Prenatal care - Diagnosis of pregnancy

Question 1

Preferred method to diagnose normal pregnancy

Answer 1

Urine hCG

• Keyword:*
• Normal

Question 2

Naegele’s rule assumes two things

Answer 2

1. A normal gestation is 280 days
2. All patients have a 28-day menstrual cycle

Question 3

Margin of error for Naegele’s rule

Answer 3

± 2 weeks

Question 4

Presumptive symptoms

Answer 4

1. Morning sickness
2. Frequency in urination
3. Quickening

Question 5

Presumptive signs

Answer 5

1. Amenorrhea
2. Beading cervical mucus
3. Chadwick sign
4. Breast engorgement
5. Skin changes
6. Increased temperature

• Note:*
• Of the discolorations in the reproductive tract, only Chadwick is presumptive

Question 6

Fetal movement

• AOG in primigravida
• AOG in multigravida

Answer 6

• AOG in primigravida
  
  • 18-20 weeks
• AOG in multigravida
  
  • 16-18 weeks

Question 7

Amenorrhea is not a reliale sign until ____ days or more after missed menses

Answer 7

10

Question 8

Cervical mucus in pregnancy

• Pattern
• Hormone responsible

Answer 8

• Pattern
  
  • Beading
• Hormone responsible
  
  • Progesterone

Memory aid:

• Beading Buntis
• Progesterone Pregnant

Question 9

Probable signs of pregnancy

Answer 9

1. Enlargement of abdomen
2. Hegar sign
3. Goodell sogn
4. Braxton Hicks contractions
5. Ballottement
6. Detection of β-hCG

Question 10

The fundic height in cm correlates with AOG when?

Answer 10

20 to 34 weeks

Question 11

When is ballottement evident?

Answer 11

In the 2nd trimester

Question 12

Positive signs of pregnancy

Answer 12

• Fetal heart tone
• Perception of fetal movement by examiner
• Sonographic recognition

Question 13

Fetal heart tone

• Auscultation
• Doppler
• TV-UTZ

Answer 13

• Auscultation
  
  • As early as 16 weeks
  • 80% at 20 weeks
  • 100% at 22 weeks
• Doppler
  
  • 10 weeks (as early as 8 weeks)
• TV-UTZ
  
  • 5 weeks

Question 14

When are the structures seen in TVS

• Gestational sac
• Yolk sac

Answer 14

• Gestational sac
  
  • 4-5 weeks
• Yolk sac
  
  • 5 weeks

Question 15

A transvaginal ultrasound should be able to show at least a gestational sac once the hCG levels have reached ____

Answer 15

Between 1,000 – 2,000 mIU/mL

Question 16

Most accurate aging tool

Answer 16

EUTZ done before 12 weeks AOG

Question 17

Amniocentesis

• When done
• Indication
• Complication

Answer 17

• When done
  
  • 15 - 20 weeks
• Indication
  
  • Karyotyping
  • FISH
  • Relieve hydramnios
• Complication
  
  • Fetal loss
  • Amniotic leak

Memory aid:

• Amniocentesis is 13 weeks
  
  • 15 to 20 weeks

Question 18

Chorionic villous sampling (CVS)

Answer 18

• When done
  
  • 10 to 13 weeks
• Indication
  
  • Karyotyping
• Complication
  
  • Fetal loss
  • Limb reduction defects
  • Oromandibular limb dysplasia