Prenatal Care: Exam and Ongoing Care
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| Perception of fetal movements | 18 -20 weeks primigravida, 14-16 weeks multigravidas
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| Chloasma | Mask of pregnancy, darkening of skin on forehead, nose, cheekbones. Worsens with sun exposure
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| Spider Telangiectasis are associated with high levels of | estrogen. Vascular stelllate marks
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| Chadwick's sign: | bluish or purplish discoloration of vagina and cervix
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| Leuokorrhea | increased vaginal discharge
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| Hegar's sign | oftening of the uterus isthmus
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| Goodell's sign | softening of the cervix
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| Fetal heart tones with doppler can be heard at | 10 weeks
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| Palpation of fetus after | 22 weeks
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| US cardia activity | 5-6 weeks
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| Most commonly used pregnancy test | Qualitative urine (level of detection:5-50mLUm/mL)
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| 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
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| US | Is widely used to assess fetus, but is not the standard of care. Not recommended by ACOG for every pregnancy
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| _____ 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
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| Ideal timing for a pre-pregnancy exam | 3 months before conception
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| 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?
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| Fundal height | If fundal height >2cm more than expected consider multiple gestation, macrosomia, hydroamnios, fibroids, or molar pregnancy
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| Sudden swelling in UE suggests | HTN and preeclampsia
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| Presence of varicose veins raises suspicion for | possible DVTs
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| When do you begin Leopold Maneuvers? | at 28 weeks
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| 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
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| Glucose test is done at | 24-28 weeks. If abnl, follow up with 3 hour glucola (fasting, 1 hour, 2 hours, 3 hours)
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| GBS testing | between 35-37 weeks
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| 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
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| Late decelerations | smooth falls in FHR after contraction has started and end after contraction ends, are associated with hypoxia and perinatal morbidity and mortality
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| Fetal Movements | 3 or more in 30 minutes
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| Biophysical Profile score of ___ is considered normal | 8-10. 6 equivocal, 4 or less is abnl and requires C-section intervention
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| L/S, PG, Fluorescence polarization, Foam Stability index all monitor | fetal lung maturity. Needs to be confirmed before ELECTIVE delivery prior to 39 weeks
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| Direct measurement of surfactant concentration (requres an amniocentesis) | Fluorescence polarization/fetal lung maturity
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| abortion and rhogam | Rhogam recommended for all unsensitized patients
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