Pregnancy Diagnosis and Prenatal Care Flashcards
List some common symptoms in pregnancy
Nausea/vomiting 🡪 “morning sickness”
Bloating
Fatigue due to rapid, large increase in progesterone
High levels, rises quickly
Frequent urination
Food cravings
Mood swings
Tender, full breasts
Produced in the synctiotroblast of a growing placenta
Enters circulation soon after implantation
Doubles every 48 hours for 30 days
hCG
hCG stands for what?
Human chorionic gonadotropin
Congestion and blueish discoloration of the cervix
Chadwick sign
Softening of the cervix
Hegar sign
Fetal Doppler can pick up fetal heart tones starting around how many weeks?
10-12 weeks
What are the two types of pregnancy tests?
Qualitative - Shows either positive or negative
Quantitative - Shows the actual amount
What is the normal bpm for fetal heart tones?
Normal 120-160
Naegel’s Rule
First day of LMP + 7 days – 3 months
Why is determining gestational age so important?
Need to be accurate to determine if pregnancy is normal and healthy
If LMP is unknown, or patient has irregular periods, what is used to estimate the gestational age?
Use the first trimester ultrasound dates (estimated by CRL)
What weeks are considered which trimester?
First trimester = 0 to 14 weeks
Second trimester = 15 to 28 weeks
Third trimester = 29 to 42 weeks
When is the first ultrasound done to establish dates for gestational age and fetal well being?
Transvaginal: 3-4 weeks
Abdominal: 5-6 weeks
What are some causes of a small fundal height?
Carries low
Low amniotic fluid
Slow growth
Fetal movement, called “quickening”, is felt around when in first pregnancy and in additional pregnancy?
20 weeks if first pregnancy
16-18 weeks if additional pregnancies
When fundal height is checked weeks 20-40, what are you looking for and why?
Want fundus measurement to be within 2cm of expected
Less than expected can indicate issues or inaccuracies in dates
We expect the fundal height to decrease when?
36+ weeks
What time frame is genetic testing done?
15-22 weeks
What time frame is glucose testing done?
24-28 week
What time frame is H&H and Antibody screen (Rh) done?
28 weeks
What time frame is GBS (unless planning a C-section) screen done?
35-37 weeks
What is the most valuable tool to assess fetal growth and anomalies?
The Ultrasound
Describe the differences between the first, second, and third ultrasounds in pregnancy
First ultrasound – assigning dates (most important thing in pregnancy)
Second ultrasound – abnormalities/organ assessment
Third ultrasound (36 weeks) – general survey since the fundal height measurement is a poor predictor of fetal outcomes
Which trimester is the most accurate to assess fetal growth and anomalies?
The first trimester
Which trimester is the least accurate to assess fetal growth and anomalies?
The third trimester
Between which weeks best for checking organ development?
18-20 weeks
If a patient is expecting twins, how often should they be monitored with an ultrasound?
Follow twins q 2-6 weeks
If sharing placenta 🡪 every 2 weeks
Babies gain how many pounds a week in the third trimester?
0.5-1.0 pounds
What are the folic acid requirements in pregnant patients (normal and history of neural tube defects)?
0.4mg needed in normal women
4mg needed if history of neural tube defects
It is recommended for pregnant patients to stop supine exercises after which trimester?
first trimester
Which vaccines must be avoided in pregnancy?
live vaccines (Varicella, MMR, Yellow fever)
Why are hottubs or saunas avoided in pregnancy?
hyperthermia is tetrogenic
Pregnant patients can fly up to how many weeks along?
Can fly up to 36 weeks
What is the last system to develop in a fetus?
Respiratory System
Phosphatidylglycerol in a fetus is a marker for what?
Marker of complete pulmonary maturation after 35 weeks
