Week 2 Material- Diagnosis of pregnancy

Question 1

5 MC sxs of early pregnancy?

Answer 1

amenorrhea
n or n/v
breast enlargement and tenderness
polyuria w/o dysuria
fatigue

Question 2

when can you first palpate a pregnant uterus (rough estimate)?

Answer 2

end of 1st trimeseter

Question 3

when can you first auscultate heart tones with a doppler?

Answer 3

10-12 weeks

Question 4

what do we measure to assess pregnancy status? when does it start to be secreted? what is it supposed to do every 2-3 days after implantation?

Answer 4

hCG
secreted after implantation
it should be doubling every 2-3 days after implantation

Question 5

will serial hCG measurements help determine gestational age?

Answer 5

NO- just did fertilization and implantation occur

Question 6

2 ways to test hCG levels? which one can be used sooner to detect pregnancy?

Answer 6

serum- becomes (+) ~9 d after conception, more sensitive

urine- becomes (+) around missed menses, less sensitive

Question 7

when can you see a gestational sac, yolk sac, cardiac activity and measurable crown-rump length on TVUS?

Answer 7

gestational sac: 4.5-5 wks
yolk sac: 5 wks
cardiac: 5.5-6 wks
measurable crown-rump: 6 wks

Question 8

what 2 things must you do if a woman becomes pregnant while she has an IUD? what is there a higher likelihood of?

Answer 8

1. U/S to determine location of pregnancy
2. if viable & intrauterine must remove IUD (whether she decides to keep or abort)
   * higher likelihood of it being ectopic

Question 9

What is Naegle’s Rule?

Answer 9

LMP- 3 mos + 7 d

Question 10

during what weeks should the uterus measurement be equal to weeks gestation?

Answer 10

20-30 wks

Question 11

when should you especially consider doing an U/S? (4 times)

Answer 11

1. irregular menses
2. unk LMP
3. pt conceived while on hormonal BC
4. physical findings differ from EDD based on LMP

Question 12

estimation of gestational age is most accurate using what two measurements and in what weeks are they most accurate (on TVUS)?

Answer 12

mean sac diameter (+/- 3 d accuracy during weeks 4.5-6)

crown-rump length (+/- 3 d accuracy during weeks 7-10)

Question 13

during the second trimester, sonographic dating uses what 4 biometric parameters? when is accuracy the best?

Answer 13

1. biparietal diameter
2. head circumference
3. abd circumference
4. femur length
   best accuracy is +/- 7 d through 20 weeks, becomes +/- 21-28 in mid to late 3rd trimester

Question 14

for what 3 reasons is an accurate EDD necessary?

Answer 14

1. help to determine pre or post maturity= determine eligibility for out of hospital birth
2. timing for tests and procedures
3. determine IUGRs