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21 Cards in this Set
- Front
- Back
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What is Nagel's rule for determining estimated delivery date? |
LMP - 3 months + 7 days |
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What are some early signs of pregnancy seen on ultrasound assessment? |
Gestational sac with double decidual sign (increased vascularity in tissue around sac)
Pseudosac centrally located
Yolk sac diagnostic of IUP seen at 5 to 5.5 weeks
Fetal pole seen at 6 to 6.5weeks |
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What confirms viability of fetus on ultrasound? |
cardiac activity (>5mm should be able to pick up a heart beat) |
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What do gravida and para mean and what numbers follow para? |
Gravida → number of times a woman has been pregnant (including this one)
Para → total number of delivered pregnancies
Full term/preterm/abortion (anything prior to 20 weeks gestation)/living
"Florida Power And Light" |
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What genetic disorders are evaluated for in prenatal care? |
Cystic fibrosis Fragile X Hemoglobinopathies Spinal muscular atrophy Phenylketonuria |
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What is done in the first trimester aneuploidy screening? |
Nuchal translucency beta-hCG will help determine relative risk of aneuploidy
Pregnancy associated plasma protein-A
Trisomy 21, 13, 18 are the most common ones in the first trimester |
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Cell free fetal DNA screen |
Only offered in high risk patients, almost as good as amniocentesis |
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Quad screen |
Less expensive test used for routine screening in the general population
MSAFP → maternal serum alpha fetal protein (predominant protein made by fetal liver, held in fetal vessels) → in babies with Down syndrome placenta makes less of these proteins
uE3 hCG Inhibin A
Much less reliable than first trimester screening or cell free DNA |
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How can an ultrasound help indicate aneuploidy? |
Nuchal translucency (if >95th percentile → increased risk of aneuploidy and heart defects)
In Caucasian population, absence of nasal bown increases the risk of Down syndrome 20 fold
Increased risk of aneuploidy if there are cystic structures in the choroid plexus (not as significant as absence of nasal bone) |
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Is maternal perception of fetal activity important in follow up visits? |
YES!
Baby's movements may become less forceful towards the end of pregnancy because they are more cramped
Movement frequency should not decrease (if this happens something is wrong) |
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Which types of pregnant women are at risk for fetal growth restrictions? |
Women with high BMI are at risk for both large and small babies |
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What are the three ways to assess fetal well-being? |
Non-stress test: simply seeing how baby is in steady state (before labor)
Contraction stress test: lookign for contractions, measure changes in mother's fundus size as well as fetal heart rate
Biophysical profile: used in an US to look at four parameters -fetal breathing, fetal movement, fetal tone (is hand flaccid or clenched), amniotic fluid |
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When is fetal well-being assessment usually done? |
Third trimester (~32 weeks of gestation) |
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What screenings are done at 26-28 weeks? |
Gestational diabetes (if blood sugar is at least 135 an hour after drinking sugar water it's a bad sign)
Antibody screen if Rh negative
Hgb |
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What are the risks accompanying gestational HTN? |
gestational HTN: 140/90 twice over 6 hours apart
- may deliver early - could be earliest sign of preeclampsia |
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What is preeclampsia and what causes it? |
Hypertensive state of pregnancy that can affect organs of mother as well as fetal growth
Starts early in pregnancy, abnormal implantation -normally as the trophoblast grows it grows into maternal spiral arterioles → denudes vasculature of that artery → converts it into venous type lake → systemic increase in prostacyclin produced → increasesd levels of thromboxane → systemic relaxation of vessels → good perfusion of uterus - in preeclampsia, don't get denuding of vasculature → no increase in prostacyclin, systemic disease, not just mild HTN |
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What qualifies someone as having preeclampsia with severe features? |
BP ≥ 160/110
Platelet count < 100,0000 Impaired liver function Renal insufficiency (Cr>1.1) Pulmonary edema New onset cerebral or visual disturbances
Severe features will lead to preterm delivery |
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What can be given to stimulate lung development in the fetus? |
Beta methasone -crosses the placenta and stimulates lung development → useful if premature birth necessary (i.e. in preeclampsia with severe features) |
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What screening tests are done at 35 to 36 weeks? |
STD screening
Group B beta-hemolytic streptococcus (if positive, treat with penicillin to prevent mother to child transmission) |
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What are the three "p"s of normal labor? |
Power → contractions
Passenger → fetal size, fetal lie (relationship of baby's spine to mother's spine), fetal attitude (how baby is presenting to cervix), fetal position (most common is occiput anterior)
Passageway |
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What is the most common female pelvic type? |
Gynecoid |
