OB/Repro Exam 1 Flashcards
ovarian cycle - follicular phase
- starts day 1 of menstruation
- one dominant follicle
- estrogen
ovarian cycle - ovulatory phase
- LH surge triggers ovulation on day 14
- fertile window: 5 days before ovulation - the day after ovulation (sperm live for 5 days)
ovarian cycle - luteal phase
- corpus luteum
- progesterone
endometrial cycle - proliferative phase
- estrogen causes endometrium to thicken
endometrial cycle - secretory phase
- progesterone
endometrial cycle - menstruation
- occurs due to change in hormones
- endometrial tissues sloughs & is expelled
neural tube closes at
week 4
fetus most susceptible to teratogens
first 8 weeks
heart tones heard on a doppler
week 12
testosterone becomes present
week 8, if not by week 10 then develops into F
lungs begin to produce surfactant
week 24
function of the placenta
- serves as a barrier between maternal and fetal blood
- nutrient & electrolyte exchange
purpose of preconception counseling
- enhance health prior to pregnancy
- provide anticipatory guidance
why is folic acid supplementation important
- prevent neural tube defects/spina bifida
presumptive s/s of pregnancy
probable/positive s/s of pregnancy
- missed period
- nausea
- breast tenderness
- urinary frequency
- fatigue
- quickening (fetal movement)
probable s/s of pregnancy
objective s/s perceived by HCP, can have other causes, not diagnostic
- chadwick’s sign (bluish discoloration of uterus due to increased vascularization)
- uterine/abdominal growth
- positive pregnancy test
positive s/s of pregnancy
objective, noted by HCP, can only be attributed to fetus
- fetus visualized by ultrasound (4-5 weeks)
- fetal heart tones (10-12 weeks)
- fetal movement (20 weeks)
GTPAL
G: gravida - total # of pregnancies
T: term - total # of term pregnancies
P: preterm - total # of preterm pregnancies
A: abortion - total # of abortions (before 20 weeks)
L: living - total # of living children
gravida & para
gravida: total # of pregnancies
para: total # of births after 20 weeks
fundal height measurement
- 36-38 weeks: fundus right up under sternum
- 40 weeks: fundus drops below 38 week level (dropping down into pelvis)
nuchal translucency test
- week 11-13
- assess fluid behind neck of fetus
- enlarged = chromosomal abnormalities or neural tube defects
anatomy ultrasound
week 20
gestational diabetes screening
week 24-28
rh
routinely given at week 28
GBS
week 35-37
cardiovascular changes
- increase blood volume by 50%
- increase HR, WBC, & RBC
- increased venous pressure & decreased blood flow to extremities results in varicose veins, hemorrhoids, edema
respiratory changes
- physiological dyspnea
- increased resp rate & O2 consumption
renal changes
- increased renal blood flow leads to urinary frequency
GI changes
- changes in metabolism lead to N/V
- increased progesterone relaxes smooth muscle leading to bloating, constipation, gas
integumentary changes
- increased melanin (linea nigra, malasma)
- increased blood flow & metabolic rate can lead to hot flashes, sweating, facial flushing
ultrasound
- done to confirm pregnancy
- evaluate fetal presentation, anatomy, amniotic fluid volume, placental position, cardiac activity, gestational measurements
- assess blood flow through uterine vessels
non-stress test
- monitor FHR patterns/accelerations for 20 mins as indication of fetal well-being
- reactive: FHR increases 15 beats above baseline for 15 seconds 2 times+ in 20 mins
amniocentesis
- *most common; used to look for intrauterine infection, hemolytic disease, fetal lung maturity
- week 15-20, results in 2 weeks
- needle inserted through abdomen to collect amniotic fluid
chorionic villus sampling
- aspiration of placental tissue for chromosomal, metabolic, & DNA testing
- week 10-13, results in 1 week
- catheter inserted through cervix or abdominally to assess placenta
importance of thyroid hormone
- pts w hypothyroidism will need up to 30% increased doses
- maternal thyroid hormone is important for fetal CNS dev in early pregnancy
hyperemesis gravidarum
- severe N/V that leads to dehydration
- may need hospitalization for IV hydration & correction of electrolytes
cervical insufficiency
- inability for cervix to retain a pregnancy
-“premature cervical dilation” - painless cervical dilation before 24 weeks
- difficult to diagnose, more likely if cervical trauma or LEEP procedure
preterm labor & birth
- leading cause of neonatal mortality
- most common reason for hospitalization during pregnancy
- tocolytic drugs can prolong birth up to 48 hours (given steroids to promote surfactant)
preterm premature rupture of membranes (PPROM)
- rupture of membranes before onset of labor & 37 weeks
- usually secondary to ascending infection, but cause is usually unknown
gestational diabetes
- tested 24-28 weeks
preeclampsia
- hypertension & proteinuria
- asymptomatic or HA, blurred vision, N/V, RUQ pain, hyperreflexia, angioedema
- magnesium sulfate as seizure precaution
placenta previa
- placenta attaches over/near cervical opening
- hemorrhage risk to mom
- presents as painless vaginal bleeding in 3rd trimester
placental abruption
- sudden onset of intense localized uterine pain
- placenta separates from uterine wall before baby is born
ectopic pregnancy
- pregnancy that occurs outside uterus, usually fallopian tube
- increased risk in pts with PID
- can result in tubal rupture & intense bleeding
- pelvic/abdominal pain esp unilaterally
- can be managed with methotrexate in early pregnancy (unruptured)
HELLP syndrome
- Hemolysis, Elevated, Liver enzymes, Low, Platelet levels
- RUQ pain
(liver enzymes increase due to ischemia to liver causing RUQ pain) - only definite cure is immediate delivery
