Changes

Question 1

Hegar’s sign

Answer 1

extreme softening of uterus

Question 2

Ballottement

Answer 2

Tapping of the lower uterus, fetus feels like it’s bouncing or rising

Question 3

Amenorrhea

Answer 3

Absence of period due to rising estrogen levels

Question 4

Chad wick’s sign

Answer 4

Increase vascular it’s causes walls to become purple (from pink)

Question 5

Pattern of uterine growth

12-38 weeks

Answer 5

12 above symphysis pubis 
16 middle of pubis and umbillicus 
20 at umbillicus 
36 at xiphoid process 
38 primagravida = lightening occurs

Question 6

At what week does the uterus grow a 1cm each week

Answer 6

20

Question 7

What happens to the vagina and vulva

Answer 7

Mucosa thickens, prominent ruggae
Glycogen released, in response lactic acid
Ph from 7 to 4.5

Question 8

What happens to cervix

Answer 8

Chadwick and goodwell’s sign

Question 9

Operculum

Answer 9

Mucous plug that seals bacteria out, often lost during dilation
Sign of pre term labor if too early

Question 10

What happens to the heart

Heart sounds?

Answer 10

Pushed upward and to the left

First sound split and a systolic murmur (s3 is very common)

Question 11

What happens to the blood volume
(Plasma and RBC)
When does it level

Answer 11

Total circulatory blood volume increases
Plasma increases 45% faster than RBC 20%
By second trimester it levels

Question 12

Is BP the same?

Answer 12

Same, except for when standing

Question 13

How does the BP change according to trimesters

Answer 13

First tri = normal, decreases during 2nd, increases in 3rd to original in first tri

Question 14

Lying completely on back causes pressure of the uterus on heart
What is this called

Answer 14

Vena caval syndrome

Question 15

What is crowing and what does it cause

Answer 15

SOB

Uterus pushes diaphragm 4cm upward

Question 16

Where does breathing occur

Answer 16

Thoracic instead of abdomen

Question 17

GI system changes

Answer 17

Hyper emesis gravidarum: intense vomiing
Mouth: pytlalism excess saliva and bleeding gums
Sphincter tone decreases = heart burn
Uterus pushes intestine back to abdomen wall = slow emptying time and peristalsis = constipation
Reabsorption of bilirubin = itching

Question 18

Pytlalism

Answer 18

Gum bleed and excess saliva

Question 19

Intense vomiting

Answer 19

Hyper emesis gravidarum

Question 20

What causes itching

Answer 20

Reabsorption of bilirubin

Question 21

What hormones relax the pelvis and cause an abnormal stance

Answer 21

Relaxin and progesterone

Question 22

Curvature of lower spine

Answer 22

Lordosis

Question 23

What diastsis

Answer 23

Abdomen has difficulty stretching to fit fetus so rectus muscles separate

Question 24

Pituitary gland

Answer 24

Anterior: prolactin posterior: oxy
Decreased FSH stops period
Increased GH and melanocytes

Question 25

Thyroid and parathyroid gland

Answer 25

Increase in size because increased need of calcium

Question 26

Adrenal gland

Answer 26

Increase cortisol and aldosterone to suppress inflammation

Question 27

Pancreas

Answer 27

First tri decreased insulin

Second and third increased

Question 28

6 ways placenta alters endocrine system 
Progesterone 
Relaxin 
HCG
HPL 
Prostaglandin

Answer 28

Progesterone: maintains endometrium 
Relaxin: prevents contractions
HCG: P+E while placenta is developing
HPL: insulin antagonist and prepares for lactation
Prostaglandin: initiates labor

Question 29

3 positive signs of pregnancy

Answer 29

Auscultation of fetal heart beat
Fetal movement by examiner
Visualization of fetus

Question 30

Fetal movements felt at what weeks

Answer 30

16-20 by mom

20-24 by examiner

Question 31

Corpus luteum

Answer 31

Sac filled with proteins and RBC, allows placenta to grow for 16-20 days, after placenta takes over