Lacy's Section

Question 1

Purpose of the mucosal lining in the cervix

Answer 1

• produces mucous plug during pregnancy
• acts as a bacteriostatic agent
• provides alkaline environment to shelter sperm from the acidic pH of the vagina
• lubrication

Question 2

Fetal circulation

Answer 2

• First system to develop
• heart begins to beat after the 4th week
• detected by dopplar by 10th week

Question 3

Braxton Hicks

Answer 3

random, painless, contractions centered in the abdomen
6-7 times/day and increase with length of pregnancy
*promotes oxygenation and bloodflow to the uterus, exercises the uterine muscle, and prepares cervix for labor

Question 4

Quickening and when it occurs

Answer 4

the first movements of the fetus felt in utero. It occurs from the eighteenth to the twentieth week of pregnancy

Question 5

What is AVA

Answer 5

Artery vein artery (umbilical cord)

Question 6

Purpose of amniotic fluid

Answer 6

• Is to maintain even temperature
• cushion to protect fetus and cord from trauma
• allows fetus to remain afloat
• allows for symmetrical growth
• will become the 1st stool (meconium)
• acts as waste repository

*drink lots of fluids

Question 7

Concepts of normal fetal development

Fetal stage

Answer 7

• from the 9th week to delivery
• by 20 weeks the lungs have matured functionally to survive the outside of the uterus(viability)
• by 28 weeks eyes open, fetal posterior in the uterus becomes more stable
• the fetus is full term at 38-40 weeks

Question 8

Fraternal v.s identical twins

Answer 8

fraternal twins are two different zygote fertilized by two different sperm.

Identical twins are made of one zygote fertilized by one sperm and split to make two zygotes

Question 9

TPALM

Answer 9

T= number of term infants born after 37 weeks

P= number of preterm infants born

A= number of pregnancies aborted before 20 weeks

L= number of living children

M= multiple birth number of multiple gestations

Question 10

Nagele’s Rule

Answer 10

• take 1st day of LNMP
• subtract 3 months
• add 7 day and go forward

Example: LMP - Feb 17-24, 2009= Nov 24, 2009

Question 11

Gravida

Answer 11

The number of times a women has been pregnant, regardless of the status or outcome (twins counted as one)

Question 12

Para

Answer 12

Number of deliveries that go 20 weeks gestation or beyond, regardless of outcome (twins counted as one)

Question 13

Pseudoanemia

Answer 13

• fluid part of the blood increases more than the erythrocytes component. (Dilutional anemia)
• leading to a hematocrit level drop

Question 14

Why is there an increase in blood volume during pregnancy?

Answer 14

Blood volume gradually increases to about 45% greater than that of the pre pregnant state by the 32-34 weeks gestation for the purpose of exchange of nutrients , oxygen exchange, waste products, needs for expanded maternal tissue, reserve for blood loss during birth

Question 15

Why does urination increase during pregnancy?

Answer 15

Urinary frequency worsens during 1st and 3rd trimester because of pressure from the uterus on the bladder

• leads to UTI if mom doesn’t void
• UTI can lead to preterm labor

Question 16

Presumptive signs of pregnancy

Answer 16

• amenorrhea
• nausea morning sickness
• breast tenderness
• pigmentation changes (chloasma mask, areolar darkening and linea negra)
• urinary frequency
• fatigue
• quickening (fetal movement 16-20 weeks)
• hormonal imbalances
• PMS
• stomach virus or food poisoning
• increased peristalsis, gas
• UTI or pelvic masses
• illness, stress, sudden changes in lifestyle

Question 17

Probable signs

Answer 17

These are objective not 100% accurate and include:

• goodell’s sign= softening of the cervix*
• Chadwick’s sign= bluish-red discoloration of the cervix
• hegar’s signs= softening of the isthmus of the uterus

Question 18

Positive signs

Answer 18

100% accurate

• sonogram or ultrasound
• FHT - heard at 10 weeks with Doppler
• uterine soufflé

Question 19

What does AVA mean?

Answer 19

in the umbilical cord there are 2 arteries and 1 vein (AVA)

the arteries carry deoxygenated blood and the vein carries oxygenated blood from the placenta to the fetus

Question 20

TPAL

Answer 20

further explains “para”
F or T- full term (>37 weeks) P- preterm (20-36 weeks and 6 days gestation
A- abortions or miscarriages L- living (multiple gestation count as how many were delivered and remain alive

Question 21

A woman who is now pregnant, has delivered one previous prenancy at term, has delivered one pregnancy at 29 weeks (the baby died), had one elective abortion at 8 weeks, and had one spontaneous miscarriage at 12 weeks.
What is her Gravida and Para?

Answer 21

G= 5
P= 2

Question 22

Gravida

Answer 22

of times a woman has become pregnant regardless of status or outcome- twins are counted as one

Question 23

Para

Answer 23

number of deliveries that go 20 weeks gestation or beyond, regardless of outcome- twins are counted as one

Question 24

Nageles Rule

Answer 24

take first day of LNMP
subtract 3 months
then add 7 days ahead

Question 25

Positive
Presumptive
Probable
signs of pregnancy

Answer 25

Positive= US, FHT(heard at 10 weeks), movement using leopolds manuever, uterine souffle

Presumptive= amenorrhea, morning sickness, breast tenderness, pigmentation changes, urinary frequency, fatigue, quickening

Probable= Goodells sign (softening of the cervix), Hegars Sign (softening of the isthmus of the uterus, Chadwicks Sign (bluish red cervix), Ballottement (fetus floats away when palpated and then returns, pregnancy test, abdominal enlargement, stretch marks, fetal outline

Question 26

pseudoanemia

Answer 26

fluid part of blood increases more than the erythrocyte component (dilutional anemia)
Leads to hematocrit drop

Question 27

NI for N/V

Answer 27

eat crackers or dry toast 30 mins to 1 hour before rising in the morning
drink fluids between meals
small frequent meals and remain upright when eating
avoid grease, spice, and strong odors

Question 28

purposes of the amniotic fluid

Answer 28

maintains an even temp
cushions to protect
allows fetus to remain afloat
allows for symmetrical growth
will become the 1st stool
acts as a waste repository

Question 29

Difference between fraternal and identical twins

Answer 29

Identical= one fertilized ovum separates into 2 zygotes, each baby will be the same sex with the same genetic makeup

Fraternal= two separate ova are fertilized by 2 separate sperm, may or may not be the same sex

Question 30

Concepts of normal fetal development

Answer 30

-Circulatory- 1st to develop, by 4th week heart begins to develop
-Heart structure- Ductus venosus-bypasses liver to connect to the inferior vena cava
Foramen ovale- biggest and closes at birth-diverts blood from R atrium to L atrium bypassing the lungs
Ductus arteriosis- connects the pulmonary artery w/ aorta to bypass the lungs
-Respiratory- 5-17 weeks-depends on surfactants lecithin and sphigomyelin which allows lungs to expand and prevent collapsing- complete maturation 34-36 weeks
-Renal- 5th week-urine excreted into the amniotic fluid and removed by the placenta-oligohydramnios(too little fluid) may indicate renal dysfunction
-GI- nutrition and elimination done through the placenta-polyhydrmnios (too much fluid) may indicate GI defect
-Hepatic- begins to form by 4th week- cannot eliminate dead RBCs so jaundice can develop-stores iron from mother for up to 5 months- lack of Vit K
-Reproductive- sex at 8th week

Question 31

why is there an increase in blood volume during pregnancy?

Answer 31

blood volume gradually increases to 45% greater than pre-pregnancy by 32-34 weeks to allow exchange of nutrients, oxygen, waste products, expanded maternal tissue, and reserve for blood loss

Question 32

why is there urinary frequency in pregnancy?

Answer 32

pressure from enlarging uterus