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62 Cards in this Set
- Front
- Back
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zygote
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time of fert
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blastocyst
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fert to 2 weeks
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embryo
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2-8w
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preterm
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<37w partum
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term
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38-42w
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postterm
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>42w
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nagel's rule
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lmp - 3m + 7d = EDD
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crown-rump measure
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in 1st tri, using US, the MOST accurate measure of EDD!
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fundus, non-gravid
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lemon
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fundus, 8w
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tennis ball
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fundus, 10w
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baseball, FHT first heard with abd doppler (certainly by 12w)
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fundus, 12w
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will be felt at sylph pubis for first time
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fundus, 16w
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1/2 b/w symph pubis and umbilicus
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fundus, 20w
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at Umbilicus!; 1 cm per week growth from this point
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39w, fundal height?
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it drops as baby is moved down into position; increased urinary frequency
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95% of babies in what position by 36w?
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vertex or cephalic position (head down)
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caloric reqs for pregnancy:
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300cal/d
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caloric reqs for lactation:
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500cal/d
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calcium for preg
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1200-1500mg/d
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folate for pregnancy
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400mcg/folate/day
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folate for pregnancy, if fhx, previous hx of neural tube defects:
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4mg/folate for 1 month prior to pregnancy and first 3 months of gestation
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nml BMI woman should gain ___ during pregnancy:
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25-35# during pregnancy
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BMI >29, minimum rec. weight gain is:
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15#; we don't want them to LOSE weight during the pregnancy (possible ketosis complicator)
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baby gains most length in:
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2nd tri
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baby gains most weight in:
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3rd tri
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quickening occurs at:
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18w with first pregnancy; slightly earlier with subsequent pregnancies
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nausea in pregnancy:
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60-70% in 1st tri; progesterone cause (delays gastric emptying, promotes heartburn by relaxing LES); high HCG (worst at about 10w); tx: frequent small meals, avoid trigger foods, low-fat, avoid rapid fluid intake, ginger spice; Zofran / ondansetron (category B): use if intractable N/V
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HCG
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induces sx (stomach upset, breast tenderness, fatigue), peaks at 10w; grows in relation to chorion, as chorion regresses at 10w, amnion grows to take over
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serum HCG
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early on, it should double q48h; we want the Quantitative = the number; this is the most important; at 8w, it's probably 40,000
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dark-brown spotting indicates
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inevitable abortion; especially if pregnancy sx have disappeared
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ectopic pregnancy most likely ruptures at:
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8w
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CF m/c groups:
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N. european, ashkenazi groups
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HIV screening:
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Universal: all women; now we use "opt out" screening
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HCV becomes chronic in ___%?
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50% chronic HCV
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amniocentesis
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18-20w
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CVS
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10-12w
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rubella titer evidence of immunity:
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1-8 or higher
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varicella titer evidence of immunity
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1-8 or higher
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rubeola titier, evidence of immunity:
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is rubeola IgG detected?
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24-28 weeks for DM screening in pregnancy
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1h OGTT
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if rH negative at 30 weeks
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dose of rhoGam
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32-36 w, should detect movement
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>4x in one hour or =>10x in two hours
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GABHS test during pregnancy at what week?
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35-37w; abx given during birthing process
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quad screen recommended for
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all women; >35y/o; DMI
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quad screen components
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AFP (from fetal Liver) increases w/ NTD; unconjugated estriol, HCG, inhibin-A
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quad screen; high AFP means?
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NTD
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quad screen; high inhibit A and HCG; low AFP and estriol?
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trisomy 21
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category A
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demonstrated no risk to fetus; very few drugs are in this category
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Category B
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beta lactams! "B = Beta" (PCN and cephalosporins), azithromycin and erythromycin (select macrolides), APAP, IBU in tri's 1 and 2
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Category C
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c = caution; 2/3 of all meds; clarithromycin, fluoroquinolones "c = c"; bactrim; most SSRI, corticosteroids, anti-HTN
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Category D
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d = danger; use if life threatening; gentamicin (aud. nerve dmg); ACEI, ARB, Tekturna, tetracyclines; doxy = d; paroxetine / Paxil (ASD, VSD)
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Category x
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isotretinoin / Acutane, misoprostol / Cytotec, thalidomide
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tx for uncomplicated Chlamydia Trachomatis in pregnancy is:
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erythromicin
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L1 Hale's category:
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no risk during lactation
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L5 Hale's lactation category:
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coke, radioactive
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L4 examples:
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lithium, depakote
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placenta previa RF:
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older, coke, tobacco, hx of; confirmed by US; "previa is painless"; usually need a caesarian birth REFER Emergency; vaginal bleeding
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placental abruption, after 28 w, but prior to birth;
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all other RF's + abdominal trauma; vaginal bleeding, Painful Contracting Uterus; tx: stabilize and Caesarian section
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abnl intrauterine pregnancy in 98% of cases will have low ___ hormone:
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low for age serum HCG, usually 6000 or less
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in intrauterine preg, a transvag US should reveal a gestational sac when:
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HCG is >=1000
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for ectopic pregnancy mgmt:
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most resolve on own, BUT it is practice for SURGICAL intervention: salpingostomy, salpingectomy; could use methotrexate
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methotrexate use to terminate an ectopic pregnancy requires what conditions?
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<3.5cm conceptus w/o evidence of cardiac activity, ovarian tube is intact, HCG is <=15,000, woman is hemodynamically stable, woman is available for close f/u
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