Maternal Flashcards
Normal Maternal Weight Gain
20 - 35 lbs
Menstrual Phase
- sloughing off
- 1-5 days
Proliferative Phase
- ⬆️ estrogen
- thickest endometrium
- 6-14 days
Secretory Phase
- ⬆️ progesterone
- ⬆️ estrogen (13th day)
- ⬆️ blood flow
- Ovulation (14th day)
- Luteal Phase
- 14-25 days
Ischemic Phase
- Period before menstruation
- 27-28 days
Ovulation to Menstruation
- Count 14
Menstruation to Ovulation
- Count 16
Calendar Method
- No sex 5 days before and 3 days after
Cervical Mucous/Billings Method
- Clear & Stretchable
- Spinnbarkeit sign (⬆️ estrogen)
- No sex 4 days before and 3 days after
- “I feel dry during menstruation”
- “I feel wet during ovulation”
Basal Body Temperature
- ⬇️ temperature before ovulation (⬆️ estrogen)
- ⬆️ temperature during ovulation (⬆️ estrogen, ⬆️ progesterone)
- No sex 3-4 days after
Sympthothermal
- Cervical Mucous + BBT
- No sex 3-4 days after
Coitus Interruptus
- least effective
- withdrawal
Ampulla
- fallopian tube
- ectopic pregnancy
Isthmus
- BTL
Uterus
- implantation
Genotype
- race
Serotype
- blood type
Phenotype
- physical appearance
Karyotype
- DNA structure
- traits
- hereditary
XX
- Female
XY
- male
H-mole
- formation of thromboblastin
- grape like cluster/snow like cluster
DOC for H-mole
- Methotrexate
- Antidote: Leucovorin
Naegels Rule
- Jan - Mar = +9 +7 same year
- Apr - Dec = -3 +7 +1 year
McDonald’s Rule
- measure fundic height
- fundic ht x 8 ÷ 7 = AOG (weeks)
- fundic ht x 2 ÷ 7 = AOG (month)
Bartholomew Rules
- locate fundic height
Quickening
- 5 months
Haases Rule
- measure fetal length
- 1-5 months = times by itself
- 6-10 months = times 5
Products of Fertilization
Conception
2 weeks
2 months
Term
ZYGOTE
EMBRYO
FETUS
Substance that crosses barrier
ANAC
- Antibiotics
- Narcotics
- Alcohol
- Coumadin
Disease that crosses placenta
TORCH
- Toxoplasmosis
- Other Infection (Hepa B, HIV, syphilis)
- Rubella (German Measles)
- Cytomegalovirus
- Herpes Simplex (aziclovir)
Sign of Placental Separation
GRL
- Gushing of blood
- Rising Fundus (Calkin Sign)
- Lengthening of Cord
Placenta Increta
- invades myometrium
Placenta Accreta
- attach yo myometrium
- complication: abruptio placenta/bleeding
Placenta Bipartita
- placenta with 2 lobes
Placenta Tripartita
- placenta with 3 lobes
Placenta Succenturiata
- placenta with extra lobes
Battledore
- normal placenta placement but umbilical cord is attached in placental margin
Placenta Previa
- low lying placenta
- painless
- bright red
Abruptio Placenta
- premature separation of placenta
- dark red bleeding
- painful
- sharp stabbing pain
Fern Test
- test for ruptured BOW
- use Nitrazine Paper
- Yellow = urine (acidic)
- Blue = amniotic fluid (alkaline)
Alpha Fetoprotein (AFP)
- ⬆️ AFP = Neural Tube Defects
- ⬇️ AFP = Down Syndrome
Prenatal Frequency
- 1-7 months = monthly
- 8-9 months = every 2 weeks
- 10 months = every week
- Post term = 2x a week
Hypertension
- 1st trimester (H-mole)
- 2nd and 3rd trimester (PIH)
1st sign of PIH
- edema in hands and face
Maternal Weight Gain (trimester)
- 1st trimester = 1lbs per month
- 2nd and 3rd trimester = 1lbs per week
Varicose Vein
- decrease back flow to heart
- Mgt: leg elevation
Risk for Thrombus Formation
- due to venous statis in lower extremities
- Mgt: ambulation every 2 hours
Supine Hypotension
- due to compression of vena cava
- Mgt: left lying position
Leg cramps
- due to ⬇️ calcium
- Mgt: Dorsiflexion
Presumptive Sign of Pregnancy
1st trimester - BAUN
- Breasts tenderness
- Amenorrhea
- Urinary Frequency
- Nausea and Vomiting
2nd trimester - QC
- Quickening
- Chloasma (skin pigmentation)
Probable Sign of Pregnancy
1st trimester - HCG
- Hegar Sign (softening of uterus)
- Chadwick Sign (bluish vagina)
- Goodles Sign (softening of cervix)
2nd Trimester - BB
- Braxton’s Hicks Contractions
- Ballotement
Positive Sign of Pregnancy
+ FHB
+ FHT
+ Fetal movement
+ Fetal outline
Bleeding complications
1st Trimester
- Ectopic pregnancy
- Abortion
2nd Trimester
- H-mole
- Incompetent cervix
3rd Trimester
- Placenta Previa
- Abruptio Placenta
Cullen Sign
Bluish umbilicus
DOC for Ectopic Pregnancy
- Methotrexate
- Salpingectomy
Fetal Demise
- termination of pregnancy after liability (<20 weeks)
Stillbirth
- baby is alive the entire pregnancy but DIED during delivery
Spontaneous Abortion
- cause by chromosomal abnormality
Induced Abortion
- intentional abortion
Threatened Abortion
+ spotting
+ abdominal cramping
- cervical dilation
Inevitable (Imminent) Abortion
+ Spotting
+ Abdominal cramping
+ Cervical dilation
Complete Abortion
- all products are expelled
Incomplete Abortion
- some products are retained
Missed Abortion
- Fetal death in the uterus
Habitual Abortion
- 3 or more spontaneous abortion
- cause by incompetent cervix
Management for Habitual Abortion
- McDonald’s - temporary cerclage (NSVD)
- Shirodkar - permanent cerclage (CS)
Leopold Manuever
- determine fetal presentation
- void first
- supine with knees flexed
Leopold Manuever 1
- fetal presentation is cephalic or breech
- head: more firm, round and had moves independently
- breech: less well defined moves on in conjunction with the body
Leopold Manuever 2
- locate fetal back
- Back:smooth, hard, resistant surface
- Knees/Elbow: several angular nodulation
Leopold Manuever 3
- determine the part of the fetus at the inlet and its mobility
- head is not engaged: move upward or sideward
- head is engaged: head is firm settled into the pelvis
Leopold Manuever 4
- determine fetal attitude and degree of fetal extension into pelvis
- done only if in cephalic presentation
Amniocentesis
- withdrawal of amniotic fluid
- 2nd trimester
- determine
1. Maple syrup urine disease - unable to process amino acid
2. Cytinosis - accumulation of cystine within cell
Ultrasound
- diagnose pregnancy
- determine sex
- predict maturity of lungs
- confirm the presence, size, and location of the placenta and amniotic fluid
- drink plenty of water
Non-Stress Test
- measure the response of fetal heart rate in relation to fetal movement
- Reactive: 2 or more acceleration of FHR
- Non-reactive: no acceleration
Contractions Stress Test
- measure response of fetal heart rate to uterine contractions
- Nipple Stimulation
- Oxytocin stimulation
Fetal Station
(-) floating
0 engaged
(+) crowning
Mechanism of Labor
ED FIRE ERE
- Engagement
- Descent
- Flexion
- Internal Rotation
- Extension
- External Rotation
- Expulsion
Precipitate Labor
- uterine contractions are strong
- labor that lasts less than 3 hours
Complete position
Sitting
Frank positions
Buttocks
Footling
Thigh or lower legs
Gestation Hypertension
- ⬆️ bp
- no edema
- no proteinuria
- bp returns to normal after delivery
HELLP Syndrome
- Hemolysis, Elevated Liver Enzymes, Low Platelet
- proteinuria
- edema
- ⬆️bp
- Mgt: fresh frozen plasma
Early Deceleration
- fetal head compression
- begins and ends simultaneously with uterine contractions
Late Decelerations
- utero placental insufficiency
- delayed until 30-40 sec after the onset of contraction
Variable Decelerations
- fetal cord compression
- unpredictable occurrence
Puerperium
- 6 weeks period after childbirth
- Main Priority: achieve involution
Involution
- return of the reproductive organ to pre-pregnancy state
- restoration of normal menstrual cycle
Takin in Phase
- woman review her pregnancy and labor and birth
- dependent for care of self and newborn
- rejecting rooming in
Taking Hold Phase
- begin to initiate action
- independent of self care and newborn care
Letting Go Phase
- woman finally redefined her new role
- she gives up the fantasized image of a child
- accept reality
Rubra
- 1-3 days
- bright red
Serosa
- Day 3-10
- pinkish to brownish
Alba
- Day 10 until 6th week postpartum
- white in color
Return of Menstruation
- Lactating: 6 months
- Non-Lactating: 6-10 weeks
Pregnant receiving insulin (trimester)
1st trimester - ⬇️ due to hypoglycemia (brain development of baby)
2nd & 3rd trimester - ⬆️ due to GDM
Postpartum - ⬇️ due to delivery of placenta
