Term
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Definition
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Term
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Definition
(up to 12 weeks)
- BREAST TENDERNESS - first sign
- amenorrhea
- nausea
- vomiting
- fatigue
- urinary frequency |
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Term
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Definition
(13 to 27 weeks)
- Fetal movement
- abdominal discomfort secondary to stretching
- change in skin pigment
- syncopal episodes |
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Term
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Definition
- Braxton hicks contractions- PAINLESS
- abdominal growth
- return of urinary frequency w/ descent of presenting part
- increased respiratory effort until descent |
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Term
| First trimester: physical (5) |
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Definition
- Goodell's sign
- Chadwick's sign
- Hegar's sign
- Breast enlargement
- Fetal heart tones by 10 to 12 weeks |
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Term
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Definition
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Term
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Definition
first = up to 12 weeks
second = 13 to 27 weeks
third = 28 to 40 weeks |
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Term
| Second trimester: physical (3) |
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Definition
- Striae
- Fundus at umbilicus at 20 weeks, 1 cm in growth every week after
- Leopold maneuvers after 20 weeks |
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Term
| Third trimester: physical (3) |
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Definition
- Lightening may occur up to 3-4 weeks prior to labor
- loss of mucus plug/bloody show 1 week before labor
- increase in braxton hicks |
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Term
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Definition
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Term
| When is the fundus at the umbilicus |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| softening of cervicouterine junction |
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Term
| First trimester/new visit: tests (15) |
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Definition
- U/A
- Urine C&S
- CBC
- Blood group and Rh
- antibody screening
- Rubella
- HbsAg
- Syphilis testing screens
- HIV
- specialty screening
- PAP
- Cervical cultures
- STD screening
- Dating ultrasound
- Chorionic villus sampling (CVS) |
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Term
| Second trimester: tests (2 w/ 2 special) |
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Definition
- triple or quad screen at 16-20 weeks
- ultrasound for fetal survey at 18-20 weeks
- special: amnio at 15-20 weeks if FH of chromosomal abn. or AMA
- 1 hr GTT at 20 weeks if FH of diabetes or weighs more than 200 lbs |
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Term
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Definition
| HCG, estriol, and alpha-fetoprotein |
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Term
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Definition
| HCG, estriol, alpha-fetoprotein, and inhibin-A |
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Term
| Third trimester: tests (4) |
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Definition
- 1 hr GTT at 24-28 weeks routine
- RhoGAM at 28 weeks if needed
- H/H at 28-36 weeks depending on previous levels
- NST/BPP PRN for fetal well being
- GBS culture 35 weeks |
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Term
| Triple/quad screen purpose? |
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Definition
| Markers for Downs (21), Edwards (18), and neural tube defects like spina bifida |
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Term
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Definition
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Term
| AFP may be normally elevated in? |
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Definition
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Term
| Scheduling of prenatal visits |
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Definition
- 0 to 28 weeks: Q 4 weeks
- 28 to 36 weeks: Q 2 weeks
- 36 weeks to delivery: Q week |
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Term
| Calculate EDC w/ Naegele's rule |
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Definition
**calculate from when last NORMAL menstrual period BEGAN
- subtract 3 months, add 7 days and one year |
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Term
| Return OB visits: Exam and labs |
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Definition
Exam: BP, weight, FH, FHT, fetal movement, presentation, fetal lie/position
Labs: Routine, plus urine for protein, glucose, and ketones at EVERY visit |
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Term
| 18 High Risk situations needing consultation/referral |
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Definition
1. Recurrent pregnancy losses/previous fetal death in utero
2. FH of genetic anomalies
3. Fh sensitization
4. Hemoglobinopathies
5 Thrombocytopenia
6. Multiple gestation
7. Abnormal triple screen
8. Other abnormal laboratory results
9. HIV
10. Uterine bleeding
11. Abnormal ultrasound findings
12. Previous preterm labor/preterm delivery
13. Polyhydramnios/oligohydramnios
14. Intrauterine Growth retardation (IUGR)
15. Premature rupture of membranes
16. Pre-eclampsia (PIH)
17. Gestational diabetes/insulin dependent diabetes
18. Fetal presentation other than vertex after 32 to 34 weeks |
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Term
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Definition
| 15 to 20 weeks if FH of chromosomal ab or AMA |
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Term
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Definition
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Term
| ultrasound for fetal survey |
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Definition
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Term
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Definition
| 20 weeks if FH of diabetes or pt weighs more than 200 lbs |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| FDA rules for meds during pregnancy |
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Definition
• A: No risks
• B: No evidence of risks in humans
• C: Cannot rule out risks
• D: Positive evidence of risk; use only when no safer alternative exists for serious problem
• X: Contraindicated |
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Term
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Definition
o Ambulate
o Good perineal hygiene
o Pelvic muscle exercise
o Use stool softners
o Resume intercourse at least 2-6 weeks postpartum
o For Cesarean transverse wounds, remove staples post op day 3 and apply steri strips
o RTC or ER if hemorrhaging or experience fever, increase perineal or abdominal pain, breast problems or leg pain and swelling. |
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Term
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Definition
o Majority of losses in first trimester are d/t chromosomal abnormalities
o Losses in second trimester are d/t cervical incompetence, infection or uterine abnormalities
o Types of abortions
• Inevitable: SROM or dilation of cervix before 20 weeks → Uterine contents expelled and no further medical/surgical intervention needed
• Threatened: Vaginal bleeding in first trimester → Maintain stable hemodynamic state and provide emotional support
• Complete: Spontaneous and complete passage of all POC
• Incomplete: Spontaneous and incomplete passage of all POC
• Missed: Retention of all POC after death of fetus
o Management
• Medical method indicated through 49 days
• Surgical method indicated up to 12 weeks for vacuum D/C and 22 weeks for D/E |
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Term
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Definition
o Risk factors: Hx of tubal surgery, previous tubal ectopic pregnancy, PID, IUD
o S/SX: Amenorrhea, Abnormal uterine bleeding (dark brown to tarry spotting early in pregnancy), Abdominal/Pelvic pain
o Physical exam findings: CMT, Tender adnexa with possible palpable mass, Uterine enlargement
o Diagnostic testing:
• hCG is low (<6000 mIU/ml) for gestational age (plateaus w/o normal hCG increases)
• Ultrasound fails to identify IUP and hCG >1500 mIU/ml |
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Term
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Definition
o Contractions after 20 weeks but before 37 weeks gestation resulting in dilatation and effacement of cervical os
o Risk factors: Infection, Multiple gestation, Poor weight gain, Drug use, Uterine structural abnormalities, Cervical trauma, Adolescent or Advanced maternal age |
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