Antepartum 2a

• What are the five goals of prenatal care?

  1. Ensure a healthy baby and minimize maternal risk *
  2. Early, accurate estimate of gestational age
  3. Identify patients at risk for complications
  4. Anticipate and prevent problems before they occur
  5. Patient education and communication
• When should the initial visit be ideally?

  Between 6-10 weeks (or during 1st trimester)
• How often should a woman go to visits if they are 28 weeks?

  Every 4 weeks
• How often should a woman go to visits if they are 28 to 36 weeks?

  Every 2 weeks
• How often should a woman go to visit if she is 36 to 40 weeks?

  Every week
• Rubella titer: test for antibodies (positive)

  Syphilis: test for antigens (negative)

  Hepatitis B: test for antigens (negative)

  HIV: negative
• What immunizations are recommended during pregnancy?

  Influenza (inactivated), Tdap (2nd or 3rd trimester), Hepatitis A & B, and COVID-19 vaccinations
• At how many weeks does the measurement in centimeters correspond with the week's gestation?

  Between 18 and 36 weeks.
• Noninvasive prenatal (genetic) testing NIPT

  It is done at 10 weeks

  Looks at fetal DNA found in maternal serum

  Trisomies 13, 18, 21 and other rare chromosomal abnormalities
• Ultrascreen/First Trimester Screen

  It is done between 11 1/7 weeks to 13 6/7 weeks

  For chromosomal abnormalities

  Nuchal translucency plus two maternal serum tests
• Maternal Serum Alpha-Fetoprotein (MSAFP)

  Done at 15-20 weeks

  Elevated levels: NTDs such as spina bifida and open abdominal wall defects

  Decreased levels: chromosomal trisomies such as Down's syndrome
• Multiple Marker Screening (Triples, Quad, Penta)

  Done at 15-20 weeks

  Trisomies (Down syndrome) and NTDs
• Diabetes screen for GDM

  It is done at 24-28 weeks

  1 hour should be 140 and under or else 3 hour test is done
• Group B Streptococcus (GBS) culture

  It is done at 35-37 weeks
• Pregnancy danger signs part 1

  Fever of 101 F or higher

  Sudden severe or continuous pain or cramping in the lower abdomen

  Bleeding or spotting from your vagina

  Severe headaches or visual membranes
• Pregnancy danger signs part 2

  Sudden severe swelling of your hands, feet or face, or generalized edema

  Persistent vomiting

  Injury to abdomen or involved in a car accident

  Urinary symptoms: dysuria, frequency, urgency, oliguria

  4 or more uterine contractions/hour before 37 weeks
• Pregnancy danger signs part 3

  Symptoms of vaginal infection, itching, burning and increase of unusual discharge

  Continuous leaking of small amount of fluid from the vagina or gush of water from the vagina

  Decreased fetal movement after the 20th week of pregnancy

  Sores or blisters on genitals