Pregnant Flashcards
When does the ovaries differentiate?
12 wks
What does the male fetus turn off?
mullerian system
What is the dating of pregnancy?
280 days from LMP
What is first trimester?
LMP - 13 6/7 wks
What is second trimester?
14 - 27 6/7 wks
What is third trimester?
28 wk - delivery
What is primaparous?
first delivery
What are 6 causes of obstretical deaths?
HTN, hemorrhage, infection, thromboembolism, complicated labor or illegal abortions, ectompic pregnancies
What are indirect causes of obstretical deaths?
asthma, heart disease, DM type 1, SLE,
How much does body water increase in preg?
6.5-8.5
What are the cardiac changes?
enlarge heart, increase HR, increase CO, decrease VR, split 1st heart sound, bP changes
When do you see CV changes in preg?
early as 5 wk gestation
What is normal UR changes?
increase secretions, swollen mucous membrane, increase epistaxis, chronic resp alkalosis
How much should you increase calories in preg?
300kcal/day
What are some GI changes in preg?
GERD, constipation, position of appendix, decrease albumin, N/V
What are urologic changes in preg?
kidneys enlarge, ureters dilate, bladder increases vascularity, BUN/Cr decrease
What are changes in pancreas?
fasting hypoglycemia, postprandial hyperglycemia
What is thyroid changes?
increase in size, decrease TSH first tri
What are adrenal changes?
increase cortisol
What are pituitary changes?
increase size, anterior - prolactin
posterior - oxytocin
What are dental changes in preg?
increase sensitivity, bleeding gum, increase susceptibility to bacteria
What is gum disease linked to?
low birth wt and preterm labor
What is age if fundus at ASIS?
16 wks
What is age if fundus at umbilicus?
20 wk
What is age if fundus at pubic symph?
12 wk
What do you do at new OB?
fundal ht, LMP and US, hx, LABs
What timing do you only use the spatula and not brush for pap smear?
10 wk preg
What should all visits include?
Maternal vitals FHTs (doppler) Fundal height (>20w) Basic questions regarding fetal movement (>20w), bleeding, leaking, pain, dysuria Review medications
What is ultrascreen?
Ultrasound to look at nuchal translucency
PAPP-a and HCG
11-13 6/7 weeks
Screening for Trisomy 21 and 18
What is the quadruple screen at 2nd trimester?
hCG, estriol, inhibin-A, AFP
15-19 6/7w – longer if specialty labs
Can be elevated in twins, diabetes, smoking, obesity
When do you do anatomy US?
> 20 wks
When do you do gestational DM screen?
24-28 wks
27-36?
What do you do at 36 wks exam?
Group B Hemolytic Strep testing
Gonorrhea/Chlamydia testing
Leopold maneuvers to estimate fetal size
Begin more routine checking of cervix
What is term considered?
> 37 wks
What is fetal pole?
fetal lie, hands on each side, longitudinal or transverse
What is umbilical pole?
small parts/big parts, which way is back facing
What is pawlicks grip?
confirm cephalic
What is pelvic grip?
attitude, head flexed or extended
When do you see for post partum care?
4-6 wks
What post partum labs do you get?
GMD, CBC, TSH
What are the B of postpartum?
bleeding, breastfeeding, bowels, bladder, blues, birth conrol, intercourse
What is the teratogenic period?
31-71 days
When are all major organs established?
10 wk;
What does smoking cause?
Abruption, previa, growth restriction, prematurity, prolonged rupture of membranes, SAB, SIDs, cleft palate
What does ETOH do?
facial anomalies, growth retardation, CNS
What does cocaine do?
cardiac, CNS, abruption
What are the 5 components to EFM?
Baseline heartrate Beat-to-beat variability Presence of accelerations Presence of decelerations Maternal contractions
What is post term?
> 42 wks
What is the fetal occiput has reached the ischial spines and widest traverse part of infants head?
0 station
Circular pelvis, best for deliver?
gynecoid
oval AP pelvis
anthropoid, favorable
egg shaped pelvis
android
Transverse oval pelvis,
platyupelloid, bad
What are the cardinal movements of labor?
engagement, descent, flexion, internal rotation, extension, external rotation, expulsion
What causes relaxation of LES?
progestrone
What is too low placenta?
placenta previa
What ht usually requires C section?
5 ft
How do you calculate due date?
3 months + 1 year + 7 days
What is nagele’s rule?
280 days to LMP
What is reduction in fundal ht btw 38-40 wks?
lightening
What is a normal fetal HR?
120-160 bpm
What is dusty blue cervix?
chadwicks sign
What is softening of entire isthmus of cervix?
Hegar’s sign
What is the most common cause of abruptio placentae?
HTN
what is the MCC of maternal death?
postpartum hemorrhage
What is mask of pregnancy?
cholasma
What is normal with thyroid during pregnancy?
bruit
What is the weird lactation the first few days after giving birth?
colostrum
What will remain unchanged in preg?
respiratory rate
What is thinning of cervix ?
effacement
What is relationship of baby to ischeal spines?
station
What is caused by decreased vascular resisitance and vasodilation in preg?
palmar erythema and spider telangiectasia
What is the def of pre eclampisa?
> 160/>110
What are two msk complaints?
carpal tunnel and lordosis
