OB Flashcards
Where is the site of implantation in the female reproductive system
endometrium
Where is the site of fertilization in the female reproductive system
ampulla
What hormones does the ovaries make
Progesterone
Estrogen
Hormone of pregnancy
Progesterone
Onset of manarche
9-17 yrs old (aver of 11-13 yrs old)
Interval of menses
23-35 days (aver of 28 days)
Duration of bleeding in menses
2-9 days
Normal amount of blood in menses
30-80ml (1/3 cup)
Odor of menses
marigold
Phases of Menstrual Cycle
1st Phase: Follicular, Proliperative Stage
2nd Phase: Luteal, Progestational Stage
3rd Phase: Ischemic Stage
4th Phase: Menstrual Bleeding
What hormones are released by the anterior pituitary gland during the physiology of menses
Follicle Stimulating Hormone (FSH) Lutenizing Hormone (LH)
What does FSH do in the physiology of menses
Increase estrogen -> thicken endometrium
Increase Follicular Fluid -> rupture Graafian Follicle -> OVULATION (stop release of FSH)
What does LH do in the physiology of menses
Formation of corpus luteum -> progesterone -> maintain the thickness of the endometrium (for implantation of fertilized egg)
What would happen if there is no fertilization of the egg
ovum will atrophy and corpus luteum will remain in 10 days
What would happen if there is fertilization of the egg
Pregnancy where the corpus luteum will remain for 16 wks where later on the placenta will take over the production of estrogen and progesterone
When is the fertile period
3-4 days before and after period
When is the ovulation stage
Interval of Menses - 14
S/Sx of of Ovulation
Increased body temperature (increase of 0.07-0.08 degrees C for 3 full days)
Mittelschmerz
(+) Spinbarkeit
(+) Ferning
Clear, Elastic, Thin, Slippery, and Egg White Colored Cervical Mucus
Mittelsch\merz Sign
Unilateral lower abdominal discomfort (one sided)
Spinbarkeit Sign
elasticity of cervical mucus
Ferning Sign
Palm leaf pattern under the microscope
Stages of Fetal Development
Ovum: fertilization (24hrs after sex)
Zygote: Implementation (after 1 wk)
Embryo: Organogenesis (5th-8th week of pregnancy)
Fetus: 8th week to TERM
Lecithin Sphingomyelin Ratio
Lung surfactant that matures at 36th week of gestation
2:1 for fetal lung maturity
Placenta
serves as the fetal lungs, kidneys and GIT
True or False: There is direct sharing of blood flow between mother and fetus
False
Hormones released by placenta
Estrogen
Progesterone
Human Chorionic Gonadotrophin (HCG)
Human Chorionic Gonadotrophin (HCG)
responsible for nausea and vomitting
When is the peak production of HCG
60-80th day (3rd month/end of the 1st trimester)
How many arteries and veins are in the umbilical cord?
2 arteries
1 vein
What is larger in the umbilical cord, the vein or the artery?
Vein (because it provides oxygenated blood)
How long are the arteries and veins in the umbilical cord?
21 inches
What are the purposes of the amniotic fluid?
- protects the fetus from temperature and pressure changes
- aids in muscular development
- ensures adequate oxygenation for the fetus
What is the major component of amniotic fluid?
fetal urine
When does the fetus start producing fetal urine?
12-13 wks (developed kidneys)
When is the earliest time to perform amniocentesis?
12-14 wks
Normal amount of amniotic fluid
800-1200 ml
Amount of amniotic fluid in oligohydramnios
less than 800ml
What can be a cause of oligohydramnios
there is fetal renal problem/ renal agenesis
Amount of amniotic fluid in polyhydramnios
greater than 1200ml
What can be a cause of polyhydramnios
COMPLICATION OF GDM
or caused by GI problem/esophageal atresia
Gravity and Parity
Gravity: number of pregnancies regardless of the outcome of duration
Parity: Number of deliveries that reach 20 wks gestation (age of viability) even if it is delivered dead or alive
3 Principles of Identifying Parity
- Multiple Pregnancy: twins are counted as one
- Abortion: not included
- Stillbirth: counted
GTPALM definition
Gravity Term Pre Term Abortion Living Multiple Pregnancy
When should you consider that the pregnancy is term?
37 weeks and above
When should you consider that the pregnancy is preterm?
36 weeks and below
When should you consider that the pregnancy is abortion?
less than 20 wks
True or False: You should consider twins as 1 in GTPALM
True
True or False: Term and Preterm counts the number of infants born
True
What is the method to determine the expected due date of a pregnancy
Naegele’s Rule
The formula for Naegele’s Rule for the last menstrual period from January to March
Month (+9); Day (+7); Year (blank)
The formula for Naegele’s Rule for the last menstrual period from April to December
Month (-3); Day (+7); Year (blank)
What is the expected due date of a pregnant woman with a last menstrual period of Nov 20, 2021?
August 27, 2022
What is the expected due date of a pregnant woman with a last menstrual period of February 14, 2021?
November 21, 2021
What method uses the fundic height to determine the age of gestation of the pregnancy?
Bartholomew’s Method
What is the gestation age if the fundus is in the xiphoid process?
36 wks
What is the gestation age if the fundus is in the umbilicus?
20 wks
What is the gestation age if the fundus is in the symphisis pubis?
12 wks
If the mother is in her 15 wks gestation but the fundus can be seen on the umbilicus, what can be the condition of the mother?
H. mole
If the mother is in her 35 wks gestation but the fundus can be seen above the umbilicus, what can be the condition of the mother?
SUA
What are the 3 main signs and symptoms of pregnancy?
Presumptive
Probable
Positive
What are the presumptive signs of pregnancy?
Highly Subjective signs! (PRESUME) Period absent Really tired Enlarged breasts Sore breasts Urination frequency Movement perceived (quickening) Emesis and nausea
*linea negra, striae gravidarum, melasma
When does quickening usually occur?
Primipara = 20wks Multipara = 16wks
What are the probable signs of pregnancy?
Highly Documented Signs! (PROBABLE)
Positive pregnancy test
Returning of fetus when uterus pushed w/ fingers (BALLOTTEMENT)
Outline of the fetus palpated
Braxton Hick’s contractions
A softening of the cervix (Goodell’s sign)
Bluish color of vulva, vagina and cervix (Chadwick’s Sign)
Lower uterine segment is soft (Hegar’s Sign)
Enlarged uterus
What are the positive signs of pregnancy?
Can be CONFIRMED (FETUS)
Fetal movement felt by the doctor/nurse Electronic device detects FHR The delivery of the baby Ultrasound detects the baby See visible movement
What are the common discomforts during pregnancy caused by increased HCG?
Nausea and Vomiting Heartburn (Pyrosis) Constipation Backache Lordosis Wadding gait
What are the common discomforts of pregnancy if there is increase in estrogen?
Breast tenderness
Leg varicosities and pedal edema
Hemorrhoids
Leukorrhea
What are other discomforts during pregnancy?
Leg cramps
Urinary frequency
Supine Hypotensive Syndrome
Round Ligament Pain
