Exam 1 Flashcards by Katy Peterson

What stimulates gonads to produce hormones at sexual maturity?

Hypothalamus

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Where is GnRH secreted?

Hypothalamus

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Where is FSH secreted from?

Anterior pituitary

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Where is LH secreted from?

Anterior pituitary

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Structure that collects milk from alveoli and conducts it to outside

Lactiferous ducts

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Cells within alveoli that secrete milk after childbirth

Acinar cells

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Function of GnRH

Initiation of puberty in males and females
Sustaining female reproductive cycles

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Three phases of the ovarian cycle

Follicular phase
Ovulatory phase
Luteal phase

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When does the follicular phase take place?

Begins 1st day of menstruation and ends 14 days later

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What happens during the follicular phase?

Period during which an ovum matures

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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

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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

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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

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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

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What happens during ischemic phase of the endometrial cycle?

Corpus luteum regresses
Vasospasm of endometrial blood vessels causes endometrium to become ischemic and necrotic

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What happens during the menstrual phase of the endometrial cycle?

Necrotic areas of endometrium separate from the basal layers

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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

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When is the embryonic period?

3rd week - 8th week

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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)

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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)

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When is implantation complete?

By the end of the second week after fertilization

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When does the CNS begin developing?

During the 3rd week after conception

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When does the heart start beating?

22-23 days

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When does the heart develop chambers?

Begins during 4th week and completes by end of 6th week

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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