Normal Pregnancy & Multifetal Gestation Flashcards
In a multifetal pregnancy’s, if the mother has hyperemesis (severe vomiting) what can this cause to the fetuses?
Respiratory distress syndrome
In a multifetal pregnancy’s, if the mother has gestational diabetes it can cause the fetuses to have what condtion?
Cerebral palsy
This term relates to ways eggs are fertilized, number of amniotic sacs, and number of placentas?
Chorionicity
Definition of dizygotic embryos?
two separate embryos from two separate eggs that have their own amniotic sac and their own placenta
What are monozygotic embryos?
identical twins
from one egg and sperm that split into two
usually have their own amniotic sac but share a placenta
What sign will you see on ultrasound indicating monozygotic twins share a placenta?
Twin Peaks sign
If a multi fetal pregnancy is Monochorionic and monoamniotic what does this mean (technically) and what is the worst complication in these pregnancies?
- means the fetuses share a placenta and a sac
- can have a complication of umbilical cord torsion cutting off supply to both fetuses’
What is the technical term for when multifetuses share a placenta only (_________ Pregnancy)?
Monochorionic pregnancy
Nausea and vomiting usually begin ____-____ months after conception and last ___-___ weeks?
1-2 months
last 4-8 weeks
What is the medication used to treat morning sickness?
vitamin B6 (pyridoxine) & doxylamine
What combination of drugs is pyridoxine & doxylamine
A vitamin and an antihistamine
What is the cause for N/V in pregnancy?
increased progesterone and hCG
Why do hCG and progesterone cause N/V in pregnancy?
These hormones alter gastric emptying and smooth muscle contractions leading to reflux and N/V - also cause constipation
What is the caloric intake range for pregnant people?
2200-2500
How much protein do pregnant people need?
60g/day
What is the ideal BMI range for a pregnant person?
BMI of 20-24.9
What is the amount of weight gain expected in a pregnancy?
25-35 pounds
When does most weight gain happen in a pregnancy?
2nd and 3rd trimester
What is the recommended amount of Calcium and iron needed daily in pregnancy?
Ca: 1000 mg
Iron: 27mg
What does the foramen ovale do in a fetus and what does it become when the fetus is born?
- It is the open flap that allows blood to flow from the right atrium to the left atrium
- It becomes the fossa ovale
What does the ductus arteriosus do in a fetus inside the womb?
allows blood to flow from the pulmonary trunk to the aorta to keep it out of the lungs (because blood would damage the capillaries)
What does the ductus venosus do in a fetus in utero?
It allows oxygenated blood from the placenta to bypass the liver and go tot the right atria
What happens to the ductus arteriosus and ductus venosus after the fetus is birthed?
The close via sphincter muscles and become random ligaments
The placenta is fully developed by the end of what trimester?
1st
What do the umbilical veins do (think hard on this one)?
Carry oxygenated blood FROM the placenta TO the fetus
What is the role of the umbilical arteries?
Carry blood FROM the fetus - TO the placenta
Fetal blood has a 50% higher __________ concertation compared to adults?
Hemoglobin
Fetal blood can bind and carry ____-____% more O2 than adult blood?
20-30%
The hCG hormone is detectable in the urine how many days after feralization?
12-15 days
The hCG hormone is detectable in the blood how many days after feralization?
6-8 days
Most rapid pregnancy test detect hCG in levels as low as _____-_____?
25-30
If the hCG doesn’t double every 1-2 days the pregnancy is likely ______?
abnormal
Very high hCG levels in a pregnancy indicate what?
Molar pregnancy or gestational trophoblastic disease (rare tumors that grow in utero)
What is gestational trophoblastic disease
Trophoblast (placenta like cells) grow abnormally into faux placenta; this causes the pregnancy to not be viable and does not grow a fetus or baby
Body water increase is the most significant pregnancy’s change and increases by ___-____Liters of water?
6.5-8.5L
What can the excess body water in pregnancy’s cause in the pregnant person?
Dilution anemia
What hormone impacts the physiology of the cardiovascular system in pregnancy, and what are the 2 main effects?
Estrogen
1. 40% increase in cardiac output (which is SV x HR)
2. Drop in blood pressure
Increased intervascular pressure in the 2nd and 3rd trimesters can cause what two outward signs in pregnant pt?
- Varicose veins
- Hemorrhoids
What 3 physiological changes are seen in the lungs in pregnancy?
- Low PaCO2
- Low blood gas
- Respiratory alkalosis
What kidney issue is common in pregnancy due to the dilation of ureters, and what side is it most common on?
Hydronephrosis (swollen kidneys due to urine build up)
Right side
What happens to BUN and creatinine in pregnancy?
They are reduced
What happens to the GFR in pregnancy?
Increased
What hormone causes insulin resistance in pregnancy?
Human Placental Lactogen hormone
An increase in free fatty acids usually happens when?
2nd and 3rd trimester
A rise in WBC during pregnancy is normal. What is the range at which this increase can happen?
5,000-12,000 increase from NL levels
What state are pregnant people in that put them at risk for a bunch of issues?
Hypercoagulable state (clot easily-coincidentally this is great for avoiding hemorrhage during birth, but bad for literally every other day of the week)
What is Cholasma, n anatomical pregnancy change?
Darken skin patches of the face, called the “Mask of pregnancy”
What is Linea Nigra and what causes it?
Its the dark line pregnant people get from their belly button to their lower pelvic region, caused by estrogen (BC can cause this in non-pregnant PT)
What is Chadwick’s sign?
Blue tinge of cervix and vagina
What is Goodell’s sign?
Softening of cervix
What are the three ANATOMICAL cardiovascular changes in pregnancy?
- PMI displaced
- systolic flow murmur
- Venous hum: sounds like bruit and is due to increase flow to breasts
What is Leukorrhea?
An increased amount of milky white discharge that’s totally normal
