Prenatal care - Hx, PE and Dx Flashcards Preview

OBGYN - 3. OB normal > Prenatal care - Hx, PE and Dx > Flashcards

Flashcards in Prenatal care - Hx, PE and Dx Deck (31)
Loading flashcards...
1
Q

System for measuring prenatal care adequacy

A

Kessner index

2
Q

Time frame for the three trimesters

A
  • First – first 14 weeks
  • Second – through 28 weeks
  • Third – 29th to 42nd week

Note: 3 periods of 14 weeks each

3
Q

Frequency of prenatal check-up

A
  • Monthly until 28 weeks (1st two trimesters)
  • Every 2 weeks until 36 weeks
  • Weekly > 36 weeks (near term)
4
Q

Initial prenatal work-up

A
  • CBC
  • Blood typing
  • Urine culture
  • OGTT
  • HBsAg
  • RPR
  • Pap smear
  • Rubella IgG
  • Biometry
  • BPP
5
Q

75 g OGTT is best done when? Why?

A
  • When
    • At 24-28 weeks
  • Why
    • HPL is produced at this time which causes insulin resistance, lipolysis and increased fatty acids
6
Q

UTZ work-up schedule

A
  • < 12 weeks
    • TVS
  • 12 to 28 weeks
    • Biometry
  • 28 to 34 weeks
    • Biometry, BPP
  • > 34 weeks
    • Biometry, BPP, NST (closed cervix), IPM (open cervix)
7
Q

10 danger signs of pregnancy

A
  1. Headache
  2. Blurring of vision
  3. Prolonged vomiting
  4. Epigastric pain
  5. Nondependent edema
  6. Fever
  7. Dysuria
  8. Watery discharge
  9. Blood discharge
  10. Decreased fetal movement
8
Q

T/F. Twin gestation count as 2 parity

A
  • False
    • Count multiples as 1 parity, but TPAL is affected
9
Q

T/F. Stillbirths is counted as parity

A

True

10
Q

T/F. Twin abortion is counted as 1 A in TPAL

A

True

11
Q

Women with complicated pregnancies often require return visits at ___ intervals.

A

1- to 2-week

12
Q

What if OGTT finding is elevated? What if normal?

A
  • One positive, take note of the level (manage)
  • If negative, repeat at 28 and 32 weeks
13
Q

Timing for the following tests

  • Fetal aneuploidy screening
  • Serum screening for neural-tube defects
  • Vaginal and rectal GBS cultures
A
  • Fetal aneuploidy screening
    • 11 to 14 weeks and/or at 15 to 20 weeks
  • Serum screening for neural-tube defects
    • 15 to 20 weeks
  • Vaginal and rectal GBS cultures
    • 35 to 37 weeks
14
Q

Source of swab for GBS

A

Rectovaginal

15
Q

In DM, laboratory testing between ___ is the most sensitive approach

A

24 to 28 weeks

16
Q

Age

  • Young primigravida
  • Elderly primigravida
A
  • Young primigravida
    • ≤ 17 y/o
  • Elderly primigravida
    • ≥ 35 y/o
17
Q

High risk pregnancy patients

A
  • Extreme of age
  • Pregnant with medical complications
  • Poor OB history
  • Placenta previa
  • Pregnant with gynecologic tumors
  • Pregnant with coexisting trophoblastic disease or had trophoblastic disease within the last year
  • Patients with problems with fetal aging, structure, and size
  • Poly- or oligohydramnios
18
Q

Who are considered to have poor OB history?

A
  • 2 consecutive abortions
  • 3 or more repeated abortions
  • History of preterm delivery
  • History of term/preterm fetal death in utero
  • History of term/preterm neonatal death
  • Previous baby with congenital anomaly
19
Q

Smoking increases risk for:

A
  1. Placenta previa
  2. Abruptio placenta
  3. PROM
  4. Preterm delivery
  5. SGA neonate
  6. Spontaneous abortion
  7. Fetal death
  8. Fetal anomalies
20
Q

Illicit drug increases risk for:

A
  1. IUGR
  2. SGA
21
Q

Partner violence increases risk for:

A
  1. Preterm delivery
  2. IUGR
  3. Perinatal death
22
Q

Leopolds maneuver grips

A
  • L1 - Fundal grip
  • L2 - Umbilical grip
  • L3 - Pawlick’s grip
  • L4 - Pelvic grip
  • Memory aid:*
  • FUPP
23
Q

The uterus becomes an abdominal organ at what AOG?

A

12 weeks

24
Q

Fundal grip findings

A
  • What fetal pole occupies the fundus?
    • Irregular. nodular
      • Feet (cephalic presentation)
    • Hard, round, ballotable, mobile
      • Head (breech presentation)
25
Q

Umbilical grip findings

A
  • On which side is the back?
    • Linear, convex, bony ridge
      • Back
    • Numerous nodulation
      • Extremities
26
Q

Pawlick’s grip findings

A
  • What fetal part lies above the pelvic inlet?
    • Head engaged
      • Feel shoulder, fixed, knob-like
    • Head not engaged
      • Feel round, ballotable mass
27
Q

Pelvic grip findings

A
  • On which side is the cephalic prominence?
    • Opposite side as the back
      • Head is flexed
    • Same side as the back
      • Head is extended
  • Engaged or not
    • Engage if hands are parallel and does not meet
    • Not engaged if hands converge
28
Q

Tdap vaccine

  • Route
  • Dose
  • When given
A
  • Route
    • IM
  • Dose
    • 3 doses at 0, 1 and 6–12 months plus booster every 10 years or once per pregnancy
  • When given
    • Between 27–36 weeks
29
Q

Influenza vaccine

  • Route
  • Dose
  • When given
A
  • Route
    • IM
  • Dose
    • Once a year
  • When given
    • preferably between February to June
30
Q

Hepatitis B vaccine

  • Route
  • Dose
  • When given
A
  • Route
    • IM
  • Dose
    • 3 doses
  • When given
    • 0, 1 and 6 months
31
Q

Safe or contraindicated?

  • Rabies
  • MMRV
  • Meningococcus
  • Varicella
  • HPV
  • Pneumococcus
  • Hepatitis A
A
  • Rabies
    • Safe
  • MMRV
    • Contraindicated
  • Meningococcus
    • Safe (given in outbreak)
  • Varicella
    • Ig (post-exposure)
  • HPV
    • Contrainficated
  • Pneumococcus
    • If asplenic or with cardiac disease
  • Hepatitis A
    • Pre- or post-exposure