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- + 7 days to 1st day of LMP
- - 3 month
- + 1year
Fetal dvlpt stages
- Pre-embryonic - 14 days after conception
- Embryonic - day 15 to 8th week
- Fetus - 9th week til birth
- Ductus arteriosus - between aorta and pulm art
- Ductus venouses - between umbilical vein and inferior vena cava
- Foramen Ovale = between 2 atria
When can parents know the sex of their babies?
By the end of 12th week, genitalia of fetus have developped and sex of fetus can be determined visually
at about 6 weeks, compressibility and softening of the lower uterine segment
softening of the cervix that occurs at the 2nd month
violet coloration of the mucuous membrane of the cervix, vagina and vulva that occurs at week 4
Rebounding of the fetus against the examiner's fingers on palpation ( when HCP initiate a gentle tap on the cervix)
Fundal height point of references
- 16 weeks
- 20-22 weeks
- 36 weeks
- - half way between symphysis pubis and umbilicus
- - right around the umbilicus
- - up to the xiphoid process
during 18-30 months of preg, fundal height is +/-2 weeks of pregnancy.
Schedule for antepartum visits
- q 4 weeks for 1st 28-32 weeks
- q 2 weeks from 32-36 weeks
- q week from 36-40 weeks
When does a pregnant woman receives Rhogam ?
- at 28 weeks if Rh neg.
- w/in 72 hours post partum to Rh neg clients who has given birth to Rh pos baby
- after exposure to Rh Pos. blood
- c/i: rh+ pts.
How is the biophysical profile rated and what does it show?
- 1. looks at fetal breathing mvt, mvts, tone, amniotic fluid index, FHR patterns via a nonstress test
- 2. if it is normal, it indicates that fetal CNS is functional and that the fetus is not hypoxemic.
- 1. low = Downs
- 2. High = ntd or abdominal wall defect - possibility of more than 1 gestation
can detect spina bifida
drawn between 16-18 weeks - 2nd trimester
- 1. 10-13 weeks
- 2. detect genetic abnormalities
- 3. consent is obtained
- 4. bladder full
- 5. Rh neg women may be given Rhogam bc CVS inc risk of Rh sensitization
- 15-20 weeks
- detect genetic disorder, metabolic defects, fetal lung maturity
- informed consent
- if < 20 weeks, full bladder
- if > 20 weeks, empty bladder so they don't puncture it.
How many kicks should there be in a 12hr period?
at least 10
- reactive = normal
- nonreactive = abnormal
Contraction stress test
- negative = normal
- positive = abnormal
- Rubra = day 1 to day 3
- Serosa = day 4 to day 10
- Alba = day 11 to day 14
What kind of BC are better for breast feeding moms?
When do anterior and posterior fontanelle close?
- ant: between 12-18 months
- post: between 2-3 months
Normal bilirubin level in a newborn
less than 12
Normal BG in a 1 day old
> 1 day
Behaviors to expect from infant of drug abused mom?
irretable, crying all the time, difficult to console, hyperextend limbs
Tocolytics? what are they? examples?
- use to slow down uterine activities, to prevent preterm labor.
- c/i: when pt is > 37 weeks, 4cm dilated, fetal anomaly, acute fetal distress, ht disease, pre-eccampsia and ecclampsia, infection, vag. bleeding,
- ex: Indocin, Mag sulfate ( therapeutic range = 5-8 mg) - antidote: calcium gluconate, Nifedipine, Terbutaline
- Position pt on side.
- corticosteroid that help in production of surfactant, in pts between 28-32 weeks
- w/o for: Pulm edema, High BG in DM mothers, infection in mom
- use to manage post partum hemorrhage, check BP before admin, and c/i: in pts w/ htn, cardiac disease, pvd, preecclampsia, or ecclampsia
- Hemabate c/i: pts w/ asthma
Hep B vaccine for nb
- all nb should get hep b vaccine right after birth
- if mom hep b pos. give immunoglobin w/in 12 hrs of birth in addition to the HBV - then follow regular hbv schedule