Prenatal care 1 & 2 Flashcards

1
Q

When is fetal movement felt usually?

A

Multiparous: 16-18 weeks
Nulliparous: 20-22 weeks

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2
Q

When can HCG be detected in the serum?

A

8 - 9 days after ovulation
its doubles in 1.4 - 2 days

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3
Q

What is the function of HCG?

A

prevents involution of the corpus luteum which produces progesterone

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4
Q

What are the causes of false positive pregnancy tests?

A
  • renal impairment -> defective clearance of HCG
  • exogenous HCG for weight loss
  • HCG producing tumors
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5
Q

When can a gestational sac be seen on ultrasound?

A

at 4-5 weeks by transvaginal ultrasound

double shadow shows decidua capsularis & parietalis

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6
Q

What are the trimesters in a pregnancy?

A

First trimester: till the end of week 14
Second trimester: till the end of week 28
Third trimester: 42 weeks

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7
Q

When should a baby be delivered?

A
  • preterm < 37 weeks
  • term 37 - 40 weeks
  • post date 40 - 42 weeks
  • post term > 42 weeks
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8
Q

How is gestational age calculated using LMP?

A

+ 7 days
- 3 months

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9
Q

What is the most accurate method to confirm gestational age?

A

first trimester ultrasound using
- crown rump length = 45 - 84mm

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10
Q

What should be preformed for a pregnant lady on her first visit?

A

by 10 weeks max
1- detailed history & physical: nausea, vomiting, abdominal pain, blurred vision, headache, leakage of fluid
2- blood pressure
3- weight & height
4- fundal height (if late presentation): starting at 20 weeks
5- fetal heart rate: detectable at 10 weeks by doppler and by stethoscope at 20 weeks
6- cervical & pelvic examination

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11
Q

What are the lab tests that should be done in the first trimester?

A

1- hemoglobin level (repeat at 28 weeks)
2- blood group & Rh
3- Syphilis & Rubella & Chlamydia screening
4- HIV & Hepatitis B serology
5- Red cell antibodies
6- Urine protein assessment
7- urine culture

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12
Q

How much folic acid should be taken in prenatal vitamins?

A
  • 400-800 micrograms for low risk
  • 4 mg for Sickler’s with previous NTD, epileptic patients, & diabetics
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13
Q

How frequent should prenatal visits be?

A
  • every 4 weeks until 28 weeks
  • every 2 weeks until 36 weeks
  • every week after 36 weeks

10 for primigravida & 7 for multiparous usually

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14
Q

When should testing for B streptococci be done?

A

at 35 - 36 weeks through vaginal & rectal specimen
- if positive -> intrapartum IV penicillin

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15
Q

Who should receive intrapartum iv penicillin prophylaxis?

A
  • positive group b streptococci results
  • bacteriuria
  • preterm labour
  • previous infants with GBS
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16
Q

When should screening of gestational diabetes be done?

A

at booking & at 24-28 weeks for all ladies

by 50gm oral glucose load test

17
Q

when is genetic screening offered?

A

Fetal aneuploidy
- 10-14 weeks in first trimester
- 15-20 weeks in second trimester
- cell free DNA anytime after 10 weeks
- maternal serum alpha fetal protein -> increase in second trimester indicates neural tube defects

18
Q

When should anti D prophylaxis be offered?

A

for Rh -ive women at 28 & 34 weeks

19
Q

Is exercise allowed in pregnancy?

A

only moderate intensity physical exercise
150 minutes each week if there are no contradictions such as CVD or risk of preterm labor

20
Q

Can a pregnant woman travel?

A

up to 36 weeks with ambulation & lower extremity movement

21
Q

What is fetal alcohol spectrum disorders?

A
  • growth restriction
  • facial abnormalities
  • CNS disorders
22
Q

What are the effects of smoking on pregnancy?

A
  • subfertility
  • miscarriage
  • stillbirth
  • low birthweight
  • preterm delivery
23
Q

What vaccinations are taken during pregnancy?

A
  • TDAP at 27-36 weeks: tetanus toxoid, reduced diptheria toxoid, acellular pertussis
  • influenza vaccine in flu season
  • hepatitis vaccine according to exposure

no live attenuated vaccines

24
Q

What are the common symptoms in pregnancy?

A

nausea & vomiting
- disappear after 16-18 weeks
- eating small frequent meals, & ginger herbs can help

Heart Burn
- small meals & antacids can help