MATERNAL II: Madz Chokee Flashcards
Cyclic Uterine Bleeding
-Endometrium
-Average days of Menstrual Cycle: 28 days
-Menstrual Period: 4-7 days (Average: 5-6 days)
-Blood loss Menstrual Cycle: 5-80 ml (averge 50-60 ml; 1/4 cup)
Blood loss >80ml for more than 7 days, changing napkins every <2 hours.
Abnormal/ Menorrhagia
Average days of Menstrual Cycle:
28 days
Menstrual Period
4-7 days (Average: 5-6 days)
Blood loss Menstrual Cycle:
5-80 ml (averge 50-60 ml; 1/4 cup)
Body parts involved:
-Uterus
-Hypothalamus → GnRH
-Anterior Pituitary Gland
:FSH-Maturation of Ovum cortex of
ovary.
-Contains The follicles
HORMONE RESPONSIBLE FOR:
A) Primoridal Primary (Immature ovum)
↓
Graafian Follicle (Mature Ovum)
B) Stimulates ovary to produce estrogen
FSH
-Hormone for Ovulation
-stimulates ovary to produce progesterone
LH
For Irreg Cycles how to determine ovulation day?
- chart the longest and shortest cycles for 6-8 consecutive months
- Shortest cycle subtract 18 days
- longest cycle subtract 11 days
- Result= Fertile days
-Development of secondary sexual characteristics
-B-B-B-B-B
-Babae
-Balakang: Wide hips (1st)
-Boobs: Thelarche
-Buhok: Axillary hair: Adrenarche
-Bleeding: 1st menstruation: Menarche
-Bulbol: Pubic Hair: Adrenarche
-Inhibita FSH
-Ductile Structure of breast
-Growth of long bones (12 y.o.); closure of epiphysis of long bones (16-18 y.o.)
-↑ sexual desires
-↑ vaginal lubrication
-fertile cervical mucus
Estrogen
Characteristics OF CERVICAL MUCUS
-thin
-watery
-clear
-alkaline
-slippery
-abundant
- (+) Sphinbarkeit: Stretchy
1st Enlargement of the breast
Thelarche
1st Axillary hair & 1st Pubic hair
Adrenarche
1st Menstrual Cycle
Menarche
good to know
Ovulation day occurs day before the next cycle
Subtract -14= Ovulation
Subtract -5= Fertile
Hormone responsible for theIrregularities in Menstrual cycle
FSH
GTK
FSH → ↑ ESTROGEN → X FSH
LH → ↑ PROGESTERONE → X LH
Primary Menarche
menstruation not occurs ↑ 17 y.o.
-No sex if cervical mucuous is wet & elastic until 4 days after last day of wet mucus
-Last day + 4 days = Yes to sex!
Billings/ Cervical Mucus
-Hormone for pregnancy
-Prepares endometrium for implantation
-Thermogenic action (↑ BBT)
-During ovulation
↑BBT (.3-.6 C)/ (.5 -1 F)
After ovulation
↑BBT
-Mood swings (after ovulation)
-Inhibits LH
-↓ GIT motility
-Mammary gland: Lactation
-Infertile cervical mucus
PROGESTERONE
Characteristics of Infertile cervical mucus
Thick, sticky, scanty, dry, dense, opaque, (-) spinhbarkeit (non-stretchy)
Abstain from coitus/sex during temperature rise + additional 3-4 days
BBT
***To check; you must have sleep for at least 4 hours
Combination of Billings + BBT
Sympathothermal
UTERINE CYCLE
M-P-S-I
MENSTRUAL PHASE
↓E ↓P
Endometrium: Bleeding 1-6 days
PROLIFERATIVE PHASE
aka estrogenic/ post-menstrual/ pre-ovulation
↑E ↓P
Endometrium: Thickening 7-14 days
SECRETORY PHASE
aka Progestational/ post-ovulation/ pre-menstrual
↑P ↓E
Endometrium: Twisted, Spongy, Tortuous 15-26 days
ISCHEMIC PHASE
↓E ↓P
Endometrium: Vasoconstriction 27-28 days
S/sx of Ovulation
-↑BBT (↑P)
-Mittelschmerz: Pain during ovulation
-(+) Spinnbarkeit (↑E)
union of ovum + sperm
X1: female, acid resistant, slow, long-lived
Y1: Male, dies in acid, fast short-lived
22 autosomes + 22 autosomes
1 sex chromosomes + 1 S.C.
=46 Diploid Chromosomes
↓
ZYGOTE
Fertilization/ Conception
False Negative Pregnancy test
-Prior to checking for HCG in urine: Limit Fluid Intake
-↑ concentrated HCG
-1st urine (1st voided)/ 1st stream urine
=HCG is probable sx
**If you have proteinuria: false (-) negative
**if using pills: false (+) positive of HCG in
urine
-No oral contraception for 5 days
Important presumptive sign in pregnancy
Amenorrhea
Triploid Karyotype = 69
(Dispermy)
Partial H-Mole
Androgenesis duplication of paternal set of chromosomes : 46 diploid
Risk:
-40 y.o.
-PCOS
-↑Cancer
Complete H-mole
-2 Ovas fertilized by 2 different sperms
-Different features
-2 placenta, BOW, Fetuses
fraternal twins/ dizygotic twins
-1 zygote split into 2
-same sex
Identical twins/ Monozygotic
Types of Identical Twins:
*Dichorionis- 2 chorions→ 2 placenta
*Diamnionic- 2 amions → 2 bow
Splitting: 1st 3 days after fertilization
Identical twins that has:
2 amions → 2 bow
Diamnionic
Identical twins that has:
2 chorions→ 2 placenta
Dichorionic
1 placenta; 2 BOW
splitting: 4-7th day after fertilization
Monochorionic, Diamnionic
1 placenta, 1 BOW
Splitting: 8-13 th day
Monochorionic, monoamnionic
cleavage is incomplete
Splitting: >13 days
Conjoined Twins
Complications of multifetal pregnancies
- MATERNAL ANEMIA ↑IRON
- PRE-ECLAMPSIA
- PRE-TERM LABOR DUE TO OVERDISTENTION OF UTERUS
4.MALPRESENTATION
↓ - DYSTOCIA: difficult, painful, prolonged labor
- POST-PARTAL HEMORRHAGE
Site of implantation/ Nidation
-Fundus: uppermost portion of uterus
Signs of implantation
-Slight pain
-Vaginal Spotting
2 embryonic membranes
A.) Amion: Inner facing the fetus ; thin
B.) Chorion: Outer facing the uterus; thick
2 layers :
*Cytotrophblastic: Langham layer- To protect fetus against toxoplasmosis & syphilis on the 1st 16-18 weeks of pregnancy.
* Synctiotrophoblast: Production of HCG
: Nutrition
Most common identical twins
Dichorionic Diamnionic
Iron needs:
Non-Pregnancy: 15-18mg/ day
Pregnancy (1): 27-30 mg/ day
Twins: 60-100 mg/day
The average length of pregnancy for twins
Twins: 36 weeks
Triplets: 32 weeks
Quad: 30 weeks
Babies delivered 1 month early
<2,500 grams :LBW
Babies delivered 2 months early
<1,500 grams: VLBW
How much does a woman can carry?
5 kilos
GTK
we cannot dx placenta previa <5 months or <20 weeks
-Too early to be identified to transport to fundus
GTK
Threatened Aborton
-painless
-<16 weeks
GTK
Dx of pregnancy
Through Ultrasound
<6 weeks
Vaccine not allowed to pregnant woman
Live attenuated Vaccine
e.g., Sputnik Covid Vaxx (The rest of covid vaxx can be administered)
ADVERSE REACTION: Can cause VSD (Ventricular Septal Defect)
INFECTIONS THAT CAN CROSS PLACENTA
T-O-R-C-H
-Toxoplasmosis: 3rd trimester
Other Infx:
*-Syphilis: 2nd trimester
*-Parvovirus B19
*-Varicella Zoster Virus
*-Listeria
-Rubella
-Cytomegalovirus
-Herpes Simplex Virus-2 (HSV-2)
**Vertically Transmitted via placenta, blood, body fluids, breastmilk
**BACTERIA DOESNT CROSS PLACENTA
***3rd trimester: Toxoplasmosis
2nd trimester: Syphilis
1st trimester: The rest of R-C-H
TERATOGENS:
Damage to 8th cranial nerve leading to poor hearing & deafness
Streptomycin/Quinine
TERATOGENS:
Staining of both enamel & inhibit growth of long bones
Tetracycline
TERATOGENS:
Leads to hemolysis & hyperbilirubenia
Vitamin K
TERATOGENS:
Enlargement of thyroid glands or goiter
Iodides
TERATOGENS:
Can cause Amelia (Abscence of limbs)
Phocomelia (absence of distal extremities)
Thalidomides
TERATOGENS:
can cause cleft lip & cleft palate & abortion
Steroids
TERATOGENS:
Congenital malformation right heart defects (Ebstein Anomaly)
Lithium/ BENZODIAZIPINES
TERATOGENS:
Can cause IUGR, Fetal hydantoin syndrome microcephaly, heart defects, nail hypoplasia
Dilantin/Phenytoin (Anti-convulsant)
TERATOGENS:
Can cause LBW, Fetal alcohol withdrawal syndrome characterized by microcephaly
Alcohol
TERATOGENS:
LBW, Abruptio, previa, ectopic,
Smoking
TERATOGENS:
LBW
CAFFEINE
TERATOGENS:
LBW & Abruptio placenta (occurs 5th month: 3rd trimester
Abortion:1st trimester (<20 weeks)
Cocaine
Antibiotic for Syphilis
Pen-G (1st antibiotic)
Erythromycin (2nd) if allergy to pen G
DOC for toxoplasmosis
Sulfadiazine
