PRENATAL CARE Flashcards
Perception of fetal movement
16-18 weeks - multigravida
18-20 weeks - nulligravida
B-hCG
8-9 days after ovulation - detection
60-70 days - reach peak levels
16 weeks - plateau
gestational sac
small anechoic fluid collection within the endometrial cavity
4-5 weeks
The first sonographic evidence of pregnancy
gestational sac
pseudogestational sac or pseudosac
fluid collection within the endometrial cavity with an ectopic pregnancy
intradecidual sign
anechoic center surrounded by a single echogenic rim
double decidual sign
two concentric echogenic rings surrounding the gestational sac
yolk sac
brightly echogenic ring with an anechoic center
5.5 weeks
Confirms intrauterine location
yolk sac
Cardiac motion is noted
6 weeks
Crown rump length - predictive of gestational age within 4 days
up to 12 weeks gestation
Major goals of prenatal care
define the health status of the mother and fetus
estimate the gestational age
initiate a plan for continued obstetrical care
Pelvic Inlet Landmarks
POSTERIOR
promontory
sacral alae
LATERAL
linea terminalis
ANTERIOR
pubic symphysis
pubic rami
True/Anatomic Conjugate
promontory to upper margin of symphysis
11 cm
Obstetric Conjugate
promontory to posterior symphysis
subtract 1.5 to 2 cm from diagonal conjugate
> 10 cm
Diagonal Conjugate
promontory to LOWER margin of symphysis
> 11.5 cm
measured manually
Subsequent Prenatal Visits
4 week intervals – until 28 weeks
every 2 weeks – until 36 weeks
weekly – after 36 weeks
Weeks wherein the fundal height correlates closely with gestational age in weeks
b/w 20 and 34 weeks gestation
FHR
110-160 bpm
fundic soufflé
sharp, whistling sound that is synchronous with the FETAL pulse
caused by the rush of blood through the umbilical arteries
uterine soufflé
soft, blowing sound that is synchronous with the MATERNAL pulse
produced by the passage of blood through the DILATED UTERINE VESSELS
heard most distinctly near the lower portion of the uterus
35-37 weeks
• vaginal and rectal group B streptococcal (GBS) cultures obtained in all women
24-28 weeks
All pregnant women are screened for GESTATIONAL DM, whether by history, clinical factors, or routine laboratory testing
15-20 weeks
Serum screening for neural-tube defects
11-14 weeks and/or 15-20 weeks
Fetal aneuploidy screening; depending on the protocol selected
Average retained pregnancy weight
2.1 Ib or 1 kg
With potentially toxic effects
iron, zinc, selenium, and vitamins A, B6, C, and D
Caloric increase recommended during pregnancy
100 to 300 kcal/d
Recommended protein intake during pregnancy
1 g/kg/d
Supplemented daily iron for pregnant women
27 mg of elemental iron
Recommended elemental iron per day for large women, has a multifetal gestation, begins supplementation late in pregnancy, takes iron irregularly, or has a depressed hemoglobin level
60 to 100 mg of elemental iron per day
Recommended iodine allowance
220 µg/d
Recommended daily intake during pregnancy
12 mg
Manifested by a frequently fatal cardiomyopathy in young children and reproductive-aged women
Selenium deficiency
Develops in the same circumstances as in nonpregnant individuals-a common example is hyperemesis gravidarum
Potassium deficiency
Supplementation in early pregnancy can lower neural-tube defect risks
400 µg/d
Recommended for woman with a prior child with a neural-tube defect
4 mg/d
Has been associated with congenital malformations when taken in high doses (> 10,000 IU/d) during pregnancy
Vitamin A
In the absence of obstetrical or medical complications, pregnant women can safely travel
up to 36 weeks’ gestation
Immunization in Pregnancy
Tetatus-Diptheria-Acelluar Pertussis (TDAP)
Influenza Vaccine
Hepatitis B
Safe vaccines during pregnany
rabies vaccine (killed-virus)
Hepatitis A
Pneumococcus
Varicella Ig (post exposure)
Contraindicated vaccines during pregnancy
Measles Mumps Rubella Varicella HPV
INCREASED hCG CONDITIONS
multiple pregnancy molar pregnancy exogenous injection impaired renal clearance hCG secreting tumors from GI, ovary, bladder, lungs
Predictive of gestational age w/n 4 days
Crown Rump Length
