Antepartum Flashcards
(243 cards)
1
Q
pregnancy signs and symptoms that may be caused by something other than pregnancy
A
presumptive signs of pregnancy
2
Q
pregnancy signs and symptoms: abdomen enlargement uterine enlargement fetal outline palpation ballottement uterus shape change piskacek's sign hegar's sign goodell's sign chadwick's sign BH ctx positive pregnancy test
A
probable signs of pregnancy
3
Q
pregnancy signs and symptoms:
FHT heard by fetoscope or doppler
sonographic evidence of pregnancy
palpation of fetal movement
A
positive signs of pregnancy
4
Q
differential dx for pregnancy
A
leiomyoma
ovarian cyst
pseudocyesis
5
Q
average duration of human pregnancy
A
280 days
6
Q
prior to placental formation in pregnancy, progesterone is released by the:
A
corpus luteum
7
Q
chorionic villi develop from:
A
the outer wall of the blastocyst
8
Q
chorionic villi blood pertains to the:
A
fetus
9
Q
umbilical cord has ___ artery(s) and ____ vein(s)
A
1 vein, 2 arteries
10
Q
umbilical arteries carries _________ blood from ______ to ________
A
deoxygenated blood from fetus to placenta
11
Q
umbilical vein carries ___________ from ____________ to ___________
A
oxygenated blood from placenta to fetus
12
Q
implantation occurs ____ days after fertilization
A
6-7
13
Q
oxygen and glucose are transported across the placenta via:
A
facilitated perfusion
14
Q
the trophoblast eventually becomes the:
A
placenta
15
Q
________ system changes in pregnancy may cause:
increased chest diameter (5-6 cm) / decreased residual volume
mild respiratory alkalosis–> decreased PCO2
diaphragm level rise of 4 cm
nasal congestion
increased tidal volume/ minute ventilatory/ minute oxygen uptake
dyspnea
A
respiratory
16
Q
________ system changes in pregnancy may cause:
dilation of renal calyces, pelvis and ureters–> UTI
decreased bladder tone
increased renal blood flow 35-60%
decreased renal threshold for glucose, protein, water-soluble vitamins, calcium, hydrogen ions
increased GFR 40-50%
increased renin-angiotensin-aldosterone system–> Na+/water retention, resistance to pressor effect of angiotensin II, maintenance of normal BP
A
GU/Renal
17
Q
pregnancy can be considered a ____________ state because _________ and ___________ increase in pregnancy
A
hypercoaguable
fibrinogen (factor I) and factors VII-X
18
Q
diastolic BP is ______ in 1st and 2nd trimesters due to development of new vascular beds and peripheral tone relaxation (progesterone) which results in decreased flow resistance
A
lower
19
Q
prolactin levels are 10x _______ in pregnancy
A
higher
20
Q
pituitary gland _________ by 100% in pregnancy
A
enlarges
21
Q
thyroid gland _________ in size in pregnancy
A
increases
22
Q
TSH does/does not cross the placenta?
A
does not
23
Q
thyroid-stimulating immunoglobulins and TRH do/ do not cross the placenta?
A
do
24
Q
adrenal glands double serum ________ levels in pregnancy
A
cortisol
25
adrenal glands remain their size but increase _________ that produces glucocorticoid in pregnancy
zona fasciculata
26
pancreas experiences hypertrophy and hyperplasia of the __________ in pregnancy
B cells
27
pregnancy causes _________ resistance as a result of placental hormones especially hPL
insulin
28
recommended weight gain for pre-pregnancy BMI < 18.5
28-40 lbs at rate of 1 lb/wk
29
recommended weight gain for pre-pregnancy BMI 18.5-24.9
25-35 lbs at rate of 1 lb/wk
30
recommended weight gain for pre-pregnancy BMI 25-29.9
15-25 lbs at rate of 0.6 lb/wk
31
recommended weight gain for pre-pregnancy BMI >30
11-20 lbs total at rate of 0.5 lb/wk
32
average pregnancy weight gain
28 lbs
33
protein metabolism is __________ in pregnancy
increased
34
carb metabolism is altered in pregnancy causing blood glucose levels to be 10-20% _____ in pregnancy
lower
35
number of times woman has been pregnancy regardless of outcome
gravida
36
number of pregnancies carried to 20th wk gestation or delivery on infant weighing > 500 gm regardless of outcome
para
37
woman who has never been pregnancy
nulligravida
38
woman who has not carried a baby to 20 wks or 500 gm
nullipara
39
woman who is pregnancy for the first time
primigravida
40
woman who has carried a pregnancy past the 20th wk or who is currently pregnancy for the first time and is carrying past the 20th wk
primipara
41
woman pregnant two or more times
multigravida
42
woman who has carried two or more pregnancies past the 20th wk or has delivered an infant weighing >500 gm
multipara
43
woman who has given birth 7x or more
grand mulipara
44
TPAL
Term (>37 wks)
Premature (20-36.6 wks or 500-2499 gm)
Abortions (<20 wks or <500 gm)
Living
45
calculation based on 28-day menstrual cycle assuming average length of pregnancy to be 280 days or 10 lunar months
Naegele's Rule
46
Order of Leopold's maneuvers
```
Lie
Presentation
Position
Attitude
Variety
EFW
```
47
hormone responsible for bleeding gums in pregnancy
estrogen
48
BP decrease in supine hypotensive syndrome is a direct result of:
decreased cardiac output
49
increased respiratory rate due to changes in CO2 threshold in pregnancy is due to increase in this hormone
progesterone
50
dependent edema in pregnancy is associated with:
maternal obesity
51
normal change in pregnancy of the cervix to a bluish hue
Chadwick's sign
52
softening of the isthmus of the cervix
Hegar's sign
53
softening of the cervix during pregnancy
Goodell's sign
54
at term, the uterus weighs _____ gm with a ___ L volume
1100 gms with 5 L volume
55
breasts develop _________ follicles during pregnancy
Montgomery's
56
pelvis shape found in 23.5% of white and 50% of nonwhite women that favors posterior position of the fetus and is adequate size for vaginal birth due to large size
Anthropoid
57
pelvis shape commonly known as the male pelvis found in 32.5% of white and 15.7% of nonwhite women that is a heavy, heart-shape that leads to increased posterior positions, dystocia, and operative births
Android
58
pelvis shape commonly known as a female pelvis found in 41-42% of women with a good prognosis for vaginal birth
Gynecoid
59
rare pelvic type that occurs in less than 3% of women that has a poor prognosis for vaginal birth due to short anterior-posterior (AP) diameter
Platypelloid
60
longitudinal axis of fetal head is ___ cm
11 cm
61
fetal shoulder width is ___-___ cm
12-15
62
the effect of flexion is to change the longitudinal axis from 11 cm to smaller diameter of ___ cm
9.5 cm
63
inlet transverse diameter is much _______ at ___ cm than the anteroposterior diameter
wider at 13.5 cm
64
the least diameter of the pelvis is the ____ plane
mid
65
the pelvic inlet conjugate we can measure clinically is:
diagonal
66
normal/adequate pelvic diagonal conjugate measurement _____ cm
11.5
67
transverse ("interspinous") diameter of the midplane which is the smallest of the pelvis
10 cm
68
anteroposterior diameter of the midplane
11.5 cm
69
the pubic arch angle should be at least ____ degrees
90
70
second trimester screening a.k.a. multiple marker screening is performed between ___-___ weeks
15-20
71
2nd trimester screening a.k.a. multiple marker screening detects:
neural tube defects, trisomies 18 and 21
72
triple genetic screen includes:
MSAFP, estriol, hCG
73
quad genetic screen includes:
MSAFP, estriol, hCG, inhibin A
74
1st trimester screening is performed between ___-___ weeks
10-13
75
serologic testing for pregnancy-associated plasma protein (PAPP-A) ad hCG, an U/S exam to measure nuchal translucency and the mother's age are combined to calculate risk for trisomies 18 and 21
first trimester screening
76
results of 1st and 2nd trimester screening are combined to increase accuracy of detecting trisomy 21
combined 1st and 2nd trimester screening
77
serologic screening test on mother analyzes the small amount of DNA that is released from the placenta into the bloodstream of the mother; screens for aneuploidy (trisomies 13, 18, 21) and problems with sex chromosomes
can be performed as early as 10 weeks
cell-free DNA testing
78
sidewalls that extend from the upper anterior angle of the sacrosciatic notch to the ischial tuberosities should be:
straight
79
Vit B6 dose for N+V in pregnancy
pyridoxine (Vit B6) 25 mg BID or TID PO
80
doxylamine dose for N+V in pregnancy
12.5 mg BID or QID *with* Vit B6 PO
81
metoclopramide dose for N+V in pregnancy
5-10 mg q6-8 hrs PO
82
promethazine dose for N+V in pregnancy
25 mg q4 hrs per rectum
83
rubella vaccine should be given at least ___ weeks prior to conception
4
84
normal score for BPP (in absence of oligohydramnios)
8-10
85
equivocal score for BPP which indicates repeat testing
6
86
abnormal score for BPP that requires immediate further evaluation
4 or less
87
thyroid hormones availability _________ by 40-100% in pregnancy
increase
88
Reasons for decreased _________ pool in pregnancy:
placental transfer to the fetus
increased loss due to increased GFR
increased loss due to increased renal blood flow
iodine
89
____________ deficiency can lead to:
miscarriage
stillbirth
preventable mental retardation
iodine
90
N+V has been associated with alterations in _________ hormones
thyroid
91
a foreign tissue from the same species but with a different antigenic makeup
semiallograft
92
Inflammation at the maternal-placental interface is most marked in which trimesters?
1st and 3rd
93
most common contributor to the classification of pregnancy dermatoses called Atopic eruption of pregnancy (AEP)
eczema of pregnancy
94
sensation of "prickly heat" experienced by some women in pregnancy is related to:
eccrine sweat gland activity
95
alterations in skin pigmentation during pregnancy are thought to be related to:
effects of estrogen and progesterone on melanocytes
96
A separate placental lobe attached by blood vessels to the main placenta
Succenturiate
97
structure that adheres to the endometrium and leads to the decidual reaction
blastocyst
98
During implantation, the products of conception attach to the maternal endometrium via invasion by the:
blastocyst
99
At approximately 4-5 days after fertilization, the morula reaches the uterine cavity and becomes the:
blastocyst
100
hormone of pregnancy stimulates the corpus luteum to continue to function
hCG
101
pregnancy hormone that has thyroid stimulating (TSH)- like properties
hCG
102
hormone that is lowest during the 1st trimester and increases to baseline levels in the 2nd trimester and 3rd trimester.
TSH
103
pre-eclampsia may cause __________ fetal growth
assymetric
104
maternal position that enhances water excretion
side-lying
105
When blood vessels run from the umbilical cord between the amnion and chorion through the membranes to the placenta
Velamentous cord insertion
106
During placentation, trophoblastic tissue invades the maternal spiral arteries causing:
Disruption of elastic and muscular properties in the vessel wall
107
Macrobid can cause hemolysis in person with:
G6PD deficiency
108
med associated with gastroschisis if taken in 1st trimester
Sudafed (psuedoephedrine)
109
Terb may cause:
pulmonary edema
110
2nd trimester dating U/S is accurate within +/- ____ days
10
111
Naegele's Rule
LMP + 7 days
| subtract 3 months
112
most sensitive traditional screening test for Down Syndrome
integrated screen
113
Appropriate genetic screening tests to discuss and offer at 8 wk prenatal appt
inegrated screen and CF screen
114
screening test has the lowest detection rate for Down Syndrome
triple screen
115
preferred test to offer to women who desire to screen for both Down Syndrome and neural tube defects (NTD)
quad screen
116
95% accurate for detecting Down Syndrome in the fetus
integrated screening
117
screening that should be offered to all women at the first prenatal visit and is usually done via a blood draw.
CF screening
118
Meiosis results in daughter cells that have:
23 chromosomes
119
Nuchal translucency measures thickness of the nape of the neck that is due to:
excess accumulated fluid
120
Protein secreted by the trophoblast
Pregnancy-associated plasma protein A (PAPP-A)
121
Imprinting affects gene expression through:
epigenetic control
122
encapsulated tumor that contains hair, teeth, bone, or other tissue
Ovarian teratoma
123
Alpha fetoprotein (AFP) levels in maternal serum is used to screen for:
neural tube defects
124
```
Indications for _________:
placenta previa
age >40 years
substance abuse
antiphospholipid antibody syndrome
cyanotic heart dx
chronic HTN
GDM requiring insulin
hemoglobinophathies
Preeclampsia
hyperthyroidism, poorly controlled
renal dx
hx of stillbirth
seizure disorder, poorly controlled
sickle cell dx
lupus
abnormal maternal serum screening
IVF
cholestasis
late-term/post-term pregnancy
multifetal gestation
pemphigoid gestonis
abruptionin current pregnancy
congenital abnormalities
decreased FM
IUGR
oligo
poly
umbilical cord abnormalities
```
NST
125
```
Indications for _________:
placenta previa
age >40 years
substance abuse
antiphospholipid antibody syndrome
cyanotic heart dx
chronic HTN
GDM requiring insulin
hemoglobinophathies
Preeclampsia
hyperthyroidism, poorly controlled
renal dx
hx of stillbirth
seizure disorder, poorly controlled
sickle cell dx
lupus
abnormal maternal serum screening
IVF
cholestasis
late-term/post-term pregnancy
multifetal gestation
pemphigoid gestonis
abruption current pregnancy
congenital abnormalities
decreased FM
IUGR
oligo
poly
umbilical cord abnormalities
```
NST
126
```
Risk Factors for _________:
pelvic inflammatory disease
STI
therapeutic abortion followed by infection
endometriosis
previous pelvic surgery
failed BTL
tube scarring
menstrual reflux/hormonal alteration of tube motility
```
ectopic pregnancy
127
Questions:
Have you felt need to Cut down on drinking?
Have people Annoyed you by criticizing your drinking?
Have you ever felt bad or Guilty about drinking?
Have you ever had a drink in the morning to steady nerves or get rid of hangover (Eye opener)?
CAGE Screening Tool
128
Questions:
Tolerance: How many drinks can you hold
Worried: Have close friends/family worried/complained about your drinking?
Eye-openers: Do you sometimes have a drink in the morning when you first get up?
Amnesia: Has anyone told you about something you did you don't remember when drunk?
Cut down: Do you sometimes feel the need to cut down on drinking?
TWEAK Screening Tool
129
Percentage of women who gave birth in 2016 who smoked in pregnancy
7.2%
130
Age group with highest prevalence of smoking in pregnancy (10.7%)
20-24
131
Ethnicity with highest prevalence of smoking in pregnancy (16.7%)
Ethnicity with lowest prevalence of smoking in pregnancy (0.6%)
highest: Non-Hispanic American Indian/Alaskan Native
lowest: Non-Hispanic Asian
132
```
Complications of ____________:
stillbirth
preeclampsia
abruption
previa
spontaneous abortion
ectopic pregnancy
PROM
IUGR
preterm birth
SGA
```
smoking in pregnancy
133
```
Infant effects of __________:
low birth weight
small head circumference
shorter length
irritability
hyperactivity
tremors
high-pitched cry
excessive sucking
```
cocaine/meth use in pregnancy
134
```
Maternal effects of ____________:
migraines
seizures
PROM
abruption
HTN crisis
spontaneous abortion
preterm labor
```
cocaine/meth use in pregnancy
135
parvovirus spreads through:
respiratory secretions
136
rubella spreads through:
respiratory secretions
137
```
Effects of __________:
IUGR
cataracts
retinopathy
heart defects (PDA)
hearing impairement
```
congenital rubella syndrome
138
Adults with CMV are usually:
asymptomatic
139
Without antiretrovirals, HIV has _____% chance of transmission to infant in pregnancy
15-45%
140
With antiretrovirals, HIV has _____% chance of transmission to infant in pregnancy
1%
141
zika virus can cause:
microcephaly and severe brain damage
142
```
Causes ___________ growth restriction:
tobacco
alcohol
Dilantin (phenytoin)
cocaine
heroin
congenital infections
chromosomal abnormalities
```
Symmetric
143
Causes of ___________ growth restriction:
reduced nutrition to fetus
uteroplacental perfusion abnormalities
Asymmetric
144
process in which a needle is inserted under real-time U/S through the maternal abdomen and then into the umbilical cord so that blood can be aspirated or blood/meds can be given to fetus
cordocentesis
145
most common used drug in pregnancy
nicotine
146
____% of pregnancies where FHT are heard will continue to term after early bleeding
90%
147
```
Diff Dx for _________:
ectopic
implantation bleeding
threatened abortion
cervicitis
cervical polyps
vaginitis
trauma/intercourse
disappearing twin
autoantibody/autoimmune disorder
```
1st trimester bleeding
148
____% of women have low-lying placenta in 1st trimester
30%
149
elevated maternal _____ is associated with:
neural tube defects
multiple gestations
placental abruption
serum alpha-fetoprotein (AFP)
150
pair of genes for each characteristic inherent in an individual
genotype
151
a sensitized Rh negative mother does not need:
Rhogham
152
cervical cerclage is done after ___-___ weeks and is 80-90% successful
12-14 weeks
153
treatment for syphilis in pregnant women
benzathine pen G 2.4 million units I x 1 dose
154
treatment for BV in pregnant women
metronidazole 500 mg PO BID x 7 days
OR 250 mg PO TID x 7 days
OR clindamycin 300 mg PO BID x 7 days
155
treatment for trichomoniasis in pregnant women
metronidazole 2 gm PO x 1 dose
156
symmetric growth restriction usually becomes evident in:
midpregnancy
157
symmetric growth restriction is due to conditions that reduce:
cell size and number
158
90% of ectopic pregnancies are assocated with B-hCG levels less than ______ IU/L
6500
159
treatment for chlamydia in pregnancy women
azithromycin 1 gm PO x 1 dose
OR amoxicillin 500 mg PO TID x 7 days
(alternatives: Erythromycin)
160
___-____% of pregnancies are ABO incompatible
20-25%
161
mother Rh negative with negative antibody titer is a ____________ pregnancy
unsensitized
162
mother Rh negative with positive antibody titer (> 1:4) is a ____________ pregnancy
sensitized
163
Management for unsensitized pregnancy:
Draw ABO/D group and antibody titer at 1st visit
Repeat antibody screen at 28 wks
Give RhoGAM at 28 wks
If infant Rh+, give RhoGAM after delivery
164
Management for sensitized pregnancy:
Seek consultation or transfer care
Follow fetus with U/S
Follow titers to assess need for amniocentesis
165
positive induration of PPD skin test for no-risk persons
15 mm
166
Preeclampsia is defined as:
HTN plus proteinuria (>300 mg per 24 hr urine or >1+ on dipstick or PCR > 0.3 mg/dL)
167
Preeclampsia can be diagnosed w/o __________ if one of these is present:
thrombocytopenia
impaired liver function (LFTs double normal)
serum creatinine > 1.1
pulmonary edema
cerebral/visual disturbances
proteinuria
168
Preeclampsia w/ severe features is defined as:
```
preeclampsia with addition of:
BP > 160/110
thrombocytopenia
impaired liver function (LFTs double normal)
serum creatinine > 1.1
pulmonary edema
cerebral/visual disturbances
```
169
IDA in 2nd trimester is most likely due to:
blood volume expansion
170
microcytic, hypochromic, low Hgb indicates:
IDA
171
megaloblastic anemia is due to low:
folic acid
172
postpartum diabetes screening is the ___ hr ___ gm OGTT
2 hr 75 gm
173
women at high risk for gonorrhea/chlamydia should be screened at:
1st prenatal visit and 3rd trimester
174
Laboratory testing for HIV commonly includes:
ELISA followed by Western Blot
175
appropriate time in pregnancy to draw an antibody screen for ALL women
at 1st prenatal visit
176
lab test used for the routine prenatal antibody screen
indirect coombs
177
a woman with hx of syphillis treated 10 years ago will have _________ VDRL/RPR titer at 1st prenatal visit
normal
178
RhoGAM may be given via:
IM or IV
179
Taking Sudafed in pregnancy is most concerning in the _____ trimester
1st
180
substances considered to be teratogenic must have:
stage-sensitive effect depending on time of exposure during pregnancy
181
the goal of treatment for opioid addiction in pregnancy is:
maintenance
182
Teratogens that affect which organ can cause damage at any time during pregnancy?
the brain
183
class of antibiotics associated with fetal cardiovascular defects and/or oral cleft defects
sulfanomides
184
direct effect of nicotine on the fetus
neurotransmitter sytem changes
185
drugs that exert effects on growth or development in the second or third trimesters
fetotoxic agents
186
dyspnea is most commonly experienced during which trimesters?
1st & 3d
187
physiology of shortness of breath in pregnancy:
secondary to awareness of hyperventilation and decreased CO2
188
physiologic factor that influences respiration in late pregnancy
increased subcostal angle
189
best advice for heartburn during pregnancy
avoid beverages with meals
190
most appropriate lab test to order when evaluating a pregnant woman for Restless Leg Syndrome
serum ferritin
191
Pemphigoid Gestationis (PG) may spread to:
palms and soles
192
Pregnant women abusing substances may be more willing to disclose their substance use if:
they are routinely screened using a screening tool like Audit-C
193
```
Associated with ____________:
post-maturity syndrome
cord compression
uteroplacental insufficiency
fetal growth restriction
dehydration
congenital abnormalities (renal agenesis, Potter's syndrome)
viral diseases
PPROM
use of indomethacin as tocolytic
```
oligohydramnios
194
TSH levels __________ during the first trimester when hCG levels are high
decrease
195
___________ associated with:
2nd trimester bleeding
PTB
PPROM
circumvillate placenta
196
Most common problem with succenturiate lobe placenta
retained placenta after birth
197
"Battledore" placenta
marginal insertion
198
- placental vessels are vulnerable to rupture and compression during labor and birth
- rupture can cause rapid fetal exsanguination
- life threatening fetal hemorrhage
velamentous cord insertion
199
condition when the velamentous vessels cross over the cervical os
vasa previa
200
```
Risk Factors for __________:
placenta previa
multifetal gestation
hx of ART
obesity
smoking
```
velamentous cord insertion and vasa previa
201
___________ associated with:
PTB
FGR
perinatal morbidity/mortality
velamentous cord insertion
202
placental implantation is anchored to the myometrium instead of the decidua (endometrium)
- -attached to myometrium
- -incidence increasing d/t inc in Cesareans & ART/IVF
- -attaches to scarred or damaged uterus
- -more common in people with placenta previa
placenta accreta
203
placental implantation that *invades* the myometrium
| --can be life threatening
placenta increata
204
placental implantation that extends through the myometrium & serosa and attaches to adjacent maternal organs
--can be life threatening
placenta percreta
205
```
Associated with ____________:
fetal structural anomalies
multifetal gestation (monozygotic twins, twin-to-Twin Transfusion Syndrome)
diabetes
fetal infection
fetal chromosomal abnormalities
```
polyhydramnios
206
the fetus is at greatest risk with ___________ maternal CMV infection
primary
207
listeriosis can be acquired through eating:
soft cheeses
208
Risk of fetal transmission for parvovirus B19 is ___-___%
30-50%
209
Toxoplasmosis infection in pregnancy is often:
asymptomatic
210
If a woman contracts varicella infection 4 days prior to giving birth, the newborn needs:
varicella-zoster immune globulin
211
Hep C transmission in labor may promoted by:
Prelabor ROM
| use of internal monitors
212
elective Cesarean delivery should be offered to a woman who is human immunodeficiency virus (HIV) positive based on:
viral load
213
The greatest risk of CMV transmission to the fetus occurs with a primary infection during:
1st trimester or early 2nd trimester.
214
Fifth's Disease is caused by which virus:
parvovirus B19
215
After pregnant woman's known exposure to Fifth's disease, midwife should order:
serum parvovirus IgM and IgG
216
processed foods such as pate, hummus, wieners, and sliced deli meats can cause infection of:
listeriosis
217
Woman most likely to pass Hep B to fetus is positive for:
Hepatitis B surface antigen (HBsAg) positive and
| Hepatitis B e-antigen (HBeAg) positive
218
infection that has the potential to cause fetal anemia, hydrops fetalis, or fetal death
parvovirus B19
219
condition that may cause fetal deafness, cataracts, and cardiac defects
rubella
220
garden work puts woman at risk for contracting:
toxoplasmosis
221
if woman's partner is exposed to Zika, they should:
abstain from all sex or use condoms for remainder of pregnancy
222
swollen lymph nodes, fatigue and sore throat are symptoms of:
CMV
223
fetal fibronectin (fFN) test best predicts those women who will:
not give birth in the next 2 weeks
224
```
Risk Factors for __________:
age <17 or >35
genetic variants
BMI < 19.8
Low SES
short pregnancy interval < 18 mo
substance abuse
smoking
FGR
congenital abnormalities
infection
isoimmunization with hydrops
life stress
history of PTB
low weight gain
AA race
pregnant woman born preterm
prior cervical surgery
Mulleran tract abnormalities
short cervical length
polyhydramnios
multifetal gestation
HTN/HELLP
placenta previa
pyelonephritis
vag bleeding in > one trimester
ASB/lower UTI
peridontal disease
```
PTB
225
Vaginal progesterone is most effective for women with a cervical length of ≤ ___ mm prior to ___ weeks gestation weeks.:
< 20 mm prior to 24 weeks
226
```
Risk Factors for ___________:
prolonged ROM
prolonged labor
>4 vag exams
internal monitors
```
intra-amniotic infection
227
nitrazine false positives:
BV, trich, blood, lube, semen
228
fern false positives:
cervical mucus, semen
229
vaginal pooling false positives:
vaginal infections, prelabor cervical ripening, semen
230
asymptomatic bacteruria should be treated if colony count is > ___________
100,000
231
gonorrhea treatment in pregnancy:
ceftriaxone (Rocephin) 250 mg IM x 1 dose
AND!!!
azithromycin (Zithromax) 1 g PO x 1 dose
232
HSV treatment in pregnancy:
acyclovir 400 mg PO TID x 7-10 days
200 mg PO 5x/day x 7-10 days
valacyclovir 1 gm PO BID x 7-10 days
233
classic test method for assessing ROM****
fern
234
normal pH of vagina
4.5
235
amniotic fluid pH
7.0-7.5
236
GBS in urine is diagnostic at _______ colony count
10,000
237
Macrobid and sulfonamides are contraindicated in women with:
G6PD deficiency
238
trimethoprim (Bactrim, Septra) use with caution for UTI
ACOG: can be used safely in _____ trimester
in _____ trimester if no other abx available
safe in 2nd trimester
| 1st trimester only if no other abx
239
fluoroquinolones
tetracycline
doxycycline
are __________ in pregnancy
contraindicated
240
```
Factors that decrease success of ______:
oligohydramnios
anterior placenta
engaged in pelvis
fetal back down (posterior)
maternal obesity
```
ECV
241
ripe cervix= Bishop score of ___ or greater
8
242
RDA for pregnancy (kcal and protein)?
2500 kcal/day and 60 g protein
243
AFP is detected starting at ___ weeks
2nd trimester
