Barkley Tests during pregnancy p 39

1 AFP
2 Acetylcholinesterase
3Triple/ Quad Screening

1 PUBS
2 Fetoscopy

Chorionic vills sampling (BCD)

1 Biochemical
2 Chromosomal
3 DNA abnormalities

8-12 weeks gestation

(BCD)

1 Biochemical
2 Chromosomal
3 DNA abnormalities

11-14 weeks

for second trimester diagnosis-15-18 weeks

early as the 6-8th week of pregnancy.

Alpha feta protein

after 14 wks of gestation

Fetal neural tube or body wall defect

increased risk of Downs syndrome

1 MSAFP
2 AFAFP

Amniotic fluid Alpha fetoprotein screening

Maternal serum Alpha fetoprotein screening

after 14 weeks gestation

(16-20 Barkley)

varied levels of each factor may indicate risk of Down syndrome, trisomy 18, or other chromosome abnormalities

BEAT+ INHIBIN A

1 AFP
2 beta HCG
3 Estriol
4 Inhibin A

1 Beta HCG
2 AFP
3 Estriol

TRIPLE SCREEN

Cortisol
stress hormone

A protein produced by the placenta and ovaries

Sensitivity to the detection of DS is made stronger by the the addition of Inhibin A.

increased = greater likehood of Down Syndrome; sensitivity to the detection of DS is made stronger by the the addition of Inhibin A.

After 14 weeks gestation

neural tube defect

Second trimester

(BCD)

1 Biochemical
2 Chromosomal
3 DNA abnormalities FROM FETAL BLOOD

4 Subtle abnormalities associated with disorders from fetal structures

Percutaneous umbilical blood sampling

second trimester

(BCD)

1 Biochemical
2 Chromosomal
3 DNA abnormalities

The gestational sac is seen earlier than a fetus can be detected on an U/S. A gestational sac can be seen as early as the 5th week of pregnancy or 3 weeks after conception.

About 6.5 weeks into a pregnancy, most U/S techs can clearly see the fetal HB.A fetal heartbeat appears on an U/S as a small flickering image. Since a fetal Doppler may not be able to pick up the fetal heartbeat until later in the first trimester

fetal structures are best viewed after 12 weeks

up to 1 week before traditional ultrasound.

Fetoscopy is an endoscopic procedure during pregnancy to allow access to the fetus, the amniotic cavity, the umbilical cord, and the fetal side of the placenta. A small (3–4 mm) incision is made in the abdomen, and an endoscope is inserted through the abdominal wall and uterus into the amniotic cavity.

1biopsy
2 laser occlusion of abnormal blood vessels

an instrument used to examine the interior of a hollow organ or cavity of the body. Unlike most other medical imaging devices, endoscopes are inserted directly into the organ
looking inside the body for medical reasons using an endoscope

G4P2-1-1-3

TPAL

a=# of pregnancies (4)
b=# of term pregnancies (2)
c=# of preterm pregnancies (1)
d=# of abortions (1)
e=# of living children (3)

+1 year-3months+7 days from LMP= due date

Pap, Cervical cultures, u/s
Hemoglobin/ hematocrit
Rh Factor and blood type (if Rh negative, rescreen at 26-28 weeks)
Rubella screen
Varicella or history of chicken pox, rubella, and hepatitis vaccine
Cystic Fibrosis screen
Hepatitis B surface antigen
Tay Sach’s screen
Sickle Cell prep screen
HIV test
Hemoglobin levels
Hematocrit levels
Specific tests depending on the patient, such as testing for tuberculosis and Hepatitis C
Your healthcare provider will p

Test @ 24-28 weeks

If high risk, 14-18 weeks

Group B beta hemolytic strep

Hgb

1 Wt
2 BP
3 Edema
4 Fundal growth
5 Fetal growth
6 FHT
7 Position

q 4 weeks until 28th wk
q 2 wks until 36 wk then q wk until delivery

12 wks

12 wks

1/2 B/T sb AND UMBILICUS

-Fundus @ umbilicus
-Fetal movement
-FHT by stethoscope

# weeks gestation

difference of 2 cm or more in uterine size from gestation weeks

the liver of fetus and mom; higher in multiple gestations and neural tube defects; lower in Down's and fetal demise- Prevent with folate 400 mcg QD

It usually takes 3 to 4 weeks after the 1st day of the LMP for a home pregnancy test to reveal a positive result.

Conception typically occurs about two weeks after your period begins. This means your Conception typically occurs about two weeks after your period begins. Menses is counted as part of your pregnancy — even though you weren't pregnant at the time.

Week 3: Fertilization

Gestational age is the time that has passed since the onset of the last menstruation, which generally or as standard occurs 2 weeks before the actual fertilization. Embryonic age, in contrast measures the actual age of the embryo or fetus from the time of fertilization.

Week 4: Implantation
Yolk sac
First heartbeat 21-2 days after conception.

Week 5: The embryonic period begins

Fetal development three weeks after conception
The fifth week of pregnancy, or the third week after conception, marks the beginning of the embryonic period. This is when the baby's brain, spinal cord, heart and other organs begin to form.
Hearts pumping blood

Week 6: The neural tube closes

The neural tube closes.
The ears begin to form as otic pits.
Arm buds and a tail are visible.
Pulmonary primordium, the first traits of the lung appear.
Hepatic plate, the first traits of the liver appear.
the pancreas appear.
Urorectal septum begins to form. Thus, the rectal and urinary passageways become separated.
Anterior and posterior horns differentiate in the spinal cord
Spleen appears.

Week 7: Baby's head develops
Seven weeks into your pregnancy, or five weeks after conception, your baby's brain and face are rapidly developing.
Lens pits and optic cups form the start of the developing eye.
Nasal pits form.
The brain divides
Leg buds form and hands form as flat paddles on the arms.
kidney, starts to develop.
The initial stomach differentiation begins.

Week 8: Baby's eyes are visible
Fingers
Toes
Arms legs
Eyelids beg to form
Heart & circ more dev

Week 9: Baby's toes form

Fetal development seven weeks after conception
In the ninth week of pregnancy, or seven weeks after conception, your baby's arms grow, develop bones and bend at the elbows. Toes form, and your baby's eyelids and ears continue developing.

Week 10: Baby's neck begins to develop

Fetal development eight weeks after conception
By the 10th week of pregnancy, or eight weeks after conception, your baby's head has become more round. The neck begins to develop, and your baby's eyelids begin to close to protect his or her developing eyes.

Week 11: Baby's genitals develop

At the beginning of the 11th week of pregnancy, or the ninth week after conception, your baby's head still makes up about half of its length. However, your baby's body is about to catch up, growing rapidly in the coming weeks.

Your baby is now officially described as a fetus. This week your baby's eyes are widely separated, the eyelids fused and the ears low set. Red blood cells are beginning to form in your baby's liver. By the end of this week, your baby's external genitalia will start developing into a penis or clitoris and labia majora.

Week 12: Baby's fingernails develop

Fetal development 10 weeks after conception
Twelve weeks into your pregnancy, or 10 weeks after conception, your baby is developing fingernails. Your baby's face now has a human profile.

By now your baby might be about 2 1/2 inches (61 millimeters) long from crown to rump and weigh about 1/2 ounce (14 grams).

Softening of the cervix.

Cervical cyanosis

Softening of the cervicouterine junction

10-12 weeks

20 weeks

28, 36

0-28wks-- q 4 wks
28-36 wks---q 2 wks
36 on q week

If a woman is found to be Rh negative during pregnancy, it is usually necessary that she receive an intramuscular injection of Rhogam.

28 wks & w/i 72 hrs of delivery

Most often Rhogam is given to women at 28 weeks of pregnancy. The Rh negative mother is most likely to be exposed to the baby’s blood in the last 3 months of pregnancy, so a second dose is often given within 72 hours of delivery if the baby is found to be Rh positive. A mother must also receive a dose after any invasive procedure such as amniocentesis or after an induced termination

24 weeks

+9 months + 7 days
to 1st day of LMP

Pregnancy termination at anytime prior to viability (either through spotaneous expulsion, medical/ surgical removal)

Done w/i 49 days from the 1 st day of LMP

Mifepristone (mifeprex)

Misoprostol (prostaglandin)

BP>140/90, or
Rise in systolic > 30 mmHg, or
Diastolic >15 mmHg
Above an established baseline on @ least 2 occasions, w/ readings 6 hrs apart.

PIH+
protieniria+
generalized edema after 20 wks gestation

PIH + seizure

BP 160/100, h/a, epigastric or RUQ pain, vsual changes, tonic clonic, oliguria

HELLP

H Hemolysis
E elevated
L liver enzymes
L loe
P platelet count

Occurence of contractions after 20 wks but before 37 wks gestation which results in dilation & effacement of cervical os.

1-2 weeks after conception. hCG can be found in high quantities in the 1st morning urine or at any time in a serum sample of a pregnant woman.

If preg is very early and the morning urine is not used the urine test may be negative in a pregnant woman.