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OBGYN rotation review > prenatal care > Flashcards

prenatal care Flashcards

(66 cards)

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1
Q

if a preggo is underweight w/ a BMI of less than 18.5, how many pounds is it recommended that she gain during pregnancy

A

28-40

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2
Q

how much exercise should a preggo be getting per week

A

150 min

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3
Q

2nd trimester is considered week ___ to ___

A

13 to 26 6/7

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4
Q

when do fetal kick counts begin?

what are you wanting?

A

at the third trimester

want

10 kicks/rolls/flutters within 2 hours

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5
Q

Naegeles rule

A

how to estimate when baby will be born

add 7 days to LMP

add 9 months

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6
Q

LMP means

A

1st day of last menstrual cycle

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7
Q

if a preggo is obese w/ a BMI over 30, how many pounds is it recommended that she gain during pregnancy

A

11-20

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8
Q

what bloodwork are you getting at the 1st trimester visit

A

​CBC (anemia?

blood type and RH

antibody screen

rubella and varicella titers

RPR (syphilis testing)

Hep B antigen

HIV

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9
Q

what is NIPT

A

Non-Invasive Prenatal Test

serum draw that tests DNA

coincides with a Nuchal Translucency scan that can be done instead of First Trimester Screening to indicate trisomies

done as early as 9 weeks

earlier detection than FTS but more expensive

(optional)

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10
Q

when is the 2nd trimester visit?

what diagnostic tests are done

A

18-22 weeks

ultrasound

look for abnormalities, fetal position, location and status of placenta, Amniotic Fluid Index, cervical length, estimate fetal weight

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11
Q

what vaccinations does a woman trying to become pregnant need to be up to date on

A

MMR

varicella

Hep B

Flu

Tdap

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12
Q

which weeks are you doing US and Leopold Maneuvers

A

(3rd trimester)

weeks 32 to 34

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13
Q

what is Non Stress Test (NST)

A

traces the fetal HR and uterine activity for 20 minutes

need minimum of 2 acclerations that increase by 15 bpm and last for 15 seconds

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14
Q

at 20 weeks, the fundal heigh is measured to

A

the umbilicus

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15
Q

leopolds maneuvers

A

how you check the positioning of the fetus

done at 32 to 34 weeks

(3rd trimester)

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16
Q

if a preggo is of normal weight w/ a BMI of 18.5 to 24.9, how many pounds is it recommended that she gain during pregnancy

A

25-35

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17
Q

how is the success rate of induction estimated?

A

Bishop score

8 to 13 = high chance of success

0 to 4 = high chance of failure

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18
Q

what is the quickening and when does it occur

A

first fetal movements

1st pregnancy = 18 to 20 weeks

2+ pregnancies = 16 to 18 weeks

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19
Q

how often should a patient be seeing the OBGYN during pregnancy

A

first 28 weeks = every 4 weeks

weeks 28-36 = every 2 weeks

weeks 36 onwards = weekly

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20
Q

when should the 1st trimester visit be

A

between 8-10 weeks

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21
Q

antenatal

A

means prenatal

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22
Q

what is the lightening and when does it occur

A

when the fetus drops into the pelvis

at 36 to 38 weeks

decreases Amniotic Fluid Index

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23
Q

what are some social things you need to talk about with a newly pregnant patient

A

intentional pregnancy?

domestic violence?

substance abuse?

inherited diseases?

barriers to routine visits

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24
Q

what is an NT scan

A

sonogram that determines if Nuchal Translucency (NT) is thickened which can indicate Down Syndrome and cardiac abnormalities

done between 11 and 14 weeks

(optional but often covered and available)

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25
what urine lab tests are you doing at the 1st trimester visit
UA urine cx
26
when do you do a Quad Screen
if NT and FTS were not performed (if they were, only do the AFP
27
If you have a high risk pregnancy, what tests might you do in the 3rd trimester
NST Biophysical Profile
28
what is early term pregnancy
37 weeks to 38 6/7 weeks
29
if you have a RhD negative mom, when are you giving Rh Immune Globulin and how much
at 28 to 30 weeks 300 ug
30
what is the most accurate screen for Downs
NIPT | (Non-Invasive Prenatal Testing)
31
what labs do you get at every visit
urine | (check glucose and protein)
32
which weeks are you doing cervical exams to determine dilation, effacement, station, position, and presenting part
weeks 35 to 40 | (3rd trimester)
33
**which prenatal visit is all about the US** (looks at anatomy, fetal position, location and status of placenta, Amniotic Fluid Index, cervical length, fetal weight estimates)
2nd trimester 18 to 22 weeks
34
what is a Biophysical Profile (BPP)
**fetal US that measures fetal:** * movement * muscle tone * breathing (motion of diaphragm) * amniotic fluid level **each is worth 2 points w/ 8/8 being perfect** * sometimes fetal HR is measured (so 10/10)
35
when does the most accurate US dating occur
1st trimester
36
what is AFP
Alpha FetoProtein elevated levels could indicate neural tube defects performed between 15 and 22 weeks, possibly with Quad Screen optional test
37
how do you do the 3 hour glucose tolerance test
load her up with 100 grams of oral glucose 4 blood draws * fasting should be less than 95 * 1 hour should be less than 180 * 2 hour should be less than 155 * 3 hour should be less than 140 2 abnormal OR 1 value \> 200 = FAIL = GDM
38
EDC means
estimated date of confinement same thing as estimated date of delivery
39
hegars sign
palpable softening of the isthmus that is a sign of pregnancy
40
what serum markers are measured during the Quad Screen
alpha fetoprotein uE3 hCG inhibin A
41
what is full term pregnancy
39 weeks to 40 6/7 weeks
42
GA means
gestational age
43
at 12 weeks, the fundal height is measured to the
pubic symphysis
44
what is a Quad Screen
aka Maternal Serum Screen done between 15 and 22 weeks (most accurate between 16 and 18) along with AFP screens for neural tube defects and trisomies
45
when doing the Group B Strep Culture, what are you swabbing
the lower vagina and the rectum
46
what is late term pregnancy
41 weeks to 41 6/7 weeks
47
3rd trimester is considered week ___ to \_\_\_
week 27 to the end
48
during the 1st trimester visit, you should instruct the preggo to avoid what foods
fish w/ high mercury content (tuna, swordfish, etc.) raw meat/ eggs hot dogs/ deli meat unpasteurized dairy more than 200 mg of caffeine/ day
49
EDD means
estimated date of delivery
50
how and when can you determine fetal gender
in the blood at 9 weeks US at 16 weeks
51
the Bishop score gives points based on what 5 things
C-PEDS 1. Cervical consistency 2. Position of cervix 3. Effacement Percent 4. Dilation (cm) 5. Station
52
when is **everyone** tested for Gestational DM
**between weeks 24 and 28** **(3rd trimester visit)** could be sooner if reason to suspect GDM
53
chadwicks sign
blueish purple tint of vaginal walls/ cervix indicating pregnancy (due to increased blood flow; occurs around 6-8 weeks)
54
if a preggo is **overweight** w/ a BMI of less than 25 to 29.9 how many pounds is it recommended that she gain during pregnancy
15 to 25
55
how do you do 1 hour glucose challenge
load her up with 50 grams of oral glucose 1 hour later... * BS \< 140 = pass * BS 141 to 199 = abnormal ⇒ 3 hour glucose tolerance test * BS \> 200 = automatic fail = GDM
56
what is the **earliest** that a transvag US can visualize cardiac activity of the fetus
5.5 weeks
57
1st trimester is considered week __ to \_\_\_
week 1 to 12 6/7
58
which tests screen for neural tube defects
NT scan AFP Quad screen
59
what is FTS
First Trimester Screening serum draw that coincides with a Nuchal Translucency scan that **determines if PAPP-A and beta HCG are elevated which can indicate trisomies** **done between 11 and 14 weeks** **(optional)**
60
what is post term pregnancy
42+ weeks
61
in addition to bloodwork and urine testing, what other testing are you doing at the 1st trimester visit
**cytology (Pap smear, gonorrhea, and chlamydia cx)** **US (confirm EDD and r/o ectopic pregnancy)** maybe TSH, CF screening, TB, HbA1C
62
what labs are you drawing up at 24 to 28 week visits?
(3rd trimester) CBC RPR (syphillis) ABO and Rh antibody screen blood glucose
63
if someone comes in for prenatal care counseling, what supplements should you suggest
folic acid (0.4 to 0.8 mg/ day beginning 1 month prior to conception) DHA (wards off postpartum depression)
64
what are you giving someone with GDM
insulin
65
which weeks are you doing the Group B Strep Culture
weeks 35 to 37 | (3rd trimester)
66
which tests screen for trisomies
NT scan FTS NIPT Quad screen

OBGYN rotation review (14 decks)

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