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OB/GYN > Prenatal and Postpartum Care > Flashcards

Prenatal and Postpartum Care Flashcards

1
Q

What does antepartum care include?

A
  • Education at every visit

- Screening

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2
Q

True or false: for women with regular menstrual cycles, a h/o one more more missed periods following a time of unprotected sex pretty much diagnoses pregnancy

A

True, for the most part

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3
Q

When does the softening and enlargement of the uterus begin after the LMP?

A

6 weeks after

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4
Q

When is the uterus enlarged enough to be palpable in the lower abdomen?

A

12 weeks

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5
Q

What is Chadwick’s sign

A

Bluish discoloration of the cervix

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6
Q

What is Hegar’s sign?

A

Softening of the cervix

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7
Q

What is Quickening? When does this occur?

A

Patient’s initial perception of fetal movement at 16-20 weeks

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8
Q

What do pregnancy tests measure? What produces this?

A

hCG produced by the syncytiotrophoblasts of the placenta

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9
Q

When do standard urine lab tests become positive for pregnancy (how long after LMP)?

A

about 4 weeks

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10
Q

When during the day is urine concentration of hCG the highest?

A

Morning

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11
Q

What allows the serum pregnancy test to be more sensitive and specific for pregnancy? When does this become positive?

A

Tests for unique beta subunit of hCG

Two weeks from ovulation

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12
Q

Can the serum pregnancy test detect a pregnancy before a missed period?

A

Yes

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13
Q

What is the doubling time of serum hCG?

A

2 days

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14
Q

How do you detect fetal heart tones? (2 methods) When are these detectable for each method?

A
  • Traditional acoustic fetoscope (18-20 weeks)

- electronic doppler (12 weeks)

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15
Q

When does the fundal height represent the gestational age of the fetus?

A

When the uterus grows in size so that it exits the pelvis

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16
Q

What is the correlation between the fundal height and gestational age?

A

Fundal height in cm represents that gestation age of the fetus to about 36 weeks (+/- 2 weeks)

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17
Q

What level of exercise should pregnant women get to? Why not more?

A

Speaking while jogging etc

Do not risk the fetus

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18
Q

What is gestational age, technically?

A

Number of weeks that have elapsed between the 1st day of LMP and the date of delivery (NOT the presumed time of conception)

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19
Q

What is the EDD? How is this calculated?

A

Estimated date of delivery

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20
Q

What is Naegele’s rule?

A

Rule to determine the date of expectancy:

Add 1 year + 7 days to first day of LMP andn subtract 3 months

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21
Q

True or false: US established dates should take precedence over menstrual dates

A

True

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22
Q

When, in weeks gestation, can an abdominal US detect the gestational sac? What are the bhCG levels?

A

5-6 weeks

5000-6000

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23
Q

When, in weeks gestation, can an TVUS detect the gestational sac? What are the bhCG levels?

A

3-4 weeks

1000-2000

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24
Q

The embryo and cardiac activity should be seen if the hCG level is greater than what value?

A

4000

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25
What are the components of the GTPAL?
- Gravida - Parity (term/preterm) - Abortions - Living
26
What is the technical definition of abortion for the GTPAL system?
Any pregnancy loss before 20 weeks
27
What are the normal pregnancy PE intervals for prenatal care? (3)
- q 4 weeks until 28 weeks - q 2 weeks until 36 weeks - q 1 week until delivery
28
What are the leopold maneuvers, and when can you perform these?
Feeling for the fetus third trimester
29
What is the gestational age at which the fundal measurement is at the pubic symphysis
6 weeks
30
What is the gestational age at which the fundal measurement is at the umbilicus?
20 weeks
31
What is the gestational age at which the fundal measurement is at the xiphoid?
36 weeks
32
What is felt with leopold maneuvers? What is the sequence?
- Head - buttocks - back - arms/legs
33
What are the infection screens that are done at the first prenatal visit? (6)
- Rubella - HIV - Hep B and C - VDRL - GC/CT
34
When should glucose screen be performed at the first prenatal visit?
If BMI is greater than 30
35
What are the general labs that are obtained at the first prenatal visit? (4)
- CBC - TSH - ABO/Rh - Urine culture
36
During what gestational weeks is rechecking for Hb necessary in patients with gestational DM?
24-28
37
When does GBS testing begin?
35-37 weeks
38
What is the main lab that is obtained at postpartum day 1?
Hb to r/o anemia
39
Uterus emerges from the pelvis at how many weeks?
12 weeks
40
FHRs by doppler appear around what week?
12 weeks
41
What is the definition of a threatened abortion?
Bleeding before 20 weeks
42
When should the n/v of pregnancy subside?
After the first trimester
43
What is done in the 2nd trimester? (4 labs)
2nd integrated screen - Hb - Estriol - Inhibin A - AFP
44
What are the measurements on US that determine gestational age in the 2nd trimester?
- Head circumference | - Biparietal diameter
45
When is movement perceived (nulliparous/multiparous)?
18-20 weeks in nulliparous or 16 weeks in multiparous
46
What are the components of the quad screen?
- Hb - Estriol - Inhibin A - AFP
47
What is the key screening test in the 3rd trimester?
Rh test and rhogam administration
48
When is Rh screening needed?
28 weeks
49
What are the four majors tests obtained at 28 weeks?
- Rh status - Glucose GDM screen - Repeat H&H - Repeat ab screen
50
How should a seat belt be worn for a pregnant woman?
Below the uterus
51
When documenting GTPAL, do twins count as a P1 or P2?
P1
52
If a patient on medicaid desires sterilization the consent forms must be signed more than (__) days in advance, but no more than (__) days in advance.
60 | 120
53
Bleeding in the 3rd trimester should always be suspicious for what?
Rh cross reactivity--get Rh type!
54
What is placental abruption, and how does it present?
The placental lining has separated from the uterus of the mother prior to delivery Extremely painful
55
When does placenta previa usually present?
Around 32-34 weeks
56
Why do you not want to do a cervical exam if you do not know where the placenta is?
Do not want to stick fingers into the placenta, and damage it.
57
What tests are ordered at 36 weeks?
- H and H - GC/chlamydia - GBS
58
How can you confirm fetal presentation in the 3rd trimester?
Leopold maneuvers or US
59
What is the difference between PROM and PPROM?
Premature and preterm premature ROM
60
How many calories a day are needed for pregnant women?
400
61
How many lbs should a pregnant woman gain during pregnancy?
25-35 lbs
62
When should folic acid supplementation begin and end?
4 weeks preconception to at least 12 weeks gestation
63
Why should soft cheeses and uncooked lunchmeat be avoided by pregnant women?
Concern for listeria monocytogenes
64
Is sushi okay for pregnant women to eat
No
65
Why should pregnant women avoid fish?
Hg
66
What happens to moles and skin tags in pregnancy?
Darken/grow
67
What is PUPP?
Pruritic urticarial papules of pregnancy an intense pruritus that occurs in pregnancy
68
What causes the linea nigra to form?
Migration of melanocytes to the umbilicus
69
What happens to hair in pregnancy?
Gets longer, does not fall out as easily
70
What causes the erythema of the palms with pregnancy?
Dilation of the peripheral blood vessels
71
What is the treatment for diastasis recti that may occur with pregnancy?
Usually resolves on its own, but may need surgery
72
Why does GERD occur with pregnancy?
Estrogen makes the pyloric sphincter less competent
73
What happens to the kidneys with pregnancy?
Pressure on the ureters from the growing uterus may cause them to enlarge
74
Why is peristaltic activity decreased in pregnant women?
Colon is displaced upward, and posteriorly
75
What causes the urinary frequency and urgency with pregnancy?
Pressure from the enlarging uterus
76
What are the eye changes with pregnancy?
Changes in refractive power and increased lysozyme may cause clouding of contact lenses
77
True or false: pregnant patients are more at risk for mastitis even before giving birth
True
78
What causes the nasal stuffiness with pregnancy?
Increase capillaries of the nose, pharynx etc
79
What happens to the functional residual capacity in pregnancy? Vital capacity? RR? MInute ventilation?
- Decreased FRC - Increased Vc - Normal RR - Min vent increases
80
True or false: dyspnea is common in prego
True
81
What happens to HR ans SV with prego?
Increase
82
What happens to the position of the heart with pregnancy?
Shifts into a more longitudinal position
83
Systolic murmurs are not uncommon over which listening post in pregnancy?
Pulmonic
84
What happens to systemic vascular resistance with prego?
Decreases
85
What causes hemorrhoids and dependent edema with pregnancy?
Compression of the IVC by baby
86
When do uterine contractions begin? What are the early ones called?
As early as the third month of gestation Braxton Hicks
87
What is the effect of relaxin on the pelvic cartilage?
Softens to prep for delivery
88
True or false: any vaginal discharge in the 3rd trimester is concerning?
False-- very common, and physiologic
89
What causes carpal tunnel syndrome in pregnancy?
D/t fluid retention
90
What is the most common site of back pain for pregnant women?
SI joint
91
True or false: Migraine headaches are more common in pregnancy
True

OB/GYN (33 decks)

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