Intro to Obstetrics I Flashcards

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Questions and Answers

When would obstetrics ideally begin?

Before pregnancy so that patients can undergo counseling and preparation for pregnancy.

How early should prenatal vitamins be started?

3 months before conception.

When should folate be given?

Before pregnancy and continued for 12 weeks into pregnancy.

What confirms the diagnosis of pregnancy?

Cessation of menses, urine or serum B-hCG, fetal heart tones > 12 weeks, and transvaginal sonography. Signup and view all the answers

How long after conception can a positive B-hCG be detected?

8-9 days. Signup and view all the answers

What are common signs and symptoms of pregnancy?

Enlarged soft uterus, Hegar sign, Chadwick sign, nausea, vomiting, fatigue, and urinary frequency. Signup and view all the answers

What is the Hegar sign?

Softening of the isthmus of the uterus at 6 to 8 weeks. Signup and view all the answers

What is the Chadwick sign?

Reddish-blue coloration of labia, vaginal mucosa, and cervix. Signup and view all the answers

When does hCG peak during pregnancy?

8-10 weeks. Signup and view all the answers

What hormone increases as the placenta takes over?

Estriol. Signup and view all the answers

How do you date the pregnancy?

From the 1st day of LMP, adding 40 weeks for the estimated due date. Signup and view all the answers

What are the dimensions for the ideal delivery of the baby through the birth canal?

Suboccipitobregmatic dimension (about 9.5 cm). Signup and view all the answers

What is the normal frequency of prenatal checkups?

Every 4 weeks until 28 weeks, every 2 weeks from 28-36 weeks, and weekly from 36 weeks to birth. Signup and view all the answers

What is quickening?

First appreciation of fetal movement by the pregnant patient. Signup and view all the answers

What could cause a fundal height to be greater than 2 cm of the gestational weeks?

Wrong dates, macrosomia, polyhydramnios, multiple gestations, hydatidiform mole. Signup and view all the answers

What is defined as term, preterm, full term, late term, and post term?

Preterm=<36 weeks, Term=37 weeks and beyond, Early term=37-38 weeks, Full term=39-40 weeks, Late term=41-41 weeks 6 days, Post-term=42 weeks and beyond. Signup and view all the answers

What does G1 P1001 mean?

G1= pregnant once, P1001= 1 term delivery, 0 preterm, 0 abortuses, 1 living child. Signup and view all the answers

How would you write it if the patient has a twin delivery, but only one child survived?

G1 P1001. Signup and view all the answers

What is the importance of uterine contraction after birth?

To contract uterine blood flow to prevent hemorrhage. Signup and view all the answers

Where is the epidural space located?

Between the wall of the vertebral canal and dura mater. Signup and view all the answers

How is the fetus monitored during labor?

By monitoring fetal heart rate and maternal contractions. Signup and view all the answers

Study Notes

Obstetrics Overview

Obstetrics ideally begins before pregnancy for counseling on prenatal vitamins, lifestyle modifications, and genetic screening.
Prenatal vitamins should start three months prior to conception and folate should be taken before conception and continued for 12 weeks during pregnancy.

Diagnosis of Pregnancy

Cessation of menstruation is a presumptive sign; confirmation through urine or serum beta-hCG tests.
Fetal heart tones detected after 12 weeks and transvaginal sonography provide confirmation.

Signs and Symptoms of Pregnancy

Soft, boggy uterus can be checked via bimanual examination; at 6-8 weeks, uterus resembles the size of an orange.
Symptoms include Hegar sign (uterine isthmus softening), Chadwick sign (reddish-blue vaginal coloration), nausea, fatigue, urinary frequency, and skin changes such as linea nigra and chloasma.

Hormonal Changes

Human Chorionic Gonadotropin (hCG) peaks at 8-10 weeks and declines as the placenta takes over; estriol levels increase thereafter.

Ultrasound and Pregnancy Dating

Fetal parts visible via ultrasound at 10 weeks; pregnancy is dated from the last menstrual period (LMP), typically adding 40 weeks for due date.
Crown-Rump length (CRL) in the first trimester provides an accurate gestational age within four days.

Trimester Breakdown

First trimester: Weeks 1-13
Second trimester: Weeks 14-27
Third trimester: Weeks 28 to birth

Prenatal Care Frequency

Checkups: every four weeks (weeks 4-28), every two weeks (weeks 28-36), weekly (weeks 36 to birth).
Regular checks include maternal weight, blood pressure, urinary assessment, fetal heart rate (110-160 bpm), and growth.

Special Prenatal Tests

Initial tests include screenings for HIV, Rubella, and STI; follow-up tests around 24-28 weeks check for diabetes and repeat screenings.

Fetal Movement and Fundal Height

Quickening, the first fetal movement sensation, typically occurs around 20 weeks in a first pregnancy.
Fundal height correlates to gestational age between 20-34 weeks, typically within +/- 2 cm of the weeks of gestation.

Gravida and Para Definitions

Gravida refers to the number of pregnancies; nulligravida indicates no pregnancies, primigravida is the first, and multigravida refers to multiple pregnancies.
Para indicates pregnancies beyond 20 weeks; terms include nullipara (never delivered), primipara (one delivery), and multipara (two or more deliveries).

Fetal Monitoring and Engagement

Fetal engagement occurs at the level of ischial spines; crowning refers to the head emerging (+4 or +5).
Fetal stations indicate the position of the fetus relative to the ischial spines, essential for labor assessment.

Delivery Considerations

Occiput anterior is the ideal position for normal delivery; episiotomy may be performed to facilitate childbirth in specific cases.
Conditions like succenturiate lobes and velamentous cord insertion necessitate careful placental examination post-delivery to prevent complications.

Emergency Situations

Vasa previa involves fetal vessels near the cervix and requires an emergency cesarean section if bleeding occurs.

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Description

Test your knowledge about the early stages of obstetrics with these flashcards. This quiz covers essential concepts such as the timing of prenatal care and the importance of prenatal vitamins. Ideal for students preparing for exams in obstetrics and gynecology.