prenatal care

diagnosis pregnancy

amenorrhea is first sign, + nausea, breast fullness

bHCG within days of first missed period

fetal movements @ 17w

US shows gestational sac @5w

mean duration of pregnancy is ______ weeks from last menstraul period

40

Nagele rule

estimated due date - add 7 days to first day of LMP, subtract 3 months and add 12 months

gravidity vs parity

gravidity - total # pregnancies

parity - # term pregnancies and preterm pregnancies ended w/ birth

fetal hr examination can be detected when

detected @9w using doppler

fetal heart rate normal

120-160 bpm

transvag US can detect fetal cardiac movements as early as

6w

pelvic exam during prenatal care - components

pap smear, gonorrhea cultures, chlamydia test, palpation + US adnexa

nongravid uterus size

3×4×7cm

gestationla age estimated by uterine size

8w = 2x normal size

10w = 3x n

12w = 4x n

when is fundus palpable at symphysis pubis

12w

uterine size that exceeds gestsational dating by 3 or more weeks sugfgests

mulitple gestation, molar pregnancy or inaccurate date for LMP

initial lab testing prenatal care

blood group, rh

hematocrit, hb

tsh, t4

pap

rubella, anti-hep b antigen, vdrl, hiv, chlamydia, gonorrhea

urine culture

after routine screening, when sohuld high risk pregnat women by retested for TORCH (+ HIV)

36w

what painkiller allowed during pregnancy

paracetamol

weight gain recs during pregnancy

gain 11.5-16kg

during pregnancy, caloric intake ________ kcal/d is recommended

100-300

iron recommendations during pregnancy

30mg iron through last half of pregnancy

when can you do aneuploidies test (US nuchal translucency thickness and plasma proteinA)

10-13w

sonographic sign of down sd

absent nasal bone

how frequently to checkup in low-risk pregnancies

<28w - monthly

28-36w - every 2w

26-birth - once a week

fetal movements should be documented at each visit after when

17w

maternal serum testing (afp, uE3, hcg, inhibin A) when

15-18w

most accurate technique to estimate gestational age

US crown-rump length from 7-14w

when is blood glucose performed during pregnancy

24-28w

assessments at 3rd trimester visits

• fetal movement, hr

• 26-30w - hb, hematocrit

• 28-30w - Ab screen in Rh -, D IG administered if -

• 36w - repeated sero syphilis

Screening for group B streptococcus colonization at how many weeks

35-37

what vccination is recommended for high-risk patients regardless of the stage of pregnancy.

h influenzae

The patient should call physician when what signs of labour (during 3rd trimester)

rupture of membranes or contractions have occurred every 5 minutes for one hour

danger signs during third trimester

Preterm labor, rupture of membranes, bleeding, edema, signs of preeclampsia

At each check-up, typical prenatal follow-up includes what for fetus:

1. Fetal Heart rate 2. Current dimensions and their evolution 3. Amount of amniotic fluid 4. Presentation 5. Fetal movement

At each check-up, typical prenatal follow-up includes what for mother:

Blood pressure—current value and evolution

• Weight—current and evolution

• Symptoms—including headache, blurred vision, abdominal pain, nausea, vomiting, bleeding, vaginal discharge, dysuria

• Uterine Fundus - height in centimeters from symphysis

• vaginal exam