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OB Prenatal EXam
Prenatal Care: Exam and Ongoing Care
| Question | Answer |
|---|---|
| Perception of fetal movements | 18 -20 weeks primigravida, 14-16 weeks multigravidas |
| Chloasma | Mask of pregnancy, darkening of skin on forehead, nose, cheekbones. Worsens with sun exposure |
| Spider Telangiectasis are associated with high levels of | estrogen. Vascular stelllate marks |
| Chadwick's sign: | bluish or purplish discoloration of vagina and cervix |
| Leuokorrhea | increased vaginal discharge |
| Hegar's sign | oftening of the uterus isthmus |
| Goodell's sign | softening of the cervix |
| Fetal heart tones with doppler can be heard at | 10 weeks |
| Palpation of fetus after | 22 weeks |
| US cardia activity | 5-6 weeks |
| Most commonly used pregnancy test | Qualitative urine (level of detection:5-50mLUm/mL) |
| Serum pregnancy test | Level of detection (2-4 mIU/mL), as early as 1 week post conception. Use when question of nl development, ectopic, signs of pregnancy loss, previous loss |
| US | Is widely used to assess fetus, but is not the standard of care. Not recommended by ACOG for every pregnancy |
| _____ looks for major strucural anomalies including: 2 vessel cord, NTD, anencephaly, hydrocephaly, cleft lip/palate, diaphragmatic hernia, cerebral ventricles, spine, stomach, bladder, kidneys | transabdominal US |
| Ideal timing for a pre-pregnancy exam | 3 months before conception |
| Screening for Domestic Violence | Do you feel safe at home? Are there any issues or concerns that you have when your partner is home? Is there anything you want to talk about? |
| Fundal height | If fundal height >2cm more than expected consider multiple gestation, macrosomia, hydroamnios, fibroids, or molar pregnancy |
| Sudden swelling in UE suggests | HTN and preeclampsia |
| Presence of varicose veins raises suspicion for | possible DVTs |
| When do you begin Leopold Maneuvers? | at 28 weeks |
| When should HIV be tested | NC law to test in first trimester and around time of delivery; if mom not tested, baby tested before discharge |
| Glucose test is done at | 24-28 weeks. If abnl, follow up with 3 hour glucola (fasting, 1 hour, 2 hours, 3 hours) |
| GBS testing | between 35-37 weeks |
| If mom calls and says her baby has stopped moving: | have her drink 2-3 glasses of water or juice; lie down, with hands on abdomen, and count for 1 hour; if no movement must be evaluated |
| Late decelerations | smooth falls in FHR after contraction has started and end after contraction ends, are associated with hypoxia and perinatal morbidity and mortality |
| Fetal Movements | 3 or more in 30 minutes |
| Biophysical Profile score of ___ is considered normal | 8-10. 6 equivocal, 4 or less is abnl and requires C-section intervention |
| L/S, PG, Fluorescence polarization, Foam Stability index all monitor | fetal lung maturity. Needs to be confirmed before ELECTIVE delivery prior to 39 weeks |
| Direct measurement of surfactant concentration (requres an amniocentesis) | Fluorescence polarization/fetal lung maturity |
| abortion and rhogam | Rhogam recommended for all unsensitized patients |
Created by:
ltm12