CMN 568 - UNIT 6 QUESTIONS AND VERIFIED
ANSWERS
Calculation of estimated date of delivery (EDD) - Answers - 1st day of last menstrual
period (LMP)
+
7 days
-
3 months
+
1 year
Decherney Chap 6
2 periods that comprise the 1st trimester - Answers - 1) Embryonic period: 2 - 10 weeks
gestational age
2) Fetal period: 8 weeks after fertilization OR 10 weeks after onset of LMP
Decherney Ch 6
When does organogenesis occur? - Answers - Embryonic period of 1st trimester
NOTE: This is when embryo is most sensitive to teratogens
Definition of "gravid" - Answers - Total # of pregnancies regardless of outcome
Definition of parity - Answers - Total # of births, both before and after 20 weeks
gestation. Made up of 4 components:
1) Full term births
2) Preterm births (wt ≥ 500 g or ≥ 20 weeks)
3) Abortions (induced or spontaneous)
4) Living children
NOTE: Each child in a multiple is counted individually in "parity" but only ONCE in
"gravid" total. (e.g. ONE pregnancy, MULTIPLE children)
Definition of preterm infant - Answers - Born between 20 - 37 completed weeks of
gestation (259 days)
Definition of term infant - Answers - Born between 37 0/7 and 40 0/7 weeks gestation
(280 days)
Definition of post-term infant - Answers - Born after 42 weeks gestation (294 days)
,Prenatal mortality rates ___________________ (increase/decrease) as gestation
advances past due date - Answers - Increase
NOTE: Mortality increases SHARPLY after 42 weeks gestation
Definition of macrosomic infant or large for gestational age (LGA) fetus - Answers -
Weight ≥ 90th percentile at any gestational age.
Excessive fetal size should be suspected in women with ________________________.
- Answers - Previous macrosomic fetus OR women with DM
Definition of abortion - Answers - Expulsion/extraction of all or part of
placenta/membranes/fetus weighing < 500 g or with an estimated gestational weight of
< 20 weeks (or 139 days from LMP)
Definition of neonatal period - Answers - Birth to 28 days of life
Definition of perinatal period - Answers - From 28 weeks gestation to first 7 days of life.
(NOTE: This includes the late fetal and early neonatal period.)
When does nausea and vomiting ("morning sickness") usually occur in pregnancy and
by when does it usually resolve? - Answers - Begins @ 6 weeks
Resolves between 14 - 16 weeks gestation
"3 months dreary, 3 months cheery, 3 months weary"
Herf BBB
Definition of hyperemesis gravidarum - Answers - Extreme form of pregnancy-related
nausea/vomiting, characterized by:
+ Dehydration
+ Weight loss (up to 5% of pre-pregnancy weight)
+ Ketonuria
Symptoms usually begin 3-5 weeks into pregnancy and resolve by 20 weeks
Herf BBB
What are Montgomery's tubercles and when do they become more pronounced? -
Answers - + Portion of areolar gland visible on skin surface
+ Become more pronounced as early as 6 - 8 weeks gestation.
How early can breast begin secreting colostrum? - Answers - As early as 16 weeks
gestation, but should definitely be in by 28 weeks.
,Breastfeeding PPT
What is quickening and when can it occur? - Answers - "Quickening" refers to the
mother's perception of fetal movement.
Primiparidas - At 18 - 20 weeks' gestation
Multiparidas - As early as 14 weeks' gestation
Definition of chloasma - Answers - "Mask of pregnancy" or skin darkening of forehead,
bridge of nose or cheek bones.
Usually occurs after 16 weeks' gestation
Exacerbated by sunlight
What is Chadwick's sign? - Answers - Bluish discoloration of vagina and cervix. A
presumptive sign of pregnancy.
What is Hegar's sign? - Answers - Widening and softening of the body or isthmus of
uterus. Occurs at 6 - 8 weeks' gestational age.
When do Braxton Hicks contractions begin to occur? - Answers - At approx. 28 weeks'
gestation.
Difference between how exercise affects BH contractions vs. true labor contractions -
Answers - + BH contractions disappear with walking or exercise
+ True labor contractions become more intense with walking or exercise
Normal fetal heart rate - Answers - 110 - 160 BPM (higher in early pregnancy)
After how many weeks are fetal heart tones detectable by handheld Doppler? - Answers
- After 10 weeks' gestation
After how many weeks can the fetus be palpated through the maternal abdominal wall?
- Answers - After 22 weeks
Sonogram detection of the following:
+ Cardiac activity
+ Limb buds
+ Finger and limb movements - Answers - + Cardiac activity: 5-6 weeks by transvaginal
sonogram
+ Limb buds: 7 - 8 weeks
+ Finger and limb movement: 9 - 10 weeks
, When and how can sonogram be used to determine gestational age of fetus? - Answers
- + WHEN: Between 6 - 13 weeks gestation
+ HOW: Measure the crown-rump length
Uses of ultrasound in pregnancy - Answers - 1) Determine viability
2) Estimate gestational age
3) Screen for aneuploidy
4) Evaluate fetal anatomy
From 13 - 20 weeks, the most accurate way to assess gestational age via ultrasound is:
- Answers - Biparietal diameter of skull
Palpable location of uterine size at:
8 weeks
12 weeks
16 weeks
20 weeks - Answers - 8 weeks - @ symphysis pubis
12 weeks - in abdomen
16 weeks - Halfway between symphysis pubis and umbilicus
20 weeks - @ umbilicus
At how many weeks might the fundal height begin to decrease and why? - Answers - +
At 36 weeks the fundal height can begin to decrease as the head descends into the
pelvis.
What is the gold standard for diagnosis of early pregnancy failure? - Answers -
Ultrasound. It can recognize the presence of a fetus in the absence of cardiac activity
How can early pregnancy failure be detected if ultrasound results are inconclusive? -
Answers - Serial measurements of serum hCG levels which fail to detect an appropriate
increase. (In normal early pregnancy, it should be doubling every 2 days.)
DeCherney Ch 6 + Herf BBB
In late pregnancy, what is usually the first sign of fetal demise? - Answers - Absence of
fetal movement as noted by mother
Family hx of DM should alert the provider to the increased risk of _______ in the
pregnant patient? - Answers - + Gestational diabetes
+ Especially if pt has hx of large infant of previous birth defect or unexplained fetal
demise
If there is a strong suspicion of undiagnosed pregestational diabetes, when should
provider perform glucose testing? - Answers - At FIRST prenatal visit, rather than
waiting until 24 - 28 weeks gestation
ANSWERS
Calculation of estimated date of delivery (EDD) - Answers - 1st day of last menstrual
period (LMP)
+
7 days
-
3 months
+
1 year
Decherney Chap 6
2 periods that comprise the 1st trimester - Answers - 1) Embryonic period: 2 - 10 weeks
gestational age
2) Fetal period: 8 weeks after fertilization OR 10 weeks after onset of LMP
Decherney Ch 6
When does organogenesis occur? - Answers - Embryonic period of 1st trimester
NOTE: This is when embryo is most sensitive to teratogens
Definition of "gravid" - Answers - Total # of pregnancies regardless of outcome
Definition of parity - Answers - Total # of births, both before and after 20 weeks
gestation. Made up of 4 components:
1) Full term births
2) Preterm births (wt ≥ 500 g or ≥ 20 weeks)
3) Abortions (induced or spontaneous)
4) Living children
NOTE: Each child in a multiple is counted individually in "parity" but only ONCE in
"gravid" total. (e.g. ONE pregnancy, MULTIPLE children)
Definition of preterm infant - Answers - Born between 20 - 37 completed weeks of
gestation (259 days)
Definition of term infant - Answers - Born between 37 0/7 and 40 0/7 weeks gestation
(280 days)
Definition of post-term infant - Answers - Born after 42 weeks gestation (294 days)
,Prenatal mortality rates ___________________ (increase/decrease) as gestation
advances past due date - Answers - Increase
NOTE: Mortality increases SHARPLY after 42 weeks gestation
Definition of macrosomic infant or large for gestational age (LGA) fetus - Answers -
Weight ≥ 90th percentile at any gestational age.
Excessive fetal size should be suspected in women with ________________________.
- Answers - Previous macrosomic fetus OR women with DM
Definition of abortion - Answers - Expulsion/extraction of all or part of
placenta/membranes/fetus weighing < 500 g or with an estimated gestational weight of
< 20 weeks (or 139 days from LMP)
Definition of neonatal period - Answers - Birth to 28 days of life
Definition of perinatal period - Answers - From 28 weeks gestation to first 7 days of life.
(NOTE: This includes the late fetal and early neonatal period.)
When does nausea and vomiting ("morning sickness") usually occur in pregnancy and
by when does it usually resolve? - Answers - Begins @ 6 weeks
Resolves between 14 - 16 weeks gestation
"3 months dreary, 3 months cheery, 3 months weary"
Herf BBB
Definition of hyperemesis gravidarum - Answers - Extreme form of pregnancy-related
nausea/vomiting, characterized by:
+ Dehydration
+ Weight loss (up to 5% of pre-pregnancy weight)
+ Ketonuria
Symptoms usually begin 3-5 weeks into pregnancy and resolve by 20 weeks
Herf BBB
What are Montgomery's tubercles and when do they become more pronounced? -
Answers - + Portion of areolar gland visible on skin surface
+ Become more pronounced as early as 6 - 8 weeks gestation.
How early can breast begin secreting colostrum? - Answers - As early as 16 weeks
gestation, but should definitely be in by 28 weeks.
,Breastfeeding PPT
What is quickening and when can it occur? - Answers - "Quickening" refers to the
mother's perception of fetal movement.
Primiparidas - At 18 - 20 weeks' gestation
Multiparidas - As early as 14 weeks' gestation
Definition of chloasma - Answers - "Mask of pregnancy" or skin darkening of forehead,
bridge of nose or cheek bones.
Usually occurs after 16 weeks' gestation
Exacerbated by sunlight
What is Chadwick's sign? - Answers - Bluish discoloration of vagina and cervix. A
presumptive sign of pregnancy.
What is Hegar's sign? - Answers - Widening and softening of the body or isthmus of
uterus. Occurs at 6 - 8 weeks' gestational age.
When do Braxton Hicks contractions begin to occur? - Answers - At approx. 28 weeks'
gestation.
Difference between how exercise affects BH contractions vs. true labor contractions -
Answers - + BH contractions disappear with walking or exercise
+ True labor contractions become more intense with walking or exercise
Normal fetal heart rate - Answers - 110 - 160 BPM (higher in early pregnancy)
After how many weeks are fetal heart tones detectable by handheld Doppler? - Answers
- After 10 weeks' gestation
After how many weeks can the fetus be palpated through the maternal abdominal wall?
- Answers - After 22 weeks
Sonogram detection of the following:
+ Cardiac activity
+ Limb buds
+ Finger and limb movements - Answers - + Cardiac activity: 5-6 weeks by transvaginal
sonogram
+ Limb buds: 7 - 8 weeks
+ Finger and limb movement: 9 - 10 weeks
, When and how can sonogram be used to determine gestational age of fetus? - Answers
- + WHEN: Between 6 - 13 weeks gestation
+ HOW: Measure the crown-rump length
Uses of ultrasound in pregnancy - Answers - 1) Determine viability
2) Estimate gestational age
3) Screen for aneuploidy
4) Evaluate fetal anatomy
From 13 - 20 weeks, the most accurate way to assess gestational age via ultrasound is:
- Answers - Biparietal diameter of skull
Palpable location of uterine size at:
8 weeks
12 weeks
16 weeks
20 weeks - Answers - 8 weeks - @ symphysis pubis
12 weeks - in abdomen
16 weeks - Halfway between symphysis pubis and umbilicus
20 weeks - @ umbilicus
At how many weeks might the fundal height begin to decrease and why? - Answers - +
At 36 weeks the fundal height can begin to decrease as the head descends into the
pelvis.
What is the gold standard for diagnosis of early pregnancy failure? - Answers -
Ultrasound. It can recognize the presence of a fetus in the absence of cardiac activity
How can early pregnancy failure be detected if ultrasound results are inconclusive? -
Answers - Serial measurements of serum hCG levels which fail to detect an appropriate
increase. (In normal early pregnancy, it should be doubling every 2 days.)
DeCherney Ch 6 + Herf BBB
In late pregnancy, what is usually the first sign of fetal demise? - Answers - Absence of
fetal movement as noted by mother
Family hx of DM should alert the provider to the increased risk of _______ in the
pregnant patient? - Answers - + Gestational diabetes
+ Especially if pt has hx of large infant of previous birth defect or unexplained fetal
demise
If there is a strong suspicion of undiagnosed pregestational diabetes, when should
provider perform glucose testing? - Answers - At FIRST prenatal visit, rather than
waiting until 24 - 28 weeks gestation
