OB Review

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  1. Signs of pregnancy include? (3) 
    Presumptive: are s/s that lead the client to believe she is pregnant but are not conclusive

    Probable: more conclusive than presumptive signs but are still not definitive

    Positive: there are only three definite signs
  2. What are the Presumptive Signs?
    • amenorrhea
    • breast sensitivity
    • Chadwick's sign
    • fatigue
    • fingernail changes
    • urinary frequency
    • wt gain
  3. What are the Probable Signs?
    • ballotment:fetus rebounds
    • Chadwick's sign:bluish vagina
    • Goodell's sign: softening of the cervical lip
    • Hegar's sign: softening of the uterus
  4. What are the Positive Signs?
    • fetal heart tones
    • Leopold's maneuver
    • Ultrasound of the fetal outline  
  5. What is an Alpha-Fetoprotein Screening?
    *is obtained by a blood sample from the mother

    *alpha-fetoprotein is a glucoprotein produced by fetal yolk sac, GI tract, and liver

    *it can be done on mother's blood b/t 16-20weeks gestation

    *this protein passes through the placenta to the maternal circulation and is excreted through fetal circulation and into the mother's circulation

    *if abnormal levels, amniocentesis should be done
  6. What is an amniocentesis?
    *it can be done as early as 16 weeks gestation 

    *ultrasound exam of uterus is performed prior to the amnio centesis to locate the placenta and the pockets of amniotic fluid

    *full bladder is recommended

    *large bore needle is used

    *report any crampling or bleeding and avoid lifting objects heavier than 5lbs for several days
  7. When can you hear fetal tones using a fetoscope and ultrasound?
    • fetoscope:18-20 weeks
    • ultrasound:~12 weeks
  8. What is the benefit of ultrasonography?
    *it is done to determine fetal age and can be useful tool in determining fetal abnormalities
  9. Signs of Complications of Pregnancy include: (8)
    • persisrent vomiting: hyperemesis gravidarum (N&V after the fisrt trimester) can lead to fluid and electrolyte imbalances
    • vaginal bleeding:indication of placenta previa, abruptio placenta, or threatened abortion
    • abd pain:threatened abortion, an ectopic pregnancy, or abruptio placenta
    • incompetent cervix:causes spontaneous abortion (corrected by McDonalds', cerclage=procedure to close the cervix)
    • vertigo, h/a, or edema of the hands and face:preeclampsia
    • chills and fever:UTI or infection
    • excessively rapid uterine enlargement:hydatidiform mole
  10. What is TORCHS syndrome?
    *it includes toxoplasmosis, rubella, cytomegalovirus, herpes, syphillis
  11. What is a hyatidiform mole?

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    • *is a rapid proliferation of the cells within the uterus d/t trophoblastic disease
    • *rapid cell growth can be associated with chorionic carcinoma
    • *tx:dilation and curettage(scraping) or d&c
    • *not be pregnant for at least a year b/c a rising HCG level will stimulate CA cell growth
  12. What are the types of abortions?
    • *elective:evacuation of fetus
    • *threatened:produces spotting (tx is bedrest)
    • *inevitable: no fetal heart tones and part of the fetus are passed (tx:d&c)
    • *incomplete:fetal demise exists but part of the conception is not passed (tx:d&c)
    • *septic:presence of infection
    • *missed:there is fetal demise but there is no expulsion of the fetus (tx:induction of labor or a surgical removal of the fetus)        
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OB Review
2012-06-14 20:18:31

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