PRENATAL CARE

Question 1

Perception of fetal movement

Answer 1

16-18 weeks - multigravida

18-20 weeks - nulligravida

Question 2

B-hCG

Answer 2

8-9 days after ovulation - detection

60-70 days - reach peak levels

16 weeks - plateau

Question 3

gestational sac

Answer 3

small anechoic fluid collection within the endometrial cavity

4-5 weeks

Question 4

The first sonographic evidence of pregnancy

Answer 4

gestational sac

Question 5

pseudogestational sac or pseudosac

Answer 5

fluid collection within the endometrial cavity with an ectopic pregnancy

Question 6

intradecidual sign

Answer 6

anechoic center surrounded by a single echogenic rim

Question 7

double decidual sign

Answer 7

two concentric echogenic rings surrounding the gestational sac

Question 8

yolk sac

Answer 8

brightly echogenic ring with an anechoic center

5.5 weeks

Question 9

Confirms intrauterine location

Answer 9

yolk sac

Question 10

Cardiac motion is noted

Answer 10

6 weeks

Question 11

Crown rump length - predictive of gestational age within 4 days

Answer 11

up to 12 weeks gestation

Question 12

Major goals of prenatal care

Answer 12

define the health status of the mother and fetus

estimate the gestational age

initiate a plan for continued obstetrical care

Question 13

Pelvic Inlet Landmarks

Answer 13

POSTERIOR
promontory
sacral alae

LATERAL
linea terminalis

ANTERIOR
pubic symphysis
pubic rami

Question 14

True/Anatomic Conjugate

Answer 14

promontory to upper margin of symphysis

11 cm

Question 15

Obstetric Conjugate

Answer 15

promontory to posterior symphysis

subtract 1.5 to 2 cm from diagonal conjugate

> 10 cm

Question 16

Diagonal Conjugate

Answer 16

promontory to LOWER margin of symphysis

> 11.5 cm

measured manually

Question 17

Subsequent Prenatal Visits

Answer 17

4 week intervals – until 28 weeks

every 2 weeks – until 36 weeks

weekly – after 36 weeks

Question 18

Weeks wherein the fundal height correlates closely with gestational age in weeks

Answer 18

b/w 20 and 34 weeks gestation

Question 19

FHR

Answer 19

110-160 bpm

Question 20

fundic soufflé

Answer 20

sharp, whistling sound that is synchronous with the FETAL pulse

caused by the rush of blood through the umbilical arteries

Question 21

uterine soufflé

Answer 21

soft, blowing sound that is synchronous with the MATERNAL pulse

produced by the passage of blood through the DILATED UTERINE VESSELS

heard most distinctly near the lower portion of the uterus

Question 22

35-37 weeks

Answer 22

• vaginal and rectal group B streptococcal (GBS) cultures obtained in all women

Question 23

24-28 weeks

Answer 23

All pregnant women are screened for GESTATIONAL DM, whether by history, clinical factors, or routine laboratory testing

Question 24

15-20 weeks

Answer 24

Serum screening for neural-tube defects

Question 25

11-14 weeks and/or 15-20 weeks

Answer 25

Fetal aneuploidy screening; depending on the protocol selected

Question 26

Average retained pregnancy weight

Answer 26

2.1 Ib or 1 kg

Question 27

With potentially toxic effects

Answer 27

iron, zinc, selenium, and vitamins A, B6, C, and D

Question 28

Caloric increase recommended during pregnancy

Answer 28

100 to 300 kcal/d

Question 29

Recommended protein intake during pregnancy

Answer 29

1 g/kg/d

Question 30

Supplemented daily iron for pregnant women

Answer 30

27 mg of elemental iron

Question 31

Recommended elemental iron per day for large women, has a multifetal gestation, begins supplementation late in pregnancy, takes iron irregularly, or has a depressed hemoglobin level

Answer 31

60 to 100 mg of elemental iron per day

Question 32

Recommended iodine allowance

Answer 32

220 µg/d

Question 33

Recommended daily intake during pregnancy

Answer 33

12 mg

Question 34

Manifested by a frequently fatal cardiomyopathy in young children and reproductive-aged women

Answer 34

Selenium deficiency

Question 35

Develops in the same circumstances as in nonpregnant individuals-a common example is hyperemesis gravidarum

Answer 35

Potassium deficiency

Question 36

Supplementation in early pregnancy can lower neural-tube defect risks

Answer 36

400 µg/d

Question 37

Recommended for woman with a prior child with a neural-tube defect

Answer 37

4 mg/d

Question 38

Has been associated with congenital malformations when taken in high doses (> 10,000 IU/d) during pregnancy

Answer 38

Vitamin A

Question 39

In the absence of obstetrical or medical complications, pregnant women can safely travel

Answer 39

up to 36 weeks' gestation

Question 40

Immunization in Pregnancy

Answer 40

Tetatus-Diptheria-Acelluar Pertussis (TDAP) Influenza Vaccine Hepatitis B

Question 41

Safe vaccines during pregnany

Answer 41

rabies vaccine (killed-virus) Hepatitis A Pneumococcus Varicella Ig (post exposure)

Question 42

Contraindicated vaccines during pregnancy

Answer 42

``` Measles Mumps Rubella Varicella HPV ```

Question 43

INCREASED hCG CONDITIONS

Answer 43

``` multiple pregnancy molar pregnancy exogenous injection impaired renal clearance hCG secreting tumors from GI, ovary, bladder, lungs ```

Question 44

Predictive of gestational age w/n 4 days

Answer 44

Crown Rump Length