Mark Klimek - Maternity lecture
Calculating expected date of delivery/Naegale's Rule - ANSFIRST day if last menstrual period +
7 days - 3 months
Example: June 10-15 was last menstrual period
Expected date of delivery:
March 17
Calculating pregnancy weight - ANSWeek of gestation - 9 = lbs
Should only gain 3 lbs during first trimester (12 weeks or 3 months)
Example:
28 weeks gestation - 9 = 19 lb weight gain
Total weight gained during pregnancy - ANS28 lbs +/- 3
Fundus - when will you first palpated it? - ANSAfter the first trimester ~12 weeks
When will the fundus be at the level of umbillicus? - ANSWeeks 20-22
Can you determine what trimester a pregnant women is in by the fundal height? How? -
ANSPregnant but can NOT feel the fundus = first trimester, priority = Mom
Can palpated fundus at or below the umbilicus = second trimester, priority = Mom
Palpated ABOVE the umbilicus = third trimester, priority = baby
4 positive signs of pregnancy - ANSFetal skeleton on X-ray
Fetal presence on ultrasound
Auscultation of fetal heart rate (between 8-12 weeks)
When examiner palpates (NOT mom)
Types of OB questions - ANSWhen would you first... (earliest)
When would you most likely...(middle)
When should you by...(last)
When would you first auscultate a fetal heart? - ANS8 weeks
When would you auscultate a fetal heart? - ANS10 weeks
, When should you auscultate a fetal heart? - ANS12 weeks
Probably (maybe) signs of pregnancy - ANS-All urine/blood pregnancy tests
-Chadwick's sign- cervical color change to cyanosis (all C's)
-Goodell's sign - cervical softening
-Hegar's sign - uterine softening
Signs are in alphabetical order: Chadwick's, Goodell's, Hegar's
A POSITIVE pregnancy test is... - ANSNOT a positive sign of pregnancy (it is a PROBABLE
sign)
Pattern of office visits - prenatal care - ANSOnce a month until week 28
Once every 2 weeks until week 36
Once a week until delivery or week 42 (then induced)
Example:
Pregnant women comes in at week 12, when should she come in next?
Week 16
Hemoglobin will do what during pregnancy? - ANSDROP in pregnancy
11 (first trimester) = normal
10.5 (second trimester) = normal
10 (third trimester) = normal
Normal female hemoglobin - ANS12-16 g/dL
Morning sickness - what trimester? How do you treat it? - ANSFirst trimester
DRY carbohydrates before you get out of bed
Urinary incontinence - ANS1st and 3rd trimester
(Do not get it in 2nd trimester because the baby is high in the abdomen)
Tx: VOID EVERY 2 HOURS even 6 weeks after pregnancy
Calculating expected date of delivery/Naegale's Rule - ANSFIRST day if last menstrual period +
7 days - 3 months
Example: June 10-15 was last menstrual period
Expected date of delivery:
March 17
Calculating pregnancy weight - ANSWeek of gestation - 9 = lbs
Should only gain 3 lbs during first trimester (12 weeks or 3 months)
Example:
28 weeks gestation - 9 = 19 lb weight gain
Total weight gained during pregnancy - ANS28 lbs +/- 3
Fundus - when will you first palpated it? - ANSAfter the first trimester ~12 weeks
When will the fundus be at the level of umbillicus? - ANSWeeks 20-22
Can you determine what trimester a pregnant women is in by the fundal height? How? -
ANSPregnant but can NOT feel the fundus = first trimester, priority = Mom
Can palpated fundus at or below the umbilicus = second trimester, priority = Mom
Palpated ABOVE the umbilicus = third trimester, priority = baby
4 positive signs of pregnancy - ANSFetal skeleton on X-ray
Fetal presence on ultrasound
Auscultation of fetal heart rate (between 8-12 weeks)
When examiner palpates (NOT mom)
Types of OB questions - ANSWhen would you first... (earliest)
When would you most likely...(middle)
When should you by...(last)
When would you first auscultate a fetal heart? - ANS8 weeks
When would you auscultate a fetal heart? - ANS10 weeks
, When should you auscultate a fetal heart? - ANS12 weeks
Probably (maybe) signs of pregnancy - ANS-All urine/blood pregnancy tests
-Chadwick's sign- cervical color change to cyanosis (all C's)
-Goodell's sign - cervical softening
-Hegar's sign - uterine softening
Signs are in alphabetical order: Chadwick's, Goodell's, Hegar's
A POSITIVE pregnancy test is... - ANSNOT a positive sign of pregnancy (it is a PROBABLE
sign)
Pattern of office visits - prenatal care - ANSOnce a month until week 28
Once every 2 weeks until week 36
Once a week until delivery or week 42 (then induced)
Example:
Pregnant women comes in at week 12, when should she come in next?
Week 16
Hemoglobin will do what during pregnancy? - ANSDROP in pregnancy
11 (first trimester) = normal
10.5 (second trimester) = normal
10 (third trimester) = normal
Normal female hemoglobin - ANS12-16 g/dL
Morning sickness - what trimester? How do you treat it? - ANSFirst trimester
DRY carbohydrates before you get out of bed
Urinary incontinence - ANS1st and 3rd trimester
(Do not get it in 2nd trimester because the baby is high in the abdomen)
Tx: VOID EVERY 2 HOURS even 6 weeks after pregnancy
