Prenatal care and fetal monitoring

Question 1

How is a pregnancy confirmed?

Answer 1

first urine b-hcg
then a blood b-hcg (detectable 8 days after conception)
then an US

Question 2

What labs need to be ordered if your pt wants to get prego?

Answer 2

Rubella (immunize and wait 4 weeks)
Varicella (immunize before pregnancy)
Hepatitis B
HIV
Syphilis
Toxoplasmosis (if negative, avoid exposure to garden soil, cat feces, raw meat)
CMV and parvovirus B19-if negative, frequent handwashing and universal precautions for child care or health care workers
Genetic carrier testing based on ethnicity and family history

Question 3

what type of smoking cessation can be used during pregnancy?

Answer 3

SR buproprion

Question 4

Glucose challenge test is performed when?

Answer 4

28 weeks, if >140 do a 3 hr test

Question 5

Maternal serum AFP check is performed when?

Answer 5

14-22 weeks

Question 6

Vaginal culture for group B strep is performed when?

Answer 6

32 weeks, repeat gonorrhea and chlamydia testing

Question 7

where is the fundal height at 20 weeks?

Answer 7

umbilicus

Question 8

where is the fundal height at 12 weeks

Answer 8

pubic symphysis

Question 9

after how many weeks does the fetus descend into the pelvis?

Answer 9

36

Question 10

Leopold’s Maneuver

Answer 10

Determines fetal position, done near end of pregnancy

Question 11

safe OTC meds

Answer 11

Tylenol
Benadryl
Robitussin plain or DM
Sudafed not first trimester
Claritin
Mylicon, Gas X
Tums, Mylanta, Pepcid Zantac Prevacid
Benzoly Peroxide, Salicylic Acid

Question 12

safe antibiotics

Answer 12

Amoxicillin
Ampicillin
Augmentin
Bactrim (unsafe 1st trimester and after 38 weeks)
E-mycin
Keflex
Flagyl
Macrobid (not safe to use after 38 weeks
Clindamycin
Z-PACK

Question 13

fetal heart beat seen on Trans vaginal ultrasound when? fetla HR can be obtained when?

Answer 13

6 Weeks

12 weeks, 120-160 bpm

Question 14

what % of pregnancy are losses?

Answer 14

15%
10-12% in the 1st trimester

Only 3% lost after 8 weeks of gestation

Question 15

when is quad screen drawn and what does it include?

Answer 15

16-18 weeks
estriol, hcg, inhibin A, and AFP
increase suggests neural tube defect
decrease suggests Down Syndrome, genetic abnormality, or disparity in dates

Question 16

Level II Ultrasound performed when

Answer 16

18-22 Weeks

If AFP and/or Level II abnormal offer Amniocentesis

Question 17

when is the 2nd trimester completed?

Answer 17

27 weeks

Question 18

triad of pre-eclampsia

Answer 18

HTN
proteinuria
+/- edema
this usually occurs in the 3rd trimester

Question 19

what is a normal term pregnancy?

Answer 19

37 weeks

Question 20

when should the pt go to the hospital?

Answer 20

contractions every 5-10 minutes

Question 21

when is a non-stress test performed? how is it performed?

Answer 21

after 40 weeks on a weekly basis
Procedure:
Mother in left lateral supine position with continuous fetal heart rate tracing done
Normal fetus will respond with a 15bpm acceleration in heart rate lasting for 15 sec above baseline heart rate after a significant movement
2 accelerations in a 20 min period = reactive NST

Question 22

BPP (Biophysical Profile)

Answer 22

Systematic evaluation of the fetus, amniotic fluid volume, & placenta.(reflects fetal status @ time of test)

Question 23

scalp pH

Answer 23

pH of 7.3 is normal
7.20-7.25 guarded: repeat
Below 7.2: expedite delivery

Question 24

MCC of newborn blindness in 3rd world countries?

Answer 24

chlamydia

Question 25

herpes can lead to ( ) in newborns

Answer 25

CNS or ophthalmic damage

Question 26

076 protocol

Answer 26

used for pts with AIDS
AZT orally from 14 weeks until term
IV AZT during labor
Neonatal administration of AZT syrup