What weeks are termed 1st, 2nd, 3rd trimesters?
- 1st Tri--> LMP-(12-14)
- 2nd Tri--> 15-28
- 3rd Tri--> 29-42
What are the 7 presumptive symptoms of pregnancy?
- 1. Amenorrhea
- 2. Breast changes
- 3. Fatigue
- 4. Perception of fetal mvmt
- 5. Frequent urge to void
- 6. N/V/
- 7. Skin changes
What are 6 probable signs of pregnancy?
- 1. Abd enlargement (>12)
- 2. Hegar sign--> softening of uterus
- 3. McDonald's sign--> flexed uterine body cervix
- 4. Goodell's sign--> cervical softening
- 5. Chadwick's sign--> blue-violet cervix
- 6. Lab tests
What are 3 positive signs of pregnancy?
- 1. + fetal heart motion
- 2. Examiner perceives fetal movement
- 3. U/S recognition
What are 8 OB labs at initial visit?
- 1. CBC
- 2. U/A
- 3. Rubella
- 4. RPR, Heb B, HIV
- 5. ABO
- 6. PPD
- 7. Td?
- 8. Sickledex
What factors would indicate an earlier glucola testing?
- 1. Family/personal history of GDM
- 2. Obesity/erratic wt gain; BMI>28
- 3. Glucosuria
- 4. Previous stillbirth, anomaly, macrosomnia
What make diagnosis of GDM for non-fasting check?
- -2 abnormal values makes Dx of GDM
- ->200 at any one time
When is the ABO taken?
NOB & 28 weeks (if neg ABO)
When is Rhogam indicated?
- -Post AB, ectopic, bleeding, amniocentesis
- -Within 72 of delivery
When is the GBS ideally cultured?
What are 4 consequences of untreated GBS?
- 1. Pre-term labor
- 2. PROM
- 3. Chorio
- 4. Puerperal/neonatal sepsis
What is Naegle's Rule?
-LNMP - 3mo +7 days
When is the best U/S performed?
1st one--> most accurate
When does quickening usually occur?
Around 20 weeks
When can a doppler first pick up the FHTs?
as early as 10 weeks
When should pelvimetry be performed?
NOB for primigravida & 38 weeks
What diameter do you want the diagonal conjugate to be?
What diameter do you want the interspinous diameter to be?
What do you want the Tranverse Oulet diameter and pubic arch angle?
- Transverse outlet--> >10cm
- Pubic arch--> >90 degrees
Which pelvis is least likely to deliver vaginally?
How often after initial visit should subsequent visit be done?
every 4 weeks until 36weeks ( sometimes 20wk may get cut out)
Where is the uterus felt at 12, 16, 20 weeks?
- 12 weeks--> pubic symphysis
- 16 weeks--> Half of abdomen
- 20 weeks--> umbilicus
When is the Quad screen, glucola, CBC, and GBS culture?
- 16-18wks--> Quad screen
- 28 wks--> 1hr glucola
- 24-28wks--> CBC
- 36 wks--> GBS culture
When are kick counts initiated?
28 wks until delivery
What are the main components of subsequent visits? (8)
- 1. Vitals
- 2. Fetal heart monitoring
- 3. Fundal height
- 4. Labs
- 5. Assess fetal movement
- 6. Assess general well-being
- 7. Assess educational needs
- 8. Assess level of preparation