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OBSTETRICS > PRENATAL CARE > Flashcards

PRENATAL CARE Flashcards

1
Q

Not reliable indication until 10 days or more after expected menses onset

A

Cessation of menses (Amenorrhea)

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2
Q

Beaded pattern appears ______

A

after the 21st day

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3
Q

Presence of sodium chloride crystallization in the mucus

A

FERNING PATTERN

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4
Q

1st pregnancy only
- tenderness and paresthesia
- Appearance of veins
- Nipples become larger, deeply pigmented and more
erectile
- Areolae become broader and deeply pigmented
- (+) glands of Montgomery
- Gigantomastia

A

BREAST CHANGES

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5
Q

bright bluish red pigmentation at the vaginal mucosa

A

CHADWICK SIGN

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6
Q

CHANGES IN THE UTERUS
- Softening of the isthmus
- 6th to 8th week

A

Hegar sign

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7
Q

CHANGES IN THE UTERUS
-shape by 12 weeks

A

GLOBULAR

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8
Q

soft, blowing sound that is synchronous with maternal pulse

A

Uterine souffle

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9
Q
  • sharp sound that is synchronous with fetal pulse
  • produced by the rush of blood into umbilical arteries
  • Usually not heard consistently
A

Funic souffle

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10
Q

CERVIAL CHANGES

becomes patulous to admit a finger

A

EXTERNAL OS AND CERVICAL CANAL

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11
Q

CERVICAL CHANGES

should remain closed

A

INTERNAL OS

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12
Q

Perception of fetal movements
a. By the mother
- Primigravid ?
- Multigravid ?

A
  • Primigravid 18 to 20 weeks
    -Multigravid 16 to 18 weeks
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13
Q

Perception of fetal movements
b. By the examiner

A

b. By the examiner
- 20 weeks

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14
Q
  • Detectable 8-9 days after ovulation
  • Peak at 60-70 days
  • Nadir at 16th weeks
A

Beta-HCG

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15
Q

SONOGRAPHIC RECOGNITION OF PREGNANCY

4-5 weeks AOG

A

gestational sac

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16
Q

SONOGRAPHIC RECOGNITION OF PREGNANCY

35 days / 6 Weeks AOG

A

HEART MOTION

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17
Q

SONOGRAPHIC RECOGNITION OF PREGNANCY

predictive of gestational age
within 4 days

A

Up to 12 weeks
- CRL (Crown Rump Length)

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18
Q
  1. Define the health status of mother and fetus
  2. Estimate the gestational age
  3. Initiate a plan for continuing obstetrical care
A

GOAL OF INITIAL PRENATAL EVALUATION

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19
Q

ROUTINE PRENATAL CARE

A

**BCU-HV-75 OG

Blood typing
CBC
urinalysis
HBsAg
VDRL
75 grams OGTT (24 to 28 weeks AOG)

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20
Q

advanced maternal age patients (>/=35 years old)

A

routine prenatal care + neural tube defects screening

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21
Q

request it at 24-28 weeks

A

Glucose tolerance test

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22
Q

screened in the first trimester (15-20 weeks)
and repeated at the last trimester

A

Gonococcal screening

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23
Q

last trimester (29-41 weeks)

A

Group B streptococcus culture

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24
Q

NORMAL PREGNANCY DURATION

A

280 days
40 weeks

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25
Q

Expected Date of Delivery = First day of the last normal menstrual period + 7 days – 3 months

A

NAEGELE’S RULE

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26
Q

● First trimester – thru completion of 14 weeks
● Second trimester – thru completion of 28 weeks
● Third trimester – 29th thru 42nd weeks

A

TRIMESTERS
Each trimester = 14 weeks

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27
Q

Irregular menstruation: request for early transvaginal
ultrasound (at least 12 weeks of gestation which is accurate at that time) if unsure with LMP to know the AOG.

A

Regular vs irregularly menstruating women

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28
Q

● Psychosocial Risk Factors – nonbiomedical factors that affect mental and physical well-being
● Advisable frequency is at least once each trimester

A

PSYCHOSOCIAL SCREENING

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29
Q

potent teratogen

A

ETHANOL

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30
Q

o Growth restriction
o Facial abnormalities
o Central nervous system dysfunction

A

FETAL ALCOHOL SYNDROME

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31
Q

Dilated, occluded cervical glands bulging beneath the ectocervical mucosa

A

Nabothian cysts

32
Q

To identify cytological abnormalities, a Pap smear is performed, and specimens for identification

A

Chlamydia trachomatis and
Neisseria gonorrhea

33
Q

But if you have and asymptomatic bacteriuria (ASB) patient, what do you request?

A

URINE CULTURE

34
Q

Prevalence of infection from____ is 2- 13% among pregnant women.

A

Chlamydia trachomatis

35
Q

they specialize in complicated pregnancies) - to whom you may want to refer

A

PERINATOLOGIST

36
Q

subsequent prenatal visits have been scheduled at intervals of 4 weeks until 28 weeks,
2 weeks until 36 weeks,
and weekly thereafter.

A

PRE NATAL VISITS

37
Q

Measured as the distance over the abdominal wall from the top of the symphysis pubis to the top of the fundus

A

FUNDAL HEIGHT

38
Q

o Heard between 16-19 weeks with standard stethoscope.
a) 20 weeks – 80 percent
b) 21 weeks – 95 percent
c) 22 weeks – all

A

FETAL HEART SOUNDS

39
Q

FETAL HEART SOUNDS
Heard at ____ in Doppler
heard at _____ in Transvaginal

A

10 weeks
5 weeks

40
Q

● Aneuploidy Screening
o 11- 14 weeks / 15-20 weeks
● Serum screening for NTD
o 15- 20 weeks
● Repeat Hemoglobin/Hematocrit and Syphilis Screening
o 28- 32 weeks

A

SUBSEQUENT LABORATORY TESTS

41
Q

Special Screening for Genetic Diseases

A
  1. Tay Sachs Disease
  2. B Thalassemia
  3. Sickle Cell anemia
42
Q

recommendations for weight gain
normal pre-pregnancy BMI

A

25-35 lb (11.5-16 kg )

43
Q

recommendations for weight gain
1. twin pregnancy
2. young adolescents
3. Shorter women

A
  1. twin pregnancy = 35 to 45 lb (16 to 20 kg)
  2. young adolescents = strive for gains at the upper end of the range
  3. Shorter women = (<62 in. or <157 cm) strive for gains at the lower end of the range
44
Q

Birthweight can be influenced significantly by starvation
-impaired brain development (animalfetuses)
-no detectable effects (human)

A

SEVERE UNDERNUTRITION

45
Q

concept of fetal programming by which adult morbidity and mortality are related to fetal health

A

BARKER HYPOTHESIS

46
Q

Accruing weight with age - rather than parity - is considered the main factor affecting weight gain over time.

A

WEIGHT RETENTION AFTER PREGNANCY

47
Q

excessive vitamin A
may be teratogenic

A

more than 10,000 IU per day

48
Q

PREGNANCY CALORIE requirement

accumulated in the last 20 weeks

A

additional 80,000 kcal

increase of 100 to 300 kcal per day

49
Q

Protein requirement

A

1000 g of protein
5 to 6 g/day

50
Q

most AA in maternal plasma fall

A

ornithine
glycine
taurine
proline

51
Q

AA rise in concentration

A

glutamic acid
alanine

52
Q

IRON
Total = 1,000 mg
INGESTION AT BEDTIME or EMPTY STOMACH

A
  • 300 mg - fetus and placenta.
  • 200 mg - are lost through various normal routes of
    excretion, primarily the GIT
  • 500 mg - synthesis of erythrocytes.

Iron requirement after mid-pregnancy 6 to 7 mg/day.
* Recommended daily iron supplement is 27 mg, which is contained in most prenatal vitamins.

53
Q

Overtly anemic women from iron deficiency responds well to oral supplementation with____

A

IRON SALTS

54
Q

Supplemental iron is not necessary during the____

A

first 4 months of pregnancy

55
Q

CALCIUM

The pregnant woman retains approximately

A

30 g of calcium

2.5 percent of total maternal calcium, most of which is in bone

56
Q

In cases of gestational hypertension, the patient is required to take calcium in order to prevent___

A

preeclampsia

57
Q

-lead to poor appetite, suboptimal growth, and impaired wound healing
-may cause dwarfism and hypogonadism, and a specific skin disorder, acrodermatitis enteropathica

A

ZINC DEFICIENCY

REQUIREMENT
12 mg

58
Q

Maternal plasma vitamin B12 levels decrease in normal pregnancy and result mostly from reduced plasma levels of ___

A

carrier proteins— transcobalamin

59
Q

Excessive ingestion of ___ also can lead to a functional deficiency of vitamin B12.

60
Q

VITAMIN B6 supplementation

A

daily 2 mg

61
Q

VITAMIN C

A

80 to 85 mg/day
—about 20 percent more than when nonpregnant.

62
Q

In women suspected of having vit. D deficiency,
serum levels of ____ can be obtained

A

25-hydoxyvitamin D

63
Q

fivefold risk of preeclampsia

A

Women who work

64
Q

PREGNANT WOMEN EXERCISE

A

30 minutes or more per day

65
Q

excellent source of protein, are low in saturated fats, and contain omega-3 fatty acids

A

FISH
except:

shark, swordfish, king mackerel, and tile fish.

66
Q

caffeine intake during pregnancy be limited to

A

less than 300 mg daily

approximately three oz cups of coffee.

67
Q

Nausea and vomiting of varying severity usually commence

A

first and second missed menstrual period and continue until 14 to 16 weeks.

68
Q

The cravings of pregnant women for strange foods are termed

69
Q

o ice (pagophagia),
o starch (amylophagia), or
o clay (geophagia) may predominate.

A

NON FOOD CRAVINGS
triggered b SEVERE IRON DEFICIENCY

70
Q

many women experience fatigue and need increased amounts of sleep

A

effect of progesterone

71
Q

pregnant mothers
REM sleep

increased?
decreased?

72
Q

Pregnant women commonly develop increased vaginal discharge, which in many instances is not pathological. Increased mucus secretion by cervical glands in response to hyperestrogenemia is undoubtedly a contributing factor.

A

leukorrhea

73
Q

treat hematopoietic cancers

A

umbilical cord blood transplantation

74
Q

Perinatal mortality rates would be reduced by ___ if
maternal smoking was eliminated.

75
Q

patient have separate folic acid supplement during pregnancy in ____

A

FIRST TRIMESTER

76
Q

FOLIC ACID SUPPLEMENTATION
all neural tube defects can be prevented by

A

400 microgram of folic acid (peri conceptional period)
4 mg folic acid (month before conception)

OBSTETRICS (8 decks)

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