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Clin Med 3- Exam 3 > Prenatal Diagnosis and Care > Flashcards

Prenatal Diagnosis and Care Flashcards

1
Q

What is the leading cause of secondary amenorrhea?

A

Pregnancy

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2
Q

Define gestational age (GA).

A

Age in days or weeks from the last menstrual period

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3
Q

Define embryo.

A

From time of fertilization-8 weeks (GA= 10 weeks)

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4
Q

Define fetus.

A

After 8 weeks to time of birth

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5
Q

Define infant.

A

Time between delivery-1 year old

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6
Q

Define 1st trimester.

A

1st 14 weeks GA

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7
Q

Define 2nd trimester.

A

14-28 weeks GA

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8
Q

Define 3rd trimester.

A

28 wks until delivery

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9
Q

Define previable.

A

Infant delivered before 24 weeks

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10
Q

Define preterm.

A

24-37 weeks

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11
Q

Define term.

A

37-42 weeks

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12
Q

Define post-term.

A

Past 42 weeks

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13
Q

Define gravidity.

A

Number of times a woman has been pregnant

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14
Q

Define parity.

A

Number of pregnancies that led to birth after 20 weeks or >500g infant (how it is written: term, preterm, abortions, living children)

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15
Q

What does G2P1011 mean?

A

2 pregnancies, 1 term, 0 preterm, 1 abortion, 1 living child

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16
Q

What does G4P3104 mean?

A

4 pregnancies, 3 term, 1 preterm, 0 abortions, 4 living children

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17
Q

What are 4 common cardiac changes for pregnant women?

A

(1) CO inc about 30-50%
(2) SV inc about 10-15%
(3) pulse inc about 15-20 bpm
(4) systolic ejection murmur and S3 gallop common

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18
Q

What are 2 changes in BP for pregnant women?

A

(1) peripheral vascular resistance falls

(2) fall in BP in 2nd trimester, return to normal during 3rd trimester

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19
Q

How early can a pregnancy test be positive?

A

1 week after fertilization

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20
Q

What is Chadwick’s sign?

A

Bluish discoloration of vagina and cervix

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21
Q

What is Hegar’s sign?

A

Softening of uterine consistency and ability to palpate or compress the connection between the cervix and the fundus

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22
Q

What is Goodell’s sign?

A

Softening and cyanosis of cervix at or after 4 weeks

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23
Q

What is Ladin’s sign?

A

Softening of uterus after 6 weeks

24
Q

What are 4 additional pregnancy signs?

A

(1) breast swelling and tenderness
(2) linea nigra
(3) telangiectasis
(4) palmar erythema

25
Q

What is Naegele’s Rule?

A

Calculate EDC by subtracting 3 months from the LMP and adding 7 days (if uncertain LMP, use ultrasound to determine EDC)

26
Q

Why should you be concerned if an Rh antibody screen is positive?

A

Rh antibodies can destroy fetal RBCs causing hemolytic anemia (RBCs destroyed faster than the body can replace them→ fatal to fetus)

27
Q

What age is considered advanced maternal age?

A

35 or older at time of delivery

28
Q

What are the 4 tests in a quad screen?

A

(1) MSAFP (alpha-fetoprotein)
(2) hCG
(3) estriol
(4) inhibin-A

29
Q

What does it mean if MSAFP is elevated during the second trimester?

A

Inc risk of neural tube defects

30
Q

What does it mean if MSAFP is decreased during the second trimester?

A

Aneuploidies including Downs Syndrome

31
Q

What 4 things do you look at in a second trimester ultrasound (at 18-20 weeks)?

A

(1) fetal survey
(2) amniotic fluid volume
(3) placental location
(4) gestational age

32
Q

What does cell-free fetal DNA (cffDNA) analysis test for?

A

Fetal trisomies (21, 18, 13) in maternal blood

33
Q

When are 5 times an ultrasound is used during pregnancy?

A

(1) at initial visit to measure crown-rump length if uncertain LMP
(2) 1st trimester bleeding
(3) anatomy survey b/w 18-20 weeks
(4) any time fundal height is >3cm discrepant from GA
(5) confirm presentation at or after 37 weeks

34
Q

What are 3 ways of fetal karyotyping?

A

(1) amniocentesis
(2) chorionic villus sampling (CVS)
(3) cordocentesis

35
Q

When is amniocentesis usually performed and why is it done?

A

Between 15-20 weeks to obtain fetal karyotype

36
Q

What is chorionic villus sampling and when is it done?

A

Catheter placed into intrauterine cavity and small amount of chorionic villi aspirated from placenta; can obtain fetal karyotype b/w 10-13 weeks

37
Q

What is cordocentesis/PUBS?

A

Puncturing the umbilical vein under direct ultrasound guidance; karyotype analysis of fetal blood usually w/in 24-48 hrs

38
Q

When do you screen all pts for Group B Strep?

A

36 weeks

39
Q

What are 5 routine prenatal visit components?

A

(1) BP
(2) weight
(3) urine dipstick-for protein and glucose
(4) fundal height, estimated fetal weight, and fetal position
(5) auscultation of the fetal heart tones

40
Q

What is the frequency of visits when <28 weeks?

A

Every 4 weeks

41
Q

What is the frequency of visits when 28-36 weeks?

A

Every 2 weeks

42
Q

What is the frequency of visits when >36 weeks?

A

Every week

43
Q

What supplement do you want pregnant pts taking?

A

Prenatal vitamins containing 800mcg of folic acid

44
Q

What are 4 fat soluble vitamins to avoid excessive amounts of during pregnancy?

A

D, A, K, E

45
Q

Why do you want to avoid/limit fish in pregnancy?

A

Mercury risk

46
Q

What are 4 things you want to inc/supplement during pregnancy?

A

(1) calories: inc 15%/day
(2) protein: additional 10-30g/day
(3) iron: supplement 30-60mg/day
(4) calcium: 1200mg needed/day

47
Q

What are 4 2nd trimester counseling points for pregnancy?

A

(1) attend birthing classes
(2) preterm labor risks after viability
(3) breastfeeding
(4) Rhogam at 28 weeks if Rh negative

48
Q

What 8 things should be discussed during 3rd trimester?

A

(1) analgesia/anesthesia in labor
(2) operative vaginal delivery or c-section
(3) travel
(4) fetal kick counts (10 kicks/hr)
(5) labor and delivery tour-things to bring to hospital
(6) pediatrician-if boy: circumcision
(7) Group B strep
(8) postpartum contraception

49
Q

What are the 5 techniques of antepartum fetal surveillance?

A

(1) fetal movement assessment
(2) Non-stress test
(3) contraction stress test
(4) fetal biophysical profile
(5) amniotic fluid index

50
Q

What is the indication and technique for fetal movement assessment?

A

Indication: maternal perception of dec or absent fetal movement

Technique: mother counts # of kicks during a specified amt of time-have mom eat or drink something and sit or lay still

51
Q

What is a non-stress test and what are reactive and nonreactive results?

A

Measurement of fetal heart rate w/movement

Reactive (normal): 2+ fetal heart rate accelerations w/in 20 min period

Nonreactive: insufficient fetal heart rate accelerations over a 40 min period

52
Q

What is a contraction stress test and 2 decel findings on it?

A

Looking for presence or absence of late fetal heart rate decelerations in response to uterine contractions

Late decels: decels that reach their nadir after the peak of the contractions and usually persist beyond the end of the contraction

Variable decels: cord compression

53
Q

What are the 5 components to a biophysical profile and what is the scoring system of it?

A

Components: NST, fetal breathing movements, fetal movement, fetal tone, AFI

Scoring: each is 2 or 0→ normal is 8 or 10, abnormal is 4 or less

54
Q

What is amniotic fluid index (AFI) and how does it vary for oligohydramnios and polyhydramnios?

A

Summation of the largest cord-free vertical pockets in each of the 4 quadrants of an equally divided uterus

Oligohydramnios (dec amniotic fluid): no US measured pocket of fluid >2 cm or AFI of 5cm or less→ bad

Polyhydramnios: usually AFI >/= 24cm; can be normal, or cause PROM or malpresentation

55
Q

When is the postpartum follow up after a vaginal delivery and what do you check?

A

6 weeks: lochia, voiding, bowel movements, breastfeeding, depression, contraception

56
Q

When is the postpartum follow up after a c-section and what do you check?

A

2 and 6 weeks: incision check

Clin Med 3- Exam 3 (4 decks)

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