OB test 2 set 2

1st= 1kb, approx 5lbs

2nd and 3rd= 1lb per week

nl gain= 25-35lbs

• growth restriction
• not just <10% in weight, but also in length and head circumference

300 kcal/day in 2nd and 3rd tri's

• neural tube defects
• premature placental seperation
• spontaneous abortions

recommend 400mcg daily

ms= crackers

• hg= unresolved vomiting
•  = volume and hydration and nutrition deficeits

give KCl and fluid

• irritability
• incessant crying
• tremors
• hyper-reflexia
• tachypnea / apnea

this is baby withdrawl

• learning and behavior disabilities
• inability to express feelings
• strong seperation anxiety
• poor socilaztion skills
• easily overstimulated
• sleep deprived

• Tx of S & Sx
• test for infections
• check urine and meconium for presence of drug
• call social services

• screened at first prenatal visit when partner is out of room
• screened at least once per trimester

to ID high risk pregos

is one in which the life or health of the mother or fetus is jeopardized by a disorder coincidental with or unique to pregnancy

• BP and weight check
• FHR
• kick count
• Bld tests
• Urine screen for protein, glucose, and ketones

a least 3 w/n an hour

if less, NST, CST, or BPP test used

Rh+ = no intervention needed

Rh- = indirect Coombs test used on maternal blood

maternal blood tested to determine amount of Rh antibodies in mom blood

neg= just monitor fetus

• pos= give Rhogam at 28 weeks gest
• = after delivery, test baby blood with Direct Coombs test

fetal blood tested to determine presence of Rh antibodies

neg= mom does NOT need Rhogam again

pos= mom gets 2nd dose of Rhogam w/n 72 of delivery

+1 glucose is nl

protein= HTN issues

• commonly found in vaginal floura
• concern if mom tests + at 35 wks gest
• -inc risk of PTL and transmission

Women Tx with 2 doses of antibiotics before delivery

• screen, NOT Dx
• done at 15-20 wks
• tests mom's blood for low vs high risk of congenital diseases

low= routine care

• high= ultrasound to look at baby
•  = genetic testing for Downs and others

vag= 1st tri or during any if women is obese

abd= 2nd and 3rd

• 11-13 wks
• screens for trisomies 13, 18, 21
• look for excess accumulation of fluid on neck

if abnl= CVS test or Amniocentesis

• doen by ultrasound in 2nd or 3rd tri
• look for changes
• graded

I= no indents or califications

II= subtle indents and small calcifications

• III= large and calcified
•  = smoking, PT, pre-eclamp, GD

• done at 10-12 wks
• remove small sample of chorionic villi from developing placenta

comlications= blding, miscarriage, ROM, limb anomalies possible if done before 10 wks

• done during 2nd and 3rd tri's
• fetal blood obtained

can test for many things

amniotic fluid obtained after 14th wk

used for genetic testing, lung maturity, among others

ultrasound used first to determine baby's location

Lecithin/sphingomyelin ratio (L/S)

Phosphatidylglycerol )PG)

these are 2 components of surfactant

Ratio= 2:1 = maturity

• appears in amniotic fluid at 25 wks
• indicated mature lungs

tell us how perfusion is b/w mother and fetal circulation

• NST
• CST

• non stress
• monitor hooked up and mom given button to push when fetal movement felt

good to see accelerations with movement

can get false positives

• maternal DM
• chronic HTN
• prego HTN
• IUGR
• dec. fetal movement
• etc.

reactive= at least 2 accels of 15bpm lasting 15 seconds

non= do a CST or BPP

CST is done

contraction stress test

tests for uterosufficiency

need at least 3 good contractions lasting at least 40 seconds

pos= there are repeat late decelerations :(

neg= there are no late decels  :) :)

• NST:
• postive = GOOD
• negative = bad

• CST:
• positive = bad
• negative = GOOD