GTPAL and EDD
Signs of Pregnancy and Trimesters
Abortion Care
Medications
Physiological Changes
Miscellaneous
100
Your patient reports their first pregnancy ended in a miscarriage at 10 weeks, then had their first baby at 35 weeks.
G 3 P 0111
100
What are presumptive signs of pregnancy?
Breast tenderness, nausea, and vomiting
100
Define Miscarriage
Active, spontaneous expulsion of conception products before 20 weeks gestation
100
What are the medication options for a patient with Gestational Diabetes Mellitus?
Metformin, insulin therapy, glyburide
100
First trimester fetal development includes...?
Major organ development (heart, brain, spinal cord), fetal heartbeat detectable by doppler around 10-12 weeks
100
Fetal movement felt by the pregnant person
What is quickening
200
Your patient is pregnant, and they report they gave birth at 34 weeks to their first child, followed by a termination of a pregnancy at 11 weeks, and then gave birth to their second child at 41 weeks. Finally, they had a miscarriage at 8 weeks.
G 5 P 1122
200
What is a probable sign of pregnancy?
A positive HCG result on a pregnancy test
200
Define a missed abortion
The fetus has died, but all conception products remain in the uterus
200
What are some options for a patient with morning sickness?
Ondansetron (Zofran), Compazine, Benadryl, Metoclopramide (Reglan)
200
Maternal changes in the second trimester include...?
Uterus growth to accommodate fetus, increasing blood volume, decrease in early pregnancy signs
200
Name this common skin change associated with pregnancy.
Linea Nigra
300
Your patient reports they are pregnant on February 11. They state that their last menstrual period was on December 28. When is their estimated due date?
October 5.
Subtract 3 months, add seven days. December 28 - 3 months = September 28. September 28 - 7 days = October 5
300
What are some diagnostic signs of pregnancy?
Fetal visualization on an ultrasound, hearing the fetal heartbeat with a doppler, and feeling the fetus move (trained provider, >20 weeks)
300
What are the surgical managements used for abortions?
Dilation and Curettage, Dilation and Evacuation
300
If a pregnant person tests positive for Group B Strep, what are the first line medications that are given for treatment?
Penicillin/Ampicillin and Gentamicin
2nd Line: Ceftriaxone and Vancomycin300
Fetal development in the second trimester includes...?
Development of fine motor skills, facial features, quickening
300
What are some ways partners can bond with the developing fetus?
Play - pressing on the abdomen and letting the baby kick back, applying heat or cold, applying a light
Voice - reading, singing, or talking to the fetus can help bonding
400
Your patient reports their LMP was April 12. What is their EDD?
January 19.
April 12 - 3 months --> January 12
January 12 + 7 days --> January 19
400
Recommended weight gain in the second and third trimester
1-2 lbs per week
400
What signs and symptoms would warrant a patient seek emergency medical care?
Flu like symptoms, excessive bleeding, passing large blood clots
400
Methotrexate
Ectopic pregnancies and treatment for GTD
400
Maternal changes in the third trimester include...?
Weight gain, increased uterine size, back pain, edema, shortness of breath, hormonal changes to prepare for labor (oxytocin)
400
What key dietary nutrients are recommended during the antepartum period?
Folic acid, iron, calcium, protein, omega3 fatty acids
500
When was your patient's LMP? Their EDD is July 12.
October 5.
July 12 - 7 days --> July 5
July 5 + 3 months --> October 5
500
What category does this description match?
Baseline 110-160 BPM, moderate variability, with no late or variable decelerations.
Category 1, reassuring
500
What are the medications used for medically managed abortions?
Mifepristone 100mg PO immediately
Misoprostol 800mg buccally 24-28 hrs after the dose of Mifepristone
500
What would Magnesium Sulfate be given for?
As an anticonvulsant medication in a patient with preeclampsia
500
Fetal changes in the third trimester include...?
Rapid weight gain, lung and brain maturation, positioning for birth
500
If a patient is a carrier of an X-linked recessive trait, and her partner is not, what percentage does a female child have of being a carrier?
50% chance of a female child being a carrier