OB - Exam 2 - Concepts/Vocab

Question 1

Quickening

Answer 1

• Maternal perception of fetal movement for the first time, occurring usually in 16th-20th week of pregnancy
• Commonly described as flutter, difficult to distinguish from peristalsis
• Fetal movements gradually increase in intensity and frequency
  (p. 294)

Question 2

Presumptive indicators of pregnancy

Answer 2

Subjective symptoms (reported by the woman): amenorrhea, nausea and vomiting (morning sickness), breast tenderness, urinary frequency, fatigue

Objective signs (validated by examiner): elevation of basal body temperature (BBT), breast/abdominal enlargement, changes in uterus and vagina

Visible changes in skin: striae gravidarum, deeper pigmentation of areolae, chloasma (mask of pregnancy), linea nigra (pigmented line on abdomen)
(p. 330)

Question 3

Lunar months

Answer 3

4 weeks/28 days
Pregnancy lasts 10 lunar months (same as 40 weeks or 280 days)
(p. 330)

Question 4

Probable indicators of pregnancy

Answer 4

Detected by the examiner and related mainly to physical changes in uterus
- Uterine enlargement, Braxton Hicks contractions, placental souffle (sound of blood passing through placenta), balottement (examiner is able to feel fetus float during vaginal exam), positive pregnancy test

Question 5

Positive indicators of pregnancy

Answer 5

Directly attributed to the fetus

• Fetal heartbeat distinct from that of mother
• Fetal movement felt by someone other than mother
• Visualization of fetus with technique such as ultrasound

Question 6

Trimesters and sexual desire

Answer 6

Sexual expression is highly individual but generally:

First trimester - sexual desire may decrease
- Breast tenderness, nausea, fatigue, sleepiness

Second semester - increased desire for sexual release
- Sense of well-being combined with increased pelvic congestion

Third semester - Diminished sexual interest
- Somatic complaints, physical bulkiness leads to physical discomfort

Question 7

Emotional attachment process

Answer 7

Phase 1 - woman accepts biologic fact of pregnancy

• Woman needs to be able to state “I am pregnant” and incorporate idea child into body and self image
• Child is viewed as part of herself, not separate person

Phase 2 - Accepts fetus as separate (usually by 5th month)
- Beginning of mother-baby relationship

(Quiet period with hearing heartbeat, feeling child move - more introspective/(withdrawn?) - fantasy child imagined - partner may feel left out)

Phase 3 - woman prepares realistically for birth and parenting
- “I am going to be a mother” - may speculate on personality traits (based on fetal activity), or childs nature and characteristics

Question 8

Emotional response phases for man becoming father

Answer 8

Announcement phase - lasts few hours to few weeks

• Task: Accept biological fact of pregnancy
• Reaction depends on if pregnancy is desired, planned, unwanted
• If unplanned/unwanted, poor coping can lead to extramarital affairs or initiate/escalate battering partner

Second phase - moratorium phase

• Adjusts to reality of pregnancy
• Task: Accept the pregnancy
• Become more introspective
• May be short or persist until last trimester depending on man’s readiness

Focusing phase

• Task: negotiate role played in labor and prepare for parenthood
• Begins in last trimester
• Characterized by father’s active involvement in pregnancy and relationship with child

Question 9

Major concerns for man during pregnancy

Answer 9

• Getting woman to health care facility in time for birth

- Not wanting to appear ignorant

Question 10

Schedule for prenatal visits

Answer 10

• Initial visit first trimester
• Monthly visits weeks 16 through 28
• Every two weeks from weeks 29 through 36
• Weekly visits week 36 to birth

(Box 15-3)

Question 11

Occupational hazards with pregnancy

Answer 11

• Heavy lifting, exposure to chemicals, radiation - negatively affect pregnancy
• Standing for long periods of time - orthostatic hypotension
• Sitting at a desk working on a computer - carpal tunnel syndrome and circulatory stasis in legs

Question 12

Trimesters of pregnancy

Answer 12

First: weeks 1-13
Second: Weeks 14-26
Third: Weeks 27-40

Question 13

Supine hypotension

Answer 13

Low blood pressure that occurs when woman is lying flat on her back, causing feeling of faintness

Question 14

Five factors affecting labor and birth

Answer 14

5 Ps:
Passenger (fetus and placenta)
Passageway (birth canal)
Powers (contractions)
Position of the mother
Psychologic response

Question 15

Presentation

Answer 15

Part of the fetus that enters the pelvic inlet first and leads through te birth canal during labor

3 main presentations:
Cephalic (head first) - 96% of births
Breech (buttocks/feet/both first) - 3% of births
Shoulder - 1% of births

Question 16

Placental souffle

Answer 16

Sound of blood passing through the placenta
Objective, probable sign of pregnancy
(p. 330)

Question 17

Couvade syndrome

Answer 17

Man experiencing “pregnancy-like” symptoms, such as nausea, weight gain, and other physical symptoms
(p. 333)

Question 18

Informed consent for drug testing

Answer 18

Mom has to consent, but baby can be tested without consent

Question 19

Periodic changes

Answer 19

Occur with UCs

Question 20

Episodic changes

Answer 20

Not associated with UCs

Question 21

Tachysystole

Answer 21

Too many contractions - >5 in 10 min, averaged over 30 min window