Prenatal Care - Westra

Question 1

How do you calculate the EDD (Estimated Date of Delivery-Estimated Due Date)?

Answer 1

Naegele’s Rule: First Day of LMP -3 months + 7 days + one year (based on 28 day cycle)

First trimester Ultrasound

Fetal Heart tones: Doppler 10-12 weeks, Fetoscope 18-20 weeks

Quickening: Primigravida 18-19 weeks Multigravida 16-17 weeks

Question 2

How do you determine the gravida and parity of female patients?

Answer 2

G = GRAVIDITY – HOW MANY TIMES (n) THE PATIENT HAS BEEN PREGNANT INCLUDING THE CURRENT PREGNANCY

P = PARITY – RESULTS OF PREVIOUS PREGNANCIES
f=number of full-term births
p=number of pre-term births
a=number of abortions, elected or spontaneous, ectopics
l=number of living children

**Remember: “Florida Power And Light”

Question 3

What are the drug classifications and safety categories for pregnancies? Examples of each category?

Answer 3

Category A-studies in humans no risk (e.g. Vitamins)

Category B-studies in animals no risk (e.g. Tylenol/Penicillin)

Category C-no adequate studies (e.g. Vanco, Bactrim)

Category D-evidence of fetal risk but benefit may outweigh risk (e.g. Tetracyclines)

Category X-fetal risks clearly outweigh benefit (e.g. Acutane)

Question 4

What laboratory testing is completed throughout prenatal care?

Answer 4

CBC
UA 
ABO & Rh factor and antibody screen
Rubella Titer
RPR (Rapid Plasma Reagin- SYPHILLIS)
Further STD testing (GC/Chlamydia)
HBsAg     
HIV antibody

Question 5

What are the ultrasound procedures used in prenatal care?

Answer 5

FIRST TRIMESTER FOR: Dating (10-14 weeks), Trisomy 13, 18 and 21

Standard of Care in US: ultrasound ~18-20 weeks even if dating is known

Nuchal Translucency US => looks for nasal bridge, test for Down syndrome (trisomy 21), 10-12 weeks

Question 6

What are the important clinical considerations for each of the trimesters of prenatal care?

Answer 6

Every Trimester: Symptoms, Weight, Blood Pressure, Fundal Height, FHT, Abdominal Palpation, Evaluation for edema, Urinalysis?

1st Trimester (LMP-12 weeks): Assess and Counsel, Lifestyle, Nutrition Tobacco/Alcohol/Drug use, Risk Factors, Screen

2nd Trimester (13-27 weeks): Nutrition, Fetal Assessment, Fetal Growth, Symptoms and psychosocial concerns

3rd Trimester (28-40 weeks): Rhogam, Preterm Labor, Gestational Diabetes, PIH/Preeclampsia, Fetal growth, Fetal well-being/position, Screening for infection (GBS), Symptoms and psychological concerns

Question 7

Trimesters

Answer 7

First Trimester: from LMP to 12 weeks+
embryo develops all the major organs and becomes a fetus

Second Trimester: 13 weeks-27 weeks
fetus continues to develop and reaches viability

Third Trimester: 28 weeks-40 weeks (term)
fetus finishes developing and prepares for
delivery

Question 8

What is the EDD for first day of LMP on April 7th of 2016?

Answer 8

Jan. 14

Question 9

What is the EDD for first day of LMP on November 8th of 2016?

Answer 9

August 15th

Question 10

What is the EDD for first day of LMP on December 14th?

Answer 10

9/21/17

Question 11

What is Gravida para in a Mom that is pregnant with a 4 year old pre-term daughter and 2 year old full-term son?

Answer 11

G3P1102

Question 12

Chadwick’s Sign

Answer 12

generalized engorgement of the pelvic organs and is the dark discoloration bluish appearance of vulva, vagina and cervix

Question 13

Hegar’s Sign

Answer 13

Uterine and cervical consistency become softer

Increased pigmentation of the skin and appearance of stria on abdominal wall

Question 14

When do you initially give Rhogam?

Answer 14

If mom is Rh- => give at 28 weeks!

then again within 72 hours of delivery