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Spring Round II Exams > WH- Prenatal, Abortion > Flashcards

WH- Prenatal, Abortion Flashcards

1
Q

A few meds that ARENT pregnancy safe

A

ACE-I/ARB
Triptans
Statins
Tetracyclines

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2
Q

Advanced maternal age

A

> 35YO

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3
Q

UTD on immunizatoins?

A

MMR and Varicella especially bc these are LIVE and cannot be given during pregnancy

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4
Q

Start Folic acid + DHA 1 month before trying to get pregant

A

neural tube closes by 4th week

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5
Q

DHA

A

help ward off post partum depression

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6
Q

Folic acid

A

0.4-0.8 mg

4 mg if hx of NTD

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7
Q

Exam for Preconception care

A

BMI
Dental caries (can put mom at risk of preterm delivery)
Cardiopulm
Pelvic exam

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8
Q

when to use OTC Ovulation predictor kits

A

days 10-20 of cycle

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9
Q

Timed intercourse

A

Day 11,13,15,17 of cycle

day 14 is ovulation

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10
Q

1st visit

A

between 8-10 wks of pregnancy

best for 1st Ultrasound

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11
Q

Obstetric history

A 
Gravida= # of pregnancies
Para=TPAL
T: births after 37 wks
P: births prior to 37 wks
A: abortion
L: # of living children
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12
Q

G2P2002

A 
G2= 2 pregnancies
P2002 "TPAL"
2: births after 37 wks
0: preterm
0: abortions
L: 2 living children
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13
Q

LMP

A

1st day of last menses

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14
Q

Naegele’s Rule

A

add 7 days to LMP and subtract 3 mo

to predict Estimated Delivery Date (EDD)

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15
Q

EDC

A

Est date of confinement

confinement- concluding phase of pregnancy, onset of contractions to the birth of baby

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16
Q

Breast exam

A

Montg tubercles
Dilated veins
Enlarged breast, expanding areola
TTP

normal

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17
Q

Chadwick’s sign

A

Blue to purple tint of vaginal walls/cervix

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18
Q

Hegar’s sign

A

Palpable softening of isthmus

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19
Q

Montgomery tubercles on breast of pregnant women

A

oil glands on pregnant women’s breasts to keep breast tissue supple as it expands in growing breasts

to keep from cracking
prep for breastfeeding also

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20
Q

Prenatal care first visit

A 
Hcg: pregnancy test!
Specimen from pelvic: Pap, Gonn, Chlam
CBC
Blood type/ Rh
Rubella/Varicella
Syphilis (RPR)
Hep B 
HIV
UA and culture

+/- TSH, Cystic fibrosis, TB, HA1C

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21
Q

Transvaginal US can visualize cardiac activity as early as 5.5-6.5 wks BUT

A

best to wait until 8-10 weeks

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22
Q

1st US

A

R/o Ectopic!!!

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23
Q

Common items to avoid:

A

Tuna, shark, swordfish, king mackerall, Tillefish (high mercury)
Raw meet/eggs
Hot dogs, deli meat
Civiche
No More than 200 mg caffeine daily (one 12 oz cup coffee)

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24
Q

What sports to avoid

A

contact sports

hot yoga

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25
Q

How much weight should you gain?

A

25-35 lbs

Prof recommends no more than 30 lbs

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26
Q

2nd trimester

A

weeks 13-26

27
Q

3rd trimester

A

weeks 27- end

28
Q

1st trimester

A

weeks 1-12

29
Q

Frequency of visit during first 28 wks

7 mo

A

every month

30
Q

Frequency of visit during 28-36 wks

7-9 mo

A

every 2 weeks

31
Q

Frequency of visit after 36 wks

after 9 mo

A

WEEKLY

32
Q

Fetal movement

A

1st pregnancy

18-20 weeks

33
Q

Fetal movement

2nd pregnancies and so forth (bc mom knows what to expect)

A

16-18 weeks

34
Q

Fetal kicks, start to count at 3rd trimester

A

10 movements within 2 hours

35
Q

Fundal height

A

Measuring from pubic bone –> Uterine fundus (the top part)

36
Q

12 weeks

A

uterine fundus should be at

Pubic symphysis
cm

37
Q

20 weeks

A

uterine fundus should be at

Umbilicus
cm

38
Q

Doppler is able to detect between

A

10-12 weeks

110-160 bpm is normal

39
Q

Fundal height can drop after 36-38 wks d/t to

A

baby dropping into pelvis
“lightening”

mom can feel like she can breathe again

40
Q

Urine sample every visit

A

Protein levels

Glucose

41
Q

Gender

A

US at 16 weeks

42
Q

NIPT blood draw can tell gestation as early as

A

9 weeks

43
Q

1st trimester US

A

dating purposes

44
Q

2nd trimester US

A

Anatomy ultrasound

b/w 18-22 weeks GA

45
Q

3rd trimester visit

A

Lab draw
(cbc, rpr, abo and rh, antibody screen)

1 hour glucose challenge
3 hour glucose tolerance

46
Q

1 hour glucose challenge

A

50 g oral glucose

draw serum 1 hr later
<140= normal
>140: proceed to 3 hr
>200: AUTOMATIC FAIL, GDm diagnosed

47
Q

3 hour glucose test

A

100 g oral glucose load
4 draws total

fasting <95
1 hr: <180
2 hr: <155
3 hr: <140

TWO ABN VALUES= fail
ONE VALUE > 200= fail

48
Q

3rd trimester US

A

growth US
fetal position
state of placenta

49
Q

Leopold maneuver

A

place hands on belly to find position of baby

50
Q

3rd trimester- start to perform cervical exams

A

Determine:

dilation
effacement
station
position
presenting part
51
Q

Group B strep

3rd trimester

A

Can live in woman’s vagina and rectum

transmitted to baby during delivery

35-37 wks

if positive, will get Abx before labor

52
Q

Bishop score

A

based on dilation, effacement, station, cervical consistency, position of cervix

0-4: failed induction
8-13: highest chance of successful induction

53
Q

Antenatal screening

A

Trace fetal HR and uterine activity x 20 minutes

Mimimum of 2 accelerations (increase in FHR by 15 bpm and last for 15 seconds)

THIS IS GOOD!!!

54
Q

BPP

A

Fetal US

fetal mov
fetal musc tone
fetal breathing movement
amniotic fluid

perfect score is 8/8

55
Q

Optional testing

A

NT scan
FTS
NIPT Non invasive perinatal screening

56
Q

NT scan

A

nuchal translucency

b/w 11-13.6 weeks

SOFT marker for down syndrome, requires FURTHER TESTING to confirm dx

57
Q

FTS first trimester screen

with NT scan

A

SOFT markers again (screening)

For Down and Edwards

58
Q

NIPT

A

can be as early as 9 wks
drawn in place of FTS if performed w NT scan

very expensive

Confirmatory test if first NT scan was abnormal (to confirm aneuploidy- Down syndrome or Edwards)

59
Q

NIPT

A

9 weeks

confirmatory screen for Down syndrome

60
Q

Maternal serum screen

Quad screen

A

only draw this if NT/FTS were not done

b/w 15-21 wks

Screen for NTD, down, edwards

61
Q

For advanced maternal age >35YO

A

folic acid up to 4mg

daily ASA 81 mg

62
Q

AMA other considerations

A

Offer NIPT at 9 wks

Involve Maternal fetal medicine- perform level 1 US

63
Q

Antenatal testing for AMA

A

NST and BPP twice weekly starting at 36 wks

64
Q

Delivery of AMA

A

Induction vs C section recommended at 39 wks if haven’t delivered already

Spring Round II Exams (10 decks)

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