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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

25
main function of hcg
prevents involution of corpus luteum, principal site of progesterone formation in first 6 wks of pregnancy -> syncytiotrophoblast
26
hcg level progressio
detectable at 8-9 days after ovulation peak 60-70 d plateau at 16 wks
27
other causes of elevated hcg without pregnancy
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
first sonographic evidence of pregnancy
gestational sac seet in tvs 4-5 aog
29
potential indicators of early intrauterine pregnancy
intradecidual sign: anechoic center with single echogenic rim double decidual sign: two concentric echogenic rings surrounding gestational sac
30
what is appearance of yolk sac in tvs
brightly echogenic ring with anechoic center | confirms intrauterine location of pregnancy, middle of 5th week
31
cardiac motion noted at __ weeks
>6 weeks
32
trimesters
first: conception-14 wks aog second: 15-28 wks third: 29-42 wks
33
normal pregnancy duration
280 days or 40 wks
34
how to estimate pregnancy due date
LMP + 7 days - 3 mos + 1 year
35
what is a non-viable pregnancy
< / = 20 wks
36
viable pregnancies
preterm: >20 wks to <37 wks term: 37-42 wks post term: > 42 wks
37
how to get ob score
``` g = # pregnancies p = # pregnancies >20 wks t = term infants delivered p = preterm infants delivered a = miscarriages l = live children ```
38
fundic height can be measured at __ weeks
20 weeks, correlates with gestational age in weeks
39
most accurate tool for gestational age assignment
first trimester crl
40
iron sufficiency at 20 wks-delivery and 6 mos postpartum
>20 wks: hgb 110 g/L, f 12 ugL | 6 mos post: hgb 120 g/L, f 15 ugL
41
criteria for anemia in pregnancy
1st trimester: 11 g/dl 2nd trimester: 10.5 g/dl 3rd: 11 g/dl
42
severity of anemia
mild 9.5-10.5 mod 8-9.4 severe 6.9-7.9 very severe <6.9
43
t/f all filipino gravidas are high risk and should be screened for t2dm in first prenatal visit (fbs or rbs)
true fbs >/- 126 mg/dl rbs >/= 200 mg/dl hb1ac 6.5%
44
t/f if the initial dm test is normal gdm screening is done at 24-30 wks using ogtt
false, 24-28 wks
45
prenatal visits
0-28 wks: once a month 28-36 wks: every 2 wks 38 wks to term: every week
46
normal weight gain for normal bmi
1 lb/wk | 11.5-6 kg / 25-35 lbs total
47
how to compute for total energy requirement
``` DBW = (height-100) - 10% TER = DBW x activity level ``` pregnant: TER + 300kcal/kg/day lactating: TER + 500 kcal/kg/day
48
calcium supplementation
500 mg, 3x/d at 20 wks
49
iron supplementation
30-60 mg elemental iron at 8-12 wks + vit c 60 mg: ferrous fumarate, ferrous gluconate, ferrous sulfate
50
folate supplementation
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
pregnant women can fly up to ___ weeks
36 weeks gestation
52
t/f nausea and vomiting continue until 14-16 weeks
true
53
notable immunizations
tdap im 0, 1, 6-12. 1st tri flu feb-june hepb im 0, 1, 6 mos

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