Prenatal Care Flashcards
Pregnancy testing
- Can be detected as early as 1wk after implantation (8th day after ovulation)
*detection of hCG in urine 25mIU/mL or higher, serum hCG can be detected even lower
- In normal pregnancy, hCG can be detected as early as 6 days following conception w/ conc. doubling every 32-48hrs, peaing in excess of 100,000 mIU/mL in approx. 10-12wks
- Levels of 25 mIU/mL hCG are reportedly present in urine and serum as early as 2-3 days before expected menses. Serum hCG is rapidly cleared into the urine and the conc. of hCG in serum is approx. equal to the conc. in urine
When is gestational sac observable by US?
- 5wks
LEEP surgery
- LEEP stands for Loop Electrosurgical Excision Procedure. It’s a treatment that prevents cervical cancer. A small electrical wire loop is used to remove abnormal cells from your cervix. LEEP surgery may be performed after abnormal cells are found during a Pap test, colposcopy, or biopsy.
Asherman’s syndrome
- A condition characterized by adhesions and/or fibrosis of the endometrium particularly but can also affect the myometrium. It is often associated with dilation and curettage of the intrauterine cavity.
Important diseases to be immunized and/or vaccinated for prior to pregnancy
These diseases can wreak havoc on a developing fetus
- Varicella (chicken pox)
- Rubella
- Hep B and C
- Influenza- new recommendation…can be given any time
Viral illnesses harmful to a fetus and often screened for during pregnancy
- CMV
*harmful to fetus but not really screend for as there is nothing that can be done about it
- Parvovirus
- Toxoplasmosis
*have to ask expectant mother if she owns cats
Uterine size throughout pregnancy
- Palpate for uterine size
- Will be at the pubic symphysis at 12wks, at the umbilicus at 20wks and enlarges 1cm per wk thru 36wks
Chadwicks sign
- On speculum exam the cervix has a bluish appearance due to the engorgement of blood to the uterus during pregnancy
Hegar’s sign
- Compressibility and softening of the lower uterine segment, a probably sign of pregnancy; the lower uterine segment just above the cervix becomes so soft that when compressed b/w 2 fingers its wall cannot be felt or feels extremely thin
Goodell’s sign
- Significant softening of the vaginal portion of the cervix from increased vascularization. This vascularization is a result of hypertrophy and engorgement of the vessels below the growing uterus.
Landin’s sign
- Softening in the midline of the uterus anteriorly at the junction of the uterus and cervix. It occurs at about 6 weeks gestation.
McDonald’s sign
- A probable sign of pregnancy. It’s an ease in flexing the body of the uterus against the cervix
Piskacek’s sign
- Palpable lateral bulge or soft prominence one of the locations where the uterine tube meets the uterus. Piskacek’s sign can be noted in the seventh to eight week of gestation. Non pregnant uterus is pyriform in shape. By 12 weeks of gestation it becomes globular. In lateral implantation, there is asymmetrical enlargement of the uterus. One half of the uterus where the implantation occurred is firm while the other half is soft. This is known as Piskacek’s sign
When can a fetuses heart be heard?
- ~10wks
Determining correct embryo gestational age (EGA)
- Uterine size should match EGA by LMP
*if it does not match needs U/S for crrect EGA
- Important to get accurate EGA and EDC (estimated date of confinement)
- U/S 5-12wks is most accurate for EGA
*if U/S within 7 days of LMP, keep LMP dating
*if U/S >7 days difference from LMP, may need to change EDC
- After 1st trimester, U/S dating may be inaccurate by 2-3wks
- Size > Dates: consider multiples, molar pregnancy, wrong EGA, fibroids, polyhydramnios
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