Prenatal Care Flashcards
Calculate the EDD?
ex) Oct 10th, 2015
estimated date of delivery/due date = EDD
Naedele’s Rule: 1st day of LMP - 3 months + 7 days + 1 yr
ex) July 17th, 2016
determine gravida & parity of a pt
G(n)P(fpal)
- G=GRAVIDITY – HOW MANY TIMES (n) THE PATIENT HAS BEEN PREGNANT INCLUDING THE CURRENT PREGNANCY
- P=PARITY – RESULTS OF PREVIOUS PREGNANCIES
f=number of full-term births p=number of pre-term births a=number of abortions, elected or spontaneous, ectopics l=number of living children “Florida Power And Light”
What is the normal gestational length?
what is pre-term?
term?
post-term?
nGestation: 40 weeks plus/minus 2 weeks
nPre-term=gestational age <37 weeks
nTerm=gestational age 37 to 42 weeks early term, term, late term
nPost-term=gestational age >42 weeks
what are the approx. lengths of :
1st Trimester?
2nd?
3rd?
nFirst Trimester: from LMP to 12 weeks+
- embryo develops all the major organs and becomes a fetus
nSecond Trimester: 13 weeks-27 weeks
- fetus continues to develop and reaches viability
nThird Trimester: 28 weeks-40 weeks (term)
- fetus finishes developing and prepares for delivery
What are other ways [besides naegele’s rule] of determining EDD
First trimester Ultrasound
Fetal Heart tones: Doppler 10-12 weeks, Fetoscope 18-20 weeks
Quickening: Primigravida 18-19 weeks Multigravida 16-17 weeks
- A PREGNANT PATIENT WHO HAS HAD FIVE PREVIOUS PREGNANCIES THAT RESULTED IN TWO FULL TERM DELIVERIES, ONE PRETERM DELIVERY AND TWO MISCARRIAGES AND THREE LIVING CHILDREN
- FEMALE PATIENT WITH LIVING TWIN SONS Delivered at Term
- PREGNANT PATIENT WITH A 2 YEAR OLD DAUGHTER-FULL TERM DELIVERY
tell me what her GP is?
- G6 P 2-1-2-3
- G I P 2-0-0-2
- GII P1-0-0-1
What are Drug classifications for pregnancy? [5 of them]
- *Category A**-studies in humans no risk [vitamins]
- *Category B**-studies in animals no risk [acetominophen, penicillins, cephalosporins]
- *Category C**-no adequate studies [many]
- *Category D**-evidence of fetal risk but benefit may outweigh risk [carbamazapine, phenytoin]
- *Category X**-fetal risks clearly outweigh benefit [acutane]
What labs are performed in the first prenatal visit?
would you do a pap?
- nCBC
- nUA
- nABO & Rh factor and antibody screen
- nRubella Titer
- nRPR
- nHBsAg
- nHIV antibody
**you would not do Pap unless other reason for concern…cuz what would you do w/ prego & abnormal results
What do we do with pregnant patients and the following disease/runimmunized for it
rubella
varicella
influenza
Rubella: All prego women should be screened, if testing was not performed before conception
- Non-immune should be counseled about risk and vaccinated in the immediate postpartum period
Varicella: contraindicated in pregnancy….infection in the first 20 weeks of pregnancy is associated with a 1-2% risk of congenital varicella syndrome (low birth weight, limb hypoplasia, ophthalmologic and neurologic abnormalities)
- Susceptible preg women exposed are candidates for varicella zoster immune globulin
- Vaccine is safe in breastfeeding women…..maternal shingles is not a risk for the infant….Immunization should be delayed for 3 mos in women who have received Rhogam
Influenza: Recommended for second or third trimester of pregnancy during flu season
what is norm weight gain during prenancy?
[healthy]
what vitamin and how much should be taken by all women?
25-35 lbs
Folic Acid Supplementation 0.4 mg/day
What does increased nuchal translucency on US of a fetus mean?
Thickened nuchal translucency (measurements within the 2 white + markings) and absence of nasal bone (white arrow pointing to where the nasal bone should be) in a baby with Down Syndrome.
What conditions/things are we worried about in 1st trimester?
- Assess and Counsel
- Lifestyle
- Nutrition
- Tobacco/Alcohol/Drug use
- Risk Factors
What conditions or things are we concerned with in the 2nd trimester?
- Nutrition
- Fetal Assessment
- Fetal Growth
- Symptoms and psychosocial concerns
What conditions/things are we concerned about in the 3rd trimester of pregnancy?
- Preterm Labor
- Gestational Diabetes
- PIH/Preeclampsia
- Fetal growth
- Fetal well-being/position
- Screening for infection (GBS)
- Symptoms and psychological concerns
What is the Quad screen?
When is it usually done?
What would we see in Downs syndrome?
what would you see in Edwards syn?
What would you see in Patau Syn?
Look at levels of: maternal serum alpha fetoprotein [MSAFP] for open neural tube defects, **hCG, **unconjugated estriol **[UE3], pregnancy-associated plasma proteina A [PAPP-A]**
- done @ 16-18 wks gestation
- downs syndrome [trisomy 21] [2nd trimester screen]: decreased α-fetoprotein, ^^β-hCG, decreased estriol, ^^inhibin A.
- **Edwards syndrome **[trisomy 18]: ALL decreased α-fetoprotein, β-hCG, estriol, or normal inhibin A.
- **patau syndrome **[trisomy 13]: [First-trimester screen] decreased free β-hCG & PAPP-A, and ^^nuchal translucency.
