Normal Pregnancy and Care of Developing Fetus (Part 2) Flashcards
refers to the period leading up to a pregnancy, from the decision to have a baby to becoming pregnant (conceiving)
PRECONCEPTION -
includes scheduling of appointments to physicians or nurse midwives before becoming pregnant to: a. obtain reproductive life planning; b. assurance about fertility; c. genetic testing; d. detect problems that may need correction
PRECONCEPTUAL VISIT -
extent of understanding conveyed about maternal health prior to conception to ensure healthy pregnancy
Preconception knowledge:
screening and providing information and support to individuals of childbearing age
Preconceptual counseling
essential for ensuring the overall growth of newborns and mothers; a major strategy for helping to reduce complications of pregnancy such as the number of preterm or low-birth-weight babies born each year
PRENATAL CARE -
time to establish baseline data relevant to a woman’s health and identify health promotion strategies that will be important at every
PRENATAL VISIT
Private & quiet setting
Schedule the interview
Introduce yourself (role)
GOOD INTERVIEW TECHNIQUES
Purpose of initial interview:
Establish rapport
Gaining information about women’s social and psychosocial health
Obtaining a basis for anticipatory guidance for pregnancy
Establish a baseline data
Determine the gestational age of the fetus
Monitor fetal development and maternal well-being
Identify women at risk of complications
Minimize the risk of possible complications by anticipating and preventing problems before they occur
Provide time for education about pregnancy
> PURPOSE OF PRENATAL VISIT:
name, age, address, telephone number, email address, religion, ethnicity, type and place of employment, and health insurance information
Demographic Data:
the reason why the woman came to the healthcare setting (LMP, signs of pregnancy, etc.)
Chief Concern:
marital status, education level, occupation, size and structure of house, family composition, educational attainment
family Profile:
woman’s past medical history is important because past conditions can become active during or immediately after pregnancy
History of Past Illness:
can help identify potential problems a woman or her infant could experience during pregnancy or after birt
History of Family Disease:
current nutrition, elimination, sleep, recreation & interpersonal interaction
Day History or Social Profile:
age of menarche, usual cycle, interval, duration, amount of menstrual flow and any discomfort she feels
Menstrual History
Menstrual History - age of menarche, ususl cycle, interval, duration, amount of menstrual flow and any discomfort she feels
Perineal & Breast Self-examination
Past Surgery - any type of surgery on the reproductive tract
Reproductive Planning
Sexual History
Stress Incontinence
> GYNECOLOGIC HISTORY
including previous miscarriages or therapeutic abortion
History of Previous Pregnancies
compute the Expected Date of Birth (EDB) using Naegele’s Rule.
Last Menstrual Period (LMP)
First, determine the first day of your last menstrual period
Count back 3 calendar months from that date
Add 1 year and 7 days to that date
Naegele’s Rule.
Start counting from the first day of the menstrual period, a time that precedes fertilization. This period is about 2 weeks before ovulation or fertilization and 3 weeks before implantation of fertilized ovum
At the EDD, the infant is 40 weeks old ir 280 days, the average gestational or menstrual age.
ESTIMATING GESTATIONAL AGE/MENSTRUAL AGE
Formula: GA - 2 = Ovulation Age
Formula: OA + 2 = Gestational Age
> CALCULATING FROM THE DATE OF OVULATION AGE
the rule is also about computing for EDD
Procedure:
a.) determine LMP
b.) categorize the woman as a Caucasian or non-Caucasian (???)
c.) identify her gravidity (no. of times she got pregnant)
For primigravida Caucasian women:
Formula: LMP + 15 days (constant) - 3 months = EDD
For multigravida non-Caucasian women:
Formula: LMP + 10 days (constant) - 3 months = EDD
MITTENDORF’S RULE:
simplest method; if a woman seeks prenatal care within 2 weeks after missed menses and has a positive pregnancy test, this is indicative of pregnancy 6 weeks duration, that is, counting from the LMP
early prenatal care
by 16 weeks, fetal muscle movements is strong enough to activate receptors on the maternal abdominal wall
first perception of fetal movement felt by the mother; fluttering movement in the abdomen
generally it occurs 18-20 weeks
may be related to parity and placental location
EDD = add 22 weeks for primigravida, 24 weeks for multipara
quickening
Auscultation of FHT using ordinary unamplified stethoscope starts at
20 weeks
symphysis pubis (__ weeks); 2.) umbilicus (__weeks); 3.) xiphoid process (__ weeks)
12, 20, 36
explain the procedure to the patient
ask to empty the bladder
position the mother in dorsal recumbent
drape
measure the distance abdominally from the top of the symphysis pubis over the curve of the abdomen to the top of the uterine fundus
McDonald’s method:
FORMULA FOR McDonald’s method (in weeks):
FH (in cm) × 2 ÷ 7
length of embryo can be calculated during the first 5 months (in cm) of gestation by squaring the number of months in pregnancy.
Haase’s Rule
Haase Rule Formula
1-5 lunar months, multiply the month by 2
[(month of pregnancy) 2 = fetal length]
6-10 lunar months, multiply the month by 5
[(month of pregnancy) 5 = fetal length]
gestational age is assessed more accurately
ultrasound
comprehensive system for classifying pregnancy status and provides greater detail on woman’s pregnancy history.
GTPAL or GTPALM -
no. of times client was pregnant
Gravida
infants born at or after 37 weeks
Term
infants born before 37 weeks
Preterm
no. of miscarriages and therapeutic abortion
Abortion
no. of living children
Living
no. of multiple pregnancies
Multiple Pregnancy
