CMN 568 - Unit 6
Calculation of estimated date of delivery (EDD) - answer 1st day of last menstrual
period (LMP)
+
7 days
-
3 months
+
1 year
Decherney Chap 6
2 periods that comprise the 1st trimester - answer 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? - answer Embryonic period of 1st trimester
NOTE: This is when embryo is most sensitive to teratogens
Definition of "gravid" - answer Total # of pregnancies regardless of outcome
Definition of parity - answer 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 - answer Born between 20 - 37 completed weeks of
gestation (259 days)
Definition of term infant - answer Born between 37 0/7 and 40 0/7 weeks gestation (280
days)
Definition of post-term infant - answer Born after 42 weeks gestation (294 days)
Prenatal mortality rates ___________________ (increase/decrease) as gestation
advances past due date - answer Increase
NOTE: Mortality increases SHARPLY after 42 weeks gestation
,CMN 568 - Unit 6
Definition of macrosomic infant or large for gestational age (LGA) fetus - answer Weight
≥ 90th percentile at any gestational age.
Excessive fetal size should be suspected in women with ________________________.
- answer Previous macrosomic fetus OR women with DM
Definition of abortion - answer 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 - answer Birth to 28 days of life
Definition of perinatal period - answer 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? - answer Begins @ 6 weeks
Resolves between 14 - 16 weeks gestation
"3 months dreary, 3 months cheery, 3 months weary"
Herf BBB
Definition of hyperemesis gravidarum - answer 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? -
answer + 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? - answer As early as 16 weeks
gestation, but should definitely be in by 28 weeks.
Breastfeeding PPT
What is quickening and when can it occur? - answer "Quickening" refers to the mother's
perception of fetal movement.
,CMN 568 - Unit 6
Primiparidas - At 18 - 20 weeks' gestation
Multiparidas - As early as 14 weeks' gestation
Definition of chloasma - answer "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? - answer Bluish discoloration of vagina and cervix. A
presumptive sign of pregnancy.
What is Hegar's sign? - answer 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? - answer At approx. 28 weeks'
gestation.
Difference between how exercise affects BH contractions vs. true labor contractions -
answer + BH contractions disappear with walking or exercise
+ True labor contractions become more intense with walking or exercise
Normal fetal heart rate - answer 110 - 160 BPM (higher in early pregnancy)
After how many weeks are fetal heart tones detectable by handheld Doppler? - answer
After 10 weeks' gestation
After how many weeks can the fetus be palpated through the maternal abdominal wall?
- answer After 22 weeks
Sonogram detection of the following:
+ Cardiac activity
+ Limb buds
+ Finger and limb movements - answer + 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? - answer
+ WHEN: Between 6 - 13 weeks gestation
+ HOW: Measure the crown-rump length
Uses of ultrasound in pregnancy - answer 1) Determine viability
2) Estimate gestational age
3) Screen for aneuploidy
, CMN 568 - Unit 6
4) Evaluate fetal anatomy
From 13 - 20 weeks, the most accurate way to assess gestational age via ultrasound is:
- answer Biparietal diameter of skull
Palpable location of uterine size at:
8 weeks
12 weeks
16 weeks
20 weeks - answer 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? - answer + 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? - answer 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? -
answer 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? - answer 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? - answer + 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? - answer At FIRST prenatal visit, rather than waiting
until 24 - 28 weeks gestation
Measurement of diagonal conjugate of pelvic inlet - answer Distance between the
middle finger of examiner when pressed against sacral promontory in vagina, and the
point at which the patient's pubic symphysis presses on the skin between the
examiner's index finger and thumb.
Initial blood tests at first prenatal visit (preferably in 1st trimester) - answer + *CBC with
differential* - ck for infection and H/H
+ *Blood Type and Rh* - You might have to give Rhogam if they're Rh-negative
Calculation of estimated date of delivery (EDD) - answer 1st day of last menstrual
period (LMP)
+
7 days
-
3 months
+
1 year
Decherney Chap 6
2 periods that comprise the 1st trimester - answer 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? - answer Embryonic period of 1st trimester
NOTE: This is when embryo is most sensitive to teratogens
Definition of "gravid" - answer Total # of pregnancies regardless of outcome
Definition of parity - answer 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 - answer Born between 20 - 37 completed weeks of
gestation (259 days)
Definition of term infant - answer Born between 37 0/7 and 40 0/7 weeks gestation (280
days)
Definition of post-term infant - answer Born after 42 weeks gestation (294 days)
Prenatal mortality rates ___________________ (increase/decrease) as gestation
advances past due date - answer Increase
NOTE: Mortality increases SHARPLY after 42 weeks gestation
,CMN 568 - Unit 6
Definition of macrosomic infant or large for gestational age (LGA) fetus - answer Weight
≥ 90th percentile at any gestational age.
Excessive fetal size should be suspected in women with ________________________.
- answer Previous macrosomic fetus OR women with DM
Definition of abortion - answer 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 - answer Birth to 28 days of life
Definition of perinatal period - answer 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? - answer Begins @ 6 weeks
Resolves between 14 - 16 weeks gestation
"3 months dreary, 3 months cheery, 3 months weary"
Herf BBB
Definition of hyperemesis gravidarum - answer 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? -
answer + 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? - answer As early as 16 weeks
gestation, but should definitely be in by 28 weeks.
Breastfeeding PPT
What is quickening and when can it occur? - answer "Quickening" refers to the mother's
perception of fetal movement.
,CMN 568 - Unit 6
Primiparidas - At 18 - 20 weeks' gestation
Multiparidas - As early as 14 weeks' gestation
Definition of chloasma - answer "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? - answer Bluish discoloration of vagina and cervix. A
presumptive sign of pregnancy.
What is Hegar's sign? - answer 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? - answer At approx. 28 weeks'
gestation.
Difference between how exercise affects BH contractions vs. true labor contractions -
answer + BH contractions disappear with walking or exercise
+ True labor contractions become more intense with walking or exercise
Normal fetal heart rate - answer 110 - 160 BPM (higher in early pregnancy)
After how many weeks are fetal heart tones detectable by handheld Doppler? - answer
After 10 weeks' gestation
After how many weeks can the fetus be palpated through the maternal abdominal wall?
- answer After 22 weeks
Sonogram detection of the following:
+ Cardiac activity
+ Limb buds
+ Finger and limb movements - answer + 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? - answer
+ WHEN: Between 6 - 13 weeks gestation
+ HOW: Measure the crown-rump length
Uses of ultrasound in pregnancy - answer 1) Determine viability
2) Estimate gestational age
3) Screen for aneuploidy
, CMN 568 - Unit 6
4) Evaluate fetal anatomy
From 13 - 20 weeks, the most accurate way to assess gestational age via ultrasound is:
- answer Biparietal diameter of skull
Palpable location of uterine size at:
8 weeks
12 weeks
16 weeks
20 weeks - answer 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? - answer + 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? - answer 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? -
answer 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? - answer 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? - answer + 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? - answer At FIRST prenatal visit, rather than waiting
until 24 - 28 weeks gestation
Measurement of diagonal conjugate of pelvic inlet - answer Distance between the
middle finger of examiner when pressed against sacral promontory in vagina, and the
point at which the patient's pubic symphysis presses on the skin between the
examiner's index finger and thumb.
Initial blood tests at first prenatal visit (preferably in 1st trimester) - answer + *CBC with
differential* - ck for infection and H/H
+ *Blood Type and Rh* - You might have to give Rhogam if they're Rh-negative
