Pregnancy Signs & Diagnostics
A patient reports nausea, fatigue, and missed period. What type of pregnancy signs are these?
Presumptive signs
A pregnant patient feels fetal movement described as flutters for the first time. What is this called?
Quickening
Why does hemoglobin decrease during pregnancy despite increased blood volume?
Plasma volume increases more than RBCs, causing dilution (physiologic anemia)
What hemoglobin level in pregnancy indicates anemia?
Less than 11 g/dL
A patient is G3P1. What does this mean?
3 pregnancies total, 1 pregnancy reached viability
A provider notes a bluish discoloration of the cervix during exam. What is this called and what category is it?
Chadwick’s sign – Probable sign
A patient at 39 weeks reports easier breathing but increased pelvic pressure and urinary frequency. What process is occurring?
Lightening
A pregnant patient faints after standing quickly. What is the most likely cause?
Decreased blood pressure and vascular resistance causing syncope
When is Rhogam given to an Rh-negative mother? (Give one timing)
Around 28 weeks (also after birth, trauma, bleeding, etc.)
A patient had twins at 34 weeks, both alive. What is her preterm and living count?
Preterm = 1, Living = 2
A positive pregnancy test is obtained, but the provider explains this does not confirm pregnancy. Why?
It detects hCG, which can be present from other causes (miscarriage, meds, etc.), so it is only a probable sign
A patient has irregular contractions that improve with hydration and rest and do not cause cervical change. What are these?
Braxton Hicks contractions
Why are pregnant patients at higher risk for blood clots?
Pregnancy is a hypercoagulable state with increased clotting factors
A pregnant patient tests positive for Hepatitis B. What must the newborn receive immediately after birth?
Hepatitis B vaccine and Hepatitis B immunoglobulin within 12 hours
Using Naegele’s Rule, calculate the due date for LMP July 10.
April 17
During an exam, the provider pushes on the cervix and feels the fetus rebound. What is this finding and why is it not definitive?
Ballottement; it is not definitive because it is only a probable sign, not direct visualization
A patient reports severe headache, vision changes, and right upper quadrant pain. What condition should be suspected?
Preeclampsia
A patient reports shortness of breath in late pregnancy. What is the primary physiologic cause?
Enlarging uterus pushing up on the diaphragm, limiting lung expansion
A 1-hour glucose test result is 150 mg/dL. What is the next step?
Perform a 3-hour oral glucose tolerance test
Why is crown-rump length used in early pregnancy instead of full body measurements?
Because early fetal position makes full measurements unreliable; legs are not included
A patient has a confirmed intrauterine pregnancy via ultrasound with visible fetal cardiac activity. Why is this considered the only true confirmation of pregnancy?
Because visualization of the fetus and cardiac activity are positive signs, which directly confirm pregnancy
A patient reports 5 contractions in one hour with low back pain and pelvic pressure at 34 weeks. What is the priority concern and why?
Preterm labor; because ≥4 contractions/hour with symptoms before 37 weeks indicates early labor
Explain why blood pressure decreases during pregnancy despite increased blood volume.
Estrogen causes decreased peripheral vascular resistance, lowering BP even with increased volume
A pregnant patient has two elevated values on a 3-hour glucose tolerance test. What is the diagnosis and why?
Gestational diabetes; diagnosis is made when ≥2 values are elevated
A patient reports decreased fetal movement and only feels 6 kicks in 2 hours. What is the priority action and rationale?
Call the provider immediately; fewer than 10 movements in 2 hours may indicate fetal compromise