Exam 1 Flashcards
What stimulates gonads to produce hormones at sexual maturity?
Hypothalamus
Where is GnRH secreted?
Hypothalamus
Where is FSH secreted from?
Anterior pituitary
Where is LH secreted from?
Anterior pituitary
Structure that collects milk from alveoli and conducts it to outside
Lactiferous ducts
Cells within alveoli that secrete milk after childbirth
Acinar cells
Function of GnRH
Initiation of puberty in males and females
Sustaining female reproductive cycles
Three phases of the ovarian cycle
Follicular phase
Ovulatory phase
Luteal phase
When does the follicular phase take place?
Begins 1st day of menstruation and ends 14 days later
What happens during the follicular phase?
Period during which an ovum matures
What occurs during ovulatory phase?
2 days before ovulation LH and FSH levels rise
Estrogen falls, and progesterone rises
Stimulates final maturation of single follicle and release of its ovum
What occurs during the luteal phase?
Remaining cells of old follicle persist for 12 days as corpus luteum
Corpus lueum secretes estrogen and a lot of progesterone to prepare endometrium for fertilized ovum
What occurs during the proliferative phase of the endometrial cycle?
The basal layer of the endometrium starts to build back up and grow longer arteries and veins
Endometrial glands begin secreting stringy mucus to aid entry of sperm into uterus
What happens during the secretory phase of the endometrial cycle?
Endometrium continues to thicken, reaching max thickness of 5-6 mm.
Endometrium secretes substances to nourish fertilized ovum
What happens during ischemic phase of the endometrial cycle?
Corpus luteum regresses
Vasospasm of endometrial blood vessels causes endometrium to become ischemic and necrotic
What happens during the menstrual phase of the endometrial cycle?
Necrotic areas of endometrium separate from the basal layers
Function of hCG
Secreted by the zygote to signal the woman’s body that it’s pregnant
Causes corpus luteum to persist and continue secretion of estrogen and progesterone until the placenta takes over this function
When is the embryonic period?
3rd week - 8th week
Major things that happen during the embryonic period
All major body organs are completed
Structures most vulnerable to teratogens (since they’re developing so rapidly)
What is considered full term?
36-40 weeks for fertilization age (calculated from conception)
38-42 weeks of gestational age (calculated from 1st day of last menstrual period)
When is implantation complete?
By the end of the second week after fertilization
When does the CNS begin developing?
During the 3rd week after conception
When does the heart start beating?
22-23 days
When does the heart develop chambers?
Begins during 4th week and completes by end of 6th week
When does surfactant production begin?
During 24th week
When do external genitalia begin to differentiate and when are male and female characteristic distinct?
Begin to differentiate during week 7
Distinct at 12 weeks
When does the fetal period begin and end
Begins at 9 weeks and ends at birth
When does the fetus begin producing and secreting urine?
By 12 weeks
When can heartbeat be detected with Doppler?
Maybe by 10 weeks, but by 12 for sure
When is heart beat detectable by ultrasound?
8 weeks
When does quickening occur?
During weeks 13-16, esp if woman has been pregnant before
When does vernix develop?
Weeks 17-20
When does lanugo develop?
Weeks 17-20
When is brown fat deposited?
Weeks 17-20
When does surfactant reach levels that increase likelihood of survival outside of uterus?
Not until 26-28 weeks
When does blood formation shift to the bone marrow?
By 28 weeks
When does the fetus typically assume head down position?
Week 25-28
Usual schedule for prenatal assessment in normal pregnancy
Conception to 28 weeks: every 4 weeks
29-36 weeks: every 2 weeks
37 weeks to birth: every week
When does the fundal height start being equal to the gestational age of the fetus in weeks?
At week 20, until 32
When does the fundus reach its highest level, at the xiphoid process?
36 weeks
When does the fundus measure at the umbilicus?
20 weeks
Chadwicks sign
One of the earliest signs of pregnancy
Bluish purple coloring of the cervix caused by hyperemia
Goodells sign
Cervical softening
What are Leopold maneuvers?
Systematic method of palpating fetus through abdominal wall during latter part of pregnancy
Provide info about location and presentation of fetus
Classes to help pregnant women
1st tri: safe pregnancy, self care, select provider & make birth plan
2nd tri:
3rd tri: labor and delivery, breast feeding, parenting
Dick reed childbirth education
Method of slow abdominal breathing and rapid chest breathing in advanced labor
Bradley childbirth education
First to include father as support person for husband coached childbirth
Lamaze childbirth education
Psychoprophylaxis
Uses mind to prevent pain
Normal weight gain for pregnancy
25-35 lbs
How many calories should woman eat during pregnancy?
2200 - 2900
How many extra calories should you eat during the second trimester?
340 extra
How many extra calories should be eaten a day during the third trimester?
452 extra
When is AFP screening done?
16-18 weeks
What do AFP levels mean?
Low levels suggest chromosomal abnormalities such as trisomy 21
High levels associated with NTD such as anencephaly or spina bifida
What is chorionic villus sampling used to detect?
Chromosomal, metabolic, or dna abnormalities
Advantages of cvs
Results known sooner
What is amniocentesis used to detect?
Chromosomal, metabolic, or genetic abnormalities
Fetal lung maturity (LS ration 2:1)
Diagnose fetal infections and amniotic fluid volume disorders
When is amniocentesis performed?
Between 15-20 weeks
What is detected when determining FLM?
Lecithin-sphingomyelin (L/S) ration 2:1
Surfactant
Lamellar bodies which work with surfactant, so if they’re present, surfactant is too
When is a percutaneous umbilical blood sampling done?
After 18 weeks
(In umbilical vein)
Risks during a percutaneous umbilical blood sampling
Fetal bradycardia and bleeding
Laceration or hematoma of umbilical cord
Thrombosis
Infection
Preterm labor
Preterm premature rupture of membranes
Pregnancy loss
When is antepartum fetal surveillance typically initiated?
24-32 weeks for high risk pregancies
How is a fetal movement count done?
Based on maternal perception
Count to 10 method: 10 distinct movements in 1-2 hours
What if mother feels <10 movements in 1-2 hours?
Baby may be having hypoxic event
First line of testing in fetal surveillance
NST
What does an NST observe?
Fetal heart rate to fetal movement
How is the fetal position determined?
With leopold’s maneuver
What is a reactive NST
2 or more accelerations within a 20 min period
What is a nonreactive NST?
Fewer than 2 accelerations in a 40 min period
Baseline fetal HR
110-160
When would a contraction stress test be performed?
If NST findings are non reactive
Goal of a contraction stress test
Stimulate 3 contractions in 10 mins
Interpretation of a contraction stress test
Negative: no late decelerations
Positive: late declarations present with 50% of contractions
Equivocal: suspicious intermittent late decels
Unsatisfactory: fewer than 3 contractions in 10 min
What does a positive CST mean?
Fetal growth restriction
Late decels during labor
Meconium staind fluid
Low 5 min apgar scores
Still birth
What is a biophysical profile used for?
To assess fetal wellbeing:
- FHR
- fetal movement
- fetal tone
- fetal breathing movement
- amniotic fluid amount
How is a BPP performed?
Reactivity interpreted by NST and other 4 parameters measured by real time u/s
How long does a BPP take?
30 mins
Scoring of BPP
Each category gets 0 or 2 points
8-10 = normal
6 = equivocal
0-4 = acidemia or perinatal asphyxia
What is a modified BPP
Combines NST and ultrasound of amniotic fluid
How is amniotic fluid measured and what results mean
Measuring largest pocket of fluid in four maternal abd quads
2 cm or less = oligohydramnios
18-20 cm = hydramnios
What does fetal Doppler flow ultrasound monitor?
Blood flow through umbilical cord
Assesses:
- condition of placenta
- Hemodynamic components of vascular resistance in high risk pregnancies with fetal growth restriction
- detects fetal anemia
When is how is fetal Doppler flow reported?
Normal
Decreased
Reversed
Hormone that sends extra glucose to baby
hCS
