Answers | Verified | Latest 2024 Version
When can fetal heart tones be detected w/doppler? - ✔✔10-12 weeks
When is fetal movement appreciated? - ✔✔17-18 weeks
When should you get a "quantitative" beta-hCG - ✔✔
-to diagnose & follow ectopic pregnancy
-monitor trophoblastic dz
-screen for fetal aneuploidy
What supplement is given in pregnancy to decrease neural tube defects for all reproductive-age women?
- ✔✔Folic acid supplements
What additional supplements are given for complete vegeterians - ✔✔vitamin D & vitamin B12
What kind of immunoglobulins can cross the placenta? - ✔✔IgG
Prenatal screening at the initial visit - ✔✔Heme= CBC, Rh factor, Type & Screen
ID= UA & culture, rubella Ab titer, HBsAg, RPR/VDRL, cervical G/C, PPD, IV, Pap smear (to check for
dysplasia).
If indicated: HbA1C, Sickle cell screening. Can also discuss genetic screening (Tay-Sachs dz, Cystic
Fibrosis).
When are prenatal visits conducted? - ✔✔Weeks 0-28= every 4 weeks (7*4=28)
Weeks 29-35= every 2 weeks
Weeks 36-birth= every week
,When is a quad screen conducted? - ✔✔15-22 weeks
When's an ultrasound for full anatomic screen done? - ✔✔18-20 weeks
When is the 1 hr glucose challenge test for gestational DM done? - ✔✔24-28 weeks
When is RhoGAM given to Rh- women? - ✔✔28-30 weeks
When's GBS culture done?
(and cervical culture for N gonorrhoeae & Chlamydia in selected populations). - ✔✔35-40 weeks or 32-
37 weeks
when can a nuchal transparency test be ordered? - ✔✔9-14 weeks
4 elements of the Quad Screen - ✔✔maternal serum AFP
B-hCG
Estradiol
Inhibin A
What's associated with ELEVATED maternal serum AFP (MSAFP)?
(<2.5 MoMs) - ✔✔Open neural tube defects (spina bifida, anencephaly)
Abdominal wall defects (gastroschisis, omphalocele)
Multiple gestation
Incorrect gestational dating
Fetal death
Placental abnormailities (like rupture)
What's associated with REDUCED maternal serufm AFP (MSAFP)
(<0.5 MoM) - ✔✔Trisomy 21 & 18
, Fetal demise
Inaccurate gestational dating
Quad screen in trisomy 18 - ✔✔all are decreased
(still "UNDERage" at age 18)
Quad screen in Trisomy 21 - ✔✔Decreased AFP
Increased B-hCG
Decreased Estradiol
Increased Inhibin A
earliest screening for down syndrome & trisomy 18? - ✔✔PAPP-A + nuchal transparency +free B-hCG
done at 9-14 weeks ("Full Integrated test")
Note-> nuchal transparency is increased.
(PAPP-A= pregnancy-associated plasma protein A)
At what time (weeks) is CVS vs amniocentesis done? - ✔✔CVS= 10-12 weeks
Amniocentesis= 15-20 weeks
Which is indicated in women who will be >35 yo at time of delivery? - ✔✔amniocentesis
What are the major infectious organisms that can cross the placenta? - ✔✔TORCHeS:
Toxoplasmosis
Other (parvovirus, varicella, Listeria, TB, malaria, fungi)
Rubella
CMV
Herpes simplex virus
HIV