Prenatal Care Flashcards by joseph dizon

Q

Amenorrhea

During the first month of pregnancy, such episodes are likely the consequences of

A

Blastocyst implantation

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Q

Amenorrhea

Should generally prompt evaluation for an abnormal pregnancy

A

First trimester bleeding

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Q

Lower reproductive tract changes

Vaginal mucosa appears dark bluish, red and congested

A

Chadwick sign

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Q

Lower reproductive tract changes

Softening of the vaginal portion of the cervix from increased vascularization

A

Goodell sign

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Q

Lower reproductive tract changes

Softening in the consistency of the uterus

A

Hegar sign

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Q

Lower reproductive tract changes

When uterine body and cervix can easily be flexed against one another

A

McDonald sign

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Q

Lower reproductive tract changes

As symetrical softened enlargement of the uterine corner caused by placental development

A

Piskacek sign

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Q

Lower reproductive tract changes

May cause similar softening

A

Estrogen progestin contraceptives

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Q

Associated with pregnancy affects the consistency and microscopic appearance of cervical mucus

A

Increase in progesterone secretion

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Q

Typically seen in the mid portion of the menstrual cycle, makes pregnancy unlikely

A

Fernlike pattern

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Q

Uterine changes

During bimanual examination

A

It feels doughy or elastic

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Q

Uterine changes

Marked that the cervix and uterine body seem to be separate organs

A

Isthmic softening

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Q

Uterine changes

Uterine body is almost globular, with an average diameter of 8cm.

A

By 12 weeks gestation

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Q

Uterine changes

A soft blowing sound that is synchronous with maternal pulse

A

Uterine soufflé

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Q

Uterine changes

A sharp, whistling sound that is synchronous with the fetal pulse

A

Funic soufflé

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Q

Uterine changes

It is produced by the passage of blood through the dilated uterine vessels and is heard most distinctly near the lower portion of the uterus

A

Uterine soufflé

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Q

Uterine changes

Rush of blood through the umbilical arteries and may not be heard consistently

A

Funic soufflé

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Q

Breast and skin changes

Less obvious in

A

Multiparas

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Q

Breast and skin changes

Maybe absent during pregnancy and may also be seen in women taking

A

Estrogen containing contraceptives

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Q

Fetal movements

Maternal perception of fetal movement depends on factors such as

A

Parity and habitus

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Q

Fetal movements

Perceive between

A

16 and 18 weeks of gestation

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Q

Fetal movements

Primigravida may not appreciate fetal movement until

A

20 weeks

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Q

Pregnancy test

Basis of endocrine assays of pregnancy

A

HCG

Urine

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Q

Pregnancy test

Alpha sub unit of HCG is identical to

A

LH
FSH
TSH

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Pregnancy test HCG prevents involution of the corpus luteum, which is the principal site of progesterone formation during

First 6 weeks of pregnancy

Pregnancy test Produce HCG amounts that increase during first T

Syncytiotrophoblast

Pregnancy test HCG can be detected in maternal serum or urine

8-9 days after ovulation

Pregnancy test Doubling time of HCG

1.4-2.0

Pregnancy test HCG peak

60-70days

Pregnancy test HCG plateau

16 weeks

Measurement of HCG Before 8 weeks

Syncytiotrophoblast and cytotrophoblast

Measurement of HCG After 8 weeks

Syncytiotrophoblast

Measurement of HCG | Antibodies were developed with high specificity for

Beta subunit

Sonography recognition of pregnancy Commonly used to accurately establish gestational age and confirm pregnancy location

Transvaginal sonography

Sonography recognition of pregnancy First sonographic evidence of pregnancy 4-5 weeks AOG

Gestational sac

Sonography recognition of pregnancy Seen in ectopic pregnancy

Pseudo gestational sac

Sonography recognition of pregnancy Normal gestational sac implants

Eccentrically in the endometrium

Sonography recognition of pregnancy Pseudo sac is seen in the

Midline of the endometrial cavity

Sonography recognition of pregnancy An anechoic center surrounded by a single echogenic rim

Intra decidual sign

Sonography recognition of pregnancy Two concentric echogenic rings

Double decidual sign

Sonography recognition of pregnancy Equivoloc findings

Pregnancy of unknown location

Prenatal record Not pregnant nor ha been pregnant

Nulligravida

Prenatal record Buntis o nabuntis irrespective to outcome

Gravida

Prenatal record First pregnancy

Primigravida

Prenatal record With successive pregnancy

Multigravida

Prenatal record Never completed a pregnancy beyond 20 weeks

Nullipara

Prenatal record Delivered only once

Primipara

Prenatal record Completed two or more pregnancies to 20 weeks gestation or more

Multipara

Prenatal record Determined by number of pregnancy reaching 20 weeks

Parity

Normal pregnancy duration Mean duration

First day of the last menstrual period is very close to 280 days or 40 weeks

Normal pregnancy duration Naegele rule formula

-3 +7 +1 from the first day of last menstrual period

Normal pregnancy duration | Assumes pregnancy begun approximately 2 weeks before ovulation but not always the case

Gestational menstrual age

Normal pregnancy duration Assumes pregnancy begun after the start of LMp Used by embryologist

Ovulation/ fertilization age

1st trimester

Up to 14 weeks

2nd trimester

Up to 28 weeks

3rd trimester

Up to 42 weeks

Pathological mechanism of cigarette smoking

Increased carboxyhemoglobin Reduced utero placental blood flow Direct toxic effect of nicotine Fetal nicotine exposure > maternal

Clinical evaluation Perform as part ofthe evaluation

Pelvic examination

Clinical evaluation Bluish red passive hyperemia of the cervix

Chadwick sign

Clinical evaluation Dilated, occluded cervical glands bulging beneath the ectocervical mucosa

Nabothian cysts

Clinical evaluation The cervix is not normally dilated except at the

External OS

Clinical evaluation To identify cytological abnormalities Done during 1st prenatal visit

Pap smear Include Chlamydia trachomatis Neisseria gonorrheae

All pregnant women should be screened for these at the first visit

Hep B Syphilis Rubella

Most accurate tool for gestational age assignment and is performed as clinically indicated

First trimester crown rump length

Can also provide an estimated gestational age, but with declining accuracy

Sonographic interrogation

6 weeks AOG

Uterine size ORANGE

8 weeks AOG

Uterine size LARGE ORANGE

12 weeks of AOG

Uterine size GRAPE fruit

Presumptive sign

``` Amenorrhea NV Change in breast size Increase urinary frequency Fatigue ```

Probable sign

``` Enlargement of uterus Hegar sign Chadwick sign Goodell sign Piskacek sign HCG Chloasma Linea Nigra Quickening ```

Positive sign

FHT Leopolds maneuver Fetal outline on X-RAY

Amenorrhea Not reliable pregnancy indicator until

10 days or more after expected menses