Chapter 11

Question 1

1st Trimester

Answer 1

1-12+6 weeks

Question 2

2nd Trimester

Answer 2

13-26+6 weeks

Question 3

3rd Trimester

Answer 3

27-42+6 weeks

Question 4

ROM

Answer 4

rupture of membranes

Question 5

Presumptive Signs

Answer 5

(subjective)
● Least reliable
○ Breast tenderness (3-4 weeks)
○ Amenorrhea (4 weeks)
○ N/V (4-14 weeks)
○ Breast enlargement (6 weeks)
○ Urinary frequency (6-12 weeks)
○ Uterine enlargement (7-12 weeks)
○ Fatigue (12 weeks)
○ Hyperpigmentation of skin (16 weeks)
○ Fetal movements- quickening (14/16- 20 weeks) (16 wks if the avg)
○ Montgomery glands (4 weeks)

Question 6

Probable signs

Answer 6

(objective)
○ Positive pregnancy test (4-12 wks)
○ Goodell sign (5 wks)
○ Chadwick sign (6-8 wks)
○ Bluish/ vascularization
○ Hegar sign (6-12 wks)
○ Abdominal enlargement (14 wks)
○ Braxton Hicks contractions (16-28 wks)
○ Ballottement (16-28 wks)

Question 7

Positive Signs

Answer 7

Ultrasound verifications visualization (4-6 wks)
○ Fetal movement by clinical (20 wks)
○ Auscultation of fetal heart tones via Dopler (10-12 wks)

still not 100% reliable

Question 8

Goodell sign

Answer 8

(5 wks)
cervix is soft and gooey (softening of the cervix)

Goey Goddell

Question 9

Chadwick sign

Answer 9

(6-8 wks)
blue/vascular color of vaginal mucosa and cervix

Chadwick - C for color

Question 10

Hegar sign

Answer 10

(6-8 wks)

softening of lower uterine segment

Question 11

Braxton Hicks Contractions

Answer 11

(16-28 wks)
spontaneous irregular contractions that come and go

Painless

normally at end of pregnancy

Question 12

Ballottement

Answer 12

(16-28 wks)
has to do with fluid,
examiner pushes up on cervix, should feel rebounding

Question 13

quickening

Question 14

pregnancy tests looking for

Answer 14

HCG - glycoprotein
human chorionic gonadotropin
earliest biomarker for pregnancy

No HCG, not pregnant

Question 15

Uterus

Answer 15

Increase in size (20x larger),
2 ounce to 2 pounds
○ Pear shape to ovoid shape; positive = Hegar sign
○ Enhanced uterine contractility; Braxton Hicks contractions
○ Ascend into the abdomen after the first 3 months. (in pelvis before that)
○ Fundal height by 20 weeks gestation at level of umbilicus = 20 cm; reliable determination of gestational age until 36 weeks gestation

Question 16

Cervix

Answer 16

Goodell sign (5 wks)- softening/gooey
○ Mucous plug formation
○ Chadwick sign (6-8wks) bluish/ á vascular
○ Ripening (softening, effacement = thinner, & increased distension) about 4 weeks before
birth

Question 17

Vagina

Answer 17

Increase vascularity with thickening because of estrogen

○ Lengthening of vaginal vault; secretions more acidic, white, thick (leukorrhea)

Question 18

Ovaries

Answer 18

○ Enlarge until 12th-14h weeks of gestation

○ Ovulation stops because of elevated levels of estrogen progesterone

Question 19

Breasts

Answer 19

○ Increase in size and nodularity to prepare for lactation
○ Increase in nipple size,= more erect and pigmented
○ Production of colostrum: can be expressed after the 12th weeks; conversion to
mature milk after delivery

prolactin starts to be produced - prepares breast for breast feeding

Question 20

Progesterone

Answer 20

hormone of pergnancy

Question 21

leads to constipation

Answer 21

Decrease peristalsis
smooth muscle relaxation
elevated progesterone

Question 22

hemorrhoids

Answer 22

Constipation + increased venous pressure + pressure from uterus

increase water, fiber

pushing to hard can cause valsalva maneuver (pass out)