Normal Prenatal Care Flashcards Preview

Online Med Ed - Obstetrics > Normal Prenatal Care > Flashcards

Flashcards in Normal Prenatal Care Deck (24)
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1
Q

when do most of severe birth defects happen?

A

within the first 8wks

2
Q

what things are emphasized in pre-conception health?

A

folate supplementation - prevent neural tube defects
optimization of medical conditions
transition from teratogenic meds to pregnancy-safe
improved lifestyle - smoking/alcohol cessation crutial

3
Q

risk addressed in prenatal care of: safety and risk

A

genetic disease
carrier states
domestic violence
maternal complications

4
Q

risk addressed in prenatal care of: folic acid

A

neural tube defects

5
Q

risk addressed in prenatal care of: vaccinations

A

influenza
Hep B
MMR (live attenuated)

6
Q

risk addressed in prenatal care of: lifestyle

A
smoking cessation
alcohol cessation
exercise
sleep
stress management
7
Q

risk addressed in prenatal care of: optimize pre-existing disease

A

diabetes
hypertension
thyroid

8
Q

when is the first visit for pregnancy?

A

10wks

9
Q

what tests done at first visit

A
urine screen
U/S confirms
ß-HCG rarely needed
establish baseline for vitals and weight
bimanual exam
10
Q

what is ultrasound used for

A

confirm IUP, assess gestational age, assess for aneuploidy

11
Q

(G) TPAL

A
(G) = # pregnancies
T = term; # births after 37wks
P = preterm; # births before 37wks
A = abortion; # pregnancies resulting in any outcome for any reason that did not count as a live birth (<20wks)
L = living; # humans birthed alive
12
Q

GPA nomenclature

A
Gravid = # pregnancies
Para = # pregnancies brought to viable gestational age
Abortus = # pregnancies that ended before viable gestational age for any reason
13
Q

when is viability

A

<20wks

14
Q

what labs at first visit?

A
immunity - rubella, varicella, Hep B
maternal anemia
alloimmunization - ABO type; Rh Ag
infection (UTI/STI)
baseline hemoglobin - Identify correctable anemia
HIV - confirm and viral load if positive
RPR - syphilis screen
Hep B - antigen status; antibody status
urine proteinuria baseline
15
Q

how to handle asymptomatic bacteriuria

A

actively screen and treat

16
Q

MMRV vaccine

A

live attenuated, so not given during pregnancy

know titers, specifically rubella and varicella

17
Q

gonorrhea, chlamydia, and syphilis

A

assessed and treated if positive

18
Q

HIV

A

confirmatory viral load/CD4 count
HAART as soon as possible - AZT is right in pregnancy
(ziduvidine)

19
Q

Hep B status

A

can lead to vertical transmission

20
Q

cytology at first visit

A

Pap if indicated by age and history

21
Q

urine at first visit

A

urinalysis, culture - screen for and treat asymptomatic bacteriuria
protein - confounds eclampsia picture
GC/Chla - treat both if find one

22
Q

genetic testing at first visit

A

Cystic Fibrosis (caucasians) and Sickle Cell (African Americans)

23
Q

first trimester screens

A

nuchal translucency
serum HCG
PAPP-A levels

24
Q

follow up appointments

A

q4 wks until 28wks
q2 wks until 36wks
q1 wk until birth