Physiologic changes during pregnancy

Question 1

Goodell sign

Answer 1

Significant softening of the vaginal portion of the cervix from increased vascularization (earlobe-like consistency)

Question 2

Chadwick sign

Answer 2

Increased vascularity to cervix and vagina causes the vaginal walls to appear bluish purple

Question 3

Changes in the ovaries

Answer 3

Increased release of estrogen and progesterone

Question 4

a. Term for thick, yellowish fluid discharge from breasts

b. When does it usually start appearing?

Answer 4

a. Colostrum

b. As early as 16 weeks

Question 5

Position of heart during the third trimester

Answer 5

Heart is pushed upward and to the left

Question 6

a. Blood volume increase begins at how many weeks of gestation?
b. Blood volume increase reaches up to how many percentage?

Answer 6

a. 6 weeks of gestation

b. 30-45%

Question 7

Heart sounds (2 answers)

Answer 7

a. Splitting of first heart sound

b. Presence of S3

Question 8

Dilution of RBCs leads to a phenomenon called?

Answer 8

Physiologic anemia of pregnancy / Pseudoanemia of pregnancy

Question 9

a. Cardiac output increases by how many percent?
b. At what position of the pregnant woman is the CO highest?
c. At what position of the pregnant woman is the CO lowest?

Answer 9

a. 30-50%
b. Side-lying position
c. Standing, supine

Question 10

3 groups of pregnancy signs and symptoms

Answer 10

1. Presumptive signs
2. Probable signs
3. Positive signs

Question 11

Presumptive signs

a. Mini-description
b. Signs and symptoms (from TCNB)

Answer 11

a. Changes felt by the woman that are SUBJECTIVE. Not a definite pregnancy diagnosis

b. P.R.E.S.U.M.E.D.
- period absent (amenorrhea)
- really tired
- enlarged breasts
- sore breasts
- urination increased (urinary frequency)
- movement perceived (quickening): difficult to differentiate from peristalsis or gas
- emesis & nausea
- drawings on face, abdomen (linea nigra, melasma, striae gravidarum)

Question 12

Probable signs

a. Mini-description
b. Signs and symptoms (from TCNB)

Answer 12

a. Pregnancy signs that can be observed by a nurse or doctor

b. P.R.O.B.A.B.L.E.
- positive pregnancy test (high hCG levels); not guaranteed pregnant because high hCG can be caused by other conditions (medications, molar pregnancy)
- returning of fetus when uterus is pushed with fingers (ballottement)
- objective
- Braxton-Hicks contractions (painless practice contractions)
- a softened cervix (Goodell’s sign)
- bluish color of vulva, vagina, or cervix (Chadwick’s sign)
- lower uterine segment soft (Hegar’s sign)
- enlarged uterus

Question 13

Positive signs

a. Mini-description
b. Signs and symptoms (from TCNB)

Answer 13

a. Can only be attributed to a fetus (definite diagnosis for pregnancy)

b. F.E.T.U.S.
- fetal movement palpated by doctor or nurse
- electronic device detects heart tones
- the delivery of the baby
- ultrasound detects baby
- seeing visible movements

Question 14

Use of prolactin hormone (from TCNB)

Answer 14

Allows for breast milk production

Question 15

Use of estrogen hormone (from TCNB)

Answer 15

Growth of fetal organs & maternal tissues

Question 16

Use of progesterone and relaxin hormones (from TCNB)

Answer 16

Relaxes smooth muscles

Question 17

Use of progesterone hormone (from google; 2 answers)

Answer 17

• Thickens endometrium after ovulation to be able to accept a fertilized egg
• Prohibits muscle contractions in uterus that would cause the body to reject an egg

Question 18

Use of hCG hormone (from TCNB)

Answer 18

Produced by placenta, prevents menstruation

Question 19

Use of oxytocin hormone (from TCNB)

Answer 19

Stimulates contractions at the start of labor