Pregnancy
4 to 40 weeks5 modules
Physiology, prenatal care and the tests along the way, laid on the timeline the hero scrubs.
Week by week
12 weeks
Trimester 1Fundus: Pelvic brim
Milestone
First-trimester scan
The fetus
Crown-rump length about 55 mm. Nuchal translucency and nasal bone are measured in this window.
The mother
The uterus rises above the pelvic brim. Nausea starts to settle for many.
Care at this point. Dating scan (if not done), nuchal translucency and first-trimester serum screen. Low-dose aspirin from 12 to 16 weeks for those at high risk of preeclampsia.
- 01Maternal physiology: what changes, and what that does to your numbersPregnancy is a state of high output, low resistance, dilution and hypercoagulability. Read every maternal number against it.Obstetrics · foundation
- 02Prenatal care: the visit schedule and what each one is forFewer than a dozen visits, each with a purpose: dating, screening, surveillance, preparation. The schedule is the scaffolding of the longitudinal cases.Obstetrics · foundation
- 03Nausea, vomiting and hyperemesis gravidarumCommon, miserable, and occasionally dangerous. The line between the two is ketones, weight and the ability to keep fluids down.Obstetrics · condition · T1T1
- 04Rh alloimmunisation and anti-DAn Rh-negative mother, an Rh-positive fetus, and antibodies that cross the placenta. Prevention is routine; a sensitised pregnancy is followed by titres and the middle cerebral artery.Obstetrics · condition
- 05Infections in pregnancyThe ones that are screened for, the ones that cross the placenta, and the one that matters most in labour.Obstetrics · condition
Presentation-first
The way patients arrive: a symptom, a first question, a workflow, a differential with what favours and what argues against each.
- Bleeding in early pregnancyIs she stable, and where is the pregnancy?
- Bleeding in later pregnancyWhere is the placenta, and is anyone bleeding to death?
- Abdominal pain in pregnancyWhat gestation, and is the pain obstetric or not?
- Headache or raised blood pressure after 20 weeksIs this preeclampsia, and how severe?
- Decreased fetal movementsIs the fetus alive and well right now, and why did movements fall?
- Leaking fluid: rupture of membranesAre the membranes ruptured, and at what gestation?
- Contractions before 37 weeksIs this preterm labour, and if it might be, what can be done in the next 48 hours?
- Fever after deliveryWhat day, what route of delivery, and where is the source?