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NZ STATE PREP > Maternal Health > Flashcards

Maternal Health Flashcards

1
Q

What is Naegele’s rule

A

Determines expected date of delivery based on last menstrual period

3 Calender Months + 7 days

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2
Q

What is gravida/gravidity

A

A woman who is pregnant/number of pregnancies

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3
Q

Nulligravida

A

Never been pregnant

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4
Q

Primigravida

A

Pregnant for the first time

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5
Q

Multigravida

A

A woman who has had 2+ pregnancies

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6
Q

What is parity

A

The number of pregnancies that have reached viability (20 weeks of gestation) whether the fetus was born alive or not

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7
Q

What are the three categories of gravida/gravidity

A

Nulligravida, primigravida, multigravida

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8
Q

What are the three categories of parity

A

Nullipara, primipara, multipara

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9
Q

Preterm

A

0-20 weeks

Pregnancies that have reached 20 weeks but ended before 37 weeks

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10
Q

Term

A

37-42 weeks

Pregnancies that have lasted between week 37 to week 42

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11
Q

Blood + urine test to confirm pregnancy

A

Detects hCG human chorionic gondadotropin within 10 days post conception

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12
Q

Presumptive signs of pregnancy

A

-N +V
-Amenorrhea
-fatigue
-Breast enlargement + tenderness

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13
Q

Probable Signs of pregnancy

A

-Chadwicks sign (vaginal mucosa turns blue/purple)
-Hegar’s signs (softening of uterus)
-Braxton hicks (false contractions)
-Positive pregnancy test

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14
Q

Positive signs of pregnancy

A

-Fetus viewed on ultrasound
-Fetal heart beat picked up on ultrasound/Doppler

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15
Q

GTPAL

A

Gravida (number of pregnancies)
Term (number of births that reached over 37 weeks)
Pre-term (number of births that reached under 37 weeks)
Abortion (number of elective or spontaneous abortions prior to 20 weeks)
Living Children (number of living children)

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16
Q

1st trimester (weeks S+S and considerations)

A

-0-12 weeks

-Morning sickness

-Mother needs to make lifestyle changes (stop smoking + proper eating habits)
-Heart tone can be heard by 12 weeks
-Begin folic acid supplementation until 12 weeks
-0.5-2 kg weight gain

Mother needs emotional support at this time as ambivalence occurs

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17
Q

2nd trimester (weeks, S+S and considerations)

A

-13-28 weeks

-Fundus rises out of symphysis at 12-13 weeks
-Fundus at umbilicus at 20 weeks
-N+V decreases
-Weight gain 0.5kg per week

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18
Q

Maternal supplementation

A

-Folic acid until end of 12th week of pregnancy to prevent spina bifida
-Iodine during pregnancy and breastfeeding. Iodine supports production of maternal and fetal thyroid hormone which regulates development of fetal brain and nervous system
-Iron because volume of blood in your body increases in pregnancy, resulting in an increased amount of iron needed. The body uses iron to make more blood to supply oxygen to baby. Not enough iron stores can result in anemia.

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19
Q

3rd trimester (weeks, S+S and considerations)

A

-29-40 weeks

-Preparing for birth

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20
Q

Expected (normal) weight gain during pregnancy

A

13 kgs

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21
Q

Vaccinations for pregnant women

A

Boostrix (whooping cough, diptheria and tetanus) at 16-26 weeks
-flu vaccine (at any stage)
-COVID-19 vaccine (6 months after last COVID vaccine or infection)

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22
Q

Quickening (what is it? When does it occur)

A

-When a pregnant mother feels fetal movement

-Occurs 16-20 weeks

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23
Q

Is spotting normal at 28 weeks?

A

Yes. The lower part of the uterus thins during the 3rd trimester causing the area over the cervix to bleed

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24
Q

Management for varicose veins

A

-Encourage exercise
-Don’t stand for long periods of time
-TED stockings
-Elevate legs

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25
Q

Is baby weight loss after birth normal

A

Yes. Babies carry extra fluid during birth and lose 7-10% of their birth weight in the first couple of days. This weight should be regained within 2 weeks after birth

26
Q

Normal weight for newborns

A

2500 - 4000 grams

27
Q

When to suspect post-natal depression

A

If baby blues continues for 2 weeks following birth

28
Q

Bloody show

A

A bloody show occurs because the cervix starts to soften and thin (efface) and widen (dilate) in preparation for labor. Occurs late in pregnancy

29
Q

Spina bifida

A

Spina bifida is when a baby’s spine and spinal cord does not develop properly in the womb, causing a gap in the spine.

30
Q

What is a teratogen

A

Agents in fetal environment that either cause a birth defect or increase the likelihood of a birth occurring

31
Q

What happens if a pregnant women is infected with Rubella

A

-Has a teratogenic effect during the first trimester
-Can cause hearing impairment, cognitive +motor changes, blindness, cardiac defects, restricted growth
-Post 16 weeks defects are rare

32
Q

Can I consume alcohol when I’m pregnant

A

No. It increases risk of miscarriage, premature birth, low birth weight + can cause fetal alcohol syndrome
-Drinking six alcoholic beverages a day or a single episode of binge drinking in the first trimester can cause fetal alcohol syndrome

33
Q

Can I smoke when I’m pregnant

A

No. It increases risk of miscarriage + early labor
-Smoking restricts uterine blood vessels = decreased uterine blood flow + O2 supply to fetus = impaired neurodevelopment + hypoxia

34
Q

What foods should I avoid and why

A

Foods that carry risk of listeria infection e.g., soft cheese, pate, unpasteurized dairy, processed meat, precooked cold meat, pre-prepared/refrigerated salads, food containing raw eggs.

Listeria infection increases risk of premature labor or still birth + can cause infection in baby

Avoid high mercury seafood (e.g., shark, marlin, swordfish) because toxic to baby can cause nervous system damage)

Avoid smoking + alcohol

Avoid drinking >3 cups of coffee a day increased risk of miscarriage

35
Q

Morning sickness (When does it occur and why does it happen)

A

Weeks 4-12

-GDF15 hormone is made in abundance by tissue in the placenta. It acts on the brain stem causing N +V. Some women are more sensitive to increased levels of GDF15 than others

36
Q

Bleeding gums (what causes it)

A

Increased progesterone = increased blood volume + vasodilation making gums more vulnerable to bacteria + bleeding

37
Q

Urinary frequency (when does it happen and what causes it)

A

-Common in 1st trimester and reoccurs in 3rd trimester
-Caused by increased progesterone + hCG which enhances blood flow to pelvic region
-Growing uterus pushes on bladder

38
Q

Epistaxis (when does it occur and what causes it)

A

Common in 1st trimester

Nasal stuffiness

Increased progesterone = Increased blood volume = exacerbation of vascular congestion + bleeding.

HGH causes inflammation of mucous membrane lining nose

39
Q

Heart burn (when does it happen what causes it)

A

Starts at 8 weeks

Increased progesterone causes sphincter to relax = stomach content moving up oesophagus

40
Q

Constipation (when does it happen what causes it)

A

Starts first trimester

Increased progesterone = decreased GI motility = slows down passage of food through intestine (this is to allow increase absorption of nutrients from food)

41
Q

Haemorrhoids (when does it happen and what causes it)

A

2nd + 3rd trimester

Increased blood flow to pelvic region + pressure from enlarged uterus = swelling of rectal veins

42
Q

Faintness/dizziness (when does it occur and why)

A

First trimester

Progesterone = vasodilation of blood vessels to slow the return of blood

43
Q

Oedema in lower legs (when does it occur and why)

A

2nd trimester until delivery

Increase in aldosterone + cortisol cause body to retain sodium + fluid

Increased progesterone causes vasodilation to slow venous return of blood causing it to pool in lower extremities. Increased pressure pushes fluid into instersitial space

44
Q

SOB (when does it occur and why)

A

Begins 1st trimester

Expanding uterus pushes on abdomen = reduced lung capacity

Progesterone alters smooth muscle tone of airways = faster RR

45
Q

Varicose veins (when does it occur and why)

A

Common 2nd + 3rd trimester

Progesterone = vasodilation + decreased valve function + increased blood volume

46
Q

Lower back ache (when does it occur and why)

A

Common between 2nd + 3rd trimester

Increased release of relaxin causes ligaments in pelvis to loosen. Affecting stability of spine + separation of abdo muscles

47
Q

Human chorionic gondadotropin hCG (what secretes it + function)

A

-Secreted by chorionic villi
-Maintains corpus luteum to regulate secretion of oestrogen + progesterone until placenta is formed (around week 12)

48
Q

Human chorionic Somatomammotropin hCS (what secretes it + function)

A

-Chorionic villi + placenta
-Promotes fetal growth, increases breast growth, decreases mothers utilisation of glucose so it can be used for fetal growth

49
Q

Relaxin (what secretes it + function)

A

-Placenta

-Contributes to cervix dilation
-Relaxes + softens ligaments in pelvis + symphysis pubis

50
Q

Oestrogen (what secretes it + function)

A

-Corpus luteum (0-12 weeks) + from placenta (13-40 weeks)

-Stimulates myometrial growth + excitability
-Increases vascularisation of uterine tissue
-Stimulates growth of breast ducts

51
Q

Progesterone (what secretes it + function)

A

-Corpus luteum (0-12 weeks) + from placenta (13-40 weeks)

-Preps endometrium for implantation
-Maintains endometrium
-Inhibits contractions of myometrium + smooth muscle (walls of GI tract + veins)
-Stimulates growth of milk alveoli in breast

52
Q

Oxytocin (what secretes it + function)

A

Posterior pituitary gland

-Stimulate uterine contraction + “let down” reflex of milk

53
Q

Human placental lactogen hPL (what secretes it + function)

A

-Placenta

-Prepares body for breastfeeding
-Regulates metabolism and insulin sensitivity to make sure the fetus gets enough nutrients

54
Q

Virchow’s Triad

A

Pregnancy is a prothrombotic state; it has all components of Virchow’s triad: venous stasis, endothelial damage and hypercoagulability.

55
Q

Blood supply to the umbilical cord

A

The umbilical arteries carry deoxygenated fetal blood toward the placenta for replenishment, and the umbilical vein carries newly oxygenated and nutrient-rich blood back to the fetus.

56
Q

When does menstrual bleeding return after birth?

A

Not breastfeeding = 6-8 weeks, Breastfeeding = vary

57
Q

How to “bring milk in”

A

Frequent breastfeeding, massage breast + lean in to make it easy for baby to latch breast

58
Q

Ectopic pregnancy (what is it, S+S)

A

-Fertilized egg implanted outside of uterus

-Symptoms include abdominal rigidity; rapid, shallow respirations; tachycardia; and shock.

-Ruptured ectopic pregnancy commonly has sharp pain in the lower abdomen, with spotting and cramping.

59
Q

What causes venous stasis in pregnancy

A

-Growing uterus compresses the descending aorta and the inferior vena cava.
-Pressure forces blood to pool in leg veins rather than flowing upward.
-Causes decrease in venous return to the heart, a fall in cardiac output, and hypotension

60
Q

Why does progesterone cause vasodilation in pregnancy

A

To accomodate the increase in blood volume

NZ STATE PREP (1 decks)

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