Preg 1 Flashcards
Gestational age begins first day of ____
lasts __ days or ___ wks
Conceptional age begins w ___
___ less than GA
First trimester lasts from ___ to ___ days of GA
Second trimester from ___ wks gestation to ___ days GA
Third trimester from ___wks to ___
Viability is ability to survive outside ____
Nonviable less than __
Periviable ___ wks GA
Viable > ___wks
Last menstrual period
280, 4
fertilization
2 wks
Fert, 13 wks, 6
14, 27 wks 6 days
28, delivery
uterus
22 wks
22-24wks
24wks
Preterm birth is delivery bw __ wks and ___ days
Term deilvery occurs after __ wks
Post term is delivery after __ wks
Miscarriage/SAB delivery is less than ___ wks
Number of times woman has been pregnant indicated by
Patient who has never been pregnant
Pt preg for first time
Pt preg multiple times
20wks, 36 wks 6 days
37 wks
42 wks
20 wks
graviditiy
Nulligravid
Primigravid
Multigravid
Number of times woman has given birth indicated by
Never given birth to fetus over 20 wks GA
Pt who is giving birth for first time
Pt who has given birth mult
times
TPAL for
Abortus is either __ or __ at less than ___wks
L number currently
Parity
Nullipara
Primarpara
Multipara
term, preterm, abortive, living
spontaneous, elective, 20wks
living
1st prenatal visit is to determine baseline ___, and any __/____/__RF
perform __/___/__
establish ___
bw 8-32 wks, pt visits every ___
bw 32-36 wks, pt visits every __
36+, pt visits every
health status, obstet/medical/surgical
hx/PE/labs
GA
4wks
2wks
1wk
All prenatal visits, take MW B Urine dip for \_\_\_ and signs of \_\_\_ or \_\_\_ Fundal \_\_\_ Doppler measurement of \_\_\_ maybe \_\_\_
Fundal height allows estimate of ___ and __ vol
Fetal HR confirms ___ and looks for abnorms that may alert such things as ___/__/___
BP for ___ of preg
Fundal ht- measure from top of __ to top of ___
maternal weight BP protein, asx bacteriuria/UTI height measurement fetal hr Leopold maneuvers
fetal growth, amniotic fluid
viability, tachy/brady/arrhythmias
pubic symphysis, fundus (uterus)
Measure gestation ht from __ wks onward
20 wks gestation, fundus is at ___
fundal ht in cm should eq ___ in wks
difference of < ___ cms indicates US to asses ___
Leopold maneuvers allow determination of ___ w/in uterus
also help to estimate ___
20
maternal umbilicus
GA
3cm, fetal size
fetal position
fetal size
2 palpate sides of ___
Leopold maneuver
#1 Palpate at ___
feel for hard/round surface of ___ or softer ___
feel for ___
feel for small parts such as __ and ___
#3 palpate above \_\_\_ feel for \_\_\_ solid/round \_\_\_ softer \_\_ or \_\_\_
#4 (face feet) palpate above \_\_\_ asses descent of \_\_\_ into pelvis
fundus
fetal head/butt
uterus
head
hands/feet
pubic symphysis
read
butt
nothing
pubic symphysis
fetal part
Fetal HR
from __ GA onward, detect fetal heart tones w ___
At 24-28 wks, perform __ test
27-36 wks, get __ vac
28 wks, get ___ if indicated
35 wks, get __ culture
can get gender at ___
16 wks perform __ precautions and __ screening
12wks, counsel on __ and __ and __, get __ and __ and ___
12wks, Doptone
Glucose challenge
Tdap
Rhogam
GBS
20wks
miscarriage precautions, genetic
dating, diet/nutrtion/substance, genetic screening/labs/immunizations
RF for preg complications include Maternal age > C FH of S M Previous
Twin gestations
zygosity is the number of ___
Chorionicity and ___ is the number of distinct ___/__ and ___
35 chronic HTN T2DM Smoking Meds C sections
fertilized ova
amnionicity
placentas/chorions, amniotic sacs
Single fertilized ovum that then splits is
Simultaneous but independent release/fert two separate ova is
Describes likelihood of ___ and risk of ___
Chorionicity describes number of separate __ or __
Amnionicity describes number of separate ___
Describes ___ of preg
monozygous
dizygous
shared traits, genetic abnormalities
chorions/placentas
amniotic sacs
risk level
2 placentas and 2 amniotic sacs would be __/___ aka ___
1 shared placenta and 2 amniotic sacs would be ___ aka ___
1 shared placenta and 1 shared aniotic sac would be ___ aka ___
dichorionic/diamniotic (DI di twins)
monochorionic/diamniotic (mono/di twins)
monochorionic/monoamniotic (mono/mono twins)
monozygous chorionicity and amnionicity determned by___
splits days 1-3 (__ stage) become ___ twins
splits days 4-8 (__ stage), become __ twins
splits day 8-13 (__ stage) becomes __ twins
Split > day 13 (___stage) become ___ twins
share ___ and __ and __
Dizygous twins are all
timing of split
morula, di/di
blastocyst, mono/di twins
implanted blastocyst, mono/mono twins
embryonic disc, conjoined
organs, placenta, amniotic sac
di/di twins
2/3 of twins are
1/3 are
2/3 of monozygous split day
1/3 split
1% split day
Dizygous twins have __
inc w ___ and ___, also ___ >35
Can be __ or __ gender
If different gender, then must be __/___/___
dizygous
monozygous
4-8
1-3
8-13
genetic predisposition
IVF/ART/ inc maternal age
same/different
dizygous/dichorionic/diamniotic
Monozygous twins have __ genetic predisposition
inc w ___
always ___
Dx twinning by ___
__ is better
Chorionicity dx based on __ and ___
Zygosity can only be dx on US if ____
Di/Di have __ placentas, __ membrane, ___/__ sign
Mono/di have __ placenta, ___ membrane, __ sign at attachement
Mono/mono has ___ visible membrane, signs of early ___
no
ART
same gender
US
earlier
placenta, membranes
two diff genders
separate, thick, lambda/twin peak
same, thin, t sign
no, cord entanglement
All twins at inc risk for P G P IU\_\_ and \_\_\_ \_\_ and \_\_ abnormalities
inc risk of __ abnromalities
greater w
Dizygous twins
inc risk of __/__ abnorm
risk of aneuploidy is __ compared to __
Complication of monozyg twins
Splitting is a __ event
Inc risk of ___
Inc risk of
preterm delivery
gestational DM
preeclampsia
IUGR, growth abnrom
structural
monozygous
aneuploid, genetic
2x greater, singleton
teratogenic
strctural abnroaml
CHD
Mono/Di twins have risk of ___ (TTTS)
All __ placentas have anastamoses
can be __ to __
__ to __
__ to ___
TTTS caused by unbalanced sites of ___ to__ anastamosis w/in shared ___, outnumbering ___ or ___
One twin (__ twin) transuses blood to other twin (___ twin)
donor twin becomes ___
Both at risk for ___ (cardiac failure) and death
twin twin transfusion syndrome
monochorionic
artery/artery
vein/vein
artery to vein
artery/vein, placenta
donor, recipient
stuck twin
fetal hydrops
Donor twin can develop A, H, O, O, Circulatory __, G__, R, D
Recipient can develop P, H, P, P, circulatory __, H__, H, D
Recipient twin will have ___ fluid
Donor twin has __ fluid and ___ membrane
Either/both can suffer
death of one can cause ___ of other
can lead to severe __ in surviving twin
anemia, HypoTN, oliguria, oligohydramnios, insufficiency, GR, RF, death
polycythemia, HTN, polyuria, polyhydramnios, overload, HF, hydrops fetalis, death
inc
low, cellophaned
cardiac decomp
death
neuro sequelae
Mono/Mono has risk of __
inc risk of fetal __/___
risk of Trisomy 21 inc w
Screening for aneuploidy
___ screen
__ screen
___ Prenatal Testing/Cell free ___
Dx test w __ and __
cord entanglement
distress/demise
maternal age
First trimester
multiple marker
Noninvasive, Fetal DNA
CVS, amniocentesis
FTS
US measurement of ___ bw __wks and__ days
Measures ___ in skin at back of ___
normal is < __ mm
thickened is > ___mm
Algorithm combines measurement of NT w blood tests for ___ and ___ (PAPPA)
Screens for __ and __only
Very __ for DS
Results in ___ days
Should do ___ lab in 2nd trimester to check for __
nuchal translucency, 11wks and 13wks 6 days
fluid, fetus neck
3mm
3mm
hCG and Preg Assc Plasma Protein A
T21 and T18 only
Sensitive
7-10 days
MSAFP, Open neural tube defect
MMS aka __ or __ or __ screen
___ test only
Bw __ and __ wks
tests levels of __ and ___ and __ and ___
has good ___
results take ___ days
Trisomy 21
T18
T13 labs
AFP, uE3, HCG, DIA
NTD/omphalocele/Gastroschisis/Multiple gestation possibly present in
Triple, Quad, Penta screen
blood
15-22wks
hCG, inhibin, estriol, MSAFP
sensitivity
7-10d
dec, dec, inc, inc
dec all
dec, NA rest
High AFP
Non Invasive Parental Testing
also called ___ (cffDNA)
examines fragments of __ DNA in maternal blood
only approved for \_\_\_ pops including A Personal/Fam hx of \_\_\_ US suggests \_\_ Abnormal \_\_\_ such as FTS/MMS
testing can start at __ wks
Tests for __ and __ and __
Also sex chromo aneuploidies such as
__, ___, __, ___
Tells __
Also tests for __ status, __
cell free fetal DNA
fetal/placental
high risk AMA abnormality aneuploidy aneuploidy screening tests
10+
T21/18/13
45X, 47XXY, 47XYY, 47XXX
gender
RhD status, Paternity
NIPT
if screen positive, still need ___ such as __ or ___ to confirm
very low rate of ___
dx, Amnio/CVS
false positive
CVS/Amnio benefit
Able to examine ____
useful to ___
Can test for other ___
Limitations
___ and risk for ___
CVS at ___wks
Amnio at ___ wks
miscarriage risk slightly higher for ____
baby’s chromos
diagnose
genetic conditions
invasive, miscarriage
10-13
15-22wks
CVS
CVS samples early ____
can be done __ or ___
amnio can be performed until ___
samples ___ for fetal ___
take cells and ___
place on ___ for analysi
placental tissue
transcervically/abdominally
delivery
amniotic fluid, skin cells
centrifuge
cell culture
