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Spring Round II Exams > WH- Prenatal, Abortion > Flashcards

WH- Prenatal, Abortion Flashcards

(64 cards)

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1
Q

A few meds that ARENT pregnancy safe

A

ACE-I/ARB
Triptans
Statins
Tetracyclines

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2
Q

Advanced maternal age

A

> 35YO

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3
Q

UTD on immunizatoins?

A

MMR and Varicella especially bc these are LIVE and cannot be given during pregnancy

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4
Q

Start Folic acid + DHA 1 month before trying to get pregant

A

neural tube closes by 4th week

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5
Q

DHA

A

help ward off post partum depression

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6
Q

Folic acid

A

0.4-0.8 mg

4 mg if hx of NTD

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7
Q

Exam for Preconception care

A

BMI
Dental caries (can put mom at risk of preterm delivery)
Cardiopulm
Pelvic exam

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8
Q

when to use OTC Ovulation predictor kits

A

days 10-20 of cycle

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9
Q

Timed intercourse

A

Day 11,13,15,17 of cycle

day 14 is ovulation

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10
Q

1st visit

A

between 8-10 wks of pregnancy

best for 1st Ultrasound

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11
Q

Obstetric history

A 
Gravida= # of pregnancies
Para=TPAL
T: births after 37 wks
P: births prior to 37 wks
A: abortion
L: # of living children
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12
Q

G2P2002

A 
G2= 2 pregnancies
P2002 "TPAL"
2: births after 37 wks
0: preterm
0: abortions
L: 2 living children
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13
Q

LMP

A

1st day of last menses

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14
Q

Naegele’s Rule

A

add 7 days to LMP and subtract 3 mo

to predict Estimated Delivery Date (EDD)

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15
Q

EDC

A

Est date of confinement

confinement- concluding phase of pregnancy, onset of contractions to the birth of baby

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16
Q

Breast exam

A

Montg tubercles
Dilated veins
Enlarged breast, expanding areola
TTP

normal

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17
Q

Chadwick’s sign

A

Blue to purple tint of vaginal walls/cervix

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18
Q

Hegar’s sign

A

Palpable softening of isthmus

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19
Q

Montgomery tubercles on breast of pregnant women

A

oil glands on pregnant women’s breasts to keep breast tissue supple as it expands in growing breasts

to keep from cracking
prep for breastfeeding also

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20
Q

Prenatal care first visit

A 
Hcg: pregnancy test!
Specimen from pelvic: Pap, Gonn, Chlam
CBC
Blood type/ Rh
Rubella/Varicella
Syphilis (RPR)
Hep B 
HIV
UA and culture

+/- TSH, Cystic fibrosis, TB, HA1C

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21
Q

Transvaginal US can visualize cardiac activity as early as 5.5-6.5 wks BUT

A

best to wait until 8-10 weeks

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22
Q

1st US

A

R/o Ectopic!!!

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23
Q

Common items to avoid:

A

Tuna, shark, swordfish, king mackerall, Tillefish (high mercury)
Raw meet/eggs
Hot dogs, deli meat
Civiche
No More than 200 mg caffeine daily (one 12 oz cup coffee)

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24
Q

What sports to avoid

A

contact sports

hot yoga

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25
How much weight should you gain?
25-35 lbs Prof recommends no more than 30 lbs
26
2nd trimester
weeks 13-26
27
3rd trimester
weeks 27- end
28
1st trimester
weeks 1-12
29
Frequency of visit during first 28 wks | 7 mo
every month
30
Frequency of visit during 28-36 wks | 7-9 mo
every 2 weeks
31
Frequency of visit after 36 wks | after 9 mo
WEEKLY
32
Fetal movement
1st pregnancy | 18-20 weeks
33
Fetal movement | 2nd pregnancies and so forth (bc mom knows what to expect)
16-18 weeks
34
Fetal kicks, start to count at 3rd trimester
10 movements within 2 hours
35
Fundal height
Measuring from pubic bone --> Uterine fundus (the top part)
36
12 weeks
uterine fundus should be at Pubic symphysis cm
37
20 weeks
uterine fundus should be at Umbilicus cm
38
Doppler is able to detect between
10-12 weeks 110-160 bpm is normal
39
Fundal height can drop after 36-38 wks d/t to
baby dropping into pelvis "lightening" mom can feel like she can breathe again
40
Urine sample every visit
Protein levels | Glucose
41
Gender
US at 16 weeks
42
NIPT blood draw can tell gestation as early as
9 weeks
43
1st trimester US
dating purposes
44
2nd trimester US
Anatomy ultrasound b/w 18-22 weeks GA
45
3rd trimester visit
Lab draw (cbc, rpr, abo and rh, antibody screen) 1 hour glucose challenge 3 hour glucose tolerance
46
1 hour glucose challenge
50 g oral glucose draw serum 1 hr later <140= normal >140: proceed to 3 hr >200: AUTOMATIC FAIL, GDm diagnosed
47
3 hour glucose test
100 g oral glucose load 4 draws total fasting <95 1 hr: <180 2 hr: <155 3 hr: <140 TWO ABN VALUES= fail ONE VALUE > 200= fail
48
3rd trimester US
growth US fetal position state of placenta
49
Leopold maneuver
place hands on belly to find position of baby
50
3rd trimester- start to perform cervical exams
Determine: ``` dilation effacement station position presenting part ```
51
Group B strep 3rd trimester
Can live in woman's vagina and rectum transmitted to baby during delivery 35-37 wks if positive, will get Abx before labor
52
Bishop score
based on dilation, effacement, station, cervical consistency, position of cervix 0-4: failed induction 8-13: highest chance of successful induction
53
Antenatal screening
Trace fetal HR and uterine activity x 20 minutes Mimimum of 2 accelerations (increase in FHR by 15 bpm and last for 15 seconds) THIS IS GOOD!!!
54
BPP
Fetal US fetal mov fetal musc tone fetal breathing movement amniotic fluid perfect score is 8/8
55
Optional testing
NT scan FTS NIPT Non invasive perinatal screening
56
NT scan
nuchal translucency b/w 11-13.6 weeks SOFT marker for down syndrome, requires FURTHER TESTING to confirm dx
57
FTS first trimester screen with NT scan
SOFT markers again (screening) For Down and Edwards
58
NIPT
can be as early as 9 wks drawn in place of FTS if performed w NT scan very expensive Confirmatory test if first NT scan was abnormal (to confirm aneuploidy- Down syndrome or Edwards)
59
NIPT
9 weeks | confirmatory screen for Down syndrome
60
Maternal serum screen Quad screen
only draw this if NT/FTS were not done b/w 15-21 wks Screen for NTD, down, edwards
61
For advanced maternal age >35YO
folic acid up to 4mg | daily ASA 81 mg
62
AMA other considerations
Offer NIPT at 9 wks | Involve Maternal fetal medicine- perform level 1 US
63
Antenatal testing for AMA
NST and BPP twice weekly starting at 36 wks
64
Delivery of AMA
Induction vs C section recommended at 39 wks if haven't delivered already

Spring Round II Exams (10 decks)

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