prenatal care & diagnosis of pregnancy Flashcards
anatomic changes in breast
E: ductal proliferation &growth; alveolar lobular growth
P: lobular hyperplasia
montgomery’s tubercles hypertrophy
cervical mucus for pregnant & nonpregnant
P: beading d/t progesterone
NP: ferning d/t estrogen
presumptive symptoms
N/V disturbance in urination fatigue perception of fetal movement breast symptoms
presumptive signs
mens cessation (>10 d) anatomical breast changes changes in vaginal mucosa skin pigmentation changes thermal signs
false positive & negative pregnancy test
+: choriocarcinoma
-: hook effect (very high causing saturation); very low on day 5
probable signs
abdominal enlargement uterus anatomical changes cervix anatomical changes braxton hicks contractions ballottement physical outlining of fetus positive endocrine test
first sonographic evidence
gestational sac (week 5) eccentrically
fluid collection w/in endometrial cavity w/ an ectopic pregnancy
pseudo-sac
single echogenic ring surrounding the gestational sac
intradecidual sign
two echogenic ring surrounding the gestational sac
double decidual sign
routine obstetric test
CBC urinalysis, urine culture & sensitivity blood grp, Rh RPR, VDRL hepB surface Ag rubella titer pap smear
assessment of gestational age
FH: 20-34 wks
FHR: steth (20 wks); doppler (8 wks / 10-12 wks)
utz
fundic height per week
12 wk: above symphysis
16 wk: bet symphysis & umbilicus
20 wk: umbilicus
36 wk: below xiphoid process
sharp whistling sound sync w/ fetal pulse
fundic souffle
soft, blowing sound sync w/ maternal pulse
uterine souffle
subsequent assessment
cervical culture for gonorrhea hgb electrophoresis HIV titer glucose screening MS-AFP
effect of overnutrition & undernutrition
O: preeclampsia, GDM, htn
U: CNS devt delay, growth retardation
average wt gain & retained
G: 28.6 lb / 12.9 kg
R: 2.1 lb / 1kg
recommended daily dietary allowance
calories: 100-300kcal/d
CHON: 1g/kg/d
CHO: 175g
fats: 15-25g
mgmt of leg varicosities
left lateral decubitus
elastic stocking
leg elevation
avoid prolong standing
mgmt of vulvar varicosities
fitted pantyhose
foam rubber pad
mgmt of hemorrhoids
topical anesthetics, warm soaks, stool-softening
incision & removal of clot
hemorrhoidectomy
use of cord blood banking
autologous transplant
suggested dose of iron supplementation
30-60mg Fe OD (all pregnant)
30-60mg OD Fe w/ 400mcg FA (anemia is prevalent)
60mg OD Fe w/ 400mcg FA (anemia is severe public health problem)
120mg OD Fe w/ 400mcg FA (clinically diagnosed anemia)
suggested dose of calcium supplementation
1.5-2 g divided in 3 doses from 20 wks until end
what def. can cause acrodermatitis enteropathica?
zinc def.
suggested dose of calcium supplementation
400 mcg OD prior to and after 3 months of pregenancy 4000 mcg (women w/ previous NTD baby)
vitamins & mineral that may not be needing supplementation
magnesium potassium fluoride pyridoxine vit. C vit. A
vitamin def. seen in strict vegetarian
Vit. B12
dose of caffeine unsafe for pregnancy
> 300mg / >3cups
complications of smoking in pregnancy
placenta previa abruptio placenta preterm labor spontaneous abortion PROM miscarriage subfertility SIDS
cleft lip hydrocephalus microcephalus weaker lungs NTD
fetal alcoholic syndrome criteria
dysmorphic features (>2: short palpebral fissure; thin vermillion upper lip; smooth philtrum) prenatal/postnatal growth impairment: <10th% abnormal brain growth, morphogenesis, or physiology (>1: head circumference <10th%; structural brain abnormalities; recurrent nonfebrile seizure) neurobehavioral impairment (>1.5SD below mean)
drug associated w/ Antley-Bixler Syndrome
fluconazole
warfarin can be safely used beyond first trim, T or F?
false
