Brainscape's Knowledge GenomeTM

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


See full index

Women's Health EOR > Prenatal Care and Normal Pregnancy > Flashcards

Prenatal Care and Normal Pregnancy Flashcards

1
Q

What is Apgar score?

A

a method to quickly summarize the health of newborn children

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

When is the test generally done?

A

at one and five minutes after birth and may be repeated later if the score is and remains low

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

How is Apgar scored?

A
  • activity (2=active movement)
  • pulse (2=>100)
  • grimace (2 =pulls away, sneeze)
  • appearance (2= pink)
  • respiration (2=crying)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a good Apgar score?

A

score >6 is good

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

When Apgar score means resuscitation?

A

score of 4 necessitates resuscitation

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

What are the characteristics of fetal size?

A
  • fetal head most critical; cephalopelvic disproportion - labor dystocia (difficult/obstructed)
  • marcosomina (birth weight >90th percentile for gestational age/> 4500 g) associated with shoulder dystocia (fetal shoulder unable to pass below maternal pubic symphysis), birth injuries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the characteristics of fetal attitude?

A

relationship of fetal parts to one another
-full flexion (chin on chest; rounded back with flexed arms, legs); smallest diameter of head (suboccipitobregmatic diameter) presents at pelvic inlet

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

What are the characteristics of fetal ile?

A

relationship of fetal cephalocaudal axis (spinal column) to maternal cephalocaudal axis

  • longitudinal (ideal): fetal spine lies along lateral
  • transverse: fetal spine perpendicular to maternal
  • oblique: fetus at slight angle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is fetal presentation?

A

fetal/presenting part enters pelvic inlet first

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

What are the characteristics of cephalic position?

A

head first

  • vertex (most common): optimal for easy delivery; head completely flexed onto chest = occiput (part of fetal skull covered by occipital bone) is presenting
  • brow: fetal head partially extended; sinciput (part of fetal skull covered by frontal bone, anterior fontanelle to orbital ridge) presenting part
  • face: fetal head hyperextended; fetal face from forehead to chin presenting part
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the characteristics of breech position?

A

head up; bottom, feet, knees present first

  • frank breech: hips flexed, knees extended, bottom presents
  • complete breech: hips, knees flexed, bottom presents
  • incomplete breech: one/both hips not completely flexed, feet present
  • shoulder: transverse lie,; shoulders present first
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the characteristics of breech presentation?

A

a breech birth happens when a baby is born bottom first instead of head first

  • around 3-5% of pregnancy women at term (37-40 weeks pregnant) will have a breech baby
  • prevalence decreases with increasing gestational age
  • 25% of fetuses under 28 weeks are breech
  • 7 to 16% are breech at 32 weeks
  • 3 to 4% are breech at term
  • a breech presentation may be frank, complete, or incomplete
  • the diagnosis of breech presentation is based on physical examination, with ultrasound confirmation, if the diagnosis is uncertain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the tx of breech presentation?

A

external cephalic version at or near term, followed by a trial of vaginal delivery if the version is successful and planned cesarean delivery if breech presentation persists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is multiple gestations?

A

the overall incidence in the US is 3%

-twins occur in 1 out of every 80 births

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

What does monozygotic mean?

A

identical

-multiple (typically two) fetuses produced by splitting of a single zygote

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does dizygotic mean?

A

fraternal

-multiple (typically two) fetuses produced by two zygotes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What does polyzygotic mean?

A

multiple fetuses produced by two or more zygotes

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

What is the dx of multiple gestations?

A

often diagnosed at first screening ultrasound other clues include

  • fundal height is usually greater than dates
  • extra fetal heart tones
  • elevated maternal alpha-fetoprotein (AFP)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the tx of multiple gestations?

A

prenatal visits should occur more frequently to monitor and prevent maternal complications

  • the most common complication is spontaneous abortion an preterm birth
  • other problems occur with greater frequency are preeclampsia and anemia
  • mange of diet, surveillance of fetal growth and cervical length
  • delivery by induction for vaginal route or c-section (common) try to deliver at >34 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the characteristics of labor (parturition)?

A

uterine contractions = cervical changes = delivery of baby, placenta

  • begins at term (37-42 weeks of gestation)
  • duration of three stages varies with gravity (nulliparas typically longer than multiparae)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the characteristics of cervical changes?

A
  • remodeling of cervix by enzymatic collagen dissolution, increase water content = softening, increased distensibility
  • cervical softening = explosion of mucus plug = “bloody show” (pink-tinged mucus)
  • spontaneous rupture of amniotic membranes (ROM)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the characteristics of false labor?

A

AKA Braxton-Hicks contractions

  • true labor: regular, increase in frequency, duration, intensity; produce cervical changes (e.g. dilation/opening, effacement/getting thinner); pain begins in lower back, radiates to abdomen, not relieved by ambulation
  • false labor: irregular, intermittent contractions, no cervical changes, pain in abdomen, walking may decrease pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the first stage of labor?

A

onset of labor to fully dilated (10 cm)

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

What are the characteristics of early/latent labor?

A
  • 8 to 12 hours
  • mild contractions every 5 to 30 minutes
  • duration 30 seconds each
  • gradually increase in frequency, intensity, duration
  • cervical dilation 0-3 cm
  • effacement 0-30%
  • spontaneous ROM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the characteristics of the active phase of labor?

A
  • 3-5 hours
  • contractions every 3 to 5 minutes
  • duration >1 minute
  • cervical dilation 3-7 cm
  • effacement 80%
  • progressive fetal descent
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the characteristics of the transition phase?

A
  • 30 minutes to 2 hours
  • intense contractions every 1.5-2 minutes
  • duration 60-90 seconds
  • cervical dilation 7 to 10 cm
  • effacement 100%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the second stage of labor?

A

fully dilated to the birth of the infant

  • AKA pushing stage
  • begins with full dilation
  • navigation through maternal pelvis dilated by 2 Ps: power, passenger, passage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the characteristics of power?

A

-frequency, duration, intensity of uterine contractions
-physiology of contractions
-stimulation of uterine myometrium
-alpha-receptors stimulate uterine contractions
-numerous oxytocin receptors, mostly on uterine fundus
-contraction steps:
wave begins in fundus, proceeds downward to rest of uterus - muscle shortened in response to stimulus - increment (build up) - acme (peak) - decrement (gradual letting up) - relaxation - fetal descent, cervical effacement, dilation - amount of pressure exerted by uterine contractions (intrauterine pressure) measured in millimeters of mercury (mmHg)

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

What are the characteristics of passenger?

A

Fetal size:

  • fetal head most critical; cephalopelvic disproportion - labor dystocia (difficult/obstructed)
  • macrosomia (birth weight >90th percentile for gestational age/>4500 g) associated with shoulder dystocia (fetal shoulder unable to pass below maternal pubic symphysis), birth injuries
  • fetal attitude: relationship of fetal parts to one another
  • full flexion (chin on chest; rounded back with flexed arms, legs); smallest diameter of head (suboccipitobregmatic diameter) presents at pelvic inlet
  • fetal Iie: relationship of fetal cephalocaudal axis (spinal column) to maternal cephalocaudal axis
  • longitudinal (ideal: fetal spine lies along maternal
  • transverse: fetal spine perpendicular to maternal
  • oblique: fetus at slight angle
  • fetal presentation: fetal/presenting part enters pelvic inlet first
  • cephalic: head first
  • vertex (most common): optimal for easy delivery; head completely flexed onto chest - occiput (part of fetal skull covered by occipital bone) is presenting
  • brow: fetal head partially extended; sinciput (part of skull covered by frontal bone. anterior fontanelle to orbital ridge) presenting part
  • face: fetal head hyperextended; fetal face from forehead to chin presenting part
  • breech: head up, bottom, feet, knees present first
  • frank breech: hips flexed, knees extended, bottom presents
  • complete breech: hips, knees flexed, bottom presents
  • incomplete breech: one/both hips not completely flexed; feet present
  • shoulder: transverse Iie; shoulders present first
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the characteristics of passage?

A
  • route through bony pelvis
  • size, type of pelvis
  • gynecoid: rounded pelvic inlet, midpelvis, outlet capacity adequate; optimal vaginal delivery
  • android: heart-shaped pelvic inlet, decrease midpelvis diameters, outlet capacity; associated with labor dystocia
  • anthropoid: oval-shaped pelvic inlet, midpelvis diameters, outlet capacity adequate, favorable for vaginal delivery
  • platypelloid: oval-shaped pelvic inlet, decreased midpelvis diameters, outlet capacity adequate, not favorable for vaginal delivery
  • Cardinal Movements (mechanisms of labor)
  • descent: presenting part reaches pelvic inlet (engagement) before onset of labor = degree of descent (fetal station), relationship of presenting part to maternal ischial spine = fetus moves from pelvic inlet (-5 station) down to ischial spines (0 station) to pelvic outlet (+4 station) to crowning at vaginal opening (+5 nation)
  • flexion: fetal chin presses against chest, head meets resistance from pelvic floor
  • internal rotation: fetal shoulders internally routes 45 degrees, widest part of shoulders in line with widest part of pelvic inlet
  • extension: fetal head passes under symphysis pubic (+4 station), moves (+5 station), emerges from vagina
  • restitution (external rotation): head externally rotates as shoulders pass through pelvic outlet, under symphysis pubis, turns to align with back
  • expulsion: anterior shoulder slips under symphysis pubis, followed by posterior shoulder, rest of the body, marks end of second stage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the characteristics of the third stage of labor?

A

delivery of infant to delivery of the placenta
-delivery of placenta, umbilical cord, fetal membranes, uterus contracts firmly, placenta begins to separate from uterine wall

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

What is the fourth stage os labor?

A

physiological adaptation to blood loss, initiation of uterine involution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the monitoring during labor?

A
  • heart rate and the pattern is an indicator of infant well-being
  • normal heart rate in newborn is 120-160 beats per minute
  • consistent decelerations after a contraction can indicate fetal distress
  • external fetal monitor - on the maternal abdomen
  • internal fetal monitor - electrode attached to the infants head
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is accelerations of fetal heart rate?

A

increased of baseline 15 bpm for 15 seconds = response to fetal movement = reassuring

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

What are early decelerations of fetal heart rate?

A

mirror images of contractions = fetal head compression = benign

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

What are variable decelerations of fetal heart rate?

A

rapid FHR drop with a return to baseline with variable shape = cord compression = benign if mild or moderate = worrisome if severe

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

What are late decelerations of fetal heart rate?

A

FHR drop at the end of the contraction = uteroplacental insufficiency = always worrisome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the physiology of the uterus during pregnancy?

A
  • increase size, capacity due to hypertrophy, hyperplasia, mechanical stretching
  • 20 times larger
  • increase strength, distensibility, contractile proteins, number of mitochondria
  • increase volume capacity (10 mL to 5 L)
  • softening of uterine isthmus (Hegar’s sign)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the physiology of the cervix during pregnancy?

A
  • formation of mucus plug, seals endocervical canal
  • increase vascularity - purplish-blue color
  • mild softening due to edema, hyperplasia (Goodell’s sign); increase softening in third trimester
40
Q

What is the physiology of the placenta during pregnancy?

A
  • develops where embryo attaches to uterine wall
  • expands to cover 50% internal uterine surface
  • functions as maternal-fetal organ for metabolic, nutrient exchange
  • secretes estrogen progesterone, relaxin, hCG
41
Q

What is the physiology of the vagina during pregnancy?

A
  • increase vascularity - bluish-purple color
  • loosening of connective tissue - increase distensibility
  • leukorrhea
  • pH of 3.5 to 6.0 - protects against bacterial infections
42
Q

What is the physiology of breast during pregnancy?

A
  • increase size, weight, nodularity, blood flow, vascular prominence
  • areola, nipples are a darker pigmentation due to increase melanocyte activity
  • increase activity of Montgomery’s tubercles (sebaceous glands)
  • progesterone increase alveolar-lobular development; prevents milk production during pregnancy (inhibits prolactin)
  • estrogen increase growth of lactiferous ducts
  • secretion of colostrum begins week 16
43
Q

What is the physiology of cardiovascular during pregnancy?

A
  • mild hypertrophy
  • S2, S3 more easily auscultated, split exaggerated
  • heart displaced upward, forward, slightly to left
  • increase heart rate by 15-20 beats/minute
  • stroke volume increase 30%, cardiac output (CO) increase 30-50% (by term); decrease blood pressure (BP) despite increased CO due to progesterone-induced vasodilation; BP = CO x systemic vascular resistance (SVR)
  • supine hypotensive syndrome caused by gravid uterus pressing on inferior vena cava (left lateral recumbent position optimal for CO, uterine perfusion)
  • gravid uterus elevated pressure veins draining legs, pelvic organs = slowed venous return, dependent edema, varicose veins, hemorrhoid
44
Q

What is the physiology of hematologic during pregnancy?

A
  • increased blood volume ( approx. 150 mL)
  • related to sodium, water retention due to changes is osmoregulation, secretion of vasopressin by anterior pituitary, renin-angiotensin-aldosterone system (RAAS)
  • increase total red blood cell (RBC) volume (30%) with iron supplementation
  • increase volume, oxygen-carrying capacity needed for increased basal metabolic rate (BMR), needs of uterine-placental unit (offsets blood loss at delivery)
  • plasma > RBC volume = hemodilution, decrease hematocrit (physiologic anemia)
  • increase white blood cells (WBC) count (approx. 5,000 to 12,000/mm3)
  • increase clotting factors (fibrin, fibrinogen): hyper coagulable state of pregnancy
45
Q

What is the physiology of respiratory during pregnancy?

A
  • increase oxygen consumption, subcostal angle, anteroposterior diameter, tidal volume (30-50%), minute ventilatory volume, minute oxygen uptake
  • gravid uterus places upward pressure on diaphragm - elevates approx. 4 cm
  • hyperventilation - mild respiratory alkalosis (renal compensation - maternal blood pH 7.40 -7.45)
  • nasal congestion, epistaxis due to estrogen - induced edema
46
Q

What is the physiology of gastrointestinal during pregnancy?

A
  • gums bleed easily due to estrogen-induced hyperemia, friability
  • progesterone-induced smooth muscle relaxation, delayed gastric emptying, decrease peristalsis = nausea, vomiting (AKA “morning sickness”); constipation; heartburn (pyrosis), esophageal reflux, intrahepatic cholestasis of pregnancy due to decrease gallbladder emptying time = increase risk of cholelithiasis
  • increase saliva production (ptyalism)
47
Q

What is the physiology of urinary and renal during pregnancy?

A

Bladder

  • first trimester: gravid uterus presses on bladder = urinary frequency, nocturne, stress incontinence
  • second trimester: uterus occupies abdominal space - decrease urinary frequency
  • third trimester: presenting part descends into pelvic - urinary frequency, nocturne, stress incontinence
  • increase glomerular filtration rate (GFR)
  • 40-50% by second trimester, increase urinary output (25%)
  • increase size of kidneys (1-1.5 cm)
  • dilation of urinary collecting system - physiologic hydronephrosis
  • urinalysis
  • glycosuria (due to increase glucose lead), increase protein excretion (due to altered proximal tubule function + increase GFR)
48
Q

What is the physiology of integumentary during pregnancy?

A
  • hyperpigmentation (due to estrogen, increase melanocyte activity) = melisma (chloasma) brownish “mask of pregnancy”, linea nigra formation on abdomen; darkening of
  • nipples, areolae, vulva
  • increase cutaneous blood flow - increase heat dissipation - increase pregnancy “glow”
  • decrease connective tissue strength secondary to increase adrenal steroid levels - increase stretch marks (striae gravidarum) in breasts, abdomen, thighs, inguinal area
  • estrogen-induced vascular permeability - spider nevi, angiomas, palmar erythema
49
Q

What is the physiology of musculoskeletal during pregnancy?

A
  • abdominal distention + shift in center of gravity = lordosis
  • enlarging uterus = separation of abdominal rectus muscles (diastasic recti)
  • increase progesterone, relaxin = increase joint mobility, “waddling” gait
  • widening of symphysis pubis
  • facilitates accommodation of fetus into pelvis
  • high bone turnover, remodeling
50
Q

What is the physiology of endocrine during pregnancy?

A
  • increase size of pituitary gland, mostly due to proliferation of lactotroph cells
  • increase intrasellar pressure - increase risk of postpartum infraction (Sheehan syndrome) in setting of postpartum hemorrhage
  • increase parathyroid hormone (meets calcium need of developing fetal skeleton)
  • physiologic hypercortisolism
  • increase need of estrogen, cortisol - increase glucocorticoids from adrenal glands = supports fetal somatic, reproductive growth
  • “diabetogenic state” of pregnancy
  • increase need for glucose, insulin production - hypertrophy, hyperplasia of pancreatic beta cells
  • decrease thyroid-stimulation hormone (TSH); thyroid gland enlarges; increase total T3, T4
  • reproductive hormones
  • hCG from placenta, estrogen, progesterone corpus luteum (first, second trimesters), placenta (second, third trimesters)
  • suppressed FSH, LH due to feedback from estrogen, progesterone, inhibin
  • decrease oxytocin levels throughout pregnancy - increase labor onset - increase second stage of labor
51
Q

What are the nutritional needs during pregnancy?

A
  • recommendation of additional 300kcal/day, weight gain of 25-35 pounds (11.5-16 kg)
  • 11 lb (5 kg): placenta, amniotic fluid, fetus
  • 2 lb. (0.9 kg): uterus
  • 4 lb (1.8 kg): increase blood volume
  • 3 lb. (1.4 kg): breast tissue
  • 5-10 lb (2.3-4.5 kg): maternal reserves
  • 600 mcg folic acid/day - RBC synthesis, placental/fetal growth, decrease risk of neural tube defects
  • 1,000 - 1,300 mg calcium/day supports pregnancy, lactation
  • 60 G protein daily supports tissue growth
  • 27 mg iron/day supports increase RBCs
52
Q

What percentage of pregnancies are unplanned?

A

50%

53
Q

What is the recommended prenatal care schedule?

A

consists of the following:

  • monthly visits to healthcare professional for weeks 4-28 of pregnancy
  • visits twice monthly from 28 to 36 weeks
  • weekly after week 36 (delivery at week 38-40)
54
Q

What are the recommendations for use of dietary supplements in pregnancy?

A
  • all pregnant women should receive a prenatal vitamin
  • folic acid supplementation (0.4 - 0.8 mg) prior to conception; 4 mg for secondary prevention
  • calcium: 1,000 to 1,300 mg/day; supplement may be beneficial for women with high risk for gestational hypertension or communities with low dietary calcium intake
  • iron: screen for anemia (Hgb/Hct) and treat if necessary, recommend 30 mg/day of iron in pregnant women
  • Vitamin A: pregnant women industrialized countries should limit to <5,000 IU/day
  • Vitamin D: consider supplementation in women with limited exposure to sunlight
55
Q

What should be done at prenatal visits?

A
  • a full physical exam should be performed at the 1st prenatal appointment
  • weight: total weight gain range (lb) should be 25-35 lb, except in obese women, for whom weight gain should be <15 lb
  • ACOG defines hypertension as BP >140 mmHg systolic or >90 mmHg diastolic
  • monitor BP especially closely in patients with chronic hypertension (predating pregnancy), preeclampsia/eclampsia, or gestational hypertension
  • UA for glucose and protein; 24-hour protein excretion is the gold standard but not practical
  • fundal height
  • fetal heart rate: usually audible by 12 weeks’ GA with a Doppler instrument
  • fetal position by abdominal palpation at 36 weeks
  • pelvic/cervical exam if indicated
56
Q

What is advanced maternal age?

A

35

-each mother should be offered testing for genetic abnormalities

57
Q

How can expectant date of confinement by calculated?

A

Naegele’s Rule

  • when was the first day of bleeding? = 1st day of the last menstrual period
  • 1’st day of menstrual period + 7 days - 3 months + 1 year
58
Q

When should an initial OB visit be?

A

6 weeks after LMP

59
Q

What does each visit assess?

A
  • fetal heart tones, blood pressure, fundal height, fetal movement and urinalysis
  • ultrasound should be able to detect fetal heart activity 1-2 weeks after 1st missed cycle (around 5-6 weeks)
60
Q

What is a triple screen?

A

AFP, HCG, Estriol

61
Q

What is quad screen?

A

AFP, HCG, Estriol, Inhibin A

62
Q

When is chorionic villus sampling done?

A

between 10-12 weeks (end of first trimester)

63
Q

When is an amniocentesis done?

A

between 15-18 weeks (beginning of second trimester) - especially for women over age 35 in the high-risk group

64
Q

When is the 75 g 2-hour oral glucose tolerance test done?

A

26-28 weeks

65
Q

When is Group B strep test done?

A

between 35-37

66
Q

Where is the uterus at 12 weeks?

A

at pubic symphysis

67
Q

Where is the uterus at 16 weeks?

A

midway from symphysis to umbilicus

68
Q

Where is the uterus at 20 weeks?

A

at umbilicus

69
Q

When is the uterus at 20-36 weeks?

A

height (in cm) above pubic symphysis correlates with weeks of gestation

70
Q

When and what are the first trimester screening?

A

11-14 weeks

  • ultrasound for nuchal translucency
  • PAPP-A and hCG
  • increase levels are seen in chromosomal abnormalities
  • low levels of PAPP-A can be associated with Down’s syndrome
71
Q

When and what is cell free fetal DNA?

A

~10 weeks

  • analyze fetal DNA in maternal blood
  • screens for trisomies 13, 18, and 21
  • positive test results should be followed by CVS or amniocentesis
72
Q

When and what is Chorionic villus sampling (CVS)?

A

11-14 weeks

-collect placental tissue to test for chromosomal and genetic abnormalities

73
Q

When and what is quadruple screen?

A

16-18 weeks

  • AFP, hCG, estriol, inhibin
  • increase AFP = neural tube or abdominal wall defects
  • increase hCG and inhabit and decrease AFP and estriol = down syndrome
  • decrease AFP, hCG, and estriol = Edwards syndrome
74
Q

When and what is an amniocentesis?

A

15-20 weeks

-collect amniotic fluid to diagnosis chromosomal abnormalities

75
Q

When and what is the glucose challenge test?

A

24-28 weeks

  • 1 hour glucose challenge test
  • if abnormal followed by glucose tolerance test
76
Q

When and what is group B strep test?

A

35-37 weeks

-swab the lower genital tract fro colonization by GBS

77
Q

What are the symptoms of pregnancy?

A
  • amenorrhea
  • increase urine frequency
  • breast engorgement
  • treat with breastfeeding/pumping or cold compress
  • nausea
  • bluish discoloration of vagina, vulva, and cervix due to vascular contestation (Chadwick’s sign)
  • softening of cervix
78
Q

What are the characteristics of urine pregnancy test (UPT)?

A
  • detects hCG or B subunit

- sensitive to 1-2 weeks

79
Q

What are the characteristics of ultrasound?

A

most accurate method to detect fetal size

  • gestational sac - 5 weeks
  • fetal image detected at 6-7 weeks
  • cardiac activity at 8 weeks
80
Q

How often are prenatal visits during the first trimester and what you do evaluate?

A 
visit every 4 weeks
Evaluate
-weight gain/loss
-BP 
-pedal edema
-fundal height
-urine dip glycosuria and proteinuria
-trace glucose is normal due to increase GFR
-trace protein is not normal and should be evaluated
81
Q

What are the characteristics of Cell-free fetal DNA?

A
  • non-invasive
  • very sensitive/specific
  • can order at 10 weeks or greater
  • can confirm with CVS or amniocentesis
82
Q

What are the characteristics of Chorionic villus sampling (CVS)?

A

a procedure where small samples of placenta are acquired in order to perform a prenatal genetic analysis (e.g. DNA analysis and cytogenetics)
-CVS is typically performed between 10 and 13 weeks of gestation

83
Q

What are the indications of CVS?

A
  • maternal age 35 years or older
  • prior child had a genetic disorder (cystic fibrosis) and chromosomal abnormalities (Down syndrome)
  • parents are carriers of a genetic disorder
  • first trimester ultrasound examination suggests a congenital anomaly
  • abnormal aneuploidy screening result
84
Q

What are the risk of doing a CVS testing?

A
  • maternal alloimmunicatidn (relative contraindication)

- vertical transmission of infection (HIV)

85
Q

What are the complications of CVS testing?

A
  • miscarriage

- amniotic fluid leakage

86
Q

What is done at 15-18 week visit?

A
  • offer triple marker screen (hCG, estriol, AFP)

- used to detect neural tube defects or trisomies

87
Q

What is done at 16-20 week visit?

A

amniocentesis if >35 years old or history indicates

88
Q

What is done at 17 week visit?

A

document movement

89
Q

What is done at 24 week visit?

A

glucose screening

90
Q

What is done at 25-28 weeks visit?

A

repeat Hct

91
Q

What are the routine third trimester tests?

A
  • urinalysis

- blood glucose

92
Q

What are preterm labor symptoms?

A
  • vaginal bleeding
  • contractions
  • rupture of membranes
93
Q

What is done at 28-30 week visit?

A

-give RhoGAM if indicated

94
Q

What is done at 28-32 week visit?

A

mothers with pre-gestational diabetes should undergo twice weekly non stress testing until delivery

95
Q

What is done at 35-37 week visit?

A

screen for Streptococcus agalactiae (group b strep)

96
Q

What is done at 36-40 week visit?

A

cervical chlamydia and gonorrhea cultures if indicated

Women's Health EOR (10 decks)

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