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10 OB > Prenatal Care > Flashcards

Prenatal Care Flashcards

1
Q

set of interventions that aim to identify and modify biomedical, behavioral, and social risks to woman’s health or pregnancy outcome through prevention and management

A

preconceptional care

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2
Q

folic acid supplementation for preconceptional care in epileptic women

A

4 mg supplementation

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3
Q

criteria to discontinue anti-seizure medications before pregnancy

A

seizure free for 2-5 years
single seizure type
normal neurological exam and normal intelligence
normalized eeg with treatment

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4
Q

t/f immunizations during pregnancy with toxoids or killed bacteria or viruses are contraindicated

A

false, NOT CONTRAINDICATED

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5
Q

t/f live vaccines are not recommended during pregnancy

A

true

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6
Q

most frequent structural fetal malformation

A 
1st = cardiac anomalies
2nd = neural tube defects
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7
Q

therapy that can reduce neural tube defects by 72%

A

preconceptional folic acid therapy (400-800 ug/d)

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8
Q

inborn error of phenylalanine metabolism carried by the mother

A

phenylketouria (cannot be inherited, but can damage fetal organs)

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9
Q

adolescent pregnancy has increased risk for ___

A

anemia, preterm delivery, preeclampsia, and std

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10
Q

pregnancy after 35 y/o has higher risk for ____

A

maternal mortality and ob complications

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11
Q

maternal age related risks stem from

A 
preterm due to hpn/dm
spontaneous preterm deliver
fetal growth disorders 
fetal aneuploidy
pregnancies from ART
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12
Q

smoking increases the risk for ___

A

preterm labor, fetal growth restriction, and low birthweight

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13
Q

a coordinated approach to medical care, continuous risk assessment, and psychological support that optimally begins before conception and extends throughout the postpartum period and interconceptional period

A

prenatal care

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14
Q

presumptive symptoms

A

nausea and vomiting
bladder frequency/infrequency
perception of fetal movement (pseudocyesis)
breast enlargement

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15
Q

violaceous discoloration of the vagina

A

presumptive sign: chadwick’s sign

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16
Q

areolas get darker and nipples get larger and more pigmented

A

presumptive sign: montgomery’s tubercles

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17
Q

melasma gavidarum or mask of pregnancy

A

presumptive sign: cholasma

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18
Q

probable signs and symptoms

A

symptoms: abdominal distention, braxton-hicks
signs: (+) pregnancy test, abdominal enlargement, outlining of fetal parts, hegar’s sign, gooddell’s sign, ballotment

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19
Q

cervical softening at 4-6 AOG

A

gooddell’s sign

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20
Q

softening of isthmus at 6-8 AOG

A

hegar’s sign

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21
Q

positive signs

A

fetal heart tone
perception of fetal movement by examinier
uts

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22
Q

progression of fetal heart tone

A

5 wks: transvaginal sonography
10 wks: doppler equipment
17 wks: stethoscope

110-160 bpm

23
Q

fetal souffle vs uterine souffle

A

fetal: rush of blood through umbilical arteries. sharp whistline sound synchronous with fetal pulse
uterine: soft blowing sound, synchronous with with maternal pulse. heard at lower potion of uterus

24
Q

the examiner can detect fetal movements at __ weeks

A

20 weeks

25
Q

main function of hcg

A

prevents involution of corpus luteum, principal site of progesterone formation in first 6 wks of pregnancy -> syncytiotrophoblast

26
Q

hcg level progressio

A

detectable at 8-9 days after ovulation
peak 60-70 d
plateau at 16 wks

27
Q

other causes of elevated hcg without pregnancy

A

AM EXO KID PT

heterophilic antibodies that bind to antibodies in immunoassay
molar pregnancy
exogenous hcg (weight loss)
renal failure with impaired hcg clearance
physiological pituitary hcg
hcg producing tumors from GI, ovary, bladder, lung

28
Q

first sonographic evidence of pregnancy

A

gestational sac seet in tvs 4-5 aog

29
Q

potential indicators of early intrauterine pregnancy

A

intradecidual sign: anechoic center with single echogenic rim
double decidual sign: two concentric echogenic rings surrounding gestational sac

30
Q

what is appearance of yolk sac in tvs

A

brightly echogenic ring with anechoic center

confirms intrauterine location of pregnancy, middle of 5th week

31
Q

cardiac motion noted at __ weeks

A

> 6 weeks

32
Q

trimesters

A

first: conception-14 wks aog
second: 15-28 wks
third: 29-42 wks

33
Q

normal pregnancy duration

A

280 days or 40 wks

34
Q

how to estimate pregnancy due date

A

LMP + 7 days
- 3 mos
+ 1 year

35
Q

what is a non-viable pregnancy

A

< / = 20 wks

36
Q

viable pregnancies

A

preterm: >20 wks to <37 wks
term: 37-42 wks
post term: > 42 wks

37
Q

how to get ob score

A 
g = # pregnancies
p = # pregnancies >20 wks
t = term infants delivered
p = preterm infants delivered
a = miscarriages
l = live children
38
Q

fundic height can be measured at __ weeks

A

20 weeks, correlates with gestational age in weeks

39
Q

most accurate tool for gestational age assignment

A

first trimester crl

40
Q

iron sufficiency at 20 wks-delivery and 6 mos postpartum

A

> 20 wks: hgb 110 g/L, f 12 ugL

6 mos post: hgb 120 g/L, f 15 ugL

41
Q

criteria for anemia in pregnancy

A

1st trimester: 11 g/dl
2nd trimester: 10.5 g/dl
3rd: 11 g/dl

42
Q

severity of anemia

A

mild 9.5-10.5
mod 8-9.4
severe 6.9-7.9
very severe <6.9

43
Q

t/f all filipino gravidas are high risk and should be screened for t2dm in first prenatal visit (fbs or rbs)

A

true

fbs >/- 126 mg/dl
rbs >/= 200 mg/dl
hb1ac 6.5%

44
Q

t/f if the initial dm test is normal gdm screening is done at 24-30 wks using ogtt

A

false, 24-28 wks

45
Q

prenatal visits

A

0-28 wks: once a month
28-36 wks: every 2 wks
38 wks to term: every week

46
Q

normal weight gain for normal bmi

A

1 lb/wk

11.5-6 kg / 25-35 lbs total

47
Q

how to compute for total energy requirement

A 
DBW = (height-100) - 10%
TER = DBW x activity level

pregnant: TER + 300kcal/kg/day
lactating: TER + 500 kcal/kg/day

48
Q

calcium supplementation

A

500 mg, 3x/d at 20 wks

49
Q

iron supplementation

A

30-60 mg elemental iron at 8-12 wks + vit c

60 mg: ferrous fumarate, ferrous gluconate, ferrous sulfate

50
Q

folate supplementation

A

low risk: 0.4-0.8 mg 30 days before pregnancy until 1st tri

high risk: 4 mg folic acid daily, 0.4-1 mg folic acid daily from 12 wks until postpartum

51
Q

pregnant women can fly up to ___ weeks

A

36 weeks gestation

52
Q

t/f nausea and vomiting continue until 14-16 weeks

A

true

53
Q

notable immunizations

A

tdap im 0, 1, 6-12. 1st tri
flu feb-june
hepb im 0, 1, 6 mos

10 OB (6 decks)

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