Pregnancy Revision questions and Answers
describe the PE features in pregnant pts (bp, cervical mucus appearance, breast
features) - ANSW Decreased blood pressure (progesterone-mediated): 90-115ish/60-
70
Cervical mucus thickening
Breast tenderness, increase in nipple size/pigmentation
describe Chadwick sign - ANSW dark blue/purple coloring of vaginal mucosa near
cervix
when is beta-hCG detectable in the serum? how much should it increase in normal
pregnancy? - ANSW present at 8 days after ovulation
increase: should double every 2 days
describe the discriminatory zone (level and what gestational age it ocurs at, what can be
seen) - ANSW Discriminatory level: beta-hCG 1200-1500 after 14 wks (to ID congenital
anomaly on US)
Level at which US findings show intrauterine structure
describe ectopic pregnancy (+/-hCG, S&S, US features, when its diagnosed, tx, risk
factors) - ANSW +hCG test, lower than expected
S&S: abdominal pain, vaginal spotting, amenorrhea, enlarged uterus
US: empty uterus
Diagnosed at 6-8 wks
Tx: surgical removal (if rupture), medical tx = methotrexate *(if <4cm, no fetal heart
tones, hCG <3500)
Risk factors: PID, endometriosis, Hx of ectopics, tubal disease, IUD, infertility
describe the 4 types of spontaneous abortion (threatened, incomplete, anembryonic,
missed) - ANSW Threatened: vaginal bleeding, closed cervix
Incomplete: open cervix, partial products of pregnancy (bleeding)
Anembryonic: gestational sac is present, beta-hCG is high, but no fetal product is
present (blighted ovum)
,Missed: sac with no growth OR fetus with prior heart tones but presents now with no
heart tones; products are intact (stillbirth)
are labs for pregnant pts different btwn countries? - ANSW NO
list the major lab tests that all pregnant pts get (Ab screens, what TORCH microbe is
screened, what viruses are screened, genetic screens, what everyone in TN gets, what
test is used for aneuploidy, what it screens for, and what 4 markers it measures) -
ANSW ABO-Rh status
Ab screen (IgG or IgM) to any blood/vascular proteins
CBC - Hb, Hct, WBC, platelets especially
Rubella titer (IgG)
HBsAg and HCV titer
UA and culture
(21+) pap smear and tests for gonorrhea, chlamydia
Genetic screens: Hb electrophoresis and CF
Everyone in TN gets a urine drug screen
Aneuploidy: *quad screen - measured AFP, hCG, serum estriol, inhibin (valid for weeks
15-20; 1 test that screens for trisomy 21, 18, and neural tube defects)
what is the rate of blood flow to a pregnant uterus? - ANSW 500 cc/min
what is normal for a fetal HR? - ANSW 120-160 bpm
describe the 4 stages of labor - ANSW 1st: Regular contractions - 6cm dilated = active
labor
2nd: Complete dilation - deliver fetus (2-3hrs)
3rd: Delivery of placenta (10-30 min)
4th: Postpartum - urination should've occurred and bleeding should be done (2 hrs after
placenta is delivered)
define an incompetent cervix (what it is, when it presents) - ANSW cervical dilation
without contractions; usually occurs in 2nd trimester (results in miscarriage)
, when does premature labor occur? - ANSW prior to 37 weeks
define postpartum hemorrhage (vaginal and C-section) - ANSW anything >500cc
>1000cc for C section
define preeclampsia (what it is, when it occurs, what it's associated with) - ANSW bp
>140/90 after 20wks, associated with proteinuria
define gestational HTN (what it is, when it occurs) - ANSW Gestational HTN: bp
>140/90 after 20wks, no proteinuria
what is the cure for preeclampsia? - ANSW delivery
what are the 3 main functions of estrogen and progesterone? (at uterus, pituitary gland,
breast) - ANSW Maintain endometrium
Suppress ovarian follicular function (inhibit FSH and LH)
Stimulate breast development
describe the stages of development after fertilization (days 1, 2, 3, 4, 5, 6-10) - ANSW
Day 1: fertilization
Day 2: 2 cell stage
Day 3: 4 cell stage
Day 4: morula
Day 5: blastula (inner cell mass=embryoblast, outer cell mass=trophoblast)
Day 6-10: implantation (requires low estrogen:progesterone ratio)
what is the source of steroid hormones in the first trimester? second/third? - ANSW
first: corpus luteum
second/third: placenta, fetal adrenal glands
what cells make up the 2 cell masses in the blastula? - ANSW inner cell mass:
embryoblasts
outer cell mass: trophoblasts
what cells are present in the outer cell mass of the blastula on day 6? - ANSW
trophoblasts proliferate and differentiate into cytotrophoblasts and syncytiotrophoblasts
describe the fx of cytotrophoblasts and syncytiotrophoblasts - ANSW
Syncytiotrophoblasts: grow to make contact with endometrial vessels (no mitosis!); also
secrete beta-hCG to act as LH at corpus luteum
describe the PE features in pregnant pts (bp, cervical mucus appearance, breast
features) - ANSW Decreased blood pressure (progesterone-mediated): 90-115ish/60-
70
Cervical mucus thickening
Breast tenderness, increase in nipple size/pigmentation
describe Chadwick sign - ANSW dark blue/purple coloring of vaginal mucosa near
cervix
when is beta-hCG detectable in the serum? how much should it increase in normal
pregnancy? - ANSW present at 8 days after ovulation
increase: should double every 2 days
describe the discriminatory zone (level and what gestational age it ocurs at, what can be
seen) - ANSW Discriminatory level: beta-hCG 1200-1500 after 14 wks (to ID congenital
anomaly on US)
Level at which US findings show intrauterine structure
describe ectopic pregnancy (+/-hCG, S&S, US features, when its diagnosed, tx, risk
factors) - ANSW +hCG test, lower than expected
S&S: abdominal pain, vaginal spotting, amenorrhea, enlarged uterus
US: empty uterus
Diagnosed at 6-8 wks
Tx: surgical removal (if rupture), medical tx = methotrexate *(if <4cm, no fetal heart
tones, hCG <3500)
Risk factors: PID, endometriosis, Hx of ectopics, tubal disease, IUD, infertility
describe the 4 types of spontaneous abortion (threatened, incomplete, anembryonic,
missed) - ANSW Threatened: vaginal bleeding, closed cervix
Incomplete: open cervix, partial products of pregnancy (bleeding)
Anembryonic: gestational sac is present, beta-hCG is high, but no fetal product is
present (blighted ovum)
,Missed: sac with no growth OR fetus with prior heart tones but presents now with no
heart tones; products are intact (stillbirth)
are labs for pregnant pts different btwn countries? - ANSW NO
list the major lab tests that all pregnant pts get (Ab screens, what TORCH microbe is
screened, what viruses are screened, genetic screens, what everyone in TN gets, what
test is used for aneuploidy, what it screens for, and what 4 markers it measures) -
ANSW ABO-Rh status
Ab screen (IgG or IgM) to any blood/vascular proteins
CBC - Hb, Hct, WBC, platelets especially
Rubella titer (IgG)
HBsAg and HCV titer
UA and culture
(21+) pap smear and tests for gonorrhea, chlamydia
Genetic screens: Hb electrophoresis and CF
Everyone in TN gets a urine drug screen
Aneuploidy: *quad screen - measured AFP, hCG, serum estriol, inhibin (valid for weeks
15-20; 1 test that screens for trisomy 21, 18, and neural tube defects)
what is the rate of blood flow to a pregnant uterus? - ANSW 500 cc/min
what is normal for a fetal HR? - ANSW 120-160 bpm
describe the 4 stages of labor - ANSW 1st: Regular contractions - 6cm dilated = active
labor
2nd: Complete dilation - deliver fetus (2-3hrs)
3rd: Delivery of placenta (10-30 min)
4th: Postpartum - urination should've occurred and bleeding should be done (2 hrs after
placenta is delivered)
define an incompetent cervix (what it is, when it presents) - ANSW cervical dilation
without contractions; usually occurs in 2nd trimester (results in miscarriage)
, when does premature labor occur? - ANSW prior to 37 weeks
define postpartum hemorrhage (vaginal and C-section) - ANSW anything >500cc
>1000cc for C section
define preeclampsia (what it is, when it occurs, what it's associated with) - ANSW bp
>140/90 after 20wks, associated with proteinuria
define gestational HTN (what it is, when it occurs) - ANSW Gestational HTN: bp
>140/90 after 20wks, no proteinuria
what is the cure for preeclampsia? - ANSW delivery
what are the 3 main functions of estrogen and progesterone? (at uterus, pituitary gland,
breast) - ANSW Maintain endometrium
Suppress ovarian follicular function (inhibit FSH and LH)
Stimulate breast development
describe the stages of development after fertilization (days 1, 2, 3, 4, 5, 6-10) - ANSW
Day 1: fertilization
Day 2: 2 cell stage
Day 3: 4 cell stage
Day 4: morula
Day 5: blastula (inner cell mass=embryoblast, outer cell mass=trophoblast)
Day 6-10: implantation (requires low estrogen:progesterone ratio)
what is the source of steroid hormones in the first trimester? second/third? - ANSW
first: corpus luteum
second/third: placenta, fetal adrenal glands
what cells make up the 2 cell masses in the blastula? - ANSW inner cell mass:
embryoblasts
outer cell mass: trophoblasts
what cells are present in the outer cell mass of the blastula on day 6? - ANSW
trophoblasts proliferate and differentiate into cytotrophoblasts and syncytiotrophoblasts
describe the fx of cytotrophoblasts and syncytiotrophoblasts - ANSW
Syncytiotrophoblasts: grow to make contact with endometrial vessels (no mitosis!); also
secrete beta-hCG to act as LH at corpus luteum
