Lecture 42 - Prenatal Care Flashcards
Ashkenazi Jewish mothers should be screened for ____-_____ disease, Familial _________, CF, Canavan disease, and ____ ____ ____ (SMA).
Tay-Sachs
Familial Dysautonomia
Spinal Muscular Atrophy (SMA)
Folic acid recommendation for pregnant women is _____mg/day. For women with a hx of births with Open Neural Tube Defects (ONTD), the dose is increased to ______mg/day.
Keep in mind the dosages are increased for multiple pregnancy.
- 4mg/day
4. 0mg/day
Pregnant women should limit their consumption of caffeine to < _____mg/day. Higher doses are linked to increased risk for ______ Growth Restriction (IUGR) and spontaneous _______.
200mg/day
Intrauterine Growth Restriction (IUGR)
Abortion
Smoking cessation for patients trying to conceive is important bc smoking increases risk of _______ placentae, Placenta _____ (placenta covers the cervix), and ______ (after birth).
Abruptio placentae
Placenta Previa
SIDS
The greatest risk for fetal alcohol syndrome is during the ______ trimester.
First
ABC’s for FDA Pregnancy Risk Categories of medications:
A –> good to go (e.g. folic acid)
B –> animal studies suggest it’s fine, but no adequate human studies (e.g. ______)
C. –> animal studies show adverse effects, but no adequate human studies. Potential benefits may warrant use. (e.g. _______)
D. –> human studies show adverse risk, but benefits in select circumstances may warrant use. (e.g. _______)
X. –> known risk, don’t use.
A. –> Folic acid
B. Amoxicillin, Ceftriaxone
C. Amlodipine, acetaminophen, Theophylline
D. Phenytoin, tetracycline
X. –> Finasteride, Retinoic Acid, Methotrexate
Signs of pregnancy include:
______ sign –> cyanosis of upper vagina and cervix
_____ sign –> softening of cervix
______ sign –> softening AND cyanosis of cervix at about 4 weeks.
Chadwick’s sign
Ladin’s sign
Goodell’s sign
When should home pregnancy tests be done and why?
They should be done with the first voiding of the morning –> this gives the best chance of avoiding a False negative (they can detect beta-hCG levels as low as 25mIU/mL)
Serum pregnancy tests can detect pregnancy (5 mIU/mL) by about day _____ (right after implantation).
8
Tranvaginal ultrasound can detect pregnancy by about week _____, when a ______ ___ is visible (Beta-hCG ~ 1500 mIU/mL)
5
Gestational sac
Dating of pregnancy can be calculated using Nagele’s rule –> ADD _____ days from last menstrual period and SUBTRACT ____ months.
7days
3 months
The discrepancy between ultrasound dating and Last Menstrual Period (LMP) dating in the first trimester is ~ ____, in the second trimester is ~ _____, and in the third trimester is ~ _____. Ultrasound should be used as the accurate date.
1 week
2 weeks
3 weeks
Pregnant mothers should be scheduled for visits every ____ weeks from initial visit to 28wks. Between 28-36wks, they should be scheduled for visits every ___-___weeks. Over the last 3 weeks (36-39), they should be scheduled for visits every week.
4 weeks
2-3 weeks
On physical exam of pregnant women, measurement of the ______ height can give a good measurement of age of fetus. Distance in cm between the pubic symphisis and ____ of the uterus (+ or - ____cm) is the fetal age. Keep in mind this is also a good measure of progression of fetal growth.
Fundus height
Fundus
+ or - 2cm
_______ maneuvers are used to determine the relative size of the fetus and its position. Begin by palpating at the top of the abdomen, then the sides, then the pelvis, then using your fingertips to feel for the face (determine which way the baby is facing).
Leopold’s maneuvers
