Concept of Reproduction Flashcards
What is Negle’s Rule to determine the due date?
Determine the first date of the LMP
-Add 7 days and subtract 3 months
How many days does the fertilized egg float around the uterus before it implants?
7-10 day
What is the first 14 days following conception referred to as ?
pre-embryonic phase
What is Cell differentation?
Some cell become the embryonic membrane (bag of water containing amniotic fluid, cushions and protects embryo, controls temperature)
- some will become the yolk sac and eventually the umbilical cord (yolk sac forms RBCs early on then becomes apart of the umbilical cord.)
- some will become the placenta. (provides metabolic and nutrient exchange between embryonic and maternal circulation)
- some will become the embryo itself
What are the functions of the placenta?
- metabolic function (produces glycogen, cholesterol, and fatty acids for fetal use)
- transport function (O2, CO2, electrolytes, etc)
- endocrine function (produces hormones vital for fetal survival; HCG, estrogen, progesterone, relaxin, etc)
- immunologic function (progesterone and HCG prevents maternal antibodies against the embryo and placenta (preventing the pregnancy from being seen as a foreign body)
What milestones are hallmark during the embryo stage of fetal development (3-8 weeks)
- highly vulnerable to teratogenesis
- 4 weeks fetal heart beat
- 6 weeks fetal circulation establishing
What milestones are hallmark during the fetus stage of fetal development (8 weeks +) ?
- (8-12 weeks) can auscultate fetal heart rate with doppler. all organs are formed but require maturation
- (16 weeks) can determine gender by ultrasound
- (20 weeks) quickening, vernix and lanugo present
- (24 weeks) surfactant production begins, alveoli develops
- (28 weeks) nervous system begins regulating some functions
- (35-36 weeks) subcutaneous fat stores (plumping up)
- (38-40 weeks) term, minimal vernix and lanugo remain
what are the presumptive signs of pregnancy ?
amenorrhea nausea/vomiting excessive fatigue urinary frequency breast changes quickening
what are the objective (probable) signs of pregnancy?
pelvic organ changes abdominal enlargement braxton hicks contractions uterine souffle (uterine sound or movements) skin pigment changes fetal outline positive pregnancy test
what is considered actual confirmation of pregnancy?
fetal heartbeat
fetal movement palpated
visualization of fetus by ultrasound
- Maternal O2 needs increase.
- Body alterations and weight increase necessitate an adjustment in posture. pelvic joints relax.
- Nausea and vomiting might occur as well as constipation
- Urinary frequency
- The placenta becomes an endocrine organ that produces a large amount of HCG, estrogen, prostaglandins, and progesterone
- Cardiac output increases 30% to 50% and blood volume increases 30% to 45% to term to meet greater metabolic needs
Physical changes associated with pregnancy
number of pregnancies
Gravidity
Nulligravida: a woman who has never been pregnant
Primigravida: a woman in her first pregnancy
Multigravida: a woman who has had two or more pregnancies
a number of pregnancies in which the fetus or fetuses reach 20 weeks of pregnancy, not the number of fetuses. _____ is not effected whether the fetus is born still born or alive.
Parity
Nullipara: no pregnancy beyond the stage of viability
Primipara: has completed one pregnancy to stage of viability
Multipara: has completed two or more pregnancies to stage of viability
what does TPAL stand for ?
T - term (born at 37 weeks +)
P - preterm (born between 20 and 36&6days)
A - Abortions/miscarriages (pregnancy ended prior to 20 weeks
L - living (living children)
How often does one have a prenatal visit?
monthly until 28 weeks, every 2 weeks until 36 weeks, and then weekly
how is a mother advised to check the fetal well-being of their baby?
“kick counts” - atleast 10 times in 3 hours
Non invasive test for fetal well being. Fetus with adequate oxygenation and an intact nervous system will have accelerations in the heart beat with movement.
- a reactive result (at least 2 accelerations of 15 beats, lasting 15 seconds over a 20 minute period) fetus is mature enough to meet this requirement at 32 weeks.
- a nonreactive result (criteria described is not met)
Non-Stress Test
What is the point of an ultrasound evaluation?
checking for :
fetal breathing movement
fetal movements of body or limbs
fetal tone (extension and flexion of extremities)
amniotic fluid volume (measure pockets of fluid)
This test evaluates oxygenation and perfusion of fetus when exposed to the stress of contractions.
- contractions cause reduced blood flow to the placenta momentarily, resulting in decreased O2 flow to the fetus.
- a decrease in the fetal heart rate indicates a poor ability to tolerate the stress of labor.
Contractions Stress Test
- a negative result = no deccelerations with 3 contractions over 10 minutes
- a positive result = repetitive, persistent late deccelerations with contractions
This test one must obtain amniotic fluid for genetic testing and/or determine fetal lung maturity (typically done around 16 weeks)
the procedure entails :
one to use a 22 g needle to withdraw 15-20 mL of fluid after applying a local anesthetic.
Amniocentesis
What is important to monitor following an amniocentesis ?
assess maternal VS and fetal heart rate
monitor for bleeding following removal of needle
monitor of s/sx of labor, ROM, and infection
substance lining fetal lungs that allows for lung elasticity. Produced in large quantities in the later weeks of pregnancy.
- Lecithin and sphingomyelin are components of ______.
- tests are done looking for those two components to ensure that the lungs are mature enough to safely deliver.
- The L/S ratio desired is at 2 or greater.
Surfactant
another test that can be done for genetic testing at 10-12 week gestation. Can be performed trans-abdominally or trans-cervically.
-the risks associated with this test is similar to those of an amniocentesis.
Chorionic Villus Sampling (CVS)
Pregnancy risk factors?
Diabetes Mellitus Anemia Substance Abuse Psychological disorders HIV heart disease
