Flashcards in Exam 2 Prenatal Care Deck (46):
Reasons for prenatal care? (5)
1) Early, accurate estimate of gestational age
2) Identify at-risk pts
3) Eval/follow health of mom/baby
4) Anticipate/intervene problems
5) Pt education
Preconception exam should include?
General physical (check for cavities)
Preconception exam should always include what lab?
When indicated? (10)
Fasting blood sugar
Cystic fibrosis carrier
Preconception care should include what immunizations? (6)
MMR (NOT if already pregnant/must wait 1 mo post)
Preconception folic acid dose?
0.4 -0.8 mg/day
4 mg if neural tube defect hx
Prenatal care 1st visit should occur when?
By week 10 (1st trimester)
Prenatal care 1st visit history should include? (7)
Full hx including:
STD, PID, Abn paps
Planned vs unintended preggo
Barriers to care
Prenatal care 1st visit Obstetric Hx includes?
G: # of pregnancies
T = Full term
P = Preterm (<37wks)
A = Abortions (spont, induced, ectopic)
L = Living
Prenatal care: Estimated Date of Confinement (Delivery) is calculated how?
(LMP + 7 days) - 3 months
Early Term is?
37 0/7 - 38 6/7 weeks
Full Term is?
39 0/7 - 40 6/7 weeks
Late Term is?
41 0/7 - 41 6/7 weeks
42 0/7 weeks on
Prenatal care 1st visit Physical Exam should include? (2)
Prenatal care 1st visit Pelvic Exam should include? (4)
Uterine size/shape/adnexa (parts joining it)
Chadwick's Sign is?
Blue coloring of vagina/cervix from ↑ blood flow
Hegar's Sign is?
Softening of isthmus (where cervix meets uterus)
What specimens should be collected during 1st visit pelvic? (2)
Prenatal care 1st visit labs should include? (11)
UA w/ C&S
Cystic Fibrosis if pt wants it
Prenatal care 1st visit additional lab for at-riskers? (5)
Prenatal care 1st visit US done how?
Cardiac motion visible how soon?
Confirm estimated delivery date (IMPORTANT!)
5 - 6 weeks
1st trimester is?
2nd trimester is?
3rd trimester is?
1 to end of wk 12
13 to end of week 26
Prenatal F/U care schedule?
1st 28 wks = Q 4 wks
28-36 wks = Q 2wks
36 wks = Q 1wk
1st fetal movements:
@ 18-20 wks w/ 1st preg
@ 16-18 wks w/ add'l pregs
Prenatal F/U visits should include? (5)
Fetal Heart Tones
Fetal Heart Tones measured how?
wks 10 - 12
Fundal Height at 12 weeks?
After 20 weeks?
12 wks = pubic symphysis
20 wks = umbilicus
1 cm additional height for each week after 20
Drops @ 36-38 weeks
Prenatal Care 3rd Tri should include? (2)
Leopold Maneuvers are?
Method of feeling for baby's position during 3rd trimester
Cervical Exam during 3rd Tri assesses what? (4)
Position of baby's head in relation to ischial spines of pelvis
Measured -5 to +5
Measurement of 0
Head entered vaginal canal w/i pelvic bones
Prenatal Care Routine Screening labs? (6)
Urine protein/sugar EVERY time
Down's @ 1st tri
Gestational DM @ 24-28 wks
CBC for anemia @ 3rd tri
Repeat Rh @ 3rd tri
Group B strep (vag/rectum) @ 35-37 wks
If Rh screen is negative, next step?
Rh IG @ 28-30 wks
Aneuploidy screening is for?
Aneuploidy screening done when/how? (3)
Sonogram for nucal translucency w/ blood markers
Maternal Quad Screen for markers AFP, uE3, hCG, inhibin A
Cell Free DNA testing is? (5)
Fetal US = ↑ aneuploidy risk
Hx of trisomy
+ test for aneu
US schedule/purpose? (3)
1st tri: dating, location, eval bleeding/pain
2nd tri (18-20wks): growth, anatomy, placenta, P gender
3rd tri: growth, presentation, bleeding, Biophys Profile
Biophysical Profile includes? (5)
Fetal Breathing Movements
Amniotic fluid vol
Appropriate Weight Gain by BMI:
18.5 - 24.9?
25 - 29.9?
<18.5 = underweight
gain 28-40 lbs
18.5 - 24.9 = normal
gain 25-35 lbs
25 - 29.9 = overweight
gain 15-25 lbs
30+ = obese
gain 11-20 lbs
Fetal Wellbeing Tests? (4)
Fetal mvmt/Kick counts
Contraction Stress Test
Compound presentation causes risk of what?
Anterior tear of vulva
(Posterior tears are more common)
Parts of pelvis:
Inlet = Symphysis (top), Sacral promontory (post), pectinate lines (lateral)
Midpelvis = Mid symphysis (top), Midpoint of sacral curve (post), Ischial spines (lateral)
Outlet = Inferior symphysis (anterior), tip of sacrum (post), Ischial tuberosities (lateral)
Passage shape best for pregnancy/delivery?
Acceptable meds for HTN in pregnancy?
NOT ACE inhib! (-prils)
Acceptable ABX for pregnancy?
NOT TCN (Doxy) during preg and breast feeding!
Topical Erythro, Clinda
Systemic Azythro, Amox