Prenatal Care Flashcards
Ramifications? Next step?
Hg<10.5 g/dL
low fetal Fe stores -> trial Fe
?thalassemia -> Hb electrophoresis
preterm delivery
Ramifications? Next step?
Rubella (-)
nonimmune to rubella -> stay away from sick contacts -> vaccinate postpartum
Ramifications? Next step?
Rh (-)
Rh disease -> RhoGAM @ 28 wks -> if baby is Rh(+) -> RhoGAM after delivery
Ramifications? Next step?
Ab(+)
isoimmunization -> identify the antibody and titer
Antigens: Lewis lives, Kell kills, Duffy dies
Ramifications? Next step? HIV ELISA(+)
?HIV -> Western/PCR -> HAART -> c/s or IV ZDV in labor (also ZDV to neonate)
Ramifications? Next step?
RPR(+)
?syphilis -> MHA-TP -> stage disease ->
1yo or unknown: IM penicillin weekly x3
Ramifications? Next step?
Gonorrhea(+)
preterm labor or blindness
IM ceftriaxone
Ramifications? Next step?
chlamydia(+)
neonatal blindness, pneumonia
azithromycin or amoxicillin orally
Ramifications? Next step?
HbsAg(+)
infectious HBV -> check LFTs and serology
baby needs HBIG and hep B vaccine
Ramifications? Next step? urine cx(+)
asymptomatic bacteriuria -> pyelonephritis 25% -> abx and recheck urine
Ramifications? Next step? pap smear(+)
ASCUS -> pap postpartum (reflexive HPV not recommended)
LGSIL/HSIL -> colposcopy
only invasive cancer would alter management
Ramifications? Next step? nuchal translucency(+) @ 11-13wks
?trisomy -> karyotype and US
Ramifications? Next step? trisomy screen (+) @ 16-20wks
?trisomy or NTD -> US to confirm dates -> amniocentesis
Ramifications? Next step?
1h diabetic screen elevated @ 26-28wks
?GDM -> 3h GTT
Ramifications? Next step?
3h GTT -> 2 abnormal values
GDM -> diet and monitor -> insulin
