Pregnancy Diagnosis and Prenatal Care

Question 1

List some common symptoms in pregnancy

Answer 1

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

Question 2

Produced in the synctiotroblast of a growing placenta

Enters circulation soon after implantation

Doubles every 48 hours for 30 days

Answer 2

hCG

Question 3

hCG stands for what?

Answer 3

Human chorionic gonadotropin

Question 4

Congestion and blueish discoloration of the cervix

Answer 4

Chadwick sign

Question 5

Softening of the cervix

Answer 5

Hegar sign

Question 6

Fetal Doppler can pick up fetal heart tones starting around how many weeks?

Answer 6

10-12 weeks

Question 7

What are the two types of pregnancy tests?

Answer 7

Qualitative - Shows either positive or negative

Quantitative - Shows the actual amount

Question 8

What is the normal bpm for fetal heart tones?

Answer 8

Normal 120-160

Question 9

Naegel’s Rule

Answer 9

First day of LMP + 7 days – 3 months

Question 10

Why is determining gestational age so important?

Answer 10

Need to be accurate to determine if pregnancy is normal and healthy

Question 11

If LMP is unknown, or patient has irregular periods, what is used to estimate the gestational age?

Answer 11

Use the first trimester ultrasound dates (estimated by CRL)

Question 12

What weeks are considered which trimester?

Answer 12

First trimester = 0 to 14 weeks

Second trimester = 15 to 28 weeks

Third trimester = 29 to 42 weeks

Question 13

When is the first ultrasound done to establish dates for gestational age and fetal well being?

Answer 13

Transvaginal: 3-4 weeks
Abdominal: 5-6 weeks

Question 14

What are some causes of a small fundal height?

Answer 14

Carries low

Low amniotic fluid

Slow growth

Question 15

Fetal movement, called “quickening”, is felt around when in first pregnancy and in additional pregnancy?

Answer 15

20 weeks if first pregnancy
16-18 weeks if additional pregnancies

Question 16

When fundal height is checked weeks 20-40, what are you looking for and why?

Answer 16

Want fundus measurement to be within 2cm of expected
Less than expected can indicate issues or inaccuracies in dates

Question 17

We expect the fundal height to decrease when?

Answer 17

36+ weeks

Question 18

What time frame is genetic testing done?

Answer 18

15-22 weeks

Question 19

What time frame is glucose testing done?

Answer 19

24-28 week

Question 20

What time frame is H&H and Antibody screen (Rh) done?

Answer 20

28 weeks

Question 21

What time frame is GBS (unless planning a C-section) screen done?

Answer 21

35-37 weeks

Question 22

What is the most valuable tool to assess fetal growth and anomalies?

Answer 22

The Ultrasound

Question 23

Describe the differences between the first, second, and third ultrasounds in pregnancy

Answer 23

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

Question 24

Which trimester is the most accurate to assess fetal growth and anomalies?

Answer 24

The first trimester

Question 25

Which trimester is the least accurate to assess fetal growth and anomalies?

Answer 25

The third trimester

Question 26

Between which weeks best for checking organ development?

Answer 26

18-20 weeks

Question 27

If a patient is expecting twins, how often should they be monitored with an ultrasound?

Answer 27

Follow twins q 2-6 weeks

If sharing placenta 🡪 every 2 weeks

Question 28

Babies gain how many pounds a week in the third trimester?

Answer 28

0.5-1.0 pounds

Question 29

What are the folic acid requirements in pregnant patients (normal and history of neural tube defects)?

Answer 29

0.4mg needed in normal women

4mg needed if history of neural tube defects

Question 30

It is recommended for pregnant patients to stop supine exercises after which trimester?

Answer 30

first trimester

Question 31

Which vaccines must be avoided in pregnancy?

Answer 31

live vaccines (Varicella, MMR, Yellow fever)

Question 32

Why are hottubs or saunas avoided in pregnancy?

Answer 32

hyperthermia is tetrogenic

Question 33

Pregnant patients can fly up to how many weeks along?

Answer 33

Can fly up to 36 weeks

Question 34

What is the last system to develop in a fetus?

Answer 34

Respiratory System

Question 35

Phosphatidylglycerol in a fetus is a marker for what?

Answer 35

Marker of complete pulmonary maturation after 35 weeks