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Medicine II: OBGYN > Prenatal Care > Flashcards

Prenatal Care Flashcards

1
Q

What are complications with adolescent pregnancy?

A 
Poor compliance
Poor nutrition
Pre-eclampsia
Preterm delivery
STDs
Increased perinatal morbidity and mortality
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2
Q

What are complications of an advanced maternal age?

A

increased frequency of medical illnesses (gestational diabetes and chronic HTN)
Increased frequency of karyotype abnormalities

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3
Q

What is the age specific risk of a karyotype abnormality of a 45 year old mother?

A

trisomy- 1:30

all abnormalities: 1:15

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4
Q

What are several prenatal care effects of race?

A 
Access to care
Medical conditions (sickle cell, thalassemia, CF)
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5
Q

What are several prenatal care effects of religion?

A

Genetics disorders (Tay-Sachs in Jews)
Transfusion (Jehovah’s Witnesses)
Abortion (Catholics and Evangelical Christians)

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6
Q

Gravidity

A

number of pregnancies

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7
Q

Parity

A

number of birth events

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8
Q

What goes into an prenatal abortion history?

A

Type of abortion
Trimester
Complications

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9
Q

In the assessment of menstrual pattern in prenatal care we need to look at:

A

LMP
Regularity
OC use
Timing of intercourse

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10
Q

What are common prenatal care childhood illnesses?

A

CHD

Viral illnesses

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11
Q

What is the most common type of connective tissue disease in the prenatal setting?

A

SLE- lupus

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12
Q

What previous surgeries should we be aware of in prenatal care?

A

Tubal surgery- possible risk of ectopic pregnancy

Uterine surgery- possible risk of uterine rupture

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13
Q

What can valproic acid cause?

A

Spina bifida

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14
Q

What can carbamazepine cause?

A

Spina bifida, facial malformations

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15
Q

What can antineoplastic agents cause?

A

Varied defest

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16
Q

What can warfarin cause?

A

facial deformity, intracranial bleeding

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17
Q

What can lithium cause?

A

cardiac malformation

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18
Q

What can tetracycline cause?

A

straining of teeth

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19
Q

What can quinolones cause?

A

cartilage injury

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20
Q

What can ace inhibitors and ARBs cause?

A

Renal injury

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21
Q

What can beta blockers cause?

A

growth restriction

22
Q

What can isotretinoin cause?

A

brain, face, thymus, heart defects

23
Q

What can topiramate cause?

A

facial cleft

24
Q

What can NSAIDs cause?

A

premature stricture of the ductus arteriosus and oligohydramnios

25
Q

What can excess heat cause?

A

Neural tube defects

26
Q

What can excess radiation cause?

A

Neural tube defects

27
Q

When taking a family history in prenatal care we have to look into these 3 big topics.

A

Mental retardation
Genetic disorders
Birth defects

28
Q

What factors determine if a particle can cross the barrier to the fetus?

A

charge
size
soluability

29
Q

What effects does smoking have on the fetus?

A

low birth weight
greater chance of a pre term birth
placental abortion
inhibited growth

30
Q

What aspects of social history impact the fetus and its development?

A

smoking
occupation
drug use

31
Q

What special laboratory studies do we need to look at during the prenatal care?

A

HBsAG
PPD
CXR
HIV serology

32
Q

What tests screen for aneuploidy?

A

Nucal translucent screening (US and blood test)- checks for trisomy 18 and 21
Quadscreen- NTD, trisomy 18 and 21
US- NTD, trisomy 13, 18, 21
Cell free fetal DNA- trisomy 13, 18, 21 and sex chromosomes

33
Q

What are two specialized laboratory tests for aneuploidy?

A

CVS (chronic villus sampling, biopsy of placenta)- 10-12 weeks - karyotype abnormalities
Amniocentesis - 15-16 weeks, chromosome abnormalities and genetic disorders (sickle cell and CF)

low risks of loss

34
Q

When do you look at the hematocrit and hemeglobin?

A

3rd trimester

35
Q

what does the glucose screen test for?

A

gestational DM

36
Q

What encompasses the prenatal focused examination?

A

BP
Wt gain
Uterine size

37
Q

What is the average total weight gain during pregnancy?

A

22lbs

38
Q

What is the recommended wt gain of an underweight patient?

A

28-40

39
Q

What is the recommended wt gain of an normal patient?

A

25-30

40
Q

What is the recommended wt gain of an overweight patient?

A

15-25

41
Q

What is the recommended wt gain of an obese patient?

A

11-20

42
Q

What are the perinatal care nutritional considerations?

A

approx 30-35 cal/kg of ideal body weight
avoid alcohol
avoid tobacco
well balanced diet, including dairy

43
Q

What is the distrinbution of calories?

A

50%- CHO
25%- Fat
25%- Protein

44
Q

Determination of gestational age by examination?

A

weeks = cm +/- 2

45
Q

What test can help determine size vs date discrepancy?

A

US

46
Q

What are the landmarks for the determination of gestational age?

A

FHT- doptone: 10-12 weeks
Fetal motion: 16-20
FHT- fetoscope: 18-20 weeks

47
Q

What is the frequency of routine apts for perinatal care?

A

monthly until 36 weeks and then every week from 36 weeks to delivery

48
Q

What is the single most important intervention in improving maternal and perinatal outcome?

A

early and consistent perinatal care

49
Q

What are the most common medical diseases that complicate pregnancy?

A 
HTN
DM
Connective tissue disease
Acquire heart disease
STD
50
Q

When testing for HBsAG if it comes back that the mom is sero + what do you do?

A

start vaccine at birth and have them come back for follow up

51
Q

What is the purpose of a quad screen test?

A

2nd trimester test

look for NTD, trisomy 18, 21

Medicine II: OBGYN (18 decks)

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