360 Childbearing/Reproductive Hlth: Exam 1

Exam 1: Care in early pregnancy, physiological changes

• Nausea and vomiting

• Urinary frequency

• Fatigue

Examples of presumptive (subjective) signs of pregnancy

• Positive pregnancy test

• Abdominal enlargement

Examples of probable (objective) signs of pregnancy

• Fetal heart sounds

• Fetal movement felt by provider

Examples of positive (diagnostic) signs of pregnancy

Number of pregnancies, includes current pregnancy

Gravida (GTPAL)

Number of deliveries past 37 weeks

Term (GTPAL)

Number of pregnancies terminated before 20 weeks

Abortions (GTPAL)

Number of pregnancies delivered between 20 and 36 weeks

Preterm (GTPAL)

Number of living children

Living (GTPAL)

Para

number of pregnancies that reached 20 weeks

Viability

The point in which a fetus has the probability of surviving outside the uterus

Goodell’s Sign

Softening of the cervix

Chadwick’s Sign

Bluish discoloration of the cervix

Gestational Age

• Number of weeks of fetal development

• From 1st day of last normal menstural period

Nuchal Translucency

• Measure fluid at back of neck to screen for chromosomal abnormalities

• Between 11-14 weeks, first trimester

Ultrasound

• Preformed to asses fetal anatomical structure, growth, amniotic fluid, gestational age, and well being

• Having a full bladder may help

• Between 18-20 weeks, second trimester for abdominal

• Transvaginal in first trimester

Maternal Serum PAPP-A & BETA HCG

• Blood test for trisomes (down syndrome, trisomy 18)

• Combined with NT for best accuracy

• Between 10-14 weeks, first trimester

Chorionic Villus Sampling (CVS)

• For patients who have an unexpected result in another genetic screening or for those who are at a higher risk for fetal abnormalities

• Risk of infection to fetus since it is Preformed transvaginally or transabdominally

• Removal of a small section of the placenta for genetic testing

• Between 10-13 weeks, first trimester

Quad Screen

• Identifies patients at risk for carrying a fetus with chromosomal disorders such as down syndrome

• Assess proteins in blood

• Between 15-20 weeks, second trimester

Amniocentesis

• Screens amniotic fluid to assess for proteins that could indicate chromosomal or genetic concerns

• May cause fluid leakage, Rh sensitization, or miscarriage

• Long needle inserted into amniotic sac to withdraw amniotic fluid

• Between 15-20 weeks, second trimester

Every 4 weeks, initial visit between 8-12 weeks

Amount of prenatal visits in the first trimester and when initial visit is

Every 4 weeks, anatomy scan at 20 weeks

Amount of prenatal visits in the second trimester and when anatomy scan is

Every 2 weeks until 36 weeks, every week after 36 weeks

Amount of prenatal visits in the third trimester