Prenatal Care Flashcards
When is cessation of menses a reliable sign of pregnancy?
10 days after the expected time of menses
During pregnancy, there are changes inn cervical mucus, (1) what are the two patterns (2) what hormone causes each of the respective patterns (3) for each hormone, which day in the menstrual period do they occur.
- fern pattern due to estrogen and beaded patterns due to progesterone
- Fern pattern happens on the 7th to 18th day of the menstrual cycle while progesterone happens on the 21st. why?
fern pattern happens in the 7th to 18th day because in the menstrual cycle, the dominant follicle will produce estrogen, causing positive feedback leading to the recruitment of LH and LSH which stimulate the ovaries to produce more estrogen.
Progesterone or beaded pattern occurs in the 21st day and above for PREGNANT women because it is produced by the placenta once the corpus luteum involutes (produces progesterone before the placenta). Mostly found on pregnant women
What is the Chadwick sign? Is it a definitive sign of pregnancy? Why?
Bluish discoloration of the vaginal mucosa due to increased vascularization
It is NOT a definitive sign of pregnancy, this is because OCPs can bring about this change.
Name the changes in the cervix during pregnancy (1)
Softening
Name the changes in the skin during pregnancy (3)
Increased pigmentation (melasma, linea nigra, abdominal striae
Name the changes in the uterus
1, at the first few weeks
2. at 8 weeks
3. at 12 weeks
first few weeks -> increased uterine size
6-8 weeks -> hegar’s sign – softening of the isthmus (junction of the internal os and corpus of uterus)
- -non-pregnant patient isthmus is <1cm
- -pregnant patient – isthmus becomes lower uterine segment
12 weeks -> Uterus almost becomes globular and becomes an ABDOMINAL organ
What do you call the soft blowing sound synchronous with maternal pulse?
What is the sound synchronous with fetal pulse?
what causes it?
Uterine souffle for mother
Funic souffle for fetus
rush of blood through the uterine ARTERIES (constricted nga so malakas pressure)
What are the changes in the breasts? And do the changes revert back after pregnancy?
Increase in breast size, tenderness.
No these do not revert back, once it happens in the first pregnancy it will stay that way
What do you call the perception of fetal movements? And when do they happen for primigravida and multigravida
Quickening
for primigravida - 18-20th week
for multigravida - 16-18th week
When can you start hearing fetal heart tones with:
- Standard non-amplified stethoscope
- Doppler
- transvaginal ultrasound
What is the normal range?
- Standard non-amplified stethoscope -> 17-19 weks
- doppler -> 10 weeks
- Transabdominal US -> 8 weeks with MSD 25
- Transvaginal US -> 5 weeks (according ro doc magpale 6-6.5weeks aog) eith MSD 13-18
Normal range for fetal heartbeat is 110-160 ON AVERAGE
at 6 weeks -> normal is 100-115
at 8 weeks -> 144-170
at 9 weeks and above 137-144
What is the basis of pregnancy tests?
How many days after ovulation does this hormone appear?
What is its doubling time?
When is its peak?
What is its function?
Which hormones have similar subunits to this hormone?
Human Chorionic Gonadotropin
9 days after ovulation
1.4-2 days
60-70 days which is the 8th to 10th week AOG
Its function is to prevent the involution of the corpus luteum because CL only has a lifespan of 14 days. the placenta produces this to keep the CL “alive” to produce progesterone
LH, TSH, FSH
How many weeks does it take before the placenta takes over the corpus luteum in production of progesterone?
Approximately 6 weeks
What are possible causes of FALSE POSTIVE pregnancies via pregnancy test? (4)
Exogenous HCG injection for weight loss
Renal failure leading to impaired HCG clearance
Physiological pituitary HCG
HCG producing tumors
When is Gestational Sac seen in ultrasound?
Yolk sac?
Crown rump length? and what is its significance?
GS seen in US in 5 weeks
YS seen in 6 weeks
at 12 weeks, measuring CRL is accurate in predicting the AOG
Side note: this is the formula for calculating AOG with CRL: Weeks = 5.2876 + (0.1584 * Crown_Rump_Length) - (0.0007 * Crown_Rump_Length2)
What are the 3 goals in maternal prenatal care?
To define the health status of baby and mother
To estimate the age of gestation
To initiate the plan for continuing obstetrical care
What are the typical components of routine prenatal care? (3)
What are the divisions between the visits? (4)
- History, Physical Examination, Laboratory Tests
2. First Visit, 15-20 weeks, 24-28 weeks, 29-41 weeks
True or False, Only in the first visit is the complete prenatal check=up done with the rest of the checkups being updates
True