Exam 4: Pregnancy and Labor

Question 1

Hormonal Changes

Answer 1

• hCG (Human Chorionic Gonadotropin)
• produced by zygote
• early pregnancy tests detect this
• increase in first trimester, then drops off
• estrogen levels rise
• progesterone levels rise
• after 1st trimester placenta is main producer of estrogen and progestrone

Question 2

Uterus and Mammary Glands

Answer 2

• enlarge
• massive growth of uterus
• fundus (top) of uterus at level of xifoid process of sternum

Question 3

Weight Gain

Answer 3

-due to enlargement of uterus/mammary glands, growing fetus, and placenta (~20 lbs max), fluid accumulation, fat deposits

Question 4

GI Tract Changes

Answer 4

• morning sickness
• heartburn
• constipation

Question 5

Cardiovascular System Changes

Answer 5

• increased blood volume in mother

- potential for varicose veins because of problems with venous circulation late in pregnancy

Question 6

Urinary System Changes

Answer 6

• 1st trimester expanding uterus pushed down on bladder
• 3rd trimester baby pushes on bladder
• makes a woman feel like she always has to pee

Question 7

Labor

Answer 7

• refers to the series of events that push/expel the infant out of the mother’s body

Question 8

False Labor (Braxton Hicks contractions)

Answer 8

-irregular smooth muscle contractions of uterus - does NOT lead into the 3 stages of true labor

Question 9

True Labor

Answer 9

• regular smooth muscle contractions of uterus that increase in intensity and frequency
• consists of 3 stages
• oxytocin initiates/continues labor
• length of labor is highly variable

Question 10

Dilation Stage

Answer 10

• 1st stage of labor from the onset of labor to complete dilation of the cervix
• cervix dilates to 10 centimeters in diameter
• amniotic fluid is expelled (“water breaks”)
• average length is 6-12 hours
• pressure from fetal head stimulates dilation

Question 11

Expulsion Stage

Answer 11

• 2nd stage of labor from complete cervical dilation to delivery of baby
• lengthy varies could be hours

Question 12

Placental Stage

Answer 12

• 3rd stage delivery of placenta

- occurs within 5-30 minutes after delivery of baby

Question 13

Changes in Mother Postpartum

Answer 13

• loss of excess fluids gained during pregnancy
• lactation
• contraction/shrinkage ofuterus
• hormonal changes

Question 14

Fluid Loss

Answer 14

• expulsion of amniotic fluid during birth
• more frequent urination for about a week
• increased sweating fro 1-2 weeks
• discharge of lochia

Question 15

Lochia

Answer 15

• postpartum period
• much heavier bleeding than typical period
• lasts 2-3 weeks (sometimes up to 4-6)

Question 16

Lactation

Answer 16

• prolactin: milk production

- oxytocin: stimulates milk release and causes uterus to contract and shrink

Question 17

Contraction/Shrinkage of Uterus

Answer 17

• 6 weeks after birth, uterus shrinks to pre-pregnancy size.
• oxytocin facilitates uterus shrinkage
• “afterpains” are uterine contractions after birth

Question 18

Hormonal Changes Postpartum

Answer 18

• estrogen and progesterone levels drop dramatically
• possible cause of “baby blues” or postpartum depression
• prolactin levels rise as you breastfeed