healthy pregnancy Flashcards
at how many days of gestation has the heart developed 4 chambers and you can hear a heart beat?
day 49 (7 weeks)
at how many weeks do arms/legs begin to bud and brain is differentiated?
weeks 4-5
at 9 weeks…
all organs and structures are present
at 12 weeks…
genitals are differentiated, produce urine, reflexes, and brain development
at 14 weeks…
greater muscle and skeletal development
at 20 weeks…
nails and lanugo
often find out the gender at…
20 weeks
at 25 weeks…
covered in vernix (cream cheese coating), opens and closes eyes, immature lungs that would allow for (some) gas exchange, maturing neuro system
in which trimester do the lungs become more mature?
third
what is amniotic fluid and what is it’s purpose?
it’s baby’s urine
purpose: protect umbilical cord and its’ vessels (decompression agent), thermoregulation
what makes up the umbilical cord?
it’s made up of 2 arteries and 1 vein (AVA) which are covered in wardens jelly (protects vessels from being compressed)
what is the purpose of the umbilical cord?
carries fetal blood to and from the placenta
what’s the purpose of the placenta?
provides oxygen and nutrition for fetus, accepts waste from fetal blood, and produces hormones
goodell’s sign
softening of the cervix
chadwick’s sign
bluish coloring of cervix
cardiac maternal changes r/t pregnancy
- pulse increases
- blood volume increases by 40-45%
- plasma volume increases by 50%
vena caval syndrome
the pregnancy places pressure on the vena cava when supine, so we want to put them on left lying to relieve pressure
what can vena caval syndrome cause?
- can lead to decreased blood flow to the heart
- can lead to HTN
what is the expected weight gain for a normal weight woman?
25-35 lbs
what is the expected weight gain for an underweight woman?
28-40 lbs
what is the expected weight gain for an overweight woman?
15-25 lbs
when is hCG released in pregnancy?
early
hPL pregnancy hormone
antagonist of insulin, more free-floating glucose so the fetus can develop
estrogen pregnancy hormone
stimulates uterine development, prepares breast for nursing and lactation
progesterone pregnancy hormone
greatest role in maintaining pregnancy, small role in helping develop lobes of breast for lactation
relaxin pregnancy hormone
helps inhibit uterine activity, diminishes strength of contractions, also aides in softening of the cervix in prep for birth
naegele’s rule
(first day of LMP) - (3 months) + (7days) = EDD
presumptive changes
subjective
ex: tender breasts, fatigue, N/V
probable changes
objective
ex: positive home pregnancy test (only means she’s probably pregnant), period late
positive changes
diagnostic
ex: things that indicate she’s definitely pregnant; seeing fetus on US, or time of delivery
TPAL
T: term pregnancies (38 wks or >)
P: preterm (20-37 wks 6 days)
A: abortions (< 20 wks)
L: living
initial prenatal labs
- pap (if needed; if out of date or in time for annual exam)
- STDs (gonorrhea, chlamydia)
- H/H
- blood type (Rh factor)
- hep B (immune?)
- rubella (immune?)
- HIV/AIDS
nuchal translucency
tests for potential genetic issues
- US and serum tested
- performed at 11-13 weeks along
quad screen
test for potential NTD (neural tube defects), potential for multiples, or genetic issues
- performed at 16 weeks along, give option to mom
components of quad screen
- AFP (alpha feta protein); looks at possibility of NTD like spina bifida or anencephaly
- hCG
- inhibin A
- estriol
3&4 look for possibility of potential genetic problems
at what point do expected mothers need to take their 1hr glucose tolerance test?
24-28 weeks
when is a 3hr GTT indicated for expected mom?
if 1hr value is > 130-140 mg/dL
what can we expect if a patient comes in GBS positive?
we must treat in L&D with PCN/ampicillin
what is GBS and how can it be harmful?
it’s bacteria normal flora in women that can cause meningitis or septicemia in neonate if exposed
how can we assess fetal development?
- fetal heartbeat
- ultrasound (US)
- quickening
at what point can we asses fetal heartbeat and how do we do it?
as early as 8 weeks or so
transvaginal US, if looking for cardiac movement
later on –> external monitor, or doppler
using abdominal ultrasound to assess fetal development:
- can do critical measurements
- view organ structures
- at 20 weeks = anatomy US
quickening is…
fetal movement felt by mom (at 20 weeks)
couvade
father going through pregnancy symptoms
