prenatal care Flashcards
What are ideal weight gains during pregnancy?
-BMI under 19.8: 28-40 lbs
BMI 19.8-26: 25-35 lbs
Weight gain needs much lower in overweight mothers (15-25 lbs)
What labs/screening tests are indicated at the first prenatal visit?
CBC, blood antibody and Rh typing, pap smear, gonorrhea/chlamydia screen, UA, RPR, rubella antibody titer, Hep B, HIV
(screen for blood/fetal rejection with CBC and Rh, do maternal health screen with pap and UA, and then look for infections)
What labs/screens are performed at 16-20wks?
16-18: quadruple screen: alpha fetal protein, beta hCG, unconjugated estriol, inhibin A
18-20 anatomic scan and ultrasound dating of the pregnancy
When is the 1 hr glucose challenge performed?
24-28 wks
When is GBS tested? What else is tested at this time?
32 to 37 wks; may also do more gonorrhea and chlamydia screens
What are the results of the first trimester screen that suggest trisomy 21?
high beta hCG, hi nuchal translucency, low PAPP-A (pregnancy associated plasma protein A)
What are the results of the first trimester screen that suggest trismoy 18 or trisomy 13?
low PAPP-A and hCG, high nuchal tanslucency. difference between these and trisomy 21 is the low hCG
What are the quad screen findings that suggest trisomy 21?
low AFP, low estriol, high hCG, high inhibin A
What are the quad screen findings that suggest trisomy 18?
low every thing; inhibin A may be normal
When should folate supplementation be started?
at least 4 wks before attempted conception
When is amniocentesis peformed and when is it indicated?
performed after 16 wks for abnormal quad screen, women over 35 who desire it, risk of Rh sensitization, but carries an excess 1% risk of SAB
When is chorionic villi sampling performed?
9-12 wks to detect chromosome abnormalities
What is percutaneous umbilical blood sampling?
blood collection from umbilical vein after 18 wk gestation to identify chromosomal defects, fetal infection and Rh sensitization
