 43% of patients).
  • Congenital Heart Disease (especially pulmonary artery stenosis and patent ductus arteriosis; 50% of patients).
28
Q

What women are most at risk for environmental exposures?

A

teachers, healthcare workers, and veterinarians

29
Q

What are the 3 environmental exposure worries?

A
  1. toxoplasmosis= rare; ingested from the feces of a cat, raw meat or milk.
  2. parvovirus B19= transmitted via respiratory droplets.
  3. CMV (herpes virus)= spread via body fluids.
30
Q

What can toxoplasmosis cause to a fetus?

A
  • nasal malformations
  • encephalitis
  • necrotizing retinochoroiditis
31
Q

What can parvovirus B19 (5th’s disease) cause to a fetus?

A
  • called 5th’s disease due to a “slapped cheek” appearance.

- hydrops fetalis

32
Q

How does congenital CMV present?

A
  • inflammation of retina, low birth weight, jaundice, rash, seizures, and microcephaly
33
Q

If the patient smokes less than 5 cigarettes/day, will this harm the fetus?

A

NO, but this is still a good time to talk about quitting, because this will affect the baby after birth.

34
Q

What other social screenings should you do for a woman looking to conceive?

A
  • alcoholism/Drug Use
  • occupational exposures
  • household chemicals (home should be adequately ventilated)
  • domestic violence
35
Q

What should your physical entail?

A
  • focus on lower genital tract
  • palpate the thyroid
  • check TSH if symptomatic.
  • external genitalia eval
  • speculum exam= visual eval of cervix, vaginal septum, discharge, and bimanual exam (uterine size, uterine mobility, adenexal masses, or pain on exam).
36
Q

Where should the uterus be at week 12?

A
  • it has expanded past the pelvis, and the patient can have “round ligament pain”
37
Q

Where should the uterus be at week 20?

A

level of the umbilicus and is considered “locked in place.”

38
Q

What could an adenexal mass indicate?

A
  • ectopic pregnancy
39
Q

So what is the purpose of a preconception doctor’s visit?

A
  • to optimize a woman’s health for pregnancy

RGU 2 (24 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions