Prenatal Assessment

Question 1

Most major morphological abnormalities occur in which weeks?

Answer 1

4 to 8wks

Question 2

When are urine Pg tests sensitive?

Answer 2

7 days after implantation (not conception)

Question 3

When do serum HCG levels double?

Answer 3

double q 48hrs in the 1st 4 weeks

Question 4

What should you check for frequent SABs?

Answer 4

progesterone. can be used to maintain Pg : if < 20 use 100-200mg prometrium vaginally

Question 5

When do you start measuring the uterus?

Answer 5

20wks (at the umbilicus)

Question 6

What do you do for a woman with a hx of genital herpes?

Answer 6

Start acyclovir at 36wks

Question 7

What is Hagars sign?

Answer 7

softening of the cervix 4-6wks

Question 8

When does quickening occur?

Answer 8

when mom feels the baby move, 18-20wks, earlier if not nulliparous

Question 9

When do you see a gestational sac and what should HCG levels be at?

Answer 9

4 wks, 1000-1500

Question 10

How much folic acid do women need pre-Pg? When does the neural tube close?

Answer 10

800mcg/d, neural tube closes 18-26d after conception (5-6wks gestational age)

Question 11

What is the prenatal visit schedule?

Answer 11

1x/mth until 3rd trimester (28wks), then q2wks until 36wks, then 1x/wk until birth

Question 12

What should be evaluated at every prenatal visit?

Answer 12

wt gain, BP, fundal ht (symphysis to fundus), Leopold’s manuever/position, fetal heart tones, edema, UA (glucose/protein), other sx’s

Question 13

Red flag sx’s during Pg?

Answer 13

vaginal bleeding, fluid leaking, persistent HA/dizziness/edema, RUQ pain, decreased fetal mov’t, fever, chills, hyperemesis

Question 14

What is on a standard OB panel?

Answer 14

blood type/Ab/Rh, Hgb/Hct, Pap, CT/HIV/RPR/Hep B testing, rubella Ab, UA, thyroid

Question 15

What can happen if Rh - women don’t get Rhogam?

Answer 15

IgG crosses placenta, destroys blood cells and causes hydrops, hemolytic anemia, death

Question 16

What is in the screening for Down syndrome?

Answer 16

nuchal translucency ( < 3mm = nml) + PAPP-A at 11-14wks and HCG. Then E3, b-HCG, AFP, inhibin A (quad screen) around 15-20wks

Question 17

What is chorionic villus sampling?

Answer 17

placenta sample done thru cervix or abdomen at 10-12wks, tests for genetic d/o only, 0.8% risk miscarriage

Question 18

What is amniocentesis?

Answer 18

sample of amniotic fluid to test for neural tube, genetic d/o, spina bifida, etc 15-18wks. Risk of miscarriage is 1 in 400 (0.25%)

Question 19

When do you do a vaginal rectal swab for GBS?

Answer 19

36-37wks