Test 1 - Antepartum Flashcards
What is a Basal Body Temperature?
One way of estimating the day of ovulation
What are you looking for when taking a Basal Body Temperature?
- Ovulation causes a sustained increase of at least 0.2 degreesC
- Temp DROPS just before ovulation
- Temp RISES slightly 0.2 degrees C ( just after ovulation ) and stays higher for 3 full days (ovulation has occurred). The fertile period has likely passed
Avoid sex until ___ days after the temperature rise to ________ pregnancy
5, prevent
When should a pt take her basal body temp?
AM before getting out of bed or eating / drinking / smoking
What route(s) can you use when taking basal body temp?
Oral
Vaginal
Rectal
** Make sure to use same route each time
Calories should be increased by ___ kcal / daily during pregnancy above normal caloric intake
300
How many pounds should an underweight pt gain during pregnancy? Healthy Weight? Overweight? Obese?
Underweight —> 28-40lbs
Healthy weight —> 25-35lbs
Overweight —> 15-25lbs
Obese —> 11-20
Dizygotic twins originate from __ fertilized egg and __ ________ sperm
2, 2 separate
Dizygotic twins share the same DNA (True or False?)
FALSE
Dizygotic twins aka __________ ______ have _______ placentas and ________ amniotic sacs
fraternal twins
separate
separate
*** Dichorionic and Diamniotic
Monozygotic twins originate from __ fertilized egg and __ sperm
1
1
Monozygotic twins aka _________ _____ have __ ____ DNA
identical twins
the same
Monozygotic twins may have separate placentas, amniotic sacs, or shared (True or False)
TRUE
What is amniotic fluid and what does it do?
Amniotic fluid is clear (slightly yellow) fluid without odor. The amniotic fluid maintains STABLE temperature, cushions the fetus from injury, and helps with LUNG development
What is the function of the placenta?
*The placenta supplies FOOD and OXYGEN to the fetus via the umbilical cord and helps fetus get rid of wastes
*Passive transfer of antibodies (immune protection) to the fetus from mother
*It is fully formed by the 10TH week of pregnancy
*Barrier to some (not all) harmful substances especially viruses and drugs
*Produces hormones of pregnancy including HCG (human chorionic gonadotropin), estrogen/progesterone
What is the umbilical cord and what does it do?
*The umbilical cord is a rope-like structure that connects the fetus to the mother’s placenta in which nutrients are received and wastes are removed
*The umbilical cord prevents the mixing of mother-fetal blood (separate circulation)
** ARTERY carries deoxygenated blood and waste products AWAY from fetus
** VEIN carries oxygenated blood and nutrients TO the fetus
A pt presents to an appointment and the provider notes a bluish coloration of the cervix. What sign is this?
Chadwick’s Sign
What does Hegar’s Sign show?
Softening of the isthmus of the uterus, the area between the cervix and the body of the uterus, occurring between 6-8 weeks of pregnancy
What does the Goodell’s Sign show?
Softening of the cervix
What is Ballottement?
The passive fetal movement elicited by pushing up against the cervix with 2 fingers. This pushes the fetal body up and, as it falls back, the examiner feels a rebound
A pt that is 24 weeks comes into her appt with a dark line of skin down the middle of her abdomen, what is this dark line called?
Linea Nigra
What is a blastocyst?
Inner solid mass of cells within the morula
What are gametes?
Female or male germ cell; contains a haploid number of chromosomes
What does morula mean?
Development stage of the fertilized ovum in which there is a solid mass of cells
What is a zygote?
Fertilized Egg
Seafood is _______ for fetal ______ and development
crucial
growth
The Omega-3 fatty acids in many fish, including docosahexaenoic acid (DHA), also can promote your baby’s _____ development
brain
How many ounces of fish is recommended per week?
8-12 ounces
Why should a pregnant woman avoid mercury?
This can damage the baby’s lungs/ kidneys/ nervous system
What fish should you AVOID when pregnant?
King mackerel
SHARK
Tilefish
MARLIN
Orange roughy
Bigeye tuna
Ahi tuna
What foods can lead to SALMONELLA poisoning and how is this prevented?
Raw egg, cookie dough, homemade ice cream
What foods can lead to LISTERIA poisoning and how is this prevented?
Unpasteurized milk, deli meat , soft cheeses, smoked meat, seafood
Pregnancy women are __x more likely to get listeriosis that other healthy adults
20
What is Nuchal Translucency screening looking for?
Fluid found at the back of the baby’s head and neck — measured by ultrasound
** Increased of ‘thickened’ Nuchal Fold measurement
What could Nuchal Translucency possibly show?
Trisomy 13
*Trisomy 18
* Trisomy 21
When would you perform a Nuchal Translucency Screening?
Ultrasound performed between 11-13 weeks gestation
Alpha-fetoprotein is a protein that is produced by ___ _____
the fetus
What is the QUAD screening?
Blood sample detecting 2 hormones (Human Chorionic Gonadatropin *hCG & Estriol) and 2 proteins (alpha-fetoprotein & Inhibin-A)
QUAD screening assesses for the risk of having…
** Trisomy 21 (downs syndrome)
** Trisomy 18
Neural Tube Defects
QUAD screenings are 80-85% accurate (True or False)
TRUE
What is Chorionic Villus Sampling (CVS)?
Provider obtains a small amount of chorionic villi from the developing placenta. Performed trans abdominal or transvaginal
Who is CVS performed on?
Women who have prior pregnancy history, family genetics, failed screen
CVS is performed between __ and __ weeks
8
12
What is the biggest advantage about CVS?
It is completed SOONER than other diagnostic tests
What are the RISKS of CVS
Preterm labor
Infection
Limb Reduction
Abruption
Fetal loss
What does CVS detect?
** T18
** T21
** Sickle Cell Disease
What is CVS UNABLE to detect ?
**Open neural tube defects (Spinal Bifida)
What is an amniocentesis?
A medical procedure used primarily in the prenatal diagnosis of genetic conditions. It involved removing and testing a small sample of cells from amniotic fluid, the fluid that surrounds the baby in the womb (uterus)
When is an amniocentesis usually performed?
Performed between 15-20 weeks
Purpose for an amniocentesis depend on __________
Trimester
Amniocentesis is performed in 2nd trimester (14-17 weeks) to assess for fetal ….
Anomalies and genetic disorders
An amniocentesis is performed in the 3rd trimester (30+ weeks) is to determine fetal ______ maturity for delivery
Lung
What are the complications of getting an amniocentesis ?
An amniocentesis has the same complications as CVS testing
How do you determine the Expected Date of Delivery (EDD)?
*Count back 3 months from first day of last period
*Add 7 days
* Add 1 Year
During a prenatal visit a pt tells you her last menstrual period was May 21,2019. Based on the Naegle’s Rule, when is the estimated due date of her baby?
February 28, 2020
A pt takes a pregnancy test, and it comes out positive. What hormone is present in order for this to happen?
Human Chorionic Gonadotropin (HCG)
How any veins and arteries are in the umbilical cord? What takes O2 rich blood to the fetus? What removes O2 poor blood from the fetus?
- 2 arteries 1 vein
- The VEIN takes O2 rich blood TO the fetus
- The ARTERY take O2 poor blood away from the fetus
What does GTPAL stand for?
G— Gravida: # of pregnancies (Including current pregnancy) regardless of the outcome
T— Full Term: (38+ weeks)
P— Pre Term: (20-37 weeks)
A— Abortions: terminations and miscarriages (<20wks)
L— Living: living children beyond the neonatal period (first 28 days)
* TWINS COUNT AS ONE PREGNANCY
A woman is currently pregnant at 22 weeks gestation. She previously had 2 miscarriages in the first trimester, now has an 11 yo daughter born at 38 weeks gestation and a 3 yo son born at 28 weeks gestation. What is her GTPAL?
G— 5
T— 1
P— 1
A— 2
L— 2
A woman is currently pregnant at 16 weeks gestation. She previously has a miscarriage at 8 weeks, now has a 2 yo daughter born at 33 weeks gestation and 3 yo twins born at 39 weeks gestation. What is her GTPAL?
G— 4
T— 1
P— 1
A— 1
L— 3
Why is the fundal height assessment performed?
To measure the size of the uterus to assess fetal growth
How is fundal height measured?
It is measured from the top of the mothers uterus (fundus) to the top of the mother’s pubic symphysis
When does fundal height assessment begin?
Begins 20wks-31st week. Not accurate in the 3rd trimester
What is normal for a fundal height assessment?
Within 2cm of weeks of pregnancy
What would be a normal fundal height for someone who is 31 weeks pregnant?
29cm - 33cm
** add/subtract 2 from the weeks pregnant**
What is a Molar Pregnancy?
It is the result of a genetic error during fertilization that leads to growth of abnormal tissue in the uterus.
Release of HIGH levels of HUMAN CHORIONIC GONADATROPIN HCG
Uterus fills with “grape-like” sacs (cluster) but NO fetus forms. DX by US
If a woman has a molar pregnancy, and they take a pregnancy test, will it be positive or negative?
POSITIVE
** Molar pregnancies release HIGH levels of HCG, which is the hormone that causes pregnancy tests to be positive
What are 2 causes of molar pregnancies?
- Egg with NO genetic material fertilized (not enough genetic material)
- Egg fertilized by 2 sperm (too much genetic material)
How do you treat a molar pregnancy?
D&C to completely remove all molar tissue that can become malignant
** follow up for ONE yr — CRITICAL due to risk of malignancy (cancer)**
The mother is at risk or developing _______________. Def- quick-growing cancer that starts in the placenta
Choriocarcinoma
1 goal of treatment for woman who has been diagnosed with molar pregnancy
PREVENT CANCER
If a woman comes in after having a molar pregnancy removed with increasing HCG levels, _______ and ________________ may be recommended
Chemo
Hysterectomy
A woman who has had a molar pregnancy removed should try to get pregnant again as soon as possible (True or False)
FALSE
** Those who have had a recent molar pregnancy removed should AVOID pregnancy for at least one year
Dry or sticky cervical mucus is a sign that a woman _____ ovulating
is not
Creamy cervical mucous is a sign that ovulation is ___________
coming
wet cervical mucus is a sign that a woman is ______ to ovulation
close
Raw egg white cervical mucus means that ovulation is _________. Usually ___, ______, and ________
approaching
wet
clear
slippery
What is the goal of preventing isoimmunization?
Mother WILL NOT create antibodies against the baby’s Rh-positive blood (prevent isoimmunization)
What is the medical treatment to prevent isoimmunization?
IM injection of Rh Immune Globulin (called Rophylac) — can now give this IV