Women with a history of giving birth to a child with a neural tube defect or a
strong family history should take Right Ans - 4mg/day Folic acid beginning
several months before pregnancy
Women with insulin-dependent diabetes and thosetaking Valproic acid and
Carbamazepine for seizuredisorder should take Right Ans - at least
1mg/day Folic acid
All other women should take Right Ans - 0.4mg/day folic acid at least one
month prior to conception
EDD Right Ans - adding 7 days to the first day of the LMP and subtracting 3
months plus 1 year (Naegele's rule)
Initial prenatal visit Right Ans - between 6-8 weeks gestation
First trimester labs Right Ans - •CBC with differential
•Blood Type and Rh
•Antibody screen
•RPR or VDRL
•HIV screening
•Hepatitis B surface Antigen (HBsAG)
•Rubella and Varicella-Zoster titers
•Urinalysis/Urine C&S (clean catch or cath sample)
•Pap smear if >21 years old (omit if normal Pap within past 3 years) . Include
HPV co-testing if over age 30
•DNA probe for Gonorrhea and Chlamydia
Glucose challenge test at initial blood test if previous... Right Ans -
gestational diabetes or high risk for diabetes; give 50g glucose, glucose level
checked one hour later
Hb electrophoresis to detect Right Ans - sickle cell or thalassemia
Tx of choice for Syphillis Right Ans - Penicillin
Tx of choice for Chalmydia Right Ans - Azithro or Amoxicillin
, Tx of choice for Gonorrhea Right Ans - Ceftriaxone or Azithro
Aneuploidy screening option 1 Right Ans - First step between 11 0/7 and
13 6/7 weeks gestation:
-Ultrasound measurement of fetal nuchal translucency
-Serum test: Pregnancy associated plasma protein A(PAPP-A) and BHCG. Used
to screen for Trisomy 13, 18, and 21
Second step between 15 and 18 weeks gestation:
-Maternal AFP to detect open neural tube defect.
CVS Right Ans - performed between 10-13 weeks gestation by either
transabdominal or transvaginal technique, risk of miscarriage but low (higher
than Amniocentesis)
Amniocentesis Right Ans - offered between 15-20 weeks gestation,
amniotic fluid collected through abdomen using spinal needle, risk of
miscarriage but very low
Prenatal visits schedule Right Ans - -After 2 missed periods
-Every 4 weeks until 28 weeks
-Every two weeks from 28-36 weeks
-Every week from 36-40 weeks
-Twice weekly if greater than 40 weeks
Prenatal care at each visit Right Ans - weight, urine dipstick, BP, fundal
height, fetal heart tones, fetal movement, edema
When is fundal height measured? Right Ans - after 18 weeks gestation
When are fetal heart tones audible? Right Ans - with doppler usually after
10- 12 weeks but reallydepends on patient habitus and fetal cooperation
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