Prenatal care trigger Flashcards
what is primipara
a woman who has delivered only one baby (alive or dead) with an estimate gestation of >20 weeks
what is multipara
a woman who has delivered 2 or more pregnancies to 20 wks gestation or more
when is 1st, 2nd and 3rd trimester
1st - 1-14 wks
2nd 15- 28wks
3rd 29-42 wks
what is the uterine size at 6,8, 12 weeks gestation
6 - small orange
8 - large orange
12 - grapefruit
when should prenatal visits occur
- every 4 weeks until 28 weeks
- every 2 weeks until 36 weeks
- every week until delivery
What genetic disorders are the following ethnic groups at risk for?
- african american
- mediterranean
- asian
- jewish
- north european
- native americans
- african american -> sickle cell
- mediterranean -> beta thalessemia
- asian -> alpha thalassemia
- jewish -> Tay Sachs, Canavan Disease, Cystic Fibrosis
- north european -> cystic fibrosis
- native americans -> cystic fibrosis
what is fundal height used for?
to monitor fetal growth and amniotic fluid volume
Describe the growth of the fundus throughout the pregnancy
- 12 weeks - fundus emerges from bony pelvis
- 16 weeks - fundus is between pubic symphysis and umbilicus
- 20 weeks - fundus is at umbilicus
- between 20-34 weeks height of uterine fundus measures closely with gestational age (25cm = 25 weeks)
what is 1 hour glucola testing
- 50g glucose drink
- draw blood 1 hr after drink.
usd to determine gestational diabetes (24-28wks usually)
what during pregnancy can result in wernickes encephalopathy
hyperemesis gravidarum
why is there increased occurance of hemorrhoids during pregnancy? what is the treatment
- increase pelvic venous pressure
- can lead to rectal vein caricosities
- tx - topical anethetics, stool softeners, warm soaks.
what is the risk factors for neural tube defects
- FmHx
- MTHFR mutation
- aneuploidy
- DM
- hyperthermia
- medications (seizure meds)
at what point should a patient be offered a targeted sonography with or without fetal echocardiography and fetal karyotyping
if nuchal translucency is >3.5mm
what elevated hormone may suggest down syndrome
elevated hCG and Inhibin
what is the Most sensitive and specific screening test for common fetal aneuploidies
cell free DNA testing
this is not equivalent to Diagnostic testing.
what are the possible complications of amniocentesis
- pregnancy loss (1 in 300-500)
- amniotic fluid leakage
- chorioamnionitis
- needle injuries to fetus
what are the relative CI to chorionic Villi sampling
- vaginal bleeding
- actival genital tract infection
- extreme uterine antee- or retroflexion
- body habitus precluding visualizaiton
how common is pregnancy loss in Chorionic villus sampling
2%
doesnt sound like alot but i feel like thats alot omg
when are limb reduction defects more and less likely to occur during chorionic villus sampling
- more likely during week 7
- less likely at >10 weeks (occurs 1 in 1000)
vaginal mucosa change of dark bluish-red
chadwick sign
what is the significance of the gestational sac on an ultrasound
first sonographic evidence of pregnancy
what is the significance of a tolk sac on ultrasound
confirms a non-ectopic pregnancy
what is the most accurate tool for gestational age
the first trimester crown rump length
what is naegele’s rule and when is it used
estimates delivery date
(LMP+7 days - 3 months = EDD)
what is kleihauer betke
a test used to assess the presence of fetal RBCs in maternal circulation
what can cause pigmentary retinopathy, hepatosplenomegaly, jaundice and sensorineural deafness amonst other issues
rubella
“CCHEEP”
- Congenital heart defects and CNS problems
- Hepatosplenomegaly and jaundice
- Eye defect (cataracts)
- ear defects (sensorineural deafness
- Pigmentary retinopathy
what disease is diagnosed via venereal disease research lab test or rapid plasma reagins?
syphillis
what is the 1 hour glucola test used for
screening for gestational diabetes
what vaccination is given in the 3rd trimester so that immunity can be passed along
TDaP
what prenatal complication can result in wernicke’s encephalopathy
hyperemesis gravidarum
a patient who is 22 weeks pregnant presents for a checkup and reports increased vaginal discharge. what is the name for this and what causes it?
leukorrhea, caused by increased estrogen which causes thinning and increased secretion of mucus in the cervical glands. this leads to increased vaginal discharge but is not usually pathological
a serum or amniotic elevation in alpha feto protein is associated with what?
neural tube defects
the most SENSITIVE test for this diagnosis is a 2nd trimester fetal US
neural tube defects
when are nuchal translucency and serum analytes obtained and what are they used for
done in first trimester
used for screening for down syndrome
elevated hCG and decreased PAPP-A are associated with what
down syndrome
decreased hCG and decreased PAPP-A are associated with what
trisomy 13 and 18
What is in a quad screen in the 2nd trimester?
i always forget this
hCG
AFP
Unconjugated estriol
inhibin (elevated = down syndrome)
what is the most sensitive and specific screening test for common fetal aneuploidies
cell free DNA
(not equivalent to diagnostic testing which is amniocentesis)
complications include vaginal spotting, infection, and limb reduction defect.
complications of performing CVS
also includes pregnancy loss:(
complications include cord bleeding, fetal-maternal bleeding and fetal bradycardia
fetal blood sampling
also includes pregnancy loss :(
what is the primary adaptive response to stress
decline in fetal growth rate
what is the secondary adaptive response to stress
what is the protocol for a patient with a BPP of 6
what is the protocol for a patient with a BPP of 2
in this test the umbilical artery, middle cerebral artery and ductus venosus are all measured
doppler velocimetry
indications for this test include fetal anemia, IUGR, and isoimmunization
MCA velocimetry
