Pregnancy Flashcards
How much folic acid is recommended for women of childbearing age?
0.4-0.8mg daily or more if at risk
Immunizations needed prior to pregnancy
Influenza
Rubella if neg titer
Varicella if at high risk of exposure otherwise wait
TdaP after 20 weeks EVERY pregnancy
Negals rule
Subtract 3 months from last menstrual period than add 7 days and one year
What should be routinely screened during pregancy according to ACOG and AMA?
domestic violence 7-20% abused during pregnancy
Dx studies first prenatal visit
Pregnancy test CBC or H&H and MCV urinalysis Blood type and Rh Rubella titer STD testing TSH
Classic sx ectopic pregnancy
Previous case Tubal pathology, tubal surgery Current IUD use Cervicitis Hx of PID
How many extra calories are needed during pregnancy?
240 second trimester and 452 third trimester
BMI 18.5-24.9 weight gain during pregnancy
25-35lbs
Needed increase in iron for pregnancy
15-30mg elemental iron
Exercise during pregnancy
30 minutes moderate activity
When should cramping be a concern?
Getting worse or with bleeding
Uterine size at 16 weeks
midway between symphysis and umbilicus
Uterine size 20 weeks
level of umbilicus
Uncomplicated appt schedule with pregnancy
every 4 weeks until 28 weeks then 2 weeks until 36 then weekly
2 step approach for gestational diabetes
50g glucose load without regard to meals. Measure one hour later. >130-140 than positive
If positive screen 3 hour 100g OGTT If 2 of the following are true, positive FAsting >95 1 hour >180 2 hour > 155 3 hour > 140
Fundal Height - McDonalds Rule
Uterine fundal height measured in cm from symphysis pubis to top of uterous. Between 18-36 weeks there is a good coorilation between height and gestational age
Down Syndrome
trisomy 21. Most common chromosomal abnormality in live births
Turner Syndrome
Most common sex chromosome in females. Loss of part or all of X chromosome. Short in stature, square chest
Quickening detected
Primapara 17-20 weeks
Subsequent - 15-16 weeks
What is given to prevent Rh neg mother from making Rh positive antibodies
Anti(D)-immune globulin
What is screened at 35-37 weeks
Group B strept screen of rectal and vaginal areas to prevent sepsis
pH of amniotic fluid
7-7.5, higher than vaginal secretions
Placenta previa
Assessment finds painless vaginal bleeding, do NOT perform vaginal exam
Preeclampsia
New onset HTN plus protienuria after 20 weeks
Eclampsea
Development of seizures with gestational HTN or preeclampsia
Gestational HTN
HTN without protienuria
Management of HTN in pregnancy
diuretics/ACE not recommended
methyldopa DOC
