Ch 13 Powerpoint, A&P of Pregnancy Flashcards
Where is the Uterus located in position to the bladder?
What does this mean for the mother’s bladder?
The Uterus is on top of the bladder
This means that as the uterus increases in size, it puts pressure on the bladder, and there is a greater corresponding need to pee more as the baby grows.
At how many weeks gestation does the Uterus typically begin to “show”?
Typically, at the 14-week mark.
The Uterus typically sees its greatest enlargement jumps at which months?
4 months, 6 months and then 9 months.
Which placental hormone relaxes contractility’s and smooth muscle?
Progesterone
What type of contractions are irregular and painless (but annoying) and can be mistaken for Labor?
How can they be treated/stopped and when?
Braxton Hicks contractions can be treated/stopped by walking and exercise around the 28th week.
Uterine blood flow, aka Uteroplacental blood flow, increases as the uterus does by 10-fold. What is the rate of uterine blood flow by term?
450-650mL/min
By using an Ultrasound or a Fetal Stethoscope, you can auscultate FHT’s and hear a Uterine Souffle. What is a Uterine Souffle?
A Uterine Souffle is a Bruit, a rushing sound of blood going through the arteries to the placenta, synchronized to the beat of the heart.
How do you compare pulses in a fetus?
Compare if the pulse and heart rate is the same
During a Cervical exam, you should be able to push up into the cervix and feel the baby do what?
Bounce
A softening of the Cervical tip can be noticed at 6 weeks. This softening of the Cervical tip is known as what sign?
Goodell Sign
AT the beginning of the 6th week of pregnancy, the Cervix shows the Goodell signs. This is marked by increased (____), slight (____) and an increase in the number of cells, known as (____)
Goodell signs is marked by increased (Vascularity), slight (Hypertrophy) and an increase in the number of cells, known as (Hyperplasia)
What forms in the cervix to act as a barrier against bacterial invasions and is rich in Immunoglobulins?
A Mucus Plug; Operculum
What is an Operculum?
A mucus plug that forms a protective barrier to stop bacterial invasions of the uterus and is rich in Immunoglobulins
The first recognition of life, aka “Feeling Movements” is known as what?
Quickening
When can Quickening be detected in Multiparous (More than one pregnancy) women?
What about for Nulliparous?
Quickening can be felt as early as 14 to 16 weeks of gestation
18 weeks for Nulliparous
For the Vagina and the Vulva, the Chadwick sign is a presumptive sign of pregnancy. What is the Chadwick sign?
When does the Chadwick sign appear?
The Chadwick sign is an increase in vascularity that causes a change in color of the vaginal mucosa, cervix, and labia. It turns purple blue.
The Chadwick sign appears at the 6–8-week mark
The Chadwick sign causes the Vaginal Mucosa, Cervix, and Labia to turn what color as a result of increased vascularity?
Purple/Violet-blue; Happens at 6-8 weeks
What kind of changes in vaginal secretion will you see during pregnancy?
You will see an increase in vaginal secretions, such as Leukorrhea
What is Leukorrhea?
Why is Leukorrhea released?
Leukorrhea is a white or greyish creamy discharge with a musty odor.
Leukorrhea is released due to cervix stimulation from estrogen and progesterone
Because a pregnancy results in lower vaginal acidity, what does a pregnancy increase the risk for in vaginas?
Yeast infections
Do newborn babies see color? How does this affect breastfeeding?
No, babies don’t see color, they see pigmentation.
They notice the contrast between the breasts and the nipple/mammary glands color and go for the nipple
What two hormones expand the milk ducts?
Estrogen and Prolactin
“Estrogen is pro-lac-tin!”
Lactogenesis stage 1 is the (____) hormone playing a role in milk secretion
HPL-Human Placental Lactogen
In the 1st trimester, colostrum is made by (____) hormone, and in the 2nd semester, colostrum is made by the (____) hormone.
What is colostrum?
1st semester colostrum is made by (Prolactin) hormone, and in the 2nd trimester, colostrum is made by the (HPL) hormone
Colostrum is that gold stuff that leaks out.
What is the overall percentage increase in blood volume during a pregnancy?
40-45% increase in blood volume
During a pregnancy, Cardiac output (______) by roughly 30 to (__), while blood pressure roughly (___________)
Cardiac output (Increases) by roughly 30 to (50%) while blood pressure roughly (stays the same)
Even though pregnant women experience an increase in cardiac output, their blood pressure remains relatively the same. How?
Because of Progesterone and Relaxin being secreted, which lead to a dilation of blood vessels and relaxing of smooth muscle.
What physical/structural differences will you see in the heart during a pregnancy?
You MAY see a slight hypertrophy of the heart, but specifically you will see the heart shift in position up and to the left due to the increasing size of the uterus.
Blood lab values change in pregnancy, so don’t freak out. What are some differences in Lab values from normal below?
HgB: 12-16 vs (_____)
Hct: 37-47 vs (_____)
Fibrinogen: 200-400 vs (_____)
HgB will decrease during pregnancy, usually 11-13
HcT will decrease, usually to 33/32
Fibrinogen will increase, usually to 400-650
Mothers are in a constant small state of hyperventilation, constantly blowing off CO2 to get O2/CO2 to and from the baby. Because of this, what kind of mild ABG state do they often present?
Mild Respiratory Alkalosis
What is the percentage increase in Tidal Volume in a pregnant woman?
40% increase in Tidal Volume
What is the hormone that is the cause of constipation early in pregnancy?
How does it cause constipation?
Progesterone is the cause of constipation early in pregnancy
This is because it causes muscle relaxation, which also slows peristalsis.
The act of eating non-food items is called what?
What is an example of this?
Pica
An example of Pica is eating ice-cubes all the time. It usually means low iron levels.
What is the annoying cycle of iron supplementation in pregnancy?
Iron deficiencies sometimes exist, so women will take iron tablets, but these iron tablets will cause constipation
Because of the increased progesterone levels, combined with the thickening and increased retention time of bile, the mothers Gallbladder is at risk for developing what?
Gallstones during pregnancy
What are 2 pregnancy changes to the urinary system?
Increased peeing due to the increasing size of the uterus putting pressure on the bladder, and increased Kidney size
What is the impact of pregnancy on the fluid and electrolyte balance?
There is no real impact on the fluid and electrolyte balance. Just monitor blood pressure. If the BP gets high that could mean fluid retention, because the BP shouldn’t increase during pregnancy.
For integumentary changes, what is Melasma known as?
Why?
Melasma is known as the “Mask of Pregnancy.”
This is because of the hyperpigmentation of the skin on the face/cheeks, nose and forehead. Super common
What is the Linea Nigra?
When does it appear?
A dark pregnancy line down the midline of the fundus to the pubis.
It appears around the 3rd month
What is Stria Gravidum?
Stretch marks
What is Melasma stimulated by?
Melasma is hyperpigmentation, aka the “Mask of Pregnancy”, stimulated by the hormone Melanotropin, which increases during pregnancy.
Angiomates are known as vascular (____), which are (____) that you can feel pulsating in the neck, trunk and arms.
Angiomates are known as vascular (spiders), which are arterioles) that you can feel pulsating in the neck, trunk and arms
Palmar Erythema is caused by elevated (____) levels that make the (____) turn (____)
Palmar Erythema is caused by elevated (estrogen) levels that make the (palms) turn (red)
What is the hormone that causes the “Pregnancy Waddle by relaxing the ligaments?
Relaxin relaxes the ligaments causing the pregnancy waddle
What happens to the Lumbosacral curve in women during pregnancy?
The lumbosacral curve increases to adjust the mother’s posture and displaces the pressure to different parts of the body
What electrolyte change causes leg cramps in pregnant women?
Calcium changes.
Restless leg syndrome is also common
Neuro Changes in pregnancy are: (____) headaches, (_____), nasal (____), fatigue, and (____) problems.
Neuro changes are (Tension) headaches, (Migraines), nasal (congestion), fatigue, and (sleeping) problems
Endocrine system issues in pregnancy are an enlarged (____) gland, (____) gland, and an enlarged (____) which increases the need for insulin.
Endocrine system changes are enlarged (Thyroid) gland, (Pituitary) gland, and an enlarged (Pancreas) which increases the need for insulin
What are the 3-P’s of a pregnancy test?
Presumptive
Probable
Positive
Which of the 3-P’s is an HCG test? (peeing on a stick)
Probable sign
Which of the 3-P’s is an Ultrasound?
Positive sign
What are some Presumptive (subjective) signs of pregnancy?
Nausea/Vomiting
Fatigue
Missed Period
What are some Probable (observable) signs of pregnancy?
Chadwick sign
HCG tick test
What is a Positive sign of pregnancy?
FHT’s
Ultrasound
By 32 weeks’ gestation, the mothers heart rate generally increases by how much?
15-20 BPM
Sometimes a mother has an increase in plasma volume that is greater than the increase in her RBC production. This results in what affliction?
Physiological Anemia
Respiratory rates are unchanged during pregnancy, but there is an increase in Tidal Volume and Minute Ventilation by what percentage?
30-50%
Decreased muscle tone contributes to what 3 afflictions in a pregnant mother?
Reflux, Constipation, and Heartburn
Urine and Blood tests for Pregnancy results are which of the 3 P’s?
Urine and Blood sample tests for HCG are both probable signs, because they COULD be something else.
