Prenatal Care Flashcards
Smoking during pregnancy is associated with what 3 problems?
- low birth weight
- premature delivery
- stillbirth
What is the #1 cause of preventable intellectual disability?
- alcohol
What are the 4 complications of the fetus in mother’s who smoke marijuana?
- neurological problems
- increased risk of infection
- low birth weight
- increased risk of SIDS
Opioid use increases the risk of what condition in the fetus?
- neonatal abstinence syndrome (NAS)
Using Naegle’s rule how do you calculate the expected date of confinement?
- LMP + 7 days - 3 months
How accurate is ultrasound dating during the first and second trimester?
- first = accurate to 5-7 days
- second = accurate to 10-14 days
During the initial consult, urine analysis and culture should be done to detect this infection.
- asymptomatic bacteriuria (GBS)
* then again at 35-37 weeks!!!
What genetic condition increases the risk of UTI in pregnancy?
- sickle cell trait
What is the most common fatal genetic disorder in north america?
Cystic Fibrosis
What is the most common inherited cause of infant death?
Spinal muscular atrophy (SMA)
What is the most common inherited cause of intellectual disability?
Fragile X Syndrome (FXS)
When only the mother is the carrier of fragile X syndrome, what is the chance the child will be affected?
50% chance
If both parents are carriers of cystic fibrosis, what is he chance the child will be affected?
25% chance
*same for spinal muscular atrophy (SMA)
What is the recommended dosage of iron supplementation?
30 mg elemental iron
What 3 foods should be voided during pregnancy?
- fish
- cheese (listeria)
- nitrites
Excess mercury intake related to fish consumption during pregnancy increases the risk of this major neurologic condition.
- cerebral palsy
If the baby is head down the heart rate will be below or above the mother’s belly button?
if you hear the heartbeat loudest below the mother’s belly button = baby is head down
What is the difference between screening and diagnostic tests?
- screening = gives a risk for a condition
- diagnostic = gives a definitive result for a condition (usually invasive)
T/F: Any pregnant female should be offered the opportunity for screening tests.
- true
At the beginning, what was the initial risk factor used for screening pregnancies for Down syndrome?
- maternal age
Nuchal translucency > ___ mm is concerning for Trisomy 21.
> 3 mm
What are the 5 most common aneuploidies probed with a non-invasive prenatal testing (NIPT)?
- 13, 18, 21, X, Y
First trimester screening is compromised of what 3 markers?
- pregnancy-associated plasma protein-A (PAPP-A) (low is bad)
- free-B-subunit-HCG (high is bad)
- nuchal translucency on ultrasound
Choroid plexus cyst is associated with what chromosomal abnormality?
- trisomy 18
Optimal time for first trimester screening appears to be how many weeks?
11 weeks
What is a non-invasive prenatal testing (NIPT) used for?
a method of determining the risk that the fetus will be born with certain genetic abnormalities (aneuplodies)
Non-invasive prenatal testing (NIPT) can be down as early as how many weeks?
10 weeks
What is the correlation between alpha fetoprotein (AFP) and trisomy 21?
- AFP is 25% lower in pregnancies affected by Trisomy 21
What is the correlation between hCG and trisomy 21?
- hCG is 2x as high in pregnancies affected by Trisomy 21
What is the major fetal abnormality seen with elevated maternal serum alpha-fetal protein (AFP)?
- open neural tube defects
When performing an ultrasound evaluation what 2 things are abnormalities and not regular markers?
- heart defects
- duodenal atresia
What are the 3 pre-natal diagnostic tests?
- Chorionic villi sampling
- Amniocentesis
- chromosome microarray (CMA)
CMA only used to detect submicroscopic changes in chromosome = not as common
When is chromosomal microarray (CMA) particularly useful?
- to detect submicroscopic gains and losses on every chromosome
What vaccines are contraindicated for pregnant females?
live attenuated viruses (e.g. MMR, varicella)
This is defined as a loss that occurs without medical or mechanical means to empty the uterus.
- spontaneous abortion
This is defined as an abortion with retention of portions of the fetal or placenta.
- incomplete abortion
What is threatened abortion?
- any vaginal bleeding in the first half of pregnancy in which 50% end up in loss
ACOG recommends screening all pregnant women for these 2 serious genetic disorder.
- Cystic Fibrosis
- Spinal Muscular Atrophy (SMA)
Hemoglobin electrophoresis should be performed in all women who have these 2 factors for thalassemia screening
- MCV < 80 fL in the absence of iron deficiency
- a family, ethnic, or medical history at higher risk for hemoglobinopathy
This is the most common monogenic cause of infant mortality.
- Spinal muscular atrophy (SMA)
What is the first line medical treatment for GBS during pregnancy?
IV penicillin
How do you swab for GBS?
- swab the inside of the lower vagina and then swab through the anal sphincter
What does a kleinhaur-betke test tell us?
- degree of fetal-maternal hemorrhage (important when managing Rh factor)
A 300 mcg of rhoGAM covers how much Rh positive RBC?
15 mL
What is RhoGAM?
- Anti-D immuneglobulin
What is the consequence if Rh status is left untreated?
can result in fetal anemia
What is the gold standard for detection of fetal anemia?
cordocentesis
How is late term defined?
41 0/7 to 41 6/7 weeks
How is post term defined?
> 42 weeks
When should you be concerned for the rhesus factor?
- mother is Rh negative
- father is Rh positive
