OB Test 4 Flashcards
An abortion is any fetal loss before ___
The third trimester
What screenings are done at the first visit?
H&H Blood type, Rh type and antibody screen HCG levels STIs (including HIV) Cervical cancer screen
What are the numbers for healthy fetal kick counts?
Up to 10/hr during 7th month… slows slightly towards 38-40 weeks (10 in 2h?)
How often are antepartum visits?
Once a month until 28 weeks.
Twice a month until 36 weeks.
Four times a month (weekly) until delivery.
What is an operculum?
Mucus plug - seals cervical canal during pregnancy.
When does quickening occur?
Primips: 18-20w
Multips: 16+ weeks
How to figure out fundal height?
Correlates with weeks of gestation (cm above pubis) between 22-34 weeks (fetal weight variations change it after that).
VOID before measuring. Same person, same position each time.
How early can colostrum be expressed?
As early as 16 weeks
Respiratory system changes
Tidal volume increases (increases hyperventilation) which causes respiratory alkalosis.
Vital capacity increases slightly; compliance and pulmonary diffusion stay the same.
Flared rib cage, increased chest circumference, thoracic breathing.
Nasal stuffiness (“rhinitis of pregnancy”)
Nosebleeds (vascular congestion/edema of nasal mucosa r/t estrogen).
True or false: pregnancy can cause a) estrogen-induced edema, b) hypersecretion of mucus, and c) vascular congestion of the nasal mucosa?
True
True or false: pregnancy can cause a) a change in white blood cell production, b) reduction in total fluid volume
False
When will shortness of breathing related to pregnancy improve?
The last few weeks, as lightening occurs.
Changes to the cardiovascular system
- Blood volume increases (plasma and erythrocytes)
- cardiac output increases
- pulse rate can increase up to 15bpm.
- blood pressure decreases. (Lowest point = 2nd trimester).
- Orthostatic hypotension d/t multiple factors (including lower albumin, increased femoral venous pressure and dependent edema
What is supine hypotensive syndrome (vena cava syndrome)?
Decrease in BP; pallor, dizziness, clamminess that occurs as a result of pregnant woman lying on back.
What is the ‘physiologic anemia of pregnancy’?
As plasma volume increases, hematocrit decreases (relative)
What happens with leukocyte production in pregnancy?
Increases - during labor and postpartum, can raise to 25k.
What happens to fibrin levels during pregnancy? Why is this a problem?
Fibrin levels increase during pregnancy.
DVT risk
What hormone causes nausea/vomiting during first trimester?
HCG
What happens to gums in pregnancy?
They can also get increased blood flow and be prone to bleeding
What are common GI symptoms in pregnancy?
- Excessive salivation
- Heartburn (d/t displacement of stomach/intestines)
- hemorrhoids
- GALLbladder stasis (gallstone formation)
- Bloating (stasis d/t progesterone = smooth muscle relaxation)
- constipation (Stasis d/t progesterone = smooth muscle relaxation)
What is the normal temp range during pregnancy?
97-99.6
What are normal urinary changes during pregnancy
Increased need to urinate in 1st and 3rd trimesters
- UTIs (increased amino acids and glucose in urine + urethral atonía + ureter stasis)
- possible glycosuria (should still check it out, but not uncommon).
What causes increased skin pigmentation?
Increased levels of estrogen and progesterone increase alpha-melanocytes.
What does relaxin and progesterone do to the joints? Which joints?
Sacroiliac, sacrococcygeal, pubic joints - relax in the later part of pregnancy. Leads to waddling gait.