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Pregnancy Flashcards

1
Q

How do you diagnose pregnancy?

A
  1. Amenorrhea
  2. Positive urine pregnancy test
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2
Q

How do you confirm EDD at 6-12 weeks?

A

Crown Rump length u/s

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3
Q

How do you confirm EDD at 13-20 weeks?

A

Biparietal diameter (u/s)

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4
Q

When will serum HCG show positive?

A

3 weeks

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5
Q

What does HCG stand for?

A

Human chorionic gonadotropin

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6
Q

When does urine HCG show positive?

A

4 weeks

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7
Q

When are fetal heart sounds audible by doppler?

A

10 weeks

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8
Q

When does fundal height equal gestational age?

A

Around 20 weeks

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9
Q

What is Naegele’s rule for EDD calculation?

A

LMP + 7 days - 3months + 1 year

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10
Q

What is full term?

A

40 weeks, 280 days

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11
Q

What weeks are an embryo

A

2-10

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12
Q

What weeks are a fetus?

A

11-40+

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13
Q

What happens during the embryonic phase?

A

Organogenesis

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14
Q

What happens during the fetal phase?

A

-Growth
-Lung development
-Brain development

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15
Q

The further a pregnancy progresses, ultrasound becomes ________ accurate in predicting due date

A

Less

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16
Q

G0P0 G=? P=?

A

G= total # of pregnancies
P= term, preterm, abortion, living

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17
Q

P=

A

term, preterm, abortion, living

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18
Q

Infant = _______

A

birth to 365 days

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19
Q

Neonate = ______

A

Birth -28 days

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20
Q

Perinatal period =

A

28 weeks GA to 7 days postpartum

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21
Q

Preterm =

A

20 weeks GA to 36 6/7 weeks GA

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22
Q

Postterm =

A

> 42 weeks gestation

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23
Q

What timeline defines abortion

A

<20 weeks

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24
Q

What are the five main physiological areas of change during pregnancy?

A
  1. CV
  2. Respiratory
  3. Renal / GU
  4. GI
  5. Heme
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25
What CV values increase during pregnancy? (5)
-Blood volume (50%) -RBC mass (30%) -Cardiac output -Stroke volume -Heart rate
26
What cardiovascular values decrease during pregnancy? (2)
-Peripheral vascular resistance -Blood pressure
27
At term, ____ of cardiac output goes to the uterus
1/3
28
What respiratory values increase in pregnancy?
Tidal volume Minute ventilation
29
What respiratory values decrease in pregnancy?
Reserve Residual volume
30
Pregnancy can cause physiologic ____ (respiratory value)
Hypocapnea
31
Pregnancy can cause mild to moderate hydro______, usually more prominent on the ___ side
Hydronephrosis, right
32
What renal values increase in pregnancy?
-Plasma flow -GFR
33
What renal values decrease in pregnancy?
Serum creatinine and BUN
34
What increases in the urine in pregnancy and what can that cause?
Glucosuria, can contribute to higher UTI risk
35
What mechanical GU change happens in pregnancy?
Bladder compression and urinary frequency
36
What happens to the GI system in pregnancy?
Slows, delayed gastric emptying, slow intestinal transit times and constipation
37
What does delayed gastric emptying cause in pregnancy?
Esophagitis
38
What heme values increase in pregnancy?
Clotting factors Fibrinogen VIII
39
What heme value decreases in pregnancy?
Fibrinolytic activity
40
What is the net prothombotic effect of heme changes in pregnancy?
Up to 8x higher
41
What is clinical pelvimetry for?
Predicting ability to deliver vaginally (not very accurate)
42
Most tests done in pregnancy are (diagnostic/screening)
Screening
43
What are two things that are never normal in pregnancy?
-Vaginal bleeding -Severe pain
44
What three things may cause bleeding in the first trimester?
1. Ectopic pregnancy 2. Spontaneous abortion 3. Gestational trophoblastic disease
45
What 3 things can cause bleeding in the 2nd and 3rd trimester?
1. Preterm labor/labor 2. Placental abruption 3. Placenta previa / vasa previa
46
How much weight should a healthy weight pregnancy gain?
25-35 lbs
47
How much weight should an underweight pregnancy gain?
35-45 lbs
48
How much weight should an overweight/obese pregnancy gain?
12-25 lbs
49
How much weight should a morbidly obese pregnancy gain?
0-15 lbs
50
How many additional calories do pts need in pregnancy?
Up to 500 extra calories in third trimester
51
What supplements should be given in pregnancy?
Iron: 30 mg Calcium: 1200 mg Folate: 400 mcg
52
How much iron should be given for anemia in pregnancy?
60-120 mg
53
When should folate supplementation be increased to 4 mg?
-Hx of neural tube defects of -On anticonvulsants
54
What are Category A meds in pregnancy?
Robust evidence of safety.
55
What are Category B meds in pregnancy?
Limited evidence of safety
56
What are Category B meds in pregnancy?
Lacking evidence of safety but no evidence of harm
57
What are Category D meds in pregnancy?
Some evidence of harm, avoid unless not possible
58
What are Category X meds in pregnancy?
Compelling evidence of harm. Do not use in pregnancy
59
What general medications are commonly used in pregnancy?
-Acetaminophen -Antihistamines -H2 blockers -Topical treatments (such as inhaled corticosteroids) -Some BP (labetalol, nifedipine)
60
Are ACEIs safe in pregnancy?
No
61
Are ARBS safe in pregnancy?
No
62
Are diuretics safe in pregnancy?
No
63
Are NSAIDS safe in pregnancy?
No
64
Why are NSAIDS contraindicated in pregnancy?
Premature closure of ductus arteriosis
65
Are retinoids safe in pregnancy?
No
66
Is doxy safe in pregnancy?
No
67
Is acetaminophen safe in pregnancy?
Yes
68
Are antihistamines safe in pregnancy?
Yes
69
Are H2 blockers safe in pregnancy?
Yes
70
Are topical treatments safe in pregnancy?
Yes
71
Are inhaled corticosteroids safe in pregnancy?
Yes
72
Is labetalol safe in pregnancy?
Yes
73
Is Nifed safe in pregnancy?
Yes
74
Are anticonvulsants safe in pregnancy?
No
75
What is the visit schedule for an uncomplicated pregnancy?
-Establish care -Monthly > 32 weeks -Then every 2 week to term -Then weekly until delivery -Possibly 2x per week if post-term
76
What testing should be done in the first trimester?
-Blood type -Antibody -STI -Anemia -Bacteriuria -Genetic carrier screening -Possible screen for aneuploidy
77
What testing is done in 2nd trimester?
-Quad screen -Fetal anatomic survey (u/s) -Gestational DM -Anemia
78
What is a quad screen?
Aneuploidy and neural tube defects
79
What screening should be the 3rd trimester?
GBS colonization

Women's Health (13 decks)

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