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OB-Gyn > Prenatal care > Flashcards

Prenatal care Flashcards

1
Q

What are the initial prenatal workup?

A
  1. CBC with DC/PC
  2. Blood typing
  3. Urinalysis, U/C
  4. FBS
  5. HBsAg
  6. Rubella IgG
  7. VDRL, RPR
  8. ICC ELISA
  9. Pap Smear
  10. 75 OGTT (24-28 weeks AOG)
  11. Biometry +/- BPP (24-28 weeks AOG)
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2
Q

Active hormone during 24-28 weeks AOG, in relation to OGTT administration?

A

Human Placental Lactogen (HPL)

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3
Q

What is Human Placental Lactogen (HPL)?

A

It has GH like action and causes insulin resistance, lipolysis and increased fatty acids.

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4
Q

In general, biophysical Profile can be tested during which AOG?

A

32-34 weeks

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5
Q

When patient has severe complications, biophysical Profile can be tested during which AOG?

A

24-28 weeks

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6
Q

Can you detect BPP components <24 weeks AOG?

A

No

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7
Q

10 Danger signs of Pregnancy with Rationale

A

Signs of Pre-eclampsia

  1. Headache
  2. Blurring of Vision
  3. Prolonged vomiting
  4. Epigastric/RUQ pain
  5. Nondependent edema

Signs of Infection

  1. Fever
  2. Dysuria
  3. Watery Vaginal Discharge

Signs of threatened pregnancy

  1. Bloody Vaginal Discharge
  2. Decreased fetal movement
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8
Q

What can cause Premature rupture of membranes (PROM)?

A

Infection

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9
Q

How do you compute EDC?

A

EDC = + 1 yr + 7 days - 3 months

Naegele Rule

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10
Q

Period of 1st trimester

A

Until 14 weeks (Spontaneous abortion)

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11
Q

Period of 2nd trimester

A

Until 28 weeks

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12
Q

Period of 3rd trimester

A

Until 42 weeks

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13
Q

Weeks of quickening in primigravid

A

18-20 weeks AOG

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14
Q

Weeks of quickening in multigravid

A

16-18 weeks AOG

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15
Q

Who are at high risk of pregnancy?

A
  1. Extremes of age ( <17 - >35 y/o)
  2. Medical Complications
  3. Poor OB Hx
  4. Placenta Previa
  5. Tumor
  6. Trophoblastic dse within last year
  7. Px with fetal aging/structure
  8. Polyhydramnios/Oligohydramnios
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16
Q

These are considered poor OB history

A
  1. 2 consecutive abortions
  2. 3 or more repeated abortions
  3. Hx of preterm delivery
  4. Hx of fetal death in utero
  5. Hx of neonatal death
  6. Previous baby with congenital anomaly
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17
Q

Maternal problems in terms of fetal structure and aging

A 
1. AOG >41 wks
2 Fetal macrosomia/IUGR
3. Unsure fetal aging
4. Multiple gestation
5. Fetal congenital anomalies
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18
Q

What composes the Menstrual History?

A 
Menarche
Interval
Duration
Amount
Symptoms
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19
Q

What risks are increased when a pregnant woman is smoking?

A 
Placenta previa
Abruptio placenta
PROM
Preterm delivery
SGA neonate
Spontaneous abortion
Fetal death
Fetal anomalies
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20
Q

What risks are increased when a pregnant woman has fetal alcohol syndrome?

A

Growth retardation
Facial anomalies
CNS dysfunction

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21
Q

What risks are increased when a pregnant woman is on illegal drugs?

A

IUGR

SGA Neonate

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22
Q

What risks are increased when a pregnant woman has experienced partner violence?

A

Preterm delivery
IUGR
Perinatal death

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23
Q

What are taken during PE of a pregnant woman

A

Fundal Height (cm)
Leopold’s
Estimated fetal weight (kg)
Fetal Heart tones

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24
Q

How do you obtain fundal height and its correlates

A

Measure from top of pubis symphysis to the top of the fundus

Correlation:
12 weeks = Uterus becomes an abdominal organ
16 weeks = Fundus is midway between pubis symphysis and umbilicus
20 weeks = Fundus at the level of umbilicus
20-34 weeks = AOG (-/+ 2)

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25
Q

How do you estimate fetal weight?

A

Cupping method

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26
Q

How do you check fetal heart tone?

A

Doppler 8 - 10 (100%) weeks

Stethoscope 16 - 20 (80%) - 22 (100%)

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27
Q

Leopold’s Maneuver?

A

L1 Fundal Grip = Fetal presentation
L2 Umbilical Grip = Fetal back
L3 Pawlick’s Grip = Fetal engagement
L4 Pelvic Grip = Fetal attitude

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28
Q

How would you know if its the head or feet you are palpalting in L1/L3?

A

Irregular & Nodular = Feet

Hard, round, ballotable, mobile = Head

29
Q

How would you know if its the back or extremities you are palpalting in L2?

A

Linear, convex, bony ridge = Back

Nodulations = Extremities

30
Q

How would you know the side of the cephalic prominence ?

A

Opposite side as the back = Head flexed

Same side as the back = Head extended

31
Q

What is the order of speculum exam?

A 
Inspect and Palpate
Speculum Exam
Pap Smear
Bimanual Examination
Rectovaginal Examination
32
Q

How do you report inspection in a normal speculum exam during inspection and palpation?

A

Normal external genitalia (labia, clitoris, and perineum). No lesions, masses and pigmentation

33
Q

How do you report inspection in a normal speculum exam?

A

The vagina and cervix is pink/violaceous. There is also no apparent masses or discharge

34
Q

How do you report inspection in a normal bimanual exam?

A

Normal external genitalia. Vagina is smooth and/or parous. The cervix is smooth, 3x3, closed and non-tender. The uterus is small/enlarged to AOG, non-tender. No adnexal masses or tenderness.

35
Q

How do you report inspection in a normal rectovaginal exam?

A

Good sphincter tone. Intact rectal vault. No intraluminal mass. Rectovaginal septum is intact. Parametria is soft, thin, smooth, pliable, with no masses. There is no fullness n the cul-de-sac. No blood per examining finger.

36
Q

Basis of AOG

A
  1. LMP (if regular)
  2. Early UTZ
  3. Late UTZ
  4. Quickening
  5. Fundal height
37
Q

Frequency of Prenatal check-up if <28 weeks (first 2 months)

A

Monthly

38
Q

Frequency of Prenatal check-up if 28-36 weeks

A

Every 2 weeks

39
Q

Frequency of Prenatal check-up if >36 weeks or close to term

A

Every week

40
Q

BMI of Underweight

A

<18.5

41
Q

BMI of Normal Weight

A

18.5-24.9

42
Q

BMI of Overweight

A

25-29.9

43
Q

BMI of Obese

A

> /= 30

44
Q

Total weight gain for underweight woman with singleton

A

28-40 lbs

45
Q

Total weight gain for normal weight woman with singleton

A

25-35 lbs

46
Q

Total weight gain for overweight woman with singleton

A

15-25 lbs

47
Q

Total weight gain for obese woman with singleton

A

11-20 lbs

48
Q

Total weight gain for normal weight woman with twins

A

37-54 lbs

49
Q

Total weight gain for overweight woman with twins

A

31-50 lbs

50
Q

Total weight gain for obese woman with twins

A

25-42

51
Q

Average weight gain in pregnancy

A

28.6 lbs (4.8kg)

52
Q

Weight loss at delivery

A

12 lbs (5.5 kg)

53
Q

Weight loss 2 weeks PP

A

9 lbs (4 kg)

54
Q

Weight loss between 2nd-6th week PP

A

5.5 lbs (2.5 kg)

55
Q

Average retained weight

A

3 lbs (1.4 kg)

56
Q

Is more than 10,000 IU teratogenic?

A

Yes

57
Q

RDA in calories

A

Increase 100-300 kcal/day

58
Q

RDA in protein

A

5-6g/day

59
Q

RDA in Iron

A

27 mg elemental Fe/day

60
Q

When do you start giving iron?

A

2nd trimester due to peak of vomiting during 1st trimester

61
Q

RDA in Folic Acid

A

400 mcg

62
Q

RDA in iron if large, twin, started late, irregular/decreased Hgb

A

60-100 mg

63
Q

RDA in Folic Acid if px has hx of neural tube defect; and when should it be given?

A

4mg, start giving preconception until 1st trimester

64
Q

Is coitus safe while pregnant?

A

Yes, except those cases with placenta previa, preterm labor and abortion

65
Q

How much caffeine intake is allowed?

A

Max: 3 cups of 5 oz percolated coffee

66
Q

Until when can a pregnant woman travel?

A

Safe until 36 weeks AOG

67
Q

Gestational sac is detected in what age of gestation

a. 2-3 weeks AOG
b. 5-6 weeks AOG
c. 3-4 weeks AOG
d. 4-5 weeks AOG

A

D

68
Q

Patient came in on her 3rd pregnancy. Her 1st pregnancy is an ectopic pregnancy and her 2nd pregnancy is a twin pregnancy (both are delivered preterm and alive). What is her GP score? *

a. G3P2 (0112)
b. G3P3 (0212)
c. G3P3 (0112)
d. G3P2 (0212)

A

A

69
Q

Vaccine CONTRAINDICATED to pregnant patients *

a. HPV
b. Vaccinia
c. COVID-19
d. Hepatitis B

A

B

OB-Gyn (7 decks)

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