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OB-GYN (A.G.) > Pregnancy > Flashcards

Pregnancy Flashcards

1
Q

What are the 3 major blood vessels in the umbilical cord? Oxygenated or deoxygenated blood?

A

2 umbilical arteries – deoxygenated blood

1 umbilical vein – oxygenated blood

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2
Q

What are the trimesters of pregnancy?

A

T1: 1-14wks
T2: 14-28wks
T3: 28-42wks

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3
Q

What is a normal pregnancy term?

A

37-42wks

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4
Q

What are the symptoms of pregnancy?

A
  • amenorrhea
  • nausea & vomiting
  • breast swelling & tenderness (pathophysiology: proliferation of secretory glands secondary to chorionic gonadotropin secretion)
  • urinary frequency (pathophysiology: increased pressure on bladder caused by uterine enlargment)
  • fatigue
  • craving or aversion to certain foods
  • weight gain
  • linea nigra (darkening of midline abdominal skin) + areola hyperpigmentation
  • constipation / bloating
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5
Q

Which trimester holds the highest risk of miscarriage?

A

T1

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6
Q

What is the GA for a preterm birth?

A

Less than 37wks 0/7days GA

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7
Q

What does GA stand for?

A

gestational age = fetal age calculated from 1st day of last menstrual period

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8
Q

What is the GA for a postterm birth?

A

More than 42wks 0/7 days GA

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9
Q

What is the normal duration of pregnancy?

A

40wks

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10
Q

What does GPAV stand for?

A

G = gravidity = total number of pregnancies (includes current, abortions, moles, multiple gestation = one pregnancy)
P = parity = number of births (can be divided into T term deliveries and P preterm deliveries)
A = abortions & ectopic pregnancies & miscarriages ending before 20wks GA
V = L = living / vivant

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11
Q

What is Goodell’s sign?

A

softening of the cervix (wks 1-6)

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12
Q

What is Chadwick’s sign?

A

bluish discoloration of the cervix and vagina secondary to pelvic vasculature engorgement (wks 6-8)

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13
Q

What is Hegar’s sign?

A

softening of the uterine isthmus (wks 6-8)

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14
Q

What are the vascular patterns associated with pregnancy?

A

telangiectasias & palmar erythema on palms

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15
Q

What is choloasma?

A

choloasma = melasma
benign hyperpigmentation of the face associated with pregnancy (and certain medications)

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16
Q

How is pregnancy diagnosed?

A

b-hCG in urine or blood
ultrasound

17
Q

What is b-hCG?

A

b-hCG = human chorionic gonadotropin = hormone produced by placental trophoblastic cells

18
Q

What does b-hCG do?

A
  1. maintains the corpus luteum during wks 3-6 pregnancy, thereby maintaining progesterone production, before luteal placental shift at wks 6-7 when progesterone production gradually shifts from the corpus luteum to the placenta
  2. promotes uterine angiogenesis
  3. promotes myometrial stability, preventing pre-labour contractions
  4. supports immune tolerance to growing embryo
19
Q

When does b-hCG start to be mesurable?

A

In serum: 9 days post-conception
In urine: 28 days after 1st day of last menstrual period

20
Q

What are the normal levels of b-hCG at different moments of the pregnancy?

A

plasma levels of b-hCG double every 48hrs from moment it is detectable up to about 8-10wks GA (peak at about 100 000), then falls during T2, then stays level but detectable throughout T3 until delivery

Basically:
10 at missed menses
100 000mIU/mL at peak at around 10wks GA
10 000 at term

21
Q

How do we determine gestational age and estimated date of delivery?

A
  1. from 1st day of last menstrual period
  2. ultrasound
22
Q

Lower levels of serum b-hCG may suggest…

A
  • ectopic pregnancy
  • miscarriage
  • inacurrate dates
  • normal
  • trisomy 18 (Edwards syndrome)
  • trisomy 13 (Patau syndrome)
23
Q

Higher levels of b-hCG may suggest…

A
  • multiple pregnancy
  • molar pregnancy
  • inacurrate dates
  • trisomy 21 (Down syndrome)
  • normal
  • kidney disease (slower clearance)
24
Q

By what is b-hCG produced?

A

primarily placental syncytiotrophoblast

also:
- nontrophoblastic malignant cells
- pituitary cells
- cytotrophoblast

25
Q

Prior to pregnancy, what hormone stimulates corpus luteum progesterone production?

A

LH

26
Q

What could cause falsely positive serum hCG but negative urine hCG?

A

Having heterophilic antibodies (cross reactivity with serum hCG test)

27
Q

What cause false hCG positives?

A
  • presence of heterophilic antibodies
  • physiological increase in hCG (by pituitary gland) in perimenopausal or menopausal women
  • hCG injections (for infertility, performance enhancement, weight loss)
  • blood transfusion from pregnant donor
  • nontrophoblast malignancy
  • familial hCG syndrome
28
Q

When is pregnancy visible on ultrasound?

A

Transvaginal:
- 5wks GA: gestational sac
- 6wks GA: fetal pole
- 6-8wks: fetal heart activity
Transabdominal:
- 6-8wks GA

29
Q

What are the physiological changes of the maternal cardiovascular system during pregnancy?

A
30
Q

Can live vaccines be administered during pregnancy?

A

no

OB-GYN (A.G.) (7 decks)

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