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Flashcards in Prenatal Care Deck (26):
0

Physiologic changes in pregnancy – cardiovascular?

1. 50% increase in Cardiac output and plasma volume
2. Decrease in Systemic vascular resistance
3. Normal/low mean arterial pressure

1

Physiologic changes in pregnancy – respiratory?

1. Tidal volume increased
2. Increase in TV increases minute ventilation
3. Respiratory rate unchanged

2

Physiologic changes in pregnancy – ABG?

1. PH 7.45 (increased)
2. PCO2 28 (decreased)
3. HCO3 18 (decreased)

primary respiratory alkalosis with partial metabolic compensation

3

Physiologic changes in pregnancy – renal?

1. 50% increase in GFR
2. Decreased serum creatinine (Increased creatinine clearance)
3. Dilated ureters
4. Glucosuria

4

Physiologic changes in pregnancy – hematologic?

1. Decreased hemoglobin
2. Decreased platelets
3. Slightly increased leukocytes

5

Physiologic changes in pregnancy – gastrointestinal?

1. Decreased LES tone
2. Delayed stomach emptying
3. Decreased gut motility

6

Isoimmunization?

Development of antibodies due to stimulation from another's RBCs

7

Asymptomatic bacteriuria?

Urine culture of 100,000+ in mid stream specimen

8

antenatal testing – goal?

Determine risk for uteroplacental insufficiency and perinatal death (NST and BPP)

9

PCO2 of 40 in the pregnant patient indicates?

Significant CO2 retention and possible impending respiratory

10

Dating via LMP and fundal height – discrepancy if?

3 cm or more difference in fundal height as what would be expected based on LMP

11

Anemia in pregnancy? Complication if untreated? Next steps?

Hemoglobin <10.5

Preterm delivery

Trial of iron, ferritin studies, hemoglobin electrophoresis

12

Patient nonimmune to rubella – when to vaccine?

Postpartum

13

If Rh antibody screen is negative?

If negative but baby is Rh positive?

Rhogam at 28 weeks

Rhogam at 28 weeks and also after delivery

14

Positive antibody screen suggests?

Lewis lives, Kell kills, Duffy dies

Lewis antibodies are IgM and do not cross placenta

15

Pregnant patient with positive HIV ELISA?

Western blot or PCR – if positive:
1. anti-HIV medicines
2. offer C-section or give IV ZDV is labor

16

Pregnant patient positive for syphilis – tx?

If less than one year – penicillin x1

If unknown/over one year – IM penicillin x3

17

Pregnant Patient positive for gonorrhea – complications? Next step?

Preterm labor, blindness

Ceftriaxone IM

18

Pregnant Patient positive for chlamydia – complications? Next step

Neonatal blindness, pneumonia

Azithromycin or amoxicillin orally

19

Pregnant Patient positive for Hepatitis B surface antigen – complications? Next step

Check LFTs and hepatitis serology to determine if chronic carrier or active hepatitis

Baby needs HB IG and hepatitis B vaccine

20

Pregnant Patient positive for urine culture but asymptomatic – complications? Next step

Asymptomatic bacteriuria leads to Pyelonephritis 25%

treat and recheck; if positive for GBS, give penicillin in labor

21

Pregnant Patient with abnormal Pap smear – Next steps?

Alter management only if invasive cancer

If ASC-US – re-PAP postpartum
If LGSIL or HGSIL – Colposcopy

22

Pregnant Patient positive for nuchal translucency – complications? Next step

May indicated trisomy

Offer karyotype and follow-up ultrasounds

23

Pregnant Patient positive for trisomy screen – complications? Next step

At risk for trisomy or neural tube defect

Ultrasound for dates. If confirmed, offer genetic amniocentesis

24

Glucose tolerance test positive it?

2 normal values

25

Pregnant patients with previous placental abruption – management?

Induction slightly before time of last abruption