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OB > ch 13 - anatomy and physiology of pregnancy > Flashcards

ch 13 - anatomy and physiology of pregnancy Flashcards

1
Q

duration of pregnancy (from first day of last normal menstrual period)

A

280 days
40 weeks
9 months

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2
Q

EGA

A

estimated gestational age

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3
Q

how long is 1st trimester

A

0-13 weeks

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4
Q

how long is 2nd trimester

A

14-26 weeks

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5
Q

how long is 3rd trimester

A

27-40 weeks

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6
Q

of times a woman has been pregnant including current

A

gravida

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7
Q

first pregnancy

A

primigravida

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8
Q

2 or more pregnancies

A

multigravida

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9
Q

of times a woman has carried a pregnancy > 20 weeks (not counting current pregnancy until after birth)

A

para

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10
Q

4 parts para is divided into

A

TPAL:
Term
Preterm
Abortion
Living children

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11
Q

division of para: # of births greater than or equal to 37 weeks

A

term

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12
Q

division of para: # of births between 20 weeks to 36 weeks + 6 days

A

preterm

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13
Q

division of para: # pregnancies ending before 20 weeks

A

abortion

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14
Q

division of para: # of children currently living

A

living children

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15
Q

what are presumptive signs of pregnancy considered

A

subjective

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16
Q

presumptive/subjective S+S pregnancy (6)

A

-breast changes
-N/V
-urinary frequency
-fatigue
-perception of fetal movement
-amenorrhea

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17
Q

what are probable signs of pregnancy considered

A

perceived by examiner

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18
Q

probable S+S pregnancy (7)

A

-abdominal enlargement
-chadwicks sign (vaginal mucosa and blue-ish cervix)
-goodell’s sign (pelvic congestion and cervical softening)
-hegar’s sign (softening of lower uterine segment)
-positive serum/pregnancy test
-braxton hicks contractions
-bollottment

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19
Q

probable sign: vaginal mucosa and cervix blue-ish

A

chadwicks sign

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20
Q

mother’s perception of fetal movement (around 16-20 weeks)

A

quickening

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21
Q

probable sign: pelvic congestion and cervical softening

A

goodell’s sign

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22
Q

probable sign: softening of lower uterine segment/isthmus

A

hegar’s sign

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23
Q

3 categories of S+S of pregnancy

A

-presumptive signs (subjective)
-probable signs (observed by examiner)
-positive signs (can only be caused by pregnancy)

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24
Q

positive S+S of pregnancy (4)

A

-visualization of fetus on ultrasound
-auscultation of fetal heart sounds
-palpation of fetal movement by examiner
-visualization of fetal movement by examiner

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25
Q

when examiner pushes up on cervix and baby pushes cervix back down

A

bollottment

26
Q

earliest biochemical marker for pregnancy

A

hCG (human chorionic gonadotropin)

27
Q

action of estrogen during pregnancy (3)

A

hypertrophy (enlargement of cells)
hyperplasia (growth of additional cells)
hyperemia (increased blood production, blue-ish)

28
Q

action of progesterone during pregnancy

A

relaxation (muscles, joints, capillary system, intestines)

29
Q

physical changes of the female repro system during pregnancy

A

-size and shape
-contractility
-blood flow (500 mL/min at term)
-quickening (16-20 wks)
-ballottement
-lightening (38 wks)
-braxton hicks

30
Q

swooshing sound heard on a doppler due to increased uterine blood flow; pulsating at mother’s heart rate

A

uterine souffle

31
Q

swooshing sound heard on a doppler due to increased uterine blood flow through umbilical cord; pulsating at baby’s heart rate

A

funic souffle

32
Q

at how many weeks pregnant does the uterus grow above the pubis symphysis

A

12 weeks

33
Q

at how many weeks pregnant does the uterus grow above umbilicus

A

20 weeks

34
Q

way to measure with tape measurer how many weeks pregnant

A

from pubis symphysis to top of fundus (in cm) = how many weeks

35
Q

reasons for uterus measuring bigger than expected during pregnancy (4)

A

-excess amniotic fluid
-gestational diabetes
-multiple babies
-dates are wrong

36
Q

vaginal and vulval changes during pregnancy (3)

A

-leukorrhea (white discharge)
-edema
-varicosities (swollen veins)

37
Q

cervical changes during pregnancy (2)

A

-friability (can cause vaginal bleeding, especially after SVE or intercourse)
-mucus plug (operculum)

38
Q

purpose of cervical plug

A

extra layer of protection against ascending organisms

39
Q

changes in breasts during pregnancy (5)

A

-increased sensitivity
-pigmentation (darker)
-dilation of blood vessels
-striae and enlargement
-colostrum (as early as 16 wks)

40
Q

cardiovascular system changes during pregnancy (4)

A

-slight hypertrophy of heart
-blood volume and composition (increases by 40-50%; physiologic anemia, bp maintained because of vasodilation)
-cardiac output increases 30-50% near 30 wks
-hyper-coagulability

41
Q

heart rate changes during pregnancy

A

increases 15-20 bpm

42
Q

consequence of hyper-coagulability during pregnancy

A

DVT

43
Q

respiratory system changes during pregnancy (4)

A

-increased vascularity of upper resp tract w/ edema
-structural adaptation (raised diaphragm, chest expansion)
-pulmonary function (increased sensitivity CO2, increased tidal volume, increased O2 consumption)
-increased basal metabolism rate (increased sweat)
-acid base balance (compensated resp alk: brings more O2 to baby)

44
Q

normal pH level for pregnant woman

A

7.4-7.45

45
Q

vital sign changes during pregnancy (3)

A

-resting pulse increased 10 bpm
-blood pressure (slightly decreased, vena cava syndrome)
-increased temp

46
Q

what is vena cava syndrome

A

-supine hypotension
-pregnant uterus compresses vena cava, blocking blood flow to right side of heart
-decreased oxygenation to fetus

47
Q

skin changes during pregnancy (7)

A

-melasma/chloasma (blue/brown discoloration of nose and cheeks)
-linea nigra
-hyperpigmentation
-striae gravidarum
-spider angiomas
-palmar erythema
-pruritus gravidarium (rare condition: PUPP)

48
Q

what is PUPP

A

rare condition: puritic uticarial papules and plaques of pregnancy

49
Q

GI changes during pregnancy

A

-appetite (N/V/morning sickness)
-mouth (hyperemia, epulis, ptyalism)
-decreased tone and motility (slower stomach emptying, reflux, constipation, hemorrhoids)

50
Q

swelling of the gums

A

epulis

51
Q

excessive salivation

A

ptyalism

52
Q

why might appendicitis be difficult to diagnose during pregnancy

A

appendix is displaced upward and to the right

53
Q

term for heartburn

A

pyrosis

54
Q

musculoskeletal changes during pregnancy (4)

A

-lordosis (center of gravity changes)
-round ligament discomfort
-common leg cramps
-diastasis recti

55
Q

renal system and bladder changes during pregnancy (10)

A

-GFR and renal plasma bloodflow increase
-increased creatinine clearance
-decreased serum creatinine, BUN and uric acid
-renal pelves and ureters dilate (larger volume urine held: stagnate urine, can lead to UTI and pyelonephritis)
-increased glucose (higher chance infection)
-bladder irritability (nocturia, increased frequency)
-increased bladder vascularity
-decreased bladder tone (increased capacity to 1500 mL)
-fluid and electrolytes (increased excretion glucose, protein and albumin)
-urinalysis may have trace protein and +1 glucose

56
Q

what position during pregnancy increases renal perfusion and function

A

lateral recumbent

57
Q

neurological system changes during pregnancy (4)

A

-sensory changes and muscle cramps in legs
-pain in back
-headache (can have altered vision)
-feeling faint

58
Q

endocrine changes during pregnancy (4)

A

-increased estrogen and progesterone
-hCG (increases until produced by placenta)
-prolactin (suppressed until placenta is delivered)
-oxytocin (causes uterine contractions)

59
Q

normal Hct v pregnant Hct

A

normal: 37-47%
pregnancy: >33%

60
Q

normal platelet count v pregnant platelet count

A

normal: 150,000-400,000
pregnancy: no change until 3-5 days after birth then increases rapidly

OB (21 decks)

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