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Women's Health Clin med > Prenatal Care > Flashcards

Prenatal Care Flashcards

(66 cards)

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1
Q

When is genetic testing done during prenatal care

A

before conception

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2
Q

What is a screening

A

identification of an asymptomatic disease, harmful condition or risk factor

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3
Q

What is the difference between a prenatal screening and a diagnostic test

A

Screenings give a probability

Diagnostic gives a definitive

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4
Q

What are some fetal diagnostic tests

A

chorionic villus sampling
amniocentesis

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5
Q

What do fetal diagnostic tests show us

A

detects all trisomies, chromosomal abnormalities, several hundred mendelian abnormalities

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6
Q

When is chorionic villus sampling preformed and what is it

A

between 10-13 weeks gestation
Bx of placental tissue

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7
Q

How is a chorionic villus sampling preformed

A

transabdominal approach preferred (less risk and higher yield)

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8
Q

When can an amniocentesis be preformed

A

> 15weeks gestation

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9
Q

Who should be offered an amniocentesis

A

All pregnant women but especially those >35 due to higher risk for abnormalities

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10
Q

What is percutaneous umbilical blood sampling

A

Fetal blood samples via percutaneous puncture of umbilical cord vein under US guidance

*generally in 3rd trimester if new abnormality is found

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11
Q

What is preimplantation genetic testing (PGT)

A

Prior to IVF implantation, polar bodies for oocytes, blastomeres from 6-8 embryos or trophectoderm sample from blastocytes are sampled

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12
Q

How many types of PGT are there and what do they test for

A

PGT-M: Risk of certain mendelian disorders

PGT-A / PGT-SR: Chromosomal abnormalities

PGT-A: primarily for embryos from older women

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13
Q

What is aneuploidy testing

A

Tests for additions or deletions from chromosomes (trisomy 21)

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14
Q

What are the genetic screening catagories

A

Carrier screening
Aneuploidy screening
Neural tube defects

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15
Q

What is the main risk factor for genetic disease

A

Advanced maternal age >35y/o

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16
Q

What is commonly screened for in pregnancy

A

CF
Hemoglobinopathies
neural tube defects
Trisomy 13,18, 21
Spinal muscle atrophy
Tay-sachs

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17
Q

Which ethnicity is at greatest risk for tay-sachs disease

A

Ashkenazi Jews

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18
Q

What is trisomy 18

A

Edwards syndrome

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19
Q

What is trisomy 13

A

Patau syndrome

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20
Q

What genetic mutations causes CF

A

CFTR mutation

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21
Q

What is a common hemoglobinopathy

A

thalassemia and sickle cell

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22
Q

When is father tested for genetic abnormalities

A

Only if the mother is positive

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23
Q

What tests are used for checking for neural tube defects

A

Maternal serum alpha fetoprotein
*elevated at 16-18 weeks

Transvaginal ultrasound (TVUS)

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24
Q

What is the test of choice with increased risk of neural tube defects

A

Transvaginal ultrasound
*screening & diagnostic

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25
Which women should have aneuploidy testing
all women regardless of age
26
What is spinal muscular atrophy
Degeneration of anterior horn cells in spinal cord and motor nuclei in lower brainstem
27
When is genetic screening done in pregnancy
First and second trimester via maternal serum markers or cfDNA and US
28
What is tested via maternal serum markers
Alpha fetoprotein Uncongugated Estriol Human chorionic gonadotropin Inhibin A
29
What are the non-invasive screening strategies during pregnancy
Integrated screening Sequential screening non-invasive prenatal test (for trisomies ONLY)
30
When is an US recommended for all pregnant women
at 18-22 weeks
31
What is looked for on 18-22 week ultrasound
Confirm gestational age determine fetal viability detect multi-fetal pregnancy
32
When are targeted prenatal ultrasounds utilized
couples with families with a history of congenital malformations
33
What is detected on targeted US
Renal malformations Achondrogenesis Gut malformations Diaphragmatic hernia microcephaly hydrocephalus
34
What finding on US mark genetic disorders
Increased nuchal translucency Echogenic cardiac focus Echogenic bowel single umbilical artery short femur length choroid plexus cyst absent nasal bone
35
what are presumptive signs of pregnancy
missed period N/V Breast changes Increased urine frequency
36
What are probable signs of pregnancy
-Enlargement of uterus -Hegars sign (Softening of isthmus) -Chadwicks sign (Cyanotic cervix) -Goodells (Softening of cervix from increased vascularity) -Piskaceks sign (Asymmetric bulge from placenta) -Positive HCG -Melasma
37
What are positive signs of pregnancy
Fetus seen on US Fetal heartbeat Delivery of baby
38
How early can hCG and urine detect pregnancy
hCG detectable 8 days post conception Urine detectable 10days after conception
39
What is the most accurate method of determining gestational age
first trimester US
40
What is the EDC calculated with
Naegeles rule *LMp -3 months + 1year + 7days
41
What trimester is a mother is if she's is 14-27 weeks gestation
2nd
42
When is the fetal heartbeat detectable
10 weeks
43
When is the uterus palpable in the abdomen
12 weeks
44
When is quickening noticed
between 18-20 weeks
45
When does the fundus reach the umbilicus
20 weeks
46
When can fetal movement be observed by partner
24 weeks
47
When does the fundus meet the max height and what is the max heigh
Xiphoid process around 36 weeks
48
How many prenatal visits are recommended
14 visits *W/ AT LEAST 1 US
49
What is FHT
Fetal heart tracing
50
What is CRL
Crown to rump length
51
What is SLIUP
Single Live intrauterine pregnancy
52
When is the first prenatal visit done and what does the appointment confirm
8-10 weeks comprehensive visit -confirm pregnancy - Estimated delivery date -prescriptions OB-GYN hx
53
When is the first prenatal visit done and what does the appointment confirm
54
What is the most important vital to check throughout pregnancy
blood pressure
55
What is the schedule for prenatal visits
first visit at 8-10 weeks every 4 weeks until 28 weeks every 2-3 weeks until 36 weeks every week until delivery
56
What infectious disease testing is done at the first prenatal visit
Hep B Rubella Varicella Chlamydia syphillis HIV If high risk = gonorrhea
57
Who is at risk for gestational diabetes
women with BMI >25 and meet 1 other risk factor -first degree reletive -prior gestational diabetes -advanced maternal age -weight gain > 11lbs since 18th bday
58
What is a normal caloric requirement during pregnancy
2200-2900 cals/day
59
How many extra calories a day are required during breast feeding
500
60
What does a new onset elevated blood pressure after 20 weeks indicate
gestational HTN or preeclampsia
61
When is gestational diabetes screened for
24 week prenatal visit
62
When is Rhogam used prenatal and what is it
Rh immunoglobulin to prevent antepartum auto immunization to possible fetal Rh-positive cells
63
When does the mother receive Tdap to protect the baby from pertussis
between 27-36 weeks
64
How do you determine fetal position
Leopolds Maneuvers
65
Who gets prenatal group B strep testing
all mothers
66
When is labor induction offered
>41 weeks

Women's Health Clin med (13 decks)

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