maternal and newborn

Question 1

Gestation

Answer 1

Gestation is the length of pregnancy, which is
generally 40 weeks from the last menstrual period
(LMP), divided into trimesters:
First trimester: 1–13 weeks
Second trimester: 14–26 weeks
Third trimester: 27–40 weeks
Estimated date of delivery (EDD) can be calculated
based on the first day of the woman’s LMP using

Question 2

Naegele rule:

Answer 2

EDD = 1st day of LMP - 3 months + 7 days +1 year
For LMP February 15, 2024:
1. Subtract 3 months  November 15, 2023
2. Add 7 days  November 22, 2023
3. Add 1 year  EDD = November 22, 2024

Question 3

Gravidity and parity

Answer 3

Gravidity (G) = Number of pregnancies
Nulligravida: Never pregnant
Primigravida: First pregnancy Multigravida: ≥2 past pregnancies
Parity (P) = Number of births at ≥20 weeks
Nullipara: No births ≥20 weeks
Primipara: First birth ≥20 weeks Multipara: ≥2 births ≥20 weeks

Question 4

“GTPAL”

Answer 4

provides a detailed obstetric history in
which parity (P) is broken down as “TPAL” (Term,
Preterm, Abortion, Living)

Question 5

Probable signs are objective findings observed by the
HCP but could still be false positives:

Answer 5

Positive pregnancy test (urine or serum)
Goodell sign: Softening of the cervix
Chadwick sign: Bluish coloration of the cervix
and vagina
Hegar sign: Softening of the lower uterine segment

Question 6

Positive signs are definitive indicators of pregnancy:

Answer 6

Fetal heartbeat heard by auscultation or doppler
Fetus visualized on ultrasound
Fetal movement palpated by HCP

Question 7

Supine hypotension:

Answer 7

To prevent supine hypotension, teach clients to never lie flat on their back after the
first trimester.

Question 8

Fundal height:

Answer 8

Fundal height indicates gestational age and fetal growth. In the second trimester,
fundal height should align with gestational age (+/- 2 weeks). If the measurement differs by more than
2 cm from the expected gestational age, assess for abnormalities, like fetal macrosomia or intrauterine
growth restriction.

Question 9

Nausea and vomiting: Caused byhormone levels
(including β-hCG) andgastric motility
y

Answer 9

Avoid an empty or overly full stomach.
Suggest eating crackers or toast upon
waking to prevent nausea from sudden blood
sugar drops.
Encourage small, frequent meals.
Drink fluids separately from meals.
Avoid triggers like strong odors and greasy or
spicy foods.
Ginger (tea or candies) and vitamin B6
supplements may reduce nausea.
Severe, persistent nausea and vomiting
(hyperemesis gravidarum) can cause dehydration
and electrolyte imbalances.
Notify HCP if unable to keep fluids or
food down.

Question 10

Nutrition

Answer 10

Folic acid: Crucial for neural tube development
Take prenatal vitamins daily.
Encourage leafy greens, fortified cereals,
and legumes.
Iron: Supportsblood volume and improves anemia
Encourage intake of lean meats, beans, and
fortified grains.
Calcium: Important for fetal bone development

Eat dairy products (milk, yogurt) or calcium-
fortified alternatives.

Question 11

First-trimester weight gain

Answer 11

Expected weight gain during the first trimester is
typically 1-4 lb (1-2 kg).
Reassure clients that weight gain may vary due
to nausea or food aversions.
Clients’ pre-pregnancy BMI determines goal for
healthy overall weight gain:
Normal BMI: 25–35 lb (11.5-16 kg)
Underweight: 28-40 lb (12.5-18 kg)
Overweight: 15–25 lb (7-11.5 kg)

Question 12

Unusual cravings (pica):

Answer 12

Craving non-food items like laundry detergent
and dirt can indicate iron-deficiency anemia.