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91 Cards in this Set
- Front
- Back
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When do commerical kits detect pregnancy?
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12-15 days after conception
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Definition of a term delivery
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37 wk of gestation
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Definition of a premature delivery?
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Delivery of infant weighing between 500 and 2500 g and delivery between 20 and 37 wk
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Bluish discoloration of vagina due to vascular congestion
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Chadwick's sign
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Softening of cervix
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Hegar's Sign
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Commercial kits detect pregnancy how many days after conception?
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12-15 days after conception
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When is the gestational sac identified?
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5 wk
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When is the fetal image detected?
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6-7 wk
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When is cardiac activity first noted?
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8 wk
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What is the most accurate method to determine gestational age?
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U/S
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Birth defect associated with Lithium?
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Ebstein's anomaly (single-chambered right side of heart)
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Birth defect associated with Carbamazepine, valproate?
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Neural Tube Defect
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Birth defect due to ACEI?
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Renal failure in neonates
Renal tubule dysgenesis Decr skull ossification |
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Birth defect of an oral hypoglycemic?
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Neonatal hypoglycemia
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Birth defect of Skeletal & CNS defects?
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Warfarin (Coumadin)
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Birth defect due to NSAIDS?
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Constriction of ductus arteriosus, necrotizing enterocolitis
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What is Nagele's Rule for the EDC?
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LMP + 7 days- 3 months + 1 year
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What does Nagele's Rule depend on?
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28 day cycles
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What FDA category is described by the following?
Medication has not shown an increased risk for birth defects in human studies |
Category A
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What FDA category is described by the following?
No risk in animals, no adequate studies in humans Risk in animal studies, but risk not seen in humans |
Category B
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What FDA category is described by the following?
Animal studies show adverse effects, NO studies in humans Studies in humans and animals are not available |
Category C
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What FDA category is described by the following?
Medications associated with birth defects in humans; however, potential benefits in rare cases may outweigh their known risks |
Category D
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What FDA category is described by the following?
Meds contraindicated |
Category X
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If a pregnant female is not already immune to rubella, should she be vaccinated?
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NO, b/c rubella is a live virus
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What is the recommended wt gain during pregnancy?
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25-35 lbs
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How often should first trimester visits occur?
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Every 4 wk
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Is trace glucosuria normal?
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Yes, trace glucosuria is normal b/c of incr glomerular filtration rate (GFR), anything more than trace protein should be evaluated)
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Estimation of gestational age by uterine size
At pubic symphysis |
12 wk
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Estimation of gestational age by uterine size
Midway from symphysis to umbilicus |
16 wk
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Estimation of gestational age by uterine size
At umbilicus |
20 wk
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Estimation of gestational age by uterine size
Height (cm) correlates with weeks of festation |
26-36 wk
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If uterine size (cm) > gestational age (wk) by >3 wk, then what should be considered?
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Multiple gestations
Molar pregnancy MOST COMMONLY inaccurae dating |
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How often should second trimester visits be conducted?
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Every 4 weeks
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When should Doppler U/S be used to evaluate fetal heartbeat at each visit?
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12 wk
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When should the triple-marker screen be offered?
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Second trimester
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What is the triple-marker screen?
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hCG
AFP estriol |
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What marker indicates Down Syndrome?
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Decreased AFP
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What marker indicates multiple gestations, neural tube deficit, & duodenal atresia?
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Increased AFP
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When should fetal movement be documented?
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17-19 wk
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Indications for amniocentesis?
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Mom > 35 yrs or hx of
recurrent miscarriages, previous child with chromosomal or single gene defect, abnormal triple-marker screen) |
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When should glucose screening with 1 hr Glucola be performed?
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24 wk
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How often should 3rd trimester visit occur?
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Every 4th wk until 32 wks
every 2 wk from 32-36 wk every wk until delivery |
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When should screening occur for Strep agalactiae
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35-37 wk
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When should RhoGAM be given if indicated?
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28-30 wk
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What are the hematologic changes in pregnancy?
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Hypercoagulability
Anemia (b/c of incr blood vol) |
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What are the cardiac changes in pregnancy?
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Increase cardiac output
Incr flow-->incr systolic murmur Decr peripheral vascular resistance |
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What happens to BP during pregnancy?
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BP decreases during first 24 wk of pregnancy with gradual return to nonpregnant levels by term
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What is the primary medical complication in pregnancy?
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Gestational DM
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What is gestational DM caused by?
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hPL
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What is the definition of macrosomia?
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>4500 g
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How is GDM diagnosed?
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1-hour Glucola screening test at 24-28 wk or at onset of prenatal care in pt with known risk factors
Confirm with 3 hr glucose tolerance test |
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What tx for GDM pregnant female is contraindicated?
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Oral hypoglycemia-->leads to neonatal hypoglycemia
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What is the tx for superficial thrombophlebitis?
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Leg elevation, rest, heat, NSAIDS
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What anticoagulant is contraindicated in pregnancy?
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Warfarin
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What is the definition of preeclampsia?
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HTN (>140/90 or Incr SBP >30 mm Hg or DBP>15 mm Hg compared to previous)
Proteinuria and/or edema |
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What is the definition of severe eclampsia?
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BP >160/110
Marked proteinuria (>1g/24-hr collection or >1+ on dip), oliguria, increased creatinine, CNS disturbances, pulmonary edema or cyanosis, epigastric RUQ pain, hepatic dysfunction |
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What is the definition of eclampsia?
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Convulsions in a women with preeclampsia
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Intrapartum prophylaxis for Group B Strep is reserved for what situations:
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1.PTL (<37 wks)
2.Prolonged ROM (>18 hr) 3. Identified with GBS during screening at 35-37 wk of gestation 4. GBS bacteriuria or previous infant with GBS disease |
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Definition of hyperemesis gravidarum
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Increased n/v that, unlike "morning sickness," persists past wk 16 of pregnancy
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How many fetal movements per hr generally indicate fetal well being?
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>4 fetal movements/hr
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What is a normal nonstress test?
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Normal (reactive) occurs when FHR increases by 15 bpm for 15 seconds following fetal movement. 2 such accelerations in 20 min are considered normal
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What are the 5 components of the biophysical profile?
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Fetal breathing
Gross body movement Fetal tone Qualitative amniotic fluid volume Reactive FHR |
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Definition of fetal breathing (part of BPP)
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Fetal breathing-->
>1 fetal breathing movement in 30 min lasting at least 30 seconds |
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Definition of gross body movement (part of BPP)
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>3 discrete movements in 30 seconds
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Definition of fetal tone (part of BPP)
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>1 episode of extension with return to flexion of fetal limbs/trunk OR opening/closing of hand
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Definition of amniotic fluid volume (part of BPP)
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>1 pocket of amniotic fluid at least 1 cm in 2 perpendicular planes
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Describe scoring system for BPP:
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Score of 8-10 is normal
Score of 6 is equivocal/further eval Score of <4 is abnormal/need intervention |
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What L:S ratio indicates mature lungs?
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L:S > 2.0
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What is normal FHR?
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120-160 bpm
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What is fetal tachycardia?
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>160 bpm for 10 min
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What is fetal bradycardia?
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<120 bpm for >10 min
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What do early accelerations result from?
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Fetal head compression
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What do variable accelerations result from?
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Umbilical cord compression
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What do late accelerations from?
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Uteroplacental insufficiency
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When should RhoGAM be administered?
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Administration of antibody to the Rh antigen within 72 hr of delivery prevents active antibody response by the mother in most cases
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When is RhoGAM given to Rh- mother if baby's father is Rh+?
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1. At 28 wks gestation
2. Within 72 hr of delivery of Rh-positive infant |
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What test identifies fetal RBCs in maternal blood?
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Kleihauer-Betke test
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What are Braxton-Hicks contractions?
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Uterine contractions without effacement and dilation of cervix
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When are pts. told to come to the hospital?
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Regular CTX q 5 min X 1 hr
ROM Significant bleeding Decrease fetal movement |
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What is the definition of prolonged latent phase?
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>20 hour in primigravid
>14 hour in multigravid |
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Does prolonged latent phase cause harm to the mother?
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NO
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What is the definition of prolonged active phase?
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>12 hr of cervical dilation
<1.2 cm/hr in primigravid <1.5 cm/hr in multigravid |
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Does prolonged active phase cause harm to the mother?
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Increase riks of intrauterine infection & increased risk of C-Section
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Definition of arrest during labor?
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Secondary arrest occurs when cervical dilation during active phase ceases for >2 hr
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When should an induction trial only occur?
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Induction trial should occur only if cervix is prepared or "ripe"
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If cervix is not ripe, what can be used to ripen the cervix?
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Prostaglandin E2
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Placental villi abnormally adhere to superficial lining of uterine wall
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Placenta accreta
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Placental villi penetrate into uterine muscle layer
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Placenta Increta
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Placental villi completely invade uterine muscle layer
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Placenta Percreta
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What is the most common infection post C-S?
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Metritis
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What is the definition of PROM?
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Rupture of chorioamnionic membrane before onset of labor
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