Bates Chapter 19 - The Pregnant Woman Flashcards
List the functions of estrogen in pregnancy:
1) Promotes endometrial growth
2) Stimulates prolactin output (readys breast tissue for lactation)
3) Contributes to hypercoagulable state
List the functions of progesterone in pregnancy:
1) Increases tidal volume and minute ventilation
2) Lowers esophageal sphincter tone
3) Relaxes tone in the ureters and bladder
List the functions of HCG in the pregnant female:
1) Supports progesterone synthesis in the corpus leuteum
List the functions of relaxin in the pregnant female:
1) Promotes ligamentous laxity in the sacroiliac joints and pubic symphysis
List the functions of erythropoietin in the pregnant female:
1) Raises erythrocyte mass
Where is the uterus located in each trimester?
1) First - in the pelvis
2) Second - Above umbilicus
3) Third - Xiphoid process
What is the term for the bluish color of the vagina and cervix noted during pregnancy?
Chadwick’s sign
What lowers the pH of the vagina which may help to protect against vaginal infections?
Lactobacillus acidophilus
What is the term for the palpable softening of the cervical isthmus?
Hegar’s sign
What is the official term for “stretch marks”?
Striae gravidarium
What do you call a brown/black stripe along the midline skin?
Linea nigra
What is the term for separation of the rectus abdominis muscle at the midline?
Diastasis recti
What are some of the common concerns of pregnancy?
1) Confirmation
2) Symptoms
3) Concerns about/attitudes toward PG
4) Current health and PMH
5) Past obstetric hx
6) Risk factors
7) Family hx
8) Plans for breast feeding
9) Gestational age and EDD
How do you calculate gestational (menstrual) age?
Count the number of weeks and days from the LMP
How do you calculate the conception age?
Two weeks prior to the menstrual age
How do you calculate the expected date of delivery (EDD) using Nagle’s Rule?
1) Determine the LMP
2) Add 7 days
3) Subtract 3 months
4) Add one year
What is the schedule for prenatal visits?
1) Monthly until 30 weeks gestation
2) Biweekly until 36 weeks
3) Weekly until delivery
What 4 things should be in the history at every visit?
1) Fetal movement (reported by patient)
2) Contractions
3) Leakage of fluids
4) Vaginal bleeding
What 4 things should be in the PE at every visit?
1) Vital signs
2) Fundal Height
3) FHR
4) Position and activity
What two vitamins should be included in a prenatal vitamin?
Folate 0.4-0.8 mg
Iron 30 mg
What tests does the standard prenatal screening panel include?
1) Blood type
2) Rh
3) Antibody screen
4) CBC
5) Rubella titer
6) Syphilis test
7) Hep B surface antigen
8) HIV
9) STI screen for G/C
10) UA with culture
When is oral glucose tolerance testing done?
24 weeks
When do you swab for group B strep (GBS)?
35-37 weeks
What immunizations can be given during pregnancy?
1) Influenza (second or third trimester in flu season)
2) Pneumococcal
3) Meningococcal
4) Hep B
Which vaccines are NOT safe during pregnancy?
1) Measles, mumps, rubella
2) Polio
3) Varicella
Who gets RhoGAM immunoglobulin?
All Rh negative women at 28 weeks gestation and again within 3 days of delivery to prevent sensitization to an Rh-positive infant
What is the term for brownish patches around the forehead, cheeks, nose and jaw?
Chloasma or melasma
Also the “mask of pregnancy”
What is the name of the common cardiac sound heard during pregnancy?
Mammary soufffle
When can fetal movement be detected?
By mother at 18-24 weeks, externally around 24 weeks
What is the term for fetal movement?
Quickening
When measuring fundal height, where is the “0” placed?
On the pubis symphysis
Where should the fundus be around 20 weeks?
At or near the umbilicus
When can FHT be auscultated by doppler?
At or around 10 weeks
What is a normal FHR?
120-160 BPM
The Leopold Maneuver is used to assess what?
1) The adequacy of fetal growth
2) Readiness for vaginal birth
What is the presentation of the fetus when the head is the presenting part?
Vertex or cephalic
What is the presentation of the fetus when parts other than the head present?
Breech
