Week 6 pt 2 Flashcards

Question

FASDs (fetal alcohol spectrum disorders) include what symptoms?

Answer 1

1) Abnormal facial features 2) Small head size 3) Decreased height/weight 4) Poor coordination, attention, learning, attention 5) Sleep, hearing, vision problems

Answer 2

1) Occurs when mother’s blood type is Rh negative and her fetus’ blood type is Rh positive 2) In subsequent pregnancies, antibodies from Rh-negative mother (anti-RH+ antibodies) may enter the blood stream of her unborn, Rh+ infant, damaging the infant’s RBCs causing anemia-related health conditions

Answer 3

Vaginal bleeding in pregnant women

Answer 4

During pregnancy, body makes special hormones and goes through many changes (such as weight gain) Because of these changes, body’s cells don’t use insulin very well.

Answer 5

Insulin is produced by pancreas, acts as a ‘key’ to let blood sugar into cells to be used as energy

Answer 6

1) Diabetes or family history of gestational DM 2) Obesity or gaining too much weight in pregnancy

Answer 7

Routine oral glucose tolerance testing (usually between 24-28 weeks) If fail the 1-hour OGTT, then must do the 3-hour OGTT test

Answer 8

Common in early pregnancy, unsure exactly why Tylenol (APAP) is safe to take during pregnancy

Answer 9

1) Correlated with the presence of the pregnancy hormone (Beta HCG) -Often worst in the morning 2) If mild, can take ginger, Vitamin B6 -If more severe, check with provider about medications (ex: Diclegis, Phenergan, Zofran, Reglan) -If unable to keep down fluids/foods, may need IV fluids

Answer 10

Body is carrying around extra fluid; gravity pulls it down

Answer 11

Possibly due to low calcium or potassium? Etiology is unclear. Massage is helpful

Answer 12

Common in late pregnancy; center of gravity has changed

Answer 13

Straining of the round ligament – causing stretch/spasm – as the uterus grows and expands. Can be very painful. Recommend slow movements, stretching.

Answer 14

Hormonal changes can cause some discharge; it’s okay as long as not malodorous or bloody Watch for infection (ex: BV) and monitor for spontaneous rupture of membranes (leakage of clear, thin liquid) Amnisure test

Answer 15

Body is carrying so much extra fluid in veins, some of which are present in the rectum. Usually resolve after pregnancy.

Answer 16

Urine HCG Serum HCG (qualitative, quantitative) Transvaginal ultrasound

Answer 17

Naegele’s Rule for Dating Pregnancy Onset of last menses Move back 3 months Then 7 days forward One year forward

Answer 18

28-day cycles with 14-day follicular phase and woman knows her LMP

Answer 19

A teratogen is an agent that can disturb the development of an embryo or fetus (fetal limb defects, bony abnormalities, etc.) Pregnancy categories Category A, B, C, D, X

Answer 20

1) Maternal illnesses: DM, PKU syndrome (phenylketonuria) 2) Infectious agents (TORCH) 3) Physical agents (radiation, heat exposure) 4) Drugs 5) Chemical agents (ex: mercury)

Answer 21

1) Thalidomide: Cancer medication (ex: multiple myeloma) -Children have short/absent limbs 2) Warfarin (Coumadin): Blood thinner -Hypoplastic nose, skeletal/ocular abnormalities, neonatal bleeding, cognitive impairment

Answer 22

Weigh risk: drug vs. disease Better to come off drugs if mother can

Answer 23

1) Levels vary throughout pregnancy because estrogen effects their metabolism 2) Medications lose efficacy – increases seizure risk - must be monitored closely

Answer 24

1)ACEs/ARBs Lisinopril, Enalapril, Ramipril, Losartan, Valsartan, Olmesartan, etc. 2) Isotretinoin (Accutane)

Answer 25

Trimethoprim-Sulfamethoxazole (Bactrim) Doxycycline/Tetracycline Fluoroquinolones Levofloxacin (Levaquin), Ciprofloxacin (Cipro)

Answer 26

1) Insulin; metformin 2) Glyburide

Answer 27

procedures

Answer 28

Primarily developed in 1960’s-1970’s Use of imperceptible sound waves that bounce off tissue and are compiled into an image Important in obstetric care because there are no known adverse fetal effects Used to detect many obstetric/fetal abnormalities Also, used to assist with various obstetric procedures such as amniocentesis, chorionic villus sampling, etc.

Answer 29

Transvaginal US Transabdominal US 3-D US Doppler sonography

Answer 30

Commonly used during 1st trimester to accurately determine the estimated due date and check fetal location and number Can also identify structural malformations

Answer 31

Transvaginal sonographic measurement of cervical length Median length at 24-28 weeks = 3.5 cm < 2.0 cm: 3-5x higher risk of preterm delivery

Answer 32

Transvaginal sonographic identification of placenta:

Answer 33

Fetal structural abnormalities Fetal growth Fetal well-being

Answer 34

1) Serial measurements provide information regarding fetal growth trajectory 2) Software combines this information to estimate fetal weight ~15% error (less utility with fetuses larger than 8 lbs.)

Answer 35

1) US allows visualization of fetal behavior -Body movement, breathing, etc. -Useful in observing fetal oxygenation and viability and used to arrive at a biophysical profile score

Answer 36

1) Test performed after 28th week of pregnancy to evaluate the health of the fetus 2) Measures body movement, muscle tone, breathing movement, heart rate, and amniotic fluid levels 3) 2 points for each event during a 30-minute session 4) Risk of fetal death within a week of a score of 8 is < 1%

Answer 37

1) Combines ultrasound information to form a 3-dimensional image of the fetus -3D reconstruction is possible with CT and MRI, but CT involves radiation and MRI is expensive and often unavailable 2) 3D imaging is better than 2D imaging at detecting malformations such as: -Facial defects -Limb abnormalities -Neural tube defects

Answer 38

1) Measures the direction and speed of blood cells as they move through vessels 2) Used to measure velocity profile of blood through fetal vessels 3) Doppler study of fetal middle cerebral artery is used to estimate fetal hematocrit -Useful in evaluating fetal anemia and issues of isoimmunization (Rh incompatibility)

Answer 39

1) > 35 years old by the time baby is due (^ risk of down syndrome) 2) Had a screening test that showed there could be a problem 3) Have a child with Down Syndrome, spina bifida, or other disorders 4) You or partner are known carrier of a genetic disorder (such as Cystic Fibrosis)

Answer 40

1) Prenatal test to remove a sample of fluid from the amniotic cavity to test for certain health conditions or infections Offered to women at risk of certain health conditions or chromosomal conditions Birth defects such as Down Syndrome, Cystic Fibrosis, spina bifida Most common invasive prenatal diagnostic procedure

Answer 41

1) Performed under ultrasonic guidance and sterile conditions RhoGAM should be given to Rh- mother due to small risk of procedure-related isoimmunization

Answer 42

1) Detects chromosomal abnormalities 2) Performed at 15-20 weeks (0.3% risk of pregnancy loss, 1% risk amniotic fluid leakage post-procedure) Increased risks if performed < 15 weeks

Answer 43

1) Amniocentesis allows testing of fluid for different biological chemicals 2) Ex: alpha-fetoprotein (AFP) and pulmonary phospholipids Elevated AFP indicates open dorsal/ventral wall Ex: neural tube defect 3) Pulmonary phospholipids present in amniotic fluids come from fetal lungs Used to evaluate risk of neonatal respiratory distress

Answer 44

Amniocentesis is used during evaluation of various prenatal infections CMV, parvovirus, varicella zoster, toxoplasmosis, etc. Culture, gram strain, cell count, glucose, etc.

Answer 45

1) Polyhydramnios: excessive accumulation of amniotic fluid due to various causes (lack of fetal swallowing, excessive fetal urination, idiopathic) -Can affect maternal respiration and/or increase risk of preterm labor -Amniocentesis is therapeutic in these cases

Answer 46

1) Prenatal test used to diagnose certain birth defects and genetic abnormalities by taking a small tissue sample of placenta, which is composed of maternal and embryonic tissue -Chorion is the embryonic portion of the placenta and has fingerlike projections (villi) 2) CVS involves removal of a sample of villi for testing -Can be performed earlier than amniocentesis but not performed before 9th week due to increased risk of malformation -Usually around weeks 10-13

Answer 47

Less precise than amniocentesis in genetic testing Does not test for neural tube defects, certain birth defects, or Rh incompatibility CVS can be performed transcervical or transabdominal RhoGAM should be administered with both

Answer 48

1) Cordocentesis – percutaneous umbilical blood sampling (PUBS) Prenatal test taking a sample of blood directly from the umbilical cord to detect for any abnormalities Genetic mutations, blood diseases, infections, etc.

Answer 49

1) Fetal blood obtained directly from umbilical vein -Performed under US guidance 2) Becoming rare due to advancements with amniocentesis and chorionic villus sampling, which are safer (less risk)

Answer 50

1) Cervical insufficiency (cervical weakness, cervical incompetence): Inability of cervix to retain pregnancy (cervix dilates before pregnancy has reached term) -Circumferential suture/band placed into/around cervix

Answer 51

1) Normal cervical length: cerclage at 13-16 weeks 2) Elongated cervix: cerclage at 22-24 weeks 3) Suture is removed prior to labor

Answer 52

A vaginal delivery that happens on its own and without labor-inducing drugs. ~68% of all births in the US

Answer 53

Drugs or other techniques initiate labor and prepare your cervix. This is also called labor induction.

Answer 54

A vaginal birth that occurs with the help of forceps or a vacuum device to get your baby out. Both spontaneous and induced vaginal delivery can be assisted.

Answer 55

1) Assisted delivery that can help with vaginal delivery when labor is not progressing (stalled in the second stage) 2) Obstetrical forceps are used to grasp the baby inside the birth canal and help guide them out. 3) When successful, they can help birthing parents avoid a c-section.

Answer 56

1) <1% of vaginal births 2) Requires a skilled clinician who is trained Can be used to rotate the baby if in poor position

Answer 57

1) Assisted delivery procedure that can help get fetus through the birth canal when labor is stalled in the second stage (pushing stage). 2) Fetal head is engaged, cervix is fully dilated, fetus is in an appropriate position, etc. ~2.5% of vaginal births

Answer 58

1) Fetus positioned feet or bottom first in the uterus. Ideally, a baby is positioned so that the head is delivered first during a vaginal birth. 2) Most breech babies will turn to a head-first position by 36 weeks. 3) Some breech babies can be born vaginally, but a C-section is usually recommended.

Answer 59

1) Surgical procedure used to deliver a baby when a vaginal delivery can't be done safely. 2) Can be planned (scheduled) or performed in an emergency. 3) It carries more risk than a vaginal delivery, with a slightly longer recovery period ~30% of deliveries in the US

Answer 60

Uterine rupture

Answer 61

1) Vaginal birth after cesarean delivery has a success rate of 60%-80%. 2) Because a surgical cut results in a scar on your uterus, the biggest risk is a uterine rupture

Answer 62

1) Circumcision is the surgical removal of foreskin from an infant’s penis. 2) There are several benefits, including a lower risk of diseases like urinary tract infections. 3) Older boys and men get circumcised as well. 4) Usually heals within a week.