Exam 2: A&P of Pregnancy Flashcards
Biochemical Marker for pregnancy
Human chorionic gonadotropin (hCG)
Trimesters of pregnancy
First trimester: weeks 1-13
Second trimester: Weeks 14-26
Third Trimester: Weeks 27-40
Obstetrical History
GTPAL
Signs of Pregnancy
-Presumptive-changes felt by the woman.
-Probable-changes observed by an examiner
-Positive- signs attributed only to the presence of a fetus
Presumptive Signs of Pregnancy
-Those that suggest but do not positively indicate pregnancy.
-Changes felt by woman
-breast changes
-amenorrhea
-Nausea and vomiting
-urinary frequency
-fatigue
Probable Signs of Pregnancy
-Strong indicators of pregnancy.
-Positive pregnancy test.
-changes observed by examiner
-Mainly physical changes in uterus
-Hegar Sign: softening and compressibility of lower uterine segment.
-Ballottement: Passive movement of the unengaged fetus.
-Goodell sign: softening of the cervical tip
-Chadwick sign: deepening color of vagina
Positve Signs
-Absolute confirmation of pregnancy
-Attributed by the presence of the fetus
-Fetal Heart tones
-Palpation of fetal movement
-Visualization of fetal movement
Uterus changes with pregnancy
-changes in size, shape, and position
-stimulated by high levels of progesterone & estrogen
-fundal height measured to estimate the duration of pregnancy.
-Lightening: b/t wks 38-40 fundal height decreases as the fetus begins to descent and engage in pelvis.
Fundal Height
-Fundal height measured to estimate the duration of pregnancy.
-Should equal the gestational age.
Uteroplacental Blood Flow
-Dependent on mother
-increases and uterus grows
cervix and vagina
-Goodell Sign & Chadwick Sign
-Leukorrhea-white or slight gray mucoid discharge with a musty odor.
-Operculum: mucus that fills the endocervical canal resulting in formation of mucus plug.
breast changes
-increased sensitivity, tingling, & heaviness
-nipples and areolae become pigmented
-Montgomery’s tubercules- hypertrophy of the sebaceous glands may be seen
-Blood Vessels more noticeable
-colostrum as early as 16 weeks
cardiovascular changes
-hypertrophy possible
-heart pushed to the left and upward
-Blood Volume increased
-Murmurs common
-increased pulse
CV System
-BV inc. 30-50%
-HR inc by 10-15 bpm
-clotting factors inc. which helps prevent hemorrhage however increases risk of DVT
-RBC mass increases (plasma portion faster..physiological anemia)
-BP unchanged d/t progesterone.
500-1000 mL of blood to uterus per minute
-supine hypotension a major problem
-Hgb < 11g/dL indicates anemia
Blood Pressure changes
-affected by age, activity level, presence of health problems.
-BP lowest on left lateral side
-compression of vena cava when woman lies flat.
-supine hypotension syndrome: resulting in woman feeling faint
Blood Volume/composition changes
-Increases by 1500 ml or 40-45% above non-pregnant state
-Physiologic anemia common
-WBCs increase
-Increased clotting factors leads to
vulnerability for thrombosis
Tendency of thrombosis
-Avoid sitting for long periods of time
-Change positions frequently
-Elastic stockings
-Anticoagulation therapy
Respiratory System Change
-O2 needs increase due to acceleration of
metabolic rate; increases by about 20%
-Ligaments of rib cage relax due to increased estrogen levels; rib cage
widens
-Elevated diaphragm and chest wall lead
to dyspnea
-Nosebleeds and nasal stuffiness are common and related to estrogen
Renal system changes
-Frequent urination is common,
particularly in the first and third
trimesters
-In the first trimester due to bladder
sensitivity
-Predisposition to urinary tract infection
(UTI)
Urinary System Changes
-Nocturia
-Kidneys working 50% harder (GFR)
-Increased renal plasma flow
-Proteinuria may occur and
is abnormal.
Integumentary System Changes
-Chloasma-pregnancy mask
-Linea nigra- pigment line from top of fundus to symphysis pubis
-Striae gravidarum- stretch marks-last past pregnancy
-Vascular spiders-raised, pulsating end
arterioles found on neck, thorax, face, &
arms
-Palmar erythema-red blotches on hands
-Pruritus- pregnancy rash
Musculoskeletal System
-Alteration in posture-Lordosis
-Center of gravity shifts
-Waddling
-Relaxation & increased mobility of
pelvic joints
-Abdominal muscles stretch and lose tone
Neurologic Changes
-Carpal tunnel syndrome
-Tension head aches
-Lightheadedness
-Hypocalcemia-may cause
neuromuscular problems such as muscle
cramps & tetany
GI system
Gums appear red and swollen and bleed easier, caused by elevated levels of estrogen (soft toothbrush)
-Delayed gastric emptying and reduced tone of esophageal sphincter allows reflux, producing heartburn. Caused by progesterone
-Decreased motility in large intestine causes constipation and hemorrhoids
-Gallbladder emptying time prolonged—may lead to stone formation
