Normal Pregnancy

Question 1

For elective termination of a pregnancy, what are 2 main drug options that can be combined with ____?

Answer 1

Mifepristone OR Methotrexate
+ Misoprostol

Question 2

For elective termination of a pregnancy, what are 2 main drug options that can be combined with _____?

Answer 2

Mifepristone OR Methotrexate
+ Misoprostol

Question 3

What are 2 surgical procedures for an elective termination of pregnancy?

Answer 3

• Manual uterine aspiration
• D&C with vacuum aspiration

Question 4

How do you calculate gestational age?

Answer 4

1st day of LMP - 3 months + 7 days

Question 5

What is the fundal height and what should it be?

Answer 5

Measurement from pubic bone to top of uterus
= # of weeks pregnant in cm is normal

Question 6

When are fetal heart tones detected?

Answer 6

10-12 weeks

Question 7

When is fetal movement detected?

Answer 7

17-18 weeks

Question 8

States the trimesters and the weeks they include

Answer 8

Trimester 1 = 1 - 13
Trimester 2 = 14 - 27
Trimester 3 = 28 - 40

Question 9

How often do prenatal visits occur?

Answer 9

• q4 weeks until 28 weeks
• q2 weeks until 36 weeks
• q1 week until delivery

Question 10

When do you screen for Gestational Diabetes?

Answer 10

24 weeks

Question 11

When do you administer Rhogam if it is needed?

Answer 11

• 28 weeks
• Within 72 hours of delivery
• Any time there is mixing of mother and baby’s blood

Question 12

When do you obtain a GBS culture? What is the treatment if positive?

Answer 12

36 weeks
= Penicillin within 4 hours of delivery

Question 13

In early pregnancy, what is expected of the beta-hCG levels?

Answer 13

Double every 48 hours

Question 14

What should be visible at week 5? 6? 7?

Answer 14

5 = gestational sac
6 = fetal pole
7 = cardiac activity

Question 15

What 4 things are included in the Quad screening?

Answer 15

AFP
Inhibin A
Estriol
Beta-hCG

Question 16

What 4 things are included in the Quad screening?

Answer 16

AFP
Inhibin A
Estriol
Beta-hCG

Question 17

What can a HIGH AFP indicate? (3)

Answer 17

Multiple gestations
Neural tube or abdomen defects

Question 18

In general, what can LOW AFP indicate?

Answer 18

Trisomies

Question 19

Describe the Quad screening result for Trisomy 18

Answer 19

ALL LOW
“underage at 18”

Question 20

Describe the Quad screening result for Trisomy 21

Answer 20

LOW AFP and Estriol
HIGH Inhibin A and Beta-hCG

Question 21

When can you perform Cell-Free Fetal DNA and what does it do?

Answer 21

10 weeks
= Fetal DNA from mother’s blood sample

Question 22

When can you perform Chorionic Villus Sampling and what is it?

Answer 22

10-12 weeks
= Aspiration of placental tissue

Question 23

When can you perform Amniocentesis and what is it?

Answer 23

15-20 weeks
= Aspiration of amniotic fluid

Question 24

What 3 tests can you do to detect fetal genetic abnormalities?

Answer 24

1. Cell-Free Fetal DNA
2. Chorionic Villus Sampling
3. Amniocentesis

Question 25

Signs of Toxoplasmosis infection?

Answer 25

1. Hydrocephalus 2. Intracranial calcifications 3. Chorioretinitis

Question 26

What will be seen on brain MRI with infection of Toxoplasmosis for neonate?

Answer 26

Ring-enhancing lesions

Question 27

What is the treatment for neonatal Toxoplasmosis? (2)

Answer 27

Pyrimethamine + Sulfadiazine

Question 28

Signs of Rubella infection?

Answer 28

1. PDA 2. Cataracts 3. Deafness 4. Blueberry rash

Question 29

Signs of CMV infection?

Answer 29

1. Periventricular Calcifications 2. Petechial rash

Question 30

Signs of Early and Late Syphilis infection?

Answer 30

Early = Snuffles, Hepatomegaly, Rash Late = Saber shins, Saddle nose, Peg teeth, Deaf

Question 31

What are some normal changes that occur to the mother following delivery?

Answer 31

- Fever and chills - Lochia = vaginal discharge - Urinary retention due to bladder atony

Question 32

If a postpartum mother experiences urinary retention, how can you help it resolve?

Answer 32

Ambulation +/- catheterizationi

Question 33

1st degree laceration

Answer 33

Vaginal mucosa

Question 34

2nd degree laceration

Answer 34

Perineal muscles

Question 35

3rd degree laceration

Answer 35

Anal sphincter

Question 36

4th degree laceration

Answer 36

Rectum

Question 37

What is the equation for MAP?

Answer 37

MAP = CO X SVR

Question 38

What happens to SVR during pregnancy?

Answer 38

DECREASES due to more placental vessels being formed and with progesterone

Question 39

The SVR will decrease during pregnancy. What occurs to the CO?

Answer 39

Increases! - Increased HR and SV

Question 40

What happens to the RBC volume/hemoglobin during pregnancy?

Answer 40

RBC volume increases but the hemoglobin will decrease due to its concentration being diluted