maternal_Normal Pregnancy and Prenatal Care
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65 Terms
When does gestational age start?
2 weeks before ovulation
What is normal gestational full age?
40 weeks
What does developmental/fetal age start?
4-6 days after ovulation
For clinical purposes, what age are we talking about?
gestational (menstrual) age
When does organogenesis occur?
embryonic period (fertilization [2 weeks] to 10 weeks gestation)
When is the fetal period?
weeks 10-13 (gestational) [8 weeks after fertilization]
when is the embryonic period?
weeks 2-10 (gestational)
when is the 2nd trimester?
week 13 to week 26/28
when is the 3rd trimester?
weeks 26/28 to week 40+
What is the perinatal period?
28 weeks gestation until 7 days of life
What is Naegele's rule?
FDLNMP +7 days - 3 mos + a year
What is live birth?
delivery of an infant that demonstrates evidence of life
What are three things that can be signs of life?
heartbeat, pulsation of umbilical cord, movement
What is abortion?
expulsion of POC before 20 weeks
What is gravidity? Parity?
total number of pregnancies; number of all births
What is an infant?
birth to one year
What is a neonate?
birth to 28 days
What is preterm?
20-36 6/7 weeks
What is term?
37 to 40 weeks
What is post term?
over 42 weeks
What is large for gestational age?
above 90th percentile or 4000 g
What is macrosomia?
over 4500 g (regardless of gestational age)
What is small for gestational age?
10th or less percentile, 2500g or less at term
Are babies susceptible to teratogens in the first two weeks? why?
no; no placenta till week 2
When are the lungs finally mature?
late in 3rd trimester (37-38 weeks)
What is viability usually confirmed by?
heartbeat on sono
What hormone is produced by the developing embryo and eventually the placenta?
beta hcg
What type of test is the urine preg test?
qualitative
What is the most common method to confirm pregnancy?
urine
Do we really ever need to do a qualitative serum test?
no
What level is a positive beta hcg?
25
What is an intermediate serum beta hcg level?
5-25
what is a negative serum beta hcg level?
<5
How long does it take beta hcg levels to double?
48-72 hours
When is beta hcg at it's highest?
end of first trimester
When does quickening usually occur in primigravida? multiparous?
18-20 weeks; 14 weeks
What is Chadwick's sign?
blue color to cervix
What is Hegar's sign?
softening of cervical isthmus
When do Braxton Hick's usually begin?
28 weeks and become more regular
How do Braxton Hick's feel?
tightening and pressure (rather than pain)
When is usually the first prenatal visit?
7-8 weeks
What do we want to make sure with about the cervix?
external os is closed
What is the best pelvis shape for birth?
gynecoid
What are some initial labs for mom?
-CBC
-blood type and Ab
-infx dz screening
-PAP
-TB screen
-urinary assessment
When would we do a pap in a pregnant?
if no normal pap in last 12 mos
How often do we do urine dips for pregnants?
every visit
Is the U/S or LNMP with Naegele's rule more accurate in the 1st trimester?
US
what are the 4 purposes if the first prenatal ultrasound?
-confirmation of intrauterine pregnancy
-confirmation of viability
-estimation of gestational age
-singleton vs multiple
What parameter is more accurate for gestational age in the first trimester on US?
crown-rump length
How often do women visit weeks 0-32?
every 4 weeks
How often do women visit weeks 32-36?
every 2 weeks
How often do women visit 36+ weeks?
weekly
What do we assess at every visit?
-BP
-edema
-weight
-urine
-fetal heart tones
-uterine size
why do we do a urinalysis each and every prenatal visit?
pregnant women can likely have asymptomatic bacteruria
Why do we check for edema?
can be a symptom of pre eclampsia
if someone is pregnant with multiples how much weight should they gain?
35-45 lbs
if someone has an underweight BMI how much weight should they gain with pregnancy?
28-40 lbs
if someone has an overweight BMI how much weight should they gain with pregnancy?
15-25 lbs
If someone is normal BMI, how much weight should they gain with pregnancy?
25-35 lb
What is Mcdonald's Rule?
fundal height in cm = gestational age in weeks
When can you start doing Mcdonald's rule?
about 20 weeks
Where is the uterus at 20 weeks?
umbilicus
When do we stop Mcdonald's rule?
34 weeks (fetus starts to "drop" near term"
When do we start Leopold's maneuvers?
26 weeks
When do we start cervical assessment?
36 weeks