Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Repro. Med 4 > Prenatal Care > Flashcards

Prenatal Care Flashcards

1
Q

When are prenatal care visits scheduled for a low-risk pregnancy?

A 
Pre-conceptual counseling
Prenatal visit
every 4 wks for 24-28 wks
every 2 weeks 28-35 wks
every week from 36, 40-41 wks 
2x/wk if 40+
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In a perfect world, when should women start the prenatal process?

A

before pregnancy happens!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What occurs at preconception counseling?

A
  • Folic acid-4mg per day
  • Calcium and iron
  • Prenatal vitamins
  • Dietary concerns
  • Exposures (workplace, environmental, medicinal)
  • Manage chronic dz
  • Switch meds if necessary to meds that are safe in pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pregnancy is generally considered to be ___ calendar months or ___ weeks.

A

10 mo
40 wks
**This includes the 2 “free weeks” prior to the fertilized ovulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If a patient had any assisted reproduction, IUI, IVF (embryo transfer) or ovulation induction, then dates should be based on _____

A

ovulation date

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

If LMP is uncertain or unreliable, what can be used to estimate how many weeks the pregnancy is?

A

U/S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you use U/S to estimate how far along the pregnancy is?

A

measure fetal C-R (crown-rump)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Fetal C-R (crown rump) length between 6-11 weeks can define gestational age to ____ days

A

+/- 7 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Fetal C-R (crown rump) length between 12-20 weeks: U/S should define gestational age to __days

A

+/- 10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

After 20 weeks: U/S estimate is ____ days of accuracy

A

+/- 14-20

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What Information about prior pregnancies can alert you to possible problems in the present pregnancy?

A
  • Gravity and Parity
  • wt and length of previous children at birth
  • previous labor experience
  • maternal/infant complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do you write out a patient’s Gravidity and Parity?

A 
G \_\_(how many times the woman has been pregnant
P _1_, \_\_2_, _3_, _4\_\_
  1. full term delivery
  2. pre-term delivery
  3. mis-carriages
  4. live births
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What 6 dzs can affect the outcome of the pregnancy and must be investigated?

A 
DM
HTN
Cardiac
Pulmonary
Autoimmune
Renal dz
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Other than dz, what other PMHx do you need to know in a pregnant woman?

A

Prior surgeries (esp obstetric surgeries)
allergies
meds
Previous trauma (esp to bony pelvis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What FHx chronic dzs do you need to know about?

A 
DM
HTN
Heart disease
CA
Anemia
Bleeding disorders
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why is the PE important at the initial prenatal visit?

A
  • detect undx illness that can affect pregnancy
  • est baseline levels (this helps guide tx later)
  • eval pelvic inlet/outlet
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

____ is used to determine blood type

A

Blood group

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

___ is used to detect anemia

A

Hgb

Hct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

___ is used to screen for syphilis

A

Rapid plasma reagin (RPR)

venereal dz test (VDRL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What other infectious dz do you need to screen for?

A

rubella
chlamydia
Hep B/C (surface antigne)
HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

___ is used to detect infection or renal dz (protein, glucose, ketones)

A

UA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

___is used to scree for cervical neoplasia

A

papanicolaou (pap) test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

___ is used to screen for DM

A

glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What other testing may you order for at risk pts?

A
  • genetic testing (sickle cell)
  • CF screening
  • early glucose if +FHx for DM or high BMI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is included in the TORCH infections you worry about?

A
  • Toxoplasmosis-cat feces;
  • Varicella
  • CMV
  • HIV
  • Parvovirus B 19
  • HSV–
  • Group B strep
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What can happen to the fetus if a mother has toxoplasmosis?

A 
Blindness (cat poop on their eyes)
mental retardation (cats are retarded) (just a way to remember it people)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What can happen to the fetus if a mother has CMV?

A

Retinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What can happen to the fetus if a mother has HIV?

A

High risk of vertical transmission in vaginal delivery

- C/S mandatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What can happen to the fetus if a mother has Parvovirus B19?

A

hydrops (heart failure of the fetus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What can happen to the fetus if a mother has HSV?

A

encephalopathy, blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What can happen to the fetus if a mother has Group B strep?

A

PNA, sepsis– (see 3rd trimester)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the autosomal recessive traits you need to screen in a pregnant woman?

A
  • Sickle cell (AA parent)
  • Thalassemia
  • CF (Caucasian parent)
  • Tays-Sachs and other dz (Ashkenazi, FHx)
  • Sex linked disorders (e.g. Fragile X) also exist–primarily affect males. Screen if risk factors exist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are potential teratogens during pregnancy that are not medications?

A

Alcohol
Smoking
Illicit drugs
Work exposures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are teratogens during pregnancy that are medications?

A

Warfarin (coumadin)– early SAB IUGR, craniofacial/CNS

Antineoplastic agents (chemo): designed to kill rapidly-dividing cells

Retinoids: Category X

DES (Diethylstilbestrol)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

___ is prenatal alcohol exposure and central nervous system (CNS) involvement.

A

Fetal Alcohol Spectrum D/o

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are facial features of a child w/ Fetal Alcohol Spectrum D/o?

A

small eye openings
smooth philtrum
thin upper lip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What are s/s of Fetal Alcohol Spectrum D/o in the CNS? (structural vs functional)

A

structural

  • mall brain size
  • alterations in specific brain regions

functional

  • cognitive and behavioral deficits
  • sensory processing deficits
  • motor and coordination problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

About __-__ % of women have reported drinking at some point during pregnancy—most typically during the 1st trimester

A

20 to 30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

> __ % of women have reported binge drinking at some time during pregnancy—most typically during the 1st trimester

A

8%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

> __ % of pregnant women reported drinking alcohol in the previous month

A

9%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

> __ % of pregnant women reported binge drinking in the previous month (4+ drinks per occasion)

A

2%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What sz meds can cause problems in the fetus? (x4)

A

Phenytoin
Valproic Acid
Carbamezapine
Phenobarbital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What issues occur in the fetal w/ phenytoin use?

A

craniofacial and limb reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What issues occur in the fetal w/ Valproic acid use?

A

1-2% risk of NTD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What issues occur in the fetal w/ carbamazepine use?

A

Elevated NTD risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What issues can occur in the pregnancy w/ phenobarbital use?

A

withdrawal

maternal/ fetal hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

If a woman does not take her anti-sz meds for a known sz d/o, what is she at risk for?

A 
Maternal/fetal trauma from falls or burns
increased risk of premature labor
miscarriage
fetal hypoxia
lowering of the fetal HR.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What should you advise pregnant women about? (S/S of pregnancy)

A 
N/V/C
Heartburn
Hemorrhoids
Varicose Veins
Leg cramps (relative hypokalemia)
Backache
HA
acne
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

First trimester bleeding occurs in __-__% of pregnancies.

Of those pregnancies, __-__ of pregnancy are lost.

A

20% to 25%

~ 25% -50%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Risk of pregnancy loss or non-viability increases if: ___ or ____

A
  • Bleeding becomes heavy

- Bleeding is accompanied with cramping or pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Risk of pregnancy loss/non-viability decreases significantly (to 3-7%) if
____
____

A
  • Intrauterine gestation with + FHR is detected

- BHCG values rise appropriately for gestational age (more on this later)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Overall weight gain in pregnancy is __-__ lbs (for a single gestation)

A

25-35 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

If the initial BMI is <20, how much should the woman gain?

A

35-45 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

If the initial BMI is >35, how much should the woman gain?

A

15 lbs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Typical wt gain is ___ lb over first 20 weeks, then ___ lb/week thereafter.

A

10lbs

1lb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What foods should be avoided in early pregnancy? (FYI)

A 
Poorly cooked meats
Raw eggs
Cold cuts and hot dogs
Soft, mould-ripened cheeses (brie, camembert, goat cheese)
Unpasteurized cheese and milk
Sushi
King mackerel, tilefish, swordfish and shark
Restrict Caffeine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What can the following foods contain that are dangerous to a pregnancy?

  • Poorly cooked meats
  • Raw eggs
  • Cold cuts and hot dogs
A

coliform bacteria
toxoplasmosis
salmonella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What can the following foods contain that are dangerous to a pregnancy?

  • Soft, mould-ripened cheeses (brie, camembert, goat cheese)
  • Unpasteurized cheese and milk
A

Listeriosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What can the following food contain that can be dangerous to a pregnancy?

  • Unpasteurized cheese and milk
  • Sushi
  • King mackerel, tilefish, swordfish and shark
A

Mercury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is the recommended amount of coffee that is allowed in pregnancy?

A

< 200 mg/d, or one 12-oz cup of coffee

**know it can be in other food items

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

In general, what type of vaccines are okay during pregnancy? What types of vaccines are NOT okay during pregnancy?

A

okay: recombinant

NOT okay: live vaccines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What are live vaccine examples that a woman shouldn’t get?

A

Rubella
MMR
Varicella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

When can live attenuated vaccines be administered around pregnancy?

A

Must be >3 months before/ after pregnancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is a “Blueberry muffin baby”?

A

A baby born with purpura due to congenital infection– think rubella, but also possible with coxsackie, toxo, hep B, CMV, EBV, and congenital syphilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What are examples of vaccines that are ok to get during pregnancy?

A

Influenza
Tetanus
Hep B
Gardasil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What occurs at each visit no matter what trimester it is? (VS etc)

A 
Wt
BP
U/A
Assess for edema
fundal ht at 20 wks 
fetal heart tones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

How is fundal ht (FH) measured?

A 
# cm from pubic symphysis to top of fundus
**Watch for FH that is > 3 cm above or below gestational age
68
Q

When should a fetal HR be present and what is the normal rate?

A

week 12

120-160 bpm

69
Q

What is not commonly advised in the PE of a pregnant woman?

A

Routine vaginal exams

Cervical checks

70
Q

What should you ask about in the first trimester visits (see pt every 4 wks)

A

(+) heartbeat by doppler by 12 weeks (or confirm by US)

Assess: VS, weight gain/loss

Ask about: N/V, comfort, appetite, bleeding

71
Q

What can be assessed on U/S to screen for chromosomal abnormalities?

A
  • Normal nuchal translucency (widened is abnormal)

- absence of nasal bones (abnormal)

72
Q

What serum levels are used to assess fetal abnormalities?

A

b-hCG

PAPP-A

73
Q

__-__% of pregnant women experience nausea and vomiting during pregnancy (NVP)?

A

70-80 %

74
Q

N and V can begin at __-__ weeks gestation and can last into ___ trimester. but usually resolves by __weeks

A

4-6 weeks
2nd trimester
16 weeks

75
Q

What contributes to N/V during pregnancy?

A

Hormonal influences

Hypoglycemia

76
Q

What can you do to help a woman manage N/V associated w/ pregnancy?

A
  • Rest
  • several small meals a day
  • BRAT (bananas, rice, applesauce, toast)
  • carbohydrate snacks at bedtime
  • Ginger
  • Sea bands
77
Q

___ is severe nausea and vomiting of pregnancy

A

Hyperemesis Gravidarum

78
Q

What are s/s of Hyperemesis Gravidarum?

A
  • Persistent V and inability to tolerate p.o.
  • Wt loss >5% of pre-pregnancy wt.
  • Dehydration (PE findings, orthostasis, ketonuria)
  • Electrolyte abnormalities
79
Q

If severe, how can you tx Hyperemesis Gravidarum?

A
  • IV hydration (break the cycle)
  • PO or IV antiemetics (Phenergan, Zofran)
  • GI motility drugs (Reglan)
  • Goal = toleration of PO liquids
  • Some wt loss can be tolerated– fetus will do okay
80
Q

IF ADMITTED for Hyperemesis Gravidarum, what should you do?

A

U/s to r/o multiple gestation and placental abnormalities (molar pregnancies)

Thyroid assessment to r/o Graves

81
Q

What causes heartburn during the 1st trimester?

A

progesterone relaxes the cardiac sphincter of the stomach and allows reflex of gastric contents into the esophagus

82
Q

What causes heartburn during the 3rd trimester?

A

pressure of the growing uterus on the stomach

83
Q

How can you manage heartburn during pregnancy?

A
  • Avoid lying flat
  • Sleeping w/ more pillows
  • lying on the right side
  • Small frequent meals
  • Avoid late night meals
  • Antacids
  • Avoid fried ,spicy, and fatty food and citrus
84
Q

What causes urinary frequency?

A

Pressure of the growing uterus on the bladder

Increased GFR

85
Q

Urinary frequency improves when the uterus rises into the abdomen after the __week.
Then, urinary frequency worsens again in __ trimester.

A

12th

3rd

86
Q

How can you manage urinary frequency during pregnancy?

A

Kegel exercises
Frequent urination
Watch for S/Sx UTI

87
Q

What causes varicosities during pregnancy?

A

Progesterone relaxes venous smooth muscle, then causing slowed venous return

Valves of the dilated veins become insufficient

Wt of the uterus causes partial venous compression from the legs

88
Q

How do you manage varicosities during pregnancy?

A

Elevate feet
Pump leg muscles
**Watch for evidence of DVT

89
Q

What causes constipation in pregnancy?

A

progesterone

iron supplementation

90
Q

What can you do to manage constipation during pregnancy?

A 
Eat diet including fruit and green vegetables, which contain fiber
Drink a lot of water
Exercise and walking
Stool softeners
OTC laxatives (mild) prn
91
Q

What should be performed during the 2nd trimester? (every 4 weeks)

A

Fetal Trisomy/NTD Screening

U/S for Fetal Anatomic Assessment

92
Q

Typically, the fundal height in cm’s should = what?

A

the # weeks gestation (+/- 3 cm)

93
Q

What should you think if the fundal height is abnormal?

A 
Large for gestational age (LGA)
Small for gestational age (SGA)
Too much fluid (polyhydramnios)
Too little fluid (oligohydramnios)
Abnormal fetal lie (transverse, breech
94
Q

When is fetal movement first noted by the pt?

A

~18 - 22 weeks

**felt earlier in subsequent pregnancies

95
Q

When is fetal movement typically first felt by an examiner?

A

after 20-24 wks

96
Q

___(fraction) pregnancies have recognizable chromosomal abnormalities

A

1/300

97
Q

95% of chromosomal abnormalities are Trisomy ___, ___, ___ or changes in ___ and ___

A

Trisomy 21, 18, 13

changes in X and Y

98
Q

Most chromosomal abnormalities result in ___ syndrome

A

down syndrome

99
Q

T/F: Increasing maternal age increases risk of chromosomal abnormalities

A

T

100
Q

When is a woman considered to be of advanced maternal age?

A

> 35 y/o

**does not take partner age into account

101
Q

Overall risk of Trisomy 21 is 1/800 at age ___; increases to 1/300 by age __

A

35 y/o

39 y/o

102
Q

Trisomy risk overall is ___ (fraction) in the 40-45 range, and is __ (fraction) by age 46

A

1/80

1/20

103
Q

What are the benefits of prenatal screening and dx?

A

parental reassurance

Prenatal dx may allow women to undertake a pregnancy they might not have otherwise undertaken

104
Q

How are fetal screenings beneficial if an abnormality is detected?

A

Increased parental options
Altered obstetric management
Facilitated neonatal management

105
Q

What is the risk of prenatal screenings?

A

Parental anxiety
Pregnancy complications- ROM, infxn, PTL
Pregnancy loss

106
Q

> ___% of structural and chromosomal fetal abnormalities are born to low risk women

A

90%

107
Q

T/F: Maternal age alone is a reliable screening tool

A

F: It is a poor screening tool– Only detects about 30% of DS cases

108
Q

What are the options for Prenatal Screening for Down Syndrome (DS) and trisomy 18?

A
  • Integrated Prenatal Screening (IPS)
  • Serum Integrated Prenatal Screening (SIPS)
  • 1st Trimester Screening (FTS)
  • Quadruple maternal serum screening (Quad Screen)
  • Maternal serum screening (Triple Screen)
109
Q

What are prenatal diagnostic tests for DS and trisomy 18?

A

Amniocentesis/CVS

110
Q

What are the 2 steps of Integrated Prenatal Screening (IPS)? When are they performed in terms of the pregnancy? Ideally?

A

1st Trimester (11-13+ 6/7 weeks – ideally week 11)

  • Nuchal translucency measurement
  • PAPP-A (pregnancy-associated plasma protein)
2nd Trimester (15-20 weeks – ideally week 15-17)
- AFP, uE3 (estriol), hCG
111
Q

What is the down side of Integrated Prenatal Screening (IPS)?

A

A single risk assessment number is produced in second trimester – so patients learn whether or not they are at risk in the second trimester- not the first.

112
Q

What is the most common reason for false + screening results in pregnancy?

A 
#1: wrong estimated delivery date
#2: multiple gestation
113
Q

What anatomical location is used in the First Trimester Nuchal Translucency screen? ( just a description)

A

Subcutaneous fluid-filled space located between back of fetal neck and skin

114
Q

First Trimester Nuchal Translucency screens are measured on U/S between __-__ weeks, [measurement (is not valid/is valid) outside of this time period]

A

11–13 weeks

Is not valid

115
Q

Great if NT measurement is not available, ____ can be used and is a 2 step approach that combines first and second trimester serum markers to produce a single risk assessment

A

Serum Integrated Prenatal Screening (SIPS)

116
Q

What is included in the Serum Integrated Prenatal Screening (SIPS)?

A

First Trimester:
PAPP-A: 11-13+6/7 weeks (11 wks is ideal)

Second Trimester:
AFP, uE3, hCG, Inhibin-A: 15–20 weeks (15-17 wks is ideal)

117
Q

During which trimester can an anatomic survey be performed?

A

2nd trimester

118
Q

What can be offered if a screen comes back (+)?

A

Chorionic sampling

Amniocentesis

119
Q

What are the risks of chorionic sampling

and amniocentesis? (x2)

A

invasive

risk for miscarriage

120
Q

Which has a higher miscarriage risk, chorionic sampling or amniocentesis?

A

Chorionic sampling

121
Q

When can chorionic sampling be performed? (weeks)

Amniocentesis? (weeks)

A

C: 10-13 wks

A: 15-22wks

122
Q

When is a level 2 US performed?

What is it looking at? (FYI)

A

16-20 weeks

Brain, spine, face, thorax, heart, gastric bubble, intestines, kidneys and bladder, fluid, limbs, placenta, cord, cervix, and gender.

123
Q

What is the lemon sign indicative of?

A

Arnold-Chiari Malformation and spina bifida

124
Q

What causes the lemon sign (pathophysiology)?

A

Bones in anterior skull curve inward because of abnormal drainage in the posterior fossa

125
Q

Estimating gestational age can be performed using what measurements?

A

Abd circumference
Head circumference
Biparietal diameter (BPD)
Femur length

126
Q

In the 3rd trimester, it is recommended to have an appointment every __ weeks until 28 week(s), then every __ week(s) until 36 weeks, then every ___ week(s) until delivery

A

4 wks
2 wks
every week

127
Q

At 32 weeks the baby weighs ~__ lbs and has a ___% chance that lungs will not be mature

A

4 lbs

50%

128
Q

At 36 week the baby will weight ~___ lbs, and has a __% chance that lungs are not quite developed

A

6 lbs

1%

129
Q

At what point would a “knot “ in the cord be most likely?

A

At birth

the knot has been made, but not pulled tight until labor

130
Q

What is included in 3rd trimester appointments?

A
  • VS including weight, BP (all trimesters!)
  • FHT’s (every visit after 12 weeks)
  • Evidence of labor, PTL
    - Presenting part (mid to late 3rd)
  • Cervical exam at 39 weeks or prn
  • Fetal Movement evaluation (28-30 wks)
131
Q

What is worrisome in the 3rd trimester (FYI) (x10)

A
  • Vaginal bleeding (including spotting)
  • Persistent abdominal pn
  • Severe and persistent V
  • Sudden gush of fluid from vagina.
  • Absence or decreased fetal movement.
  • Severe HA
  • Edema of hands, face, legs and feet.
  • Fever above 100 F (>37.7C).
  • Dizziness, blurred vision, double vision and spots before eyes.
  • Painful urination.
132
Q

If the abdomen is longer, the fetal lie is ____ (which it is 99.5% of the time)

If the abdomen is lower and broad, the fetal lie is ___

A

longitudinal

transverse

133
Q

Normal fetal heart rate is ___-___ beats/min

A

120-160

134
Q

What are the Leopold Maneuvers used for?

When do they become most important?

A

To determine what position the baby is in

Important at ~34 wks

135
Q

__-__% of fetuses at 24-28 weeks; __% at 36 weeks

are in the breech position

A

30- 40%

5% (the odds of them flipping is low bc of size)

136
Q

Breech position is associated with poor delivery outcome, _____ improves outcome over vaginal delivery,

A

c-section (c/s)

137
Q

Why should you perform a leg inspection in the 3rd trimester?

What s/s are you looking for?

A

dx preeclampsia and DVT

  • edema
  • calf redness
  • phlebitis
  • tenderness
138
Q

What complication is hyperreflexia associated w/ in pregnancy?

A

Preeclampsia

139
Q

T/F: Mild increase in vaginal d/c is abnormal and signifies issues with the placenta

A

F: Mild increase in vaginal discharge is normal in pregnancy

140
Q

STD and symptomatic BV are risk factors for ___

A

Pre-term labor

141
Q

How should a pregnant pt count fetal kicks?

When should they start monitoring this?

What is normal count?

A

Pt should sit quietly and observe fetal movement once daily

Start monitoring after ~30 weeks

10+ movements in 2 hours

142
Q

Absence of fetal movements usually precedes intrauterine fetal death by ___hours

A

48 hrs

143
Q

Why is an U/S performed in the 3rd trimester? (x3)

A

Check amniotic fluid volume
Check the position of the placenta and baby
Assess fetal well-being (BPP)

144
Q

If a baby is in the breech position, what can be done to turn the baby into the correct position?

A

external cephalic version

145
Q

What could cause a loss of amniotic fluid? (x5)

When would these occur?

A

SROM- spontaneous rupture of membranes– usually at term during labor

PROM-premature rupture of membranes– rupture of membranes prior to the onset of labor

PPROM– preterm premature rupture of membranes– prior to 36 weeks

AROM- Artificial rupture of membranes– during labor caregiver

LOF- typically used to describe the patient perception of fluid leaking from vagina

146
Q

What is a common cause of backache during pregnancy?

A

Increased lordosis during pregnancy in an effort to balance the body

RELAXIN

147
Q

How do you manage back pain in a pregnant women?

A

Exercise

Sit with knee slightly higher than the hips

148
Q

When do you screen for Gestational DM?

A

at 24-28 wks gestation

149
Q

In what patients should you screen for gestational DM prior to the regular screening time?

A

Screen for gestational DM prior to 24-28 weeks gestation is the pt has the following risk factors

  • FHx of DM or GDM
  • PMHx of metabolic syndrome
  • Obesity (>30)
150
Q

In which populations does Gestational DM most commonly occur?

A

Hispanic
AA
Asian
Pacific Island

151
Q

What are complications of gestational DM

A

Macrosomia
Neonatal hypoglycemia
Hyperbilirubinemia

152
Q

How do you screen for GDM? What would a positive result be?

A

Screen w/ 1 hour, 50-gram glucose test

Positive if > 140 (some use >135)

153
Q

If GDM screen is abnormal, what do you do next? What would be considered a positive result?

A
  • blood taken before intake
  • test a 1/2/3 hr glucose tolerance test:

positive if 2 of the 4 levels are high, or if the FBS is high.

154
Q

If diagnosed with GDM, the pregnancy becomes ‘___’ and visits are indicated how often?

A

Higher risk

Weekly

155
Q

____ wks is considered term

____ wks is considered post term

A

37

42

156
Q

Group B Strep is associated with ___, ___, and ____ if an infant delivers through a GBS colonized birth canal

A

sepsis
pneumonia
death

157
Q

A vagina swab is performed at ___ wks to screen for group B strep and, if positive, abx are required

A

36 weeks

158
Q

T/F: GBStrep is a normal colonization in vaginal flora

A

T

159
Q

What are Braxton hicks contractions? What is their purpose?

A

Runs of contractions which may be irregular, <3 per 10 minutes
** for preparation of cervix for delivery

160
Q

____ is the disturbance of the connections between the cervix and fetal membranes. Evidence shows that this can (slow down/speed up) the onset of labor

A

stripping membranes
sweeping membranes
Speed up–> can go into labor w/in 48 hrs

161
Q

What must you determine the location of prior to stripping membranes?

A

Determine the location of the placenta

162
Q

Increased risk of stillbirth and neonatal/perinatal death after ___ weeks

A

42 weeks

163
Q

At what week(s) do you induce? (3 different times, and why)

A

42 weeks

39 wks if cevix is favorable

earlier if complications exist

164
Q

What is a Poor Bishop’s score is associated with?

A

Prolonged labor and risk of C-Section

165
Q

Is it recommended to scheudle a Cesarean Delivery at Term for Suspected Macrosomia? Why or why not?

A

In general, no- because we are very bad at diagnosing it

166
Q

When predicting fetal weight…
Ultrasound is better when the fetus is less than ____grams
Clinical estimate is better from the ___-___ gram range
At ____ grams, both methods are inaccurate (usually off by >__%).

A

2500 g
2500-4000g
4000+g
>15%

167
Q

T/F: Postdate pregnancies = increased risk for both SGA and LGA infants.

A

T

Repro. Med 4 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions