Terms and physiology + checks

Question 1

How long is a pregnancy?
What are the 1st, 2nd and 3rd trimesters?

Answer 1

40 weeks

1st: 0-12 weeks
2nd:13-27 weeks
3rd: 28-40 weeks

Question 2

What is Naegele’s Rule for?

Answer 2

To estimate the baby’s due date
1st day of last menstrual period, add 7 days, add 9 months

Question 3

What is gravidity?

Answer 3

Number of pregnancies regardless of outcome

Question 4

What is parity?

Answer 4

Number of deliveries beyond 24 weeks not including current

Question 5

what is primigravida?

Answer 5

first time pregnancy regardless of outcome

Question 6

what is Primiparous?

Answer 6

First time delivery >24 weeks

Question 7

What is Multiparous?

Answer 7

2+ births >24 weeks

Question 8

What is nulliparous?

Answer 8

Never birthed >24 weeks

Question 9

How many weeks are full term?

Answer 9

37-42 weeks

Question 10

How many weeks are premature?
mild?
early?
severe?

Answer 10

<37 weeks
mild: 32-27
early: 28-32
severe: <28

Question 11

What is the gravidity and parity of twins?

Answer 11

1 pregnancy and 1 birth
G1P1

Question 12

What routine vaccines are offered to pregnant women and when?

Answer 12

16+ weeks
Pertussis (whooping cough)
Flu

Question 13

What is the ideal presentation of a foetus in a womb?
Head
lie
placenta
attitude

Answer 13

Head first
Longitudinal
upper segment
flexed vertex

Question 14

How big should the cervix diameter be for delivery?

Answer 14

10cm

Question 15

What 5 things is the placenta responsible for/transport?

Answer 15

NICHE
Nutrition
Immunity
Circulation
Hormonal
Excretion

Question 16

What type of blood does the baby have?
What hormones are exchanged?

Answer 16

HbF - high O2 affinity

Progesterone, oestrogen, bhCG, hPL (human placental lactogen)

Question 17

How do we monitor the foetus?

Answer 17

With ultrasound

Question 18

What does CRL stand for?
what does it mean?

Answer 18

Crown rump length

The length of the fetus from the top of its head to bottom of torso.

Question 19

How many weeks is it classified as an embryo?

What should the CRL be at 8-12 weeks and 21 weeks?

Answer 19

1-8 weeks

50mm

210mm

Question 20

When is surfactant produced?

Answer 20

at 35 weeks

Question 21

What is surfactant used for?

Answer 21

Reduce surface tension and prevent alveolar collapse after expiration

Question 22

What do we give if the baby is premature? ie. reduced surfactant prod
prenatal?
postnatal?

Answer 22

Prenatal - maternal prenatal corticosteroid

Baby surfactant after birth

Question 23

What are the maternal changes in pregnancy?
Cardio?
Haem?
GI?
Immunity?

Answer 23

Low BP (high CO but low TPR)

Anemia (high CO + same RBCs)

Dysmotility therefore constipation and GORD

Low immune response

Question 24

What are the maternal changes in pregnancy?
Endo?
GU?
Hormones?

Answer 24

poor glycemic control = lots of hypos in DM

High renal excretion and High UTI risk + Asymptomatic bacteriuria (ASB)

High Oestrogen, progesterone, prolactin, T3+T4, bhCG, ESR + CRP, ALP

Question 25

what 3 visual changes can we have and what are they?

Answer 25

linea nigra - dark line from umbilicus to pic area striae gravidarum - stretch marks Polymorphic eruption of pregnancy - itchy bumpy rash within stretch marks

Question 26

What is the main things midwifes check every appointment?

Answer 26

symphysis fundal height (SFH)

Question 27

What is SFH and what is it used for? what is the normal height?

Answer 27

Distance from the pubis symphysis to the top of the uterine fundus Monitors fetal growth +/- 2cm for gestational age

Question 28

What is the first check that is done and its name? How many weeks? What is tested/checked?

Answer 28

8-12 weeks Booking Screen mum for Hep B, HIV, Syphilis, sickle cell and thalessemia (HHSST) BMI, BP, FBC

Question 29

What is after the booking scan? How many weeks? What is tested for in that?

Answer 29

Dating scan 11-13+6 weeks USS to check Nuchal translucency Check the bhCG, PAPP-A

Question 30

What does nuchal translucency check? What is PAPP-A? What does it check for?

Answer 30

thickness of tissue round baby's neck Pregnancy associated plasma protein - protein made by placenta checks for trisomy 13 (Palau's syndrome), 18 (Edwards syndrome) and 21 (Downs syndrome)

Question 31

What do we look for specifically in the bhCG, PAPP-A and nuchal translucency for Downs?

Answer 31

High bhCG Low PAPP-A >/ 6mm nuchal translucency

Question 32

What do we check for at 18 - 20+6 weeks? what is that appt called?

Answer 32

Anomaly/anatomy USS Congenital heart defects (CHD), Neural tube defects (NTD), Gastroschisis + omphalocele, placenta previa

Question 33

What is checked at 28 weeks?

Answer 33

OGTT + Rhesus if Rhesus Negative Midwife - BP Checks, SFH, Urine dip

Question 34

What checks are done and 34, 38 and 41 weeks?

Answer 34

34 weeks - USS + 2nd RhoGAM dose, 2nd placenta previa scan 38 weeks - Discuss long PREG 41 weeks - Discuss inducing labour

Question 35

what is the technique to induce labour called and what happens in it?

Answer 35

Membrane sweep Finger around cervix to induce labour

Question 36

What are all mums advised to take/stop?

Answer 36

Vit D suppose 10mcg/day folate for first trimester smoking cessation no alcohol Healthy eating

Question 37

What are 3 other tests that are done?

Answer 37

CVS (Chorionic villi sample) Amniocentesis NIPT (Non invasive prenatal testing)

Question 38

When is CVS done? what is it done for?

Answer 38

11-14 weeks cells from the placenta checks for chromosomal conditions

Question 39

Amniocentesis when is it done? what is it to check for? What are the risks and %?

Answer 39

15 weeks sample amniotic fluid to check for trisomy 13, 18 and 21 Risk 0.5-1% miscarriage, precipitation of RHD, clubfoot and infection

Question 40

NIPT (Non invasive prenatal testing) when is it done? what do we do/look for? how sensitive for which disease?

Answer 40

screening test done between 15-20 weeks sample mums blood for cffDNA (Cell free foetal) 99% sensitive for Downs

Question 41

What is the quad test? when is it done? Tests for? what is shown on the test?

Answer 41

15 weeks tests for downs High bhCG Low AFP Low E3 High Inhibin A

Question 42

What is a hyperechogenic bowel? what is it associated with? When is it seen?

Answer 42

18-20 weeks downs, CF, CMV+B19 non specific marker - brighter appearing bowel