intro to OB-Table 1 Flashcards
What is the definition of preconception counseling?
Health of women and men during reproductive years
What issues should you address in women ages 15-44 in order to improve outcomes in event of pregnancy?
- ID/stabilize chronic conditions
- Minimize med risk
- Maintain IZ
- Address weight, nutrition, exercise
- ID potential genetic disorders
What should be weight loss goal for obesity?
5-10% of baseline 6mo prior to pregnancy
What is the first change women will notice when preggo?
Breast tenderness
What are clinical S/S of a suspected preggo lady?
Fatigue, N/V, breast tenderness, frequent urination, missed menses
When is there enlargement and softening of the uterus?
6 weeks
What are PE findings in a newly preggo lady?
Congestion and bluish discoloration of the vagina (Chadwick sign)
Softening of the cervix (hegar sign)
How should you confirm a suspected pregnancy?
UCG and beta- HCG
What does a UCG measure?
hcg/alpha unit which overlaps w/LH structure
What does the Q/Q beta-hCG measure?
Beta subunit
What can you visualize on US at 5-6 wks?
- embryonic cardiac activity at >4000 mIU/mL
- gestational sac (beta-hCG 5000-6000 mIU/mL)
What can TVUS detect at 3-4 wks gestation?
GA (beta-hCG 1000-2000 mIU/mL)
When can the Doppler detect fetal heart tones?
10-12 wk GA
What are the risks you want to assess during antepartum care?
- advanced maternal age (>35) and or paternal age (>50)
- hx of early preggo loss
- previous IUP complicated by chromosomal abnormality
What are genetic testing options when assessing for risk?
- carrier testing
- CVS
- Amniocentesis
What are the common chromosomal abnormalities we want to screen for?
Trisomy 21, fragile X, turner syndrome, klinefelter syndrome, and cri du chat
What weeks during the first trimester can you do screening? What tests are you going to do?
10-13 week GA
obtain beta-hCG and preggo associated plasma protein A ( PAPP-A) and a CVS
When during the second trimester do you screen? What tests do you run?
15-20wk GA
triple(no inhibin) or quad marker( AFP, estriol, hCG, and inhibin A marker)
-need maternal age, wt, ethnicity, and EGA
amniocentesis
What is the integrated 1st and 2nd trimester screen?
Combines PAPP-A plus triple or quad
What is nuchal translucency? What is it used for? When do you screen this?
Early US at initial prenatal visit
Fluid collection at the back of the neck used as a marker for Downs( 10-14wk GA)
What A/P needs to be addressed during the initial prenatal visit?
—RTC q 4 weeks until 28-30 weeks GA
—RTC q 2 weeks 28-30 to 36 weeks GA
—RTC q week >36 weeks GA
What initial labs do you want to run on the mother at the first prenatal visit?
CBC, glucose, blood type/Rh, urinalysis, Pap, STD: RPR/FTA, HIV, gc, chlamydia, hepatitis B
What are some common symptoms in preggo?
—Headache —Edema —N/V —Heartburn —Constipation —Fatigue —Leg cramps —Back pain —Round ligament pain —Varicose veins, hemorrhoids —Vaginal discharge
What should be done at all the subsequent antenatal visits?
BP, wt
Fundal ht
FHR ( tachy >160, brady
