Return Demo: Prenatal Care Flashcards
Positive pregnancies regardless whether patient had a planted ovum, abortion, etc.
Gravidity
Pregnancies that have reached 20 weeks and beyond
Parity
Format (in letters) of Obstetric Score
GxPx (F-P-A-L)
Period of time between conception and birth during which the fetus grows and develops inside the mother’s womb (preferably in weeks)
Age of Gestation (AOG)
Naegele’s Rule
Add 7 days to the FIRST day of last (normal) menstrual period, then subtract 3 months
How may alcohol affect the baby’s health inside the womb?
Fetal Alcohol Syndrome
How may illicit drugs affect the baby’s health inside the womb?
Microsmia
What are the aspects of menstruation one must ask the patient during history taking?
Menarchy, frequency, duration, regularity, amount of flow (how many napkins on average per day/cycle), presence of dysmenorrhea, intensity and duration of dysmenorrhea, last normal menstrual period (LNMP)
What are the general aspects of history taking in pregnant women?
Chief complaint, past medical history, family history, vices (inform patients in advance that you will be asking them sensitive questions), personal and social history, menstrual history, obstetrical history, present and previous pregnancies
Aspects of present pregnancy
LMP, EDC, AOG, quickening, prenatal visits, contraceptive methods used
Aspects of previous pregnancies
Number, dates, AOG, mode of delivery, place, sex, birth weight, singleton/multiple, outcome/complications (APGAR)
Which vital signs do you check for?
HR, BP, RR, Height (meters), Weight (kg), Temperature, Pulse Rate
Where do you take the fundic height?
Distance between the top of the symphysis pubis to the top of the fundus
When do you conduct the measurement of fundic height?
Past 20 weeks
When the fundic height reaches the umbilicus, how many weeks AOG?
20 weeks
During which weeks does the fundic height correlate closely with the AOG?
Between 20-34 weeks
By how much does the bladder affect the fundic height measurement when it is not emptied?
+3 cm
What position relaxes the mother’s abdominal muscles during examination?
Dorsal Recumbent. Characterized by supine position w/ knees bent and head resting on pillow
Why must hands be warmed and rubbed before abdominal examinations?
Cold hands stimulate contractions
Other name for 1st maneuver (Leopold’s)
Fundic Grip
Which part of the fetus upon palpation would move with the trunk?
buttocks
Which part of the fetus upon palpation would move independently of the trunk?
head
Characteristic of head in Fundic Grip
hard, round, firm
Characteristic of the buttocks in Fundic Grip
w/ small bony prominences, soft
Other name for 2nd maneuver (Leopold’s)
Umbilical Grip
What does the 2nd maneuver determine?
location of back and extremities
Importance of 2nd maneuver
for determining fetal heart sound
Characteristics of the fetal back
firm and smooth
Characteristics of the fetal extremities
w/ small irregularities and protrusions
Other name for 3rd maneuver (Leopold’s)
Pawlik’s Grip
What does the Pawlick’s Grip…grip?
presenting part
What does Pawlik’s Grip measure?
Engagement of the presenting part (how much farther along the pelvis is the baby)
How do you report findings in Pawlik’s Grip?
“Engaged” (presenting part is immovable) or “Floating” (presenting part may still be pushed back and forth)
Another name for the 4th maneuver (Leopold’s)
Pelvic Grip
What is the purpose of the 4th maneuver?
To confirm engagement obtained from the assessment of the 3rd maneuver
Reporting findings of the 4th maneuver: when cephalic prominence is on the same side as bony structures
vertex
Reporting findings of the 4th maneuver: when cephalic prominence is on the same side as the back
face
normal fetal heart tone accdg to Williams
110/160bpm
When is the earliest time fetal heart tone may be appreciated via transvaginal ultrasound?
5th week
When is the earliest time fetal heart tone may be appreciated via doppler?
10th week
When is the earliest time fetal heart tone may be appreciated via stethoscope?
19-20 weeks
Which part of the stethoscope is used to assess fetal heart tone?
bell
What is the analogy of the fetal heart sound heard at 19-20 weeks?
clock ticking under a pillow
The determining point for breech presentation
sacrum
The determining point for vertex presentation
occiput
The determining point for face presentation
chin (mentum)
The determining point for shoulder presentation
scapula (acromion)
Refers to the position of the long axis/spinal column of the mother
Fetal lie
Types of fetal lie
longitudinal, transverse, oblique
Part of the fetus lying right above the pelvic brim
Presentation
Kinds of fetal presentation
vertex, breech, shoulder
Basic prenatal laboratory tests
CBC (hemoglobin and hematocrit), Blood Type, Syphilis screening, HBS Ag testing, urine culture/urinalysis, pap smear, oral glucose test
how many grams of glucose for the oral glucose test?
75g
Which blood type needs attention due to high chance of severe bleeding during delivery?
ABO
Danger signs of pregnancy (head)
persistent severe headache, blurring of vision, hyperenemia gravidarum, chills and fever
Danger signs of pregnancy (abdomen)
severe persistent pain in the RUQ, dysuria, sudden decrease in intensity and frequency of quickening
Danger signs of pregnancy (vagina/perineum)
vaginal bleeding, watery leakage
Danger signs of pregnancy (lower ex)
severe pitting edema
Condition indicated by the ff danger signs: blurring of vision, severe persistent headache, pain in the RUQ, severe pitting edema
preeclampsia
Follow-up prenatal visit frequency by the 29th-36th week (early 8th to 9th months)
every 2 weeks
Follow-up prenatal visit frequency if less than 28 weeks
once every 4 weeks
Follow-up prenatal visit frequency by the 37th week (more than 9 months)
every week
Follow-up prenatal visit frequency in complicated pregnancies
more frequent visits in a week
DOH recommended prenatal visits
on or before 1st trim, 2nd trim, 3rd trim, and every 2 weeks after the 8th month ‘til pregnancy
When should folic acid supplements be taken?
At least 3 months before conception
How much iron must be taken?
27 mg
Which vitamin is dangerous to a pregnant woman’s health and may cause abortion?
Vit. A
