Obstetrics and Pregnancy

Softening of cervix (by 8 weeks)

Cervical cyanosis (by 8 weeks)

Softening of cervicouterine junction (by 8 weeks)

By 10-12 weeks

By 10-12 weeks

18-20 weeks

At 16-20 weeks trople - HCG, estriol and alpha-fetoprotein quad screenL HCG, estriol, alpha-fetoprotein and inhibin-A

At 20 weeks if hx of diabetes or pt is over 200 lb at 28 routine screening

28 weeks

0-28 q 4 weeks 28-36 q 2 weeks 36-delivery q weeks

9 months + 7 days

Pregnancy termination prior to 24 weeks

First trimester - mifeprostone (RU 486) second trimester - misoprostol

BP over 140/90 or rise in over 30/15 at 2 ocasions with reading 6 hrs apart hx: HTN, renal, cardiocascular, DM, lupus, autoimmune disorders, multiple gestation or first child, old or young mother, hx of PIH dx: BP, CBC, LFTs, 24 hrs urine for protine, Cr clearance, U/S PRN TX: rest, if worsens - referral

PIH + proteinuria + generalised edema after 20 weeks gestation S/S: sudden wt gain (over 2 lb per week or 6 lb per month), edema (non-dependent, generalized and facial), frontal or occipital H/A, visual disturbances tx: referral