Pregnancy

Question 1

zygote

Answer 1

at fertilization

Question 2

blastocyst

Answer 2

up to 2 weeks

Question 3

embryo

Answer 3

2-8 weeks

Question 4

fetus

Answer 4

8 weeks - term

Question 5

preterm infant

Answer 5

born before 37 weeks gest

Question 6

term infant

Answer 6

born between 37-42 weeks gest

Question 7

post term infant

Answer 7

born after 42 weeks gest

Question 8

naegele’s rule

Answer 8

subtract 3 mos from first day of LMP, add 7 days= 40 wks (280 days) from LMP or 38 wks (266 days) from date of conception. Adjust for yr as needed. provides reasonable estimation but can be inaccurate for women w/ irreg menses or w/ unclear LMP date.

Question 9

1 trimester ultrasound

Answer 9

using crown-rump measurement, accurate w/ potential of 7 day error margin (considered most accurate source of EDD)

Question 10

2nd trimester (up to 22 wks) ultrasound

Answer 10

using multiple fetal measurements (biparietal diameter, femur length, others) accurate w/ potential of 10-14 day error.

Question 11

nongravid uterus

Answer 11

lemon

Question 12

8 weeks

Answer 12

tennis ball or orange

Question 13

10 weeks

Answer 13

baseball; first FHT via abdominal doppler; range of of 2 wks.

Question 14

12 weeks

Answer 14

softball or grapefruit; rising above symphysis pubis.

Question 15

16 weeks

Answer 15

fundal height half way between symphysis pubis & umbilicus.

Question 16

20 weeks

Answer 16

fundus at umbilicus

Question 17

calcium

Answer 17

1000-1500 mg/d. ~40% increase from baseline needs; women ages 19-50 need 1000 mg/d. women 14-18 need min of 1300/d.

Question 18

folic acid

Answer 18

w/o hx of NTD, need 0.4-1 mg/d. ~100% inc from baseline needs. prior hx ntd or fam hx (anencephaly, myelomeningocele, spina bifida) 4 mg/d x 1 month before preg & during 1st 3 mos gest then resume 0.4-1 mg/d to promote placental/fetal growth.

Question 19

Iron

Answer 19

no deficiency= 15-30 mg/d or 100% inc from baseline needs (preg & lactation). most pnv provide sufficient amt for no def w/ singleton preg.
deficient or mult-gest= 60-100 mg/d; avoid excessive supplementation in absence of documented def d/t potential risk for free radical production & oxidative damage.

Question 20

progesterone

Answer 20

n/v. delays gastric emptying. contributes to heartburn.

Question 21

hCG

Answer 21

n/v. mechanism unclear, possibly d/t effect on CNS. __ produced by trophoblast starting at day 8 of preg. sx typically worsen when levels peak (~10 wks).

Question 22

vit B6

Answer 22

n/v. 25 mg 3-4x/d, demonstrated to be helpful in reducing nausea w/ little effect on vomiting; most helpful w/ milder sx’s.

Question 23

ginger

Answer 23

n/v. in drink or powder form (1-1.5 gm over 24hrs), as effective as vit b6 in reducing n/v.

Question 24

tay-sachs dz

Answer 24

at-risk: ashkenazi jews, french canadian, cajun ancestry. test ideally prior to preg; preg & po contraceptive use increase risk of false positive test results.

Question 25

cystic fibrosis

Answer 25

at risk: northern euro or ashkenazi jewish heritage, less common w/ african ancestry, uncommon w/ asian descent. test prior to or in early preg.

Question 26

sickle cell trait

Answer 26

at risk: african, latino, arabic, greek, maltese, italian, sardinian, turkish & indian ancestry. test prior to or in early preg.