prenatal assessment Flashcards
division of trimesters
0-12 weeks
13-27 weeks
: 28-40 weeks
term and preterm
37-42 weeks
i. At term is 37 weeks
preterm is 37
post term
i. Almost nobody goes to 42 weeks anymore b/c mom and baby gets testing every 3 days; risks are too great so induction is done by 40-41 weeks
para
Number of viable (>20 wks) births
multiples count as 1 para
Total number of pregnancies
gravida
4 pregnancies (one of which was a miscarriage
how do you write this
G4P3 (SAB1)
at risk groups
teenagers and moms over 35
1 twin pregnancy:
G1P1002
diet for pregnancy
folic acid MVI; avoid EtOH, tobacco/drugs, caffeine (no more than 200mg of coffee per day), medications
folic acid recommendations
folic acid (especially important in the first trimester; now recommended all women of child bearing age regardless of whether they are trying to get pregnant should be taking prenatal vitamins),
HTN medications pregnancy
ACEi needs to be d/c’ed; any that are Category C should be carefully monitored or switched)
Vaccinations:
Varicella, Rubella, Hep B
i. Live virus vaccines cannot be given to pregnant women
ii. If mom gets varicella infection, it is potentially devastating for the fetus
iii. Get the vaccines minimum 1 month before they get pregnant, but getting it 3 months before is better
medical history
DM, mental health, STD, etc
PID makes it difficult to get pregnant
salpingo gram can be helpful for looking at the patency of the tubes
recommendation for overweight pregnant women
ii. If obese or morbidly obese when pregnant, then weight neutral pregnancy is recommended
when are urine pregnancy tests sensitive
what time is the most accurate
- Accurate 95%-98% of the time
- Sensitive within 7 days after implantation
- Use first morning void when possible b/c hCG concentration is the highest
gold standard for medical documentation
gold standard is QUANTITATIVE B-HCG (don’t get qualitative, it’s just like Upreg).
two types of serum ECG tests
Qualitative results are read as pos or neg
Quantitative B-HCG radioisotope test used for serial testing** this is the one you actually want
how to interpret hcg
Level doubles every 48 hrs the first 3-4 wks
If having an ectopic pregnancy, the levels will not
Level should be 50 to 250 mIU/mL at the time of the first missed period
when do we see a peak/decline in HCG (normally)
Level peaks at 60-70 days then levels
10 weeks
what should the levels be in a quantitative test
level should be 50 to 250 mIU/mL at the time of the first missed period
progesterone levels Remain constant through
Remain constant through first 9-10 weeks
when would you take a progesterone levels
get them early for women that have had two or more miscarriages
early in the pregnancy might check hcg and progesterone
-Serum level checked if frequent SAB
If level < 20, Progesterone vaginal suppository
- Non viable pregnancies have lower levels
- Highly predictive of pregnancy outcomes
what does of progesterone
(Prometrium 100-200 mg inserted vaginally)
Risks for ectopic pregnancy
PID
a. Prior tubal pregnancy
b. Tubal reversal surgery
c. Endometriosis
d. Intrauterine device