prenatal care & complication lectures

Question 1

when does hcg start to appear in urine

Answer 1

8 days before missed period (clear blue can do 6 days)

Question 2

pregnancy may be diagnosed as early as ____ days after implantation

Answer 2

3-4

Question 3

when does HcG levels start to drop

Answer 3

around 12 wks

Question 4

expected time for fetal heart tone, movement & morning sickness

Answer 4

heart– 10-12 wks via doppler at 12
movement— 16-20
N/V <6-7 wks and ends at 13-16 wks

Question 5

if theres discrepancy in fundal height by 3+cm whats next

Answer 5

do US

Question 6

why should you get urine culture in first trimester

Answer 6

to detect asymptomatic bacteruria for tx

Question 7

what do you get when Rh- mom carries Rh+ baby & blood leaks into mom causing her to make antibodies against baby

Answer 7

fetal fetalis hydrops

Question 8

when should you give mom RhoGAM

Answer 8

28 wks & if bleeding/miscarriage occurs

Question 9

when do you check AFP and what does high levels mean

Answer 9

• check in 2nd trimester (14-20ish) with the triple/quad screen
• high is associated with open neural tube defects

Question 10

what should you do if there is high AFP

Answer 10

evaluate with amniocentesis

Question 11

when should you give rubella vaccine?

Answer 11

after pregnancy

Question 12

normal nuchal translucency in 1st trimester

Answer 12

< 3mm

Question 13

when should you screen for GDM (high risk vs normal)

Answer 13

• high risk– 1st trimester
• nomral– 24-28 wks (2nd trimester)

Question 14

when should you give Tdap booster to mom

Answer 14

28 wks

Question 15

3 things to do at 36 wks

Answer 15

• CBC, GBS screening-not indicated if pt had GBS bacteriuria in pregnancy
• confirm fetal position w/ US; NST and BPP
• start acyclovir prophylaxis if genital HSV

Question 16

how is GDM screened?

Answer 16

1. 1 hr OGTT with 50g non-fasting flucose
2. if over 140 then 3 hr OGTT 100g fasting

Question 17

untreated UTIs can cause (2 things)

Answer 17

• preterm labor & delivery
• fetal loss

Question 18

2 other teratogenic meds

Answer 18

methotrexate & ribavirin

Question 19

1 in _ americans are obese at start of pregnancy; same stat gains more than 40lbs in pregnancy

Answer 19

5

Question 20

leading cause of death & disability in pregnant people is

Answer 20

MVA– seat bealt should be under uterus and above fundus btwn breasts

Question 21

OTC pain med recommended for pregnant people

Answer 21

tylenol

Question 22

med to prevent or delay onset of preeclampsia

Answer 22

low dose aspirin btwn 12-18 wks

Question 23

what trimester should pelvic exam be avoided unless placenta previa has been excluded

Answer 23

3rd trimester

Question 24

premature separation of part of placenta from uterine wall; range from no bleeding to significant; can be precipitated by blunt trauma or MVA

Answer 24

placental abruption

Question 25

2 things that placenta previa increases the risk of

Answer 25

abruption & massive bleeding

Question 26

STI that can cause neonatal CT pneumonia

Answer 26

chlamydia

Question 27

a type of vaginitis Associated w/ preterm labor/delivery

Answer 27

BV

Question 28

a type of vaginitis that presents no risk to pregnancy or fetus & how its tx

Answer 28

yeast topical clotrimazole or miconazole NO PO

Question 29

condition that can cause PDA, cognititve issues and deafness

Answer 29

rubella

Question 30

can cause neonatal GC ophthalmia

Answer 30

Gonococcal conjunctivitis

Question 31

rare but common in pregnancy, related to contamined foods where mom has no sx but baby is tested after delivery

Answer 31

listeriosis

Question 32

2 readings >140/90 at least 4 hrs apart after 20 wks means

Answer 32

gestational HTN

Question 33

how is gestational HTN treated? (2)

Answer 33

expectant management with increased monitoring delivery by 37 weeks

Question 34

2 tx of preeclampsia with severe features

Answer 34

* seizure prophylaxis w/ magnesium sulfate IV * may need meds to lower BP

Question 35

tx of preeclampsia < 37 wks without severe features (2)

Answer 35

increased monitoring including BP 2x/wk NST

Question 36

tx of preeclampsia after 37 wks or with worsening condition

Answer 36

delivery

Question 37

3 ways to predict premature labor

Answer 37

* measuring cervical length (over 25mm is reassuring) * fetal fibronectin (negative is reassuring) * bishops score

Question 38

membrane ruptures before 37 wks from intrauterine infection; high morbidity but survival likely if 24-26 wks; avoid digital exams

Answer 38

PROM

Question 39

Often diagnosed by lagging fundal height; May be seen on screening US; serial US used to monitor growth

Answer 39

Intrautering growth restriction (IUGR)

Question 40

what is the biggest risk with having multiples

Answer 40

preterm labor and delivery

Question 41

most common non-traumatic cause of FT bleeding

Answer 41

spontaneous miscarriage

Question 42

leading cause of 1st trimester pregnancy-related death

Answer 42

ectopic

Question 43

commonly present w/ vaginal bleeding in early pregnancy; Increased risk at extremes of maternal age and previous molar pregnancy; bHCG over 100,000 mIu/mL

Answer 43

GTD/hydatidiform mole