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Week 3: Fetal Development > Monitoring Pregnancy > Flashcards

Flashcards in Monitoring Pregnancy Deck (25)
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1
Q

3 ways pregnancy is confirmed

A

Clinical (signs and symptoms, enlarged uterus, etc)
Pregnancy test (urine or serum)
Ultrasound

2
Q

hCG is produced by what cells

A

Placental tissue (the syncytiotrophoblasts)

3
Q

Conversion between gestational and embryonic age

A

Gestational age = embryonic age + 2 weeks

4
Q

3 ways to determine gestational age

A
  1. LMP
  2. Physical examination (clinical size of uterus)
  3. Ultrasound
5
Q

Nagele’s rule

A

Estimated delivery date = LMP - 3 months + 7 days +1 year

6
Q

What is the most accurate way to date a pregnancy?

A

Early ultrasound (7-14 weeks)
Using the crown rump length
Exception is IVF because we know the exact due date
Ideally offered to every patient

7
Q

3 reasons accurate dating is important

A

Assessing impact regarding teratogenic exposures
Monitoring fetal growth
Timing obstetrical intervention

8
Q

5 objectives in the first prenatal visit

A
Confirm pregnancy
Obtain history*
Complete physical exam
Investigations (lab and ultrasound)
Counseling
9
Q

4 objectives in prenatal visits (not the first one)

A

History from last visit
Focused physical exam
Additional investigations
Counseling

10
Q

GTPAL stands for…

A

Gravida: how many pregnancies a woman has had, including the current one
Term: number of pregnancies she has delivered at term
Preterm: 20-37 weeks
Abortus: before 20 weeks
Living: number of living children
G increases when you get pregnant, but the others increase when you deliver

11
Q

Schedule of visits for low-risk pregnancies

A

Every 4 weeks until 28 weeks
Every 2 weeks from 28-36 weeks
Every week from 36 weeks on

12
Q

3 things you really want to ask for in a focused history

A

Contractions
Bleeding
Fetal movement

13
Q

3 things to measure in a focused physical exam

A

Blood pressure
Symphyseal fundal height (from pubis to top of uterus)
Listen to fetal heart rate

14
Q

4 general screening tools

A

Maternal age (aneuploidy increases w age)
Serum biochemistry
Ultrasoun
NIPT

15
Q

3 diagnostic tools

A

Amniocentesis
Chorionic villus sampling
Fetal blood sample

16
Q

SIPS

A

Serum Integrated Prenatal Screen
Looks at maternal age and serum biochemistry
Screens for Down’s, NTDs, and trisomy 18

17
Q

IPS

A

Integrated Prenatal Screen

Looks at maternal age, serum biochemistry, and nuchal translucency scan

18
Q

Nuchal translucency scan

A

Special ultrasound technique
Looking at fluid accumulation in spinal cord
If it is enlarged there is an increased risk for Down’s

19
Q

NIPT

A

Non-invasive prenatal testing
Measures cell-free fetal DNA in serum after 10 weeks
Screens for Down’s, trisomy 18, and 13

20
Q

Second trimester detailed ultrasound

A

18-22 weeks (just to 20?)
Offered to all women
Focuses on fetal anatomy, fetal growth, amniotic fluid volume, placenta location, and may include soft markers of aneuploidy
Can see structures, but may not be able to tell how they are working

21
Q

Third trimester ultrasounds

A

Not routine

May be considered based on risk factors

22
Q

5 factors affecting the accuracy of ultrasound

A
Access to ultrasound
Maternal body habits
Number of fetuses
Position of fetus
Technical factors
23
Q

Amniocentesis

A

Sample amniotic fluid to obtain fetal cells for testing
Invasive (risk of miscarriage)
Performed after 15 weeks

24
Q

Chorionic villus sampling

A

Sample placental villi for testing
Invasive (risk of miscarriage)
Performed between 10-13 weeks

25
Q

Fetal blood sample

A

Sample fetal blood from umbilical cord or heart

Rarely used as it’s extremely invasive