Prenatal and postpartum care Flashcards
when is the uterus enlarged enough to be palpable in the lower abdomen?
12 weeks
what is the chadwick sign?
bluish discoloration of vagina
what is the hegar sign?
softening of the cervix
why is a serum pregnancy test more specific and sensitive?
detects unique beta subunit of HCG
when is it possible to detect fetal heart tones? what techniques?
- at or beyond 18-20 weeks gestation (traditional acoustic fetoscope)
- 12 weeks (electronic doppler)
how is gestational age determined?
number of weeks that have elapsed between 1st day of LMP (not presumed day of conception) and date of delivery
what is the naegele rule?
add 1 year + 7 days to first day of LMP and subtract 3 months
how is gestational age determined if the LMP date is questionable?
ultrasounded dated pregnancy
when does abdominal US detect pregnancy? transvaginal?
- abdominal: 5-6 weeks
- transvaginal: 3-4 weeks
the embryo and cardiac activity should be seen when HCG is at what level?
4000 mIU/mL or greater
abortions / miscarriages / ectopics correspond to lesser than what week gestation?
under 20 weeks
what are the normal pregnancy intervals for normal prenatal care?
Q4w until 28 weeks then
Q2w until 36 weeks then
Q1w until delivery
at 20 weeks where is the uterine fundus?
umbilicus
what are leopold maneuvers?
used to identify fetal position
at what week does the uterus emerge from the pelvis?
12 weeks
when is group B strep screening done?
35-37 weeks
when is gestational diabetes screening done?
24-28 weeks
what is “threatened abortion”?
1st trimester bleeding
what is included in the quad screen? when is it done?
- HCG
- estriol
- inhibin A
- AFP
- second trimester (16-20 weeks)
when is fetal movement felt in a nulliparous woman?
18-20 weeks
when is fetal movement felt in a multiparous woman?
16 weeks
what tests are done in 3rd trimester?
- rhogam if Rh negative (28 weeks)
- glucola GDM screen (even if neg earlier)
- repeat H&H
- repeat antibody screen
if there is bleeding in the 3rd trimester what should you check?
Rh status
is placental abruption painful or painless?
painful
placental abruption is usually associated with what condition(s)?
hypertensive disease or trauma vs. possible abuse
when does placenta previa present?
32-34 weeks
is placenta previa bleeding painful or painless?
painless
caloric requirement should increase by how much in the 3rd trimester?
340-450 kcal
folate supplementation during what time prevents neural tube defects?
4 weeks preconception to 12 weeks gestation
what are the features of pregnancy induced HTN?
- segmental arteriolar narrowing with wet, glistening appearance indicative of edema
- hemorrhages and exudates RARE
maternal blood volume increases by what % over pre-pregnancy levels?
40-50%
what is braxton hicks?
uterine contractions that occur as early as third month of gestation
what hormones are responsible for softening of the pelvic cartilage, and increased mobility?
- relaxin
- progesterone
what is the puerperium?
first 6 weeks after delivery
what occurs during puerperium?
- instruction about care of the neonate, breastfeeding, physical limitations, emotional support
- discharge instructions
- vaccinations for Tdap, MMR, influenza
what is wound separation? what is dehiscence?
- would separation: skin separates, underlying adipose separates
- dehiscence: skin separates, underlying adipose separates, AND fascial layer separates
what are the 5 Bs of the immediate postpartum period?
- brain
- breast
- bladder
- bleeding
- birth control
when does baby blues start and end?
- start: within first week
- end: by day 10
what is the onset for postpartum depression? how long does it last?
- within 4 weeks
- up to 7 months
when can postpartum contraception be started?
- at least 3 weeks postpartum
- benefits of contraception outweigh the risk of VTE
