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Women's Health Clin med > Prenatal Care > Flashcards

Prenatal Care Flashcards

1
Q

When is genetic testing done during prenatal care

A

before conception

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2
Q

What is a screening

A

identification of an asymptomatic disease, harmful condition or risk factor

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3
Q

What is the difference between a prenatal screening and a diagnostic test

A

Screenings give a probability

Diagnostic gives a definitive

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4
Q

What are some fetal diagnostic tests

A

chorionic villus sampling
amniocentesis

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5
Q

What do fetal diagnostic tests show us

A

detects all trisomies, chromosomal abnormalities, several hundred mendelian abnormalities

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6
Q

When is chorionic villus sampling preformed and what is it

A

between 10-13 weeks gestation
Bx of placental tissue

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7
Q

How is a chorionic villus sampling preformed

A

transabdominal approach preferred (less risk and higher yield)

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8
Q

When can an amniocentesis be preformed

A

> 15weeks gestation

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9
Q

Who should be offered an amniocentesis

A

All pregnant women but especially those >35 due to higher risk for abnormalities

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10
Q

What is percutaneous umbilical blood sampling

A

Fetal blood samples via percutaneous puncture of umbilical cord vein under US guidance

*generally in 3rd trimester if new abnormality is found

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11
Q

What is preimplantation genetic testing (PGT)

A

Prior to IVF implantation, polar bodies for oocytes, blastomeres from 6-8 embryos or trophectoderm sample from blastocytes are sampled

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12
Q

How many types of PGT are there and what do they test for

A

PGT-M: Risk of certain mendelian disorders

PGT-A / PGT-SR: Chromosomal abnormalities

PGT-A: primarily for embryos from older women

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13
Q

What is aneuploidy testing

A

Tests for additions or deletions from chromosomes (trisomy 21)

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14
Q

What are the genetic screening catagories

A

Carrier screening
Aneuploidy screening
Neural tube defects

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15
Q

What is the main risk factor for genetic disease

A

Advanced maternal age >35y/o

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16
Q

What is commonly screened for in pregnancy

A

CF
Hemoglobinopathies
neural tube defects
Trisomy 13,18, 21
Spinal muscle atrophy
Tay-sachs

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17
Q

Which ethnicity is at greatest risk for tay-sachs disease

A

Ashkenazi Jews

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18
Q

What is trisomy 18

A

Edwards syndrome

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19
Q

What is trisomy 13

A

Patau syndrome

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20
Q

What genetic mutations causes CF

A

CFTR mutation

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21
Q

What is a common hemoglobinopathy

A

thalassemia and sickle cell

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22
Q

When is father tested for genetic abnormalities

A

Only if the mother is positive

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23
Q

What tests are used for checking for neural tube defects

A

Maternal serum alpha fetoprotein
*elevated at 16-18 weeks

Transvaginal ultrasound (TVUS)

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24
Q

What is the test of choice with increased risk of neural tube defects

A

Transvaginal ultrasound
*screening & diagnostic

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25
Q

Which women should have aneuploidy testing

A

all women regardless of age

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26
Q

What is spinal muscular atrophy

A

Degeneration of anterior horn cells in spinal cord and motor nuclei in lower brainstem

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27
Q

When is genetic screening done in pregnancy

A

First and second trimester via maternal serum markers or cfDNA and US

28
Q

What is tested via maternal serum markers

A

Alpha fetoprotein
Uncongugated Estriol
Human chorionic gonadotropin
Inhibin A

29
Q

What are the non-invasive screening strategies during pregnancy

A

Integrated screening
Sequential screening
non-invasive prenatal test (for trisomies ONLY)

30
Q

When is an US recommended for all pregnant women

A

at 18-22 weeks

31
Q

What is looked for on 18-22 week ultrasound

A

Confirm gestational age
determine fetal viability
detect multi-fetal pregnancy

32
Q

When are targeted prenatal ultrasounds utilized

A

couples with families with a history of congenital malformations

33
Q

What is detected on targeted US

A

Renal malformations
Achondrogenesis
Gut malformations
Diaphragmatic hernia
microcephaly
hydrocephalus

34
Q

What finding on US mark genetic disorders

A

Increased nuchal translucency
Echogenic cardiac focus
Echogenic bowel
single umbilical artery
short femur length
choroid plexus cyst
absent nasal bone

35
Q

what are presumptive signs of pregnancy

A

missed period
N/V
Breast changes
Increased urine frequency

36
Q

What are probable signs of pregnancy

A

-Enlargement of uterus
-Hegars sign (Softening of isthmus)
-Chadwicks sign (Cyanotic cervix)
-Goodells (Softening of cervix from increased vascularity)
-Piskaceks sign (Asymmetric bulge from placenta)
-Positive HCG
-Melasma

37
Q

What are positive signs of pregnancy

A

Fetus seen on US
Fetal heartbeat
Delivery of baby

38
Q

How early can hCG and urine detect pregnancy

A

hCG detectable 8 days post conception

Urine detectable 10days after conception

39
Q

What is the most accurate method of determining gestational age

A

first trimester US

40
Q

What is the EDC calculated with

A

Naegeles rule
*LMp -3 months + 1year + 7days

41
Q

What trimester is a mother is if she’s is 14-27 weeks gestation

A

2nd

42
Q

When is the fetal heartbeat detectable

A

10 weeks

43
Q

When is the uterus palpable in the abdomen

A

12 weeks

44
Q

When is quickening noticed

A

between 18-20 weeks

45
Q

When does the fundus reach the umbilicus

A

20 weeks

46
Q

When can fetal movement be observed by partner

A

24 weeks

47
Q

When does the fundus meet the max height and what is the max heigh

A

Xiphoid process around 36 weeks

48
Q

How many prenatal visits are recommended

A

14 visits
*W/ AT LEAST 1 US

49
Q

What is FHT

A

Fetal heart tracing

50
Q

What is CRL

A

Crown to rump length

51
Q

What is SLIUP

A

Single Live intrauterine pregnancy

52
Q

When is the first prenatal visit done and what does the appointment confirm

A

8-10 weeks
comprehensive visit
-confirm pregnancy
- Estimated delivery date
-prescriptions
OB-GYN hx

53
Q

When is the first prenatal visit done and what does the appointment confirm

A
54
Q

What is the most important vital to check throughout pregnancy

A

blood pressure

55
Q

What is the schedule for prenatal visits

A

first visit at 8-10 weeks
every 4 weeks until 28 weeks
every 2-3 weeks until 36 weeks
every week until delivery

56
Q

What infectious disease testing is done at the first prenatal visit

A

Hep B
Rubella
Varicella
Chlamydia
syphillis
HIV
If high risk = gonorrhea

57
Q

Who is at risk for gestational diabetes

A

women with BMI >25 and meet 1 other risk factor
-first degree reletive
-prior gestational diabetes
-advanced maternal age
-weight gain > 11lbs since 18th bday

58
Q

What is a normal caloric requirement during pregnancy

A

2200-2900 cals/day

59
Q

How many extra calories a day are required during breast feeding

A

500

60
Q

What does a new onset elevated blood pressure after 20 weeks indicate

A

gestational HTN or preeclampsia

61
Q

When is gestational diabetes screened for

A

24 week prenatal visit

62
Q

When is Rhogam used prenatal and what is it

A

Rh immunoglobulin to prevent antepartum auto immunization to possible fetal Rh-positive cells

63
Q

When does the mother receive Tdap to protect the baby from pertussis

A

between 27-36 weeks

64
Q

How do you determine fetal position

A

Leopolds Maneuvers

65
Q

Who gets prenatal group B strep testing

A

all mothers

66
Q

When is labor induction offered

A

> 41 weeks

Women's Health Clin med (13 decks)

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