Prenatal Care Flashcards
at what gestation is the uterus at the xyphoid process?
36 weeks
at what age does the mother feel quickening?
20 weeks
labs to do at 16-18 weeks
serum markers for NTD
labs to do at 24- 28 weeks
glucose screen, Indirect coomb’s if mother is Rh negative and given RhoGam, CBC, RPR
Which vaccine should NOT be given in pregnancy?
MMR, varicella
When should Rhogam be given?
In Rh neg mother when there is:
- abdominal trauma
- amniocentesis
- abortion
- 28 weeks gestation
Also given postpartum within 72 hours if baby is Rh positive
What is the emergency care for a pt with prolapsed umbilical cord outside the hospital?
Place mother in knee chest or with head down (Trendelenburg) and elevate presenting part, do not stuff cord back in but relieve the pressure on it
A variant of PIH with abnormal LFTs and poor clotting
HELLP
Characterized by painless bright bleeding, uterus and soft and nontender
placenta previa
Meds that category C, D, and X
quinolones, lithium, tetracycline, warfarin, isotretinoin, valproic acid, methotrexate
softening of the isthmus of the uterus
Hegars sign
dark blue to purplish-red color of vaginal mucosa
Chadwick’s sign
softening of the cervix
Goodell’s sign
soft blowing systolic murmur heard down at the sides of the uterus. The sound is synchronous with the maternal pulse.
uterine souffle
Para is the number of births (regardless if living) after ___ weeks gestation.
20
Term is considered
after 37 weeks
Preterm is considered
20-37 weeks
Nagele’s rule
LMP minus 3 months + 7 days = EDC
f/u care intervals for pregnant women.
every 4 weeks until 28 weeks, every 2 weeks until 36 weeks, ever week after 36 weeks
results from contraction from oxytocin release to an infant’s suckling, sight, sound, and smell.
let down (milk ejection)
meds for N/V during pregnancy
eat small, bland meals; eat dry cracker or toast at breakfast; vitamin B6
Non-stress test
Mother presses button when she feels fetal movement
Reassuring or reactive non-stress test:
shows at least two 15 beats/min accelerations in fetal heart rate lasting at least 15 seconds in a 20 min period.
most common reason for non-stress test
decreased fetal movement
elements of biophysical profile (BPP)
- fetal tone
- gross body movements
- breathing movement
- amniotic fluid volume
Premature separation of the placenta form the uterine wall.
abruptio placentae
s/s of abruptio placentae
painful dark red bleeding, hard uterus
Abnormal development of placenta
molar pregnancy (trophoblastic disease)
s/s of molar pregnancy (trophoblastic disease)
severe N/V at 12-16 weeks gestation, brown discharge
trx for incompetent cervix
refer to OB by 12 weeks for cerclage
risk factors for PIH
primigravida, age less than 20 or older than 35, obesity
cerclage is usually placed at
14-18 weeks
caused by implantation of the placenta near or across the cervical os.
placenta previa
the rule of thumb is that the # of weeks gestation is the
cm of fundal height
The rule of thumb is that you want the uterus to be at the ____ right after the placenta delivers
umbilicus
risk factors for placenta abruptio
HTN, preeclampsia, cocaine use
seizures with pre-eclampsia is called
eclampsia
liver function tests during pregnancy
all normal except for elevated alkaline phosphatase
CBC during pregnancy
leukocytosis is normal; low h&h d/t hemodilution
low AFP could increase risk for
down’s syndrome
high AFP could increase risk for
neural tube defects
screen for Tay-sachs in
jewish woemn
screen for cystic fibrosis in
caucasian
normal finding in doubling time
hCG levels double every 48 hours during the first 12 weeks
popular category B drugs
antacids, colace, acetaminophen
popular category A drugs
insulin, thyroid hormone
atbx safe during pregnancy
PCN, cephalosporins, macrolides (except for clarithromycin), nitrofurantoin
HTN meds safe during pregnancy
labetalol, hydralazine, methyldopa
category C drugs
sulfa, NSAIDs,
category D drugs
ACEI/ARB, quinolones, tetracyclines
sulfa drugs during pregnancy increase risk of
hyperbilirubinemia
After receiving a live vaccine, the patient should not plan on getting pregnant for
at least the next 4 weeks
foods to avoid during pregnancy
soft cheeses, uncooked meats, cold meats, lunch/deli meat, raw milk, raw fish
normal weight gain
25-35 lbs
positive signs of pregnancy
palpation of fetus, US and visualization of fetus, FHT heard at 10-12 weeks
probable signs of pregnancy
Chadwicks, Goodell’s, Hegar’s sign;
hCG tests;
“quickening”
size and date discrepancy is when there is a difference of
2 or more cm.
BP during pregnancy
usually decreases during first and second trimester
murmur heard during pregnancy
systolic ejection murmur- normal
melasma is due to
high estrogen levels
fundi at 16 weeks
between the symphisis pubis and the umbilicus
fundi at 12 weeks
symphisis pubis
fundi at 20 weeks
umbilicus
first line trx for gestational diabetes
lifestyle modifications
risk factors for gestational diabetes
obesity, macrosomic infant (more than 9 lbs), hx of previous GDM
trx for asymptomatic bacteriuria
macrobid or amoxicillin/augmentin
spontaneous loss of fetus before it is viable (20 weeks)
spontaneous abortion
when the cervix is dilated and placenta/fetus are expelled
complete abortion
preeclampsia mostly occurs during
3rd trimester
triad of preeclampsia
HTN, proteinuria, edema (face and hands)
difference between preeclampsia and preexisting HTN
preeclampsia has to occur after 20 weeks
when mother c/o of sore nipples, education includes
to NOT stop breastfeeding
normal to hear ___ during breastfeeding; whereas it is abnormal to hear ____ during breastfeeding
swallowing; clicking
trx for mastitis
dicloxacillin or cephalexin for 10-14 days
