Healthy Pregnancy (1) Flashcards
The union of sperm from male and egg from female
Conception
What is the length of a term pregnancy
40 weeks
What is the length of the preembryonic stage
From fertilization - 14 days
What is when the egg attaches to the uterine lining
Implantation
When is the yolk sac developed by
Day 8 or 9
When does the embryonic development happen in pregnancy
Day 15-8 weeks
On what day does cardiac structure begin to beat
23
On what day does the cardiac structure mature (develop chambers)
49
Between weeks — and —, arm and leg buds are developed and the brain is differentiated
4 and 5
When are fetuses most vulnerable from teratogens
Weeks 2-8
When does fetal development take place
9 weeks-birth
When are all organs and structures present
9 weeks
When are genitals differentiated, produces urine, reflex and brain development
12 weeks
When does greater muscle and skeletal development occur
14 weeks
When do nails and lanugo develop
20 weeks
What is lanugo
Thin hair (peach fuzz)
At what week is the baby covered in vernix, opens and closes eyes, has immature lungs that allow some gas exchange, and a maturing neuro system
25 weeks
In what trimester do lungs become more mature, systems continue to develop, and fat is stored?
Third
What is amniotic fluid
Baby’s urine
What keeps the fetus warm, protects umbilical cord and vessels, and keeps the fetus warm (thermoregulation)
Amniotic fluid
what is the structure of the umbilical cord?
AVA (artery vein artery), covered in warten’s jelly
what is a clear white structure that protects vessels from compression
umbilical cord
what organ grows on the uterine wall and has fetal/maternal blood (does not mix)
placenta
what is the purpose of the placenta
fetal blood removes waste and collects nutrients from the mother’s blood
what is the function of the placenta
allows the fetus to get oxygena nd remove waste
describe anatomy of the palcenta
baby side: “shiny sholtz” vascular
uterus side: “dirty ducket” spongy
what are the uterine changes during pregnancy?
-increase in size
-increase in thickness
-braxton hicks contractions
what are braxton hicks contractions?
irregular and not real
what are the breast changes during pregnancy?
-size (inc.)
-tenderness (inc.)
-pigmentation (darken?)
-production of colostrum
cervix changes related to pregnancy
-increased vascularization leads to Goodell’s sign (softening of cervix) and Chadwicks’s sign (bluish coloring)
what is goodell’s sign?
-softening of cervix
what is chadwicks sign
bluish coloring to cervix
what are vagina changes r/t pregnancy
-increased acidic secretion
-loosening of connective tissue
during pregnancy, does cardiac output increase or decrease? and when does it peak
increases
-peaks by 30 weeks
during pregnancy, pulse ____ and BP ______
-pulse increases
-BP slightly decreases, but returns to normal by term
during pregnancy, blood volume increases by __ - __%, and plasma volume increases ___%
40-45
50
why does blood and plasma volume increase during pregnancy?
it is compensating and preparing to lose some during labor and delivery
what is vena caval syndrome?
the pregnancy places pressure on the vena cava when laying supine
what complications does vena caval syndrome lead to?
-decreased blood flow to heart (maternal)
-hypotension (maternal)
what are GI changes related to pregnancy?
-n/v
-pyrosis (heartburn)
-ptyalism (salivation)
changes in gum tissue (gingivitis, bleeding)
-bloat/constipation
-risk for gallstones
urinary changes r/t pregnancy?
pressure causes frequency in first and third trimesters
what are integumentary changes r/t pregnancy
-linea nigra (line vertical above and below umbilicus)
-chloasma (darkened area under eyes/forehead)
-striae (dec. conn. tissue strength r/t inc. adrenal steroid level)
-vascualr spider nevi (inc. blood supply r/t estrogen)
musculoskeletal changes r/t pregnancy (joints, posture, etc.)
-joints relax
-posture changes (more arched)
-center of gravity changes
-diastasis recti (abdominal muscles separate)
what is diastasis recti
when abdominal muscles separate
what is the normal weight gain for normal weight women
25-35 pounds
what is the weight gain for underweight women
28-40
how much weight do overweight people gain during pregnancy
15-25
duri g the 2nd and 3rd trimesters, caloric intake should increase by ____ kcal/day
300
how much does BMR increase during pregnancy
20-25 percent
which hormone is released by trophoblasts early in pregnancy, aka “pregnancy hormone”
hCG
which hormone is an insulin antagonist, needs more glucose for development
human placental lactogen (hPL)
which hormone stimulates uterine development and prepares breasts for nursing/lactation
estrogen
which hormone maintains pregnancy, and developes LOBES of breast for lacation
progesterone
what hormone inhibits uterine activity, decreases contraction, and softens the cervix for birth
relaxin
which hormone has a big role in lactation / milk production
prolactin
which hormone ahs a huge role in contractions (and milk letdown)
oxytocin
what is the chemical version of oxytocin given to induce contractions/labor
pitocin
what is neagele’s rule?
calculates est. due date.
-first day of LMP, subtract 3 months, add 7 days
pregnant woman LMP may 14
-May 14 ->febuary 14 -> febuary 21
what kind of changes are presumptive of pregnancy?
-subjective
-tender breasts
-n/v
-tired
what are probable changes indicating pregnancy?
-objective
-positive home pregnancy test
what are positive changes indicating pregnancy
- diagnostic
-ultrasound (absolutely knowing)
what is obstetric history
history of pregnancies
what is antepartum, intrapartum, and postpartum history?
-ante = during pregnancy, not labor
-intra = during labor
-post = after having baby
what is gestation
a pregnancy
how long is term
-40 weeks exactly
-between 38-42 weeks technically
what is gravita?
number of times pregnant, current or past, living or not living
what is nulligravida
never had pregnancy, none current
what is primigravida
very first pregnancy, only 1 pregnancy
what is multigravida
had multiple pregnancies
what is preterm or premature labor
occuring before 38 weeks
what is postterm labor
after 42 weeks
what is a stillbirth and at what age does it classify as that
born dead after 20 weeks
what is para
number of deliveries 20 weeks or after
what is primipara
delivered 1 baby after 20 weeks
what is nullipara
never delivered a baby
what is multipara
birthed more than 1 baby after 20 weeks
what does TPAL stand for
-term pregnancies (38w or greater)
-preterm (20w to 37w 6d)
-abortions (less than 20w)
-living
what is a G/TPAL for a first pregnancy with twins?
G1
T1
P0
A0
L2
what is nuchal translucency testing and when is it performed
-prenatal lab that includes ultrasound and serum testing
-done between 11-13 weeks pregnant
-shows potential genetic issues (down syndrome)
what is quad screen testing and when is it performed
optional prenatal lab that shows poyential for neural tube defect, multiples, or genetic issues
-performed at 16 weeks
what are the components of the quadruple screen prenatal lab/test
-AFP= alpha feta protein, look for neural tube defects
-hCG
-Inhibition A
-Estriol
(inhibition a and estriol test for potential genetic probs)
what prenatal lab tests risk for gestational diabetes
1 hr glucose tolerance test
when is a 1 hour glucose tolerance test done, and how is it done
-around 24-28 weeks
-give 50 gm glucose
-if gluc is above 130-140 mg/dl, a 3 hr GTT is indicated
when is the GBS prenatal lab test done, what is it, and what do the results mean
-done @ 36 weeks
-its a vaginal/rectal swab
-if the test is positive, its treated in L&D with penicillin/ampicillin
-GBS can cause meningitis or septicemia in the neonate
how is a fetal heartbeat assessed?
-transvaginal US
-external monitor
-doppler
-abd US
what does an ultrasound measure, and when is an anatomy US done?
-measures growth
-anatomy US at 20 wks
what is quickening, when does it occur, and when should there be concern
-fetal mvmt felt by mother
-happens around 20 wks
-should report decreased quickening to doctor
what are rubin’s tasks of the mother
1) safe pregnancy and delivery
2) acceptance of the child
3) binding-in
4) giving of self
what is couvade
father experiencing mornign sickness or other pregnancy symptoms
