Pregnancy

Question 1

Facts

Answer 1

1. Usually lasts 40 weeks or 9 months
2. Measured from the last menstrual period to birth
3. Divided into 3 segments called trimesters
4. Gravida indicates the numbers of times a woman is or has been pregnant
5. Parity indicates the number of births where pregnancy’s have reached viable gestational age

Question 2

Trimesters - months - weeks

Answer 2

1. 1st - 1, 2, 3 - 0-12
2. 2nd - 4, 5, 6 - 13-17
3. 3rd 7, 8, 9 - 28-40

Question 3

Key hormones of pregnancy

Answer 3

1. Human chronic gonadotropin
2. Progesterone
3. Oestrogen
4. Prolactin
5. Relaxin
6. Oxytocin

Question 4

HCG

Answer 4

1. Produced by the placenta after implantation
2. Supports the function of the corpus Luteum which is a temporary structure in the ovaries essential in early pregnancy
3. The hormone affected by pregnancy tests

Question 5

progesterone

Answer 5

1. Helps establish the placenta
2. Stimulates growth of blood vessels that supply the womb and inhibits contraction of the uterus so it grows like the baby
3. Strengthen the pelvic wall muscles for labour

Question 6

Oestrogen

Answer 6

1. Helps uterus grow, maintains its lining and heps foetal organs develop
2. Activates and regulates production of other hormones
3. Stimulates breast growth and milk duct development

Question 7

Prolactin

Answer 7

1. Main hormone needed to produce breast milk
2. Contributes to enlargement of the mammary glands and prepares them for mik production
3. Inhibits lactation during pregnancy

Question 8

Relaxin

Answer 8

1. Inhibits uterus contraction to prevent premature birth
2. Relaxes blood vessels increasing blood flow to the placenta and kidneys
3. Relaxes the joints of the pelvis and softens and lengthens the cervix during birth

Question 9

Oxytocin

Answer 9

1. Oxytocin levels rise at the start of labour stimulating contractions of uterine muscle
2. Triggers production of prostaglandins which increases contractions further
3. If labour doesn’t start naturally it can be used to induce it

Question 10

The corpus luteum

Answer 10

1. Yellow hormones secreting body in the female reproductive system
2. Formed in an ovary at the sit of a follicle or sac that has matured and released its ovum in the ovulation process

Question 11

Pituitary gland

Answer 11

1. Small pea sized gland located at the base of your brain below your hypothalamus
2. Sits in its own little chamber under your brian known as the sella turcica
3. Part of the endocrine system and oversees making several essential hormones

Question 12

Week 1-2

Answer 12

1. The first week of pregnancy starts with the first day of a womans menstrual period where she is not yet pregnant
2. During the end of the seconded week an egg is released from an ovary and this is when you are most likely to conceive if you have unprotected intercourse
3. Hormones begin to change

Question 13

Week 3

Answer 13

1. During intercourse sperm enters the vagina after the man ejaculates
2. The strongest sperm will travel through the cervix into the fallopian tubes
3. A single sperm and the ovum meet in the fallopian tube
4. When the single sperm enters the ovum conception occurs
5. The combined sperm and ovum is called a zygote
6. The zygote contains all of the genetic information needed to become a baby
7. Half the dna comes from the mothers ovum and half from the fathers sperm
8. Development begins on the day of fertilisation when the single sperm penetrates the ovum
9. The zygote spends the next few days travelling down the fallopian tube
10. It divides to form a ball of cells called blastocysts

Question 14

Blastocysts

Answer 14

1. A blastocyst is made up of an inner cell mass with an outer cell
2. The inner cell mass forms within the blastocyst prior to its implantation within the uterus
3. The inner cell mass will become the embryo
4. The embryo develops into the foetus
5. The outer layer of cells is called the trophoblast
6. This will become structures called membranes which nourish and protect the embryo

Question 15

Trophoblast

Answer 15

1. The cells that form the outer layer of a blastocyst which provides nutrients to the embryo and then develop into a large part of the placenta
2. Trophoblast invasion is the critical process in the establishment of a successful pregnancy

Question 16

Decidua

Answer 16

1. The thickened superficial endometrial layers within the uterus becomes the decidua
2. The specialised layer of endometrium that forms the base of the placenta bed

Question 17

Week 4

Answer 17

1. The ectoderm – becomes baby’s nervous system, brain, hair and skin
2. The endoderm – becomes the gut and other internal organs
3. The mesoderm – develops into the skeleton, blood systems and muscle

Question 18

Week 5

Answer 18

1. The start of the ‘embryonic period’ where all the major systems and structures develop
2. The embryos cells multiply and start to take on specific functions and this is called differentiation
3. Blood cells, kidney cells and nerve cells all develop
4. The embryo grows rapidly and the external features in the foetus begin to form
5. The brain, spinal cord, heart and gastrointestinal tract begin to develop
6. It is during the first trimester that the foetus is most at risk for damage from things that may cause birth defects and this includes certain medications, illegal drug use, heavy alcohol use, infections like rubella and other factors

Question 19

Signs and symptoms

Answer 19

1. Missed periods
2. Tender breasts
3. Morning sickness
4. Hunger
5. Frequent urination
6. Pregnancy can be confirmed with a pregnancy test which checks the levels of hcg in the blood/urine
7. High levels of hcg are thought to be a cause of hyperemesis gravidarium

Question 20

Birth defects

Answer 20

1. Certain medications
2. Illegal drug use
3. Heavy alcohol
4. Infections

Question 21

Physical signs of pregnancy

Answer 21

1. Missed menstrual period
2. Implantation bleeding that occurs at implantation of the embryo in the uterus during the 3rd or 4th week after last menstrual period
3. Increased basal body temperature sustained for over two weeks after ovulation
4. Chadwicks sign – darkening of cervix, vagina and vulva
5. Goodells sign – softening of the vaginal portion of the cervix
6. Hegars sign – softening of the uterine isthmus
7. Pigmentation of the inea alba
8. Darkening of the nippled and areolas due to an increase in hormones

Question 22

Week 8 - embryo

Answer 22

1. Arms and legs have grown longer
2. Hands and feet begin to form and look like little paddles and fingers begin to develop
3. Electrical activity begins in the developing brain and nervous system
4. The lungs start to form
5. The embryo now has a four chambered hear
6. In the heart the valves between the atria and ventricles have formed
7. Blood is being pumped through the umbilical cord to and from the embryo
8. The bluish amniotic sac surrounds the embryo and the fluid within it protects the embryo
9. The vertebral column is developed and visible but is composed of cartilage at this stage

Question 23

Week 11-14 - foetus

Answer 23

1. Eyelids fuse together and do not reopen until around the 28th week
2. The face is well formed, limbs are long and thin
3. Nails appear on the fingers and toes
4. Genitals appear
5. The liver is making red blood cells
6. They begin to swallow amniotic fluid which they excrete through the urinary system
7. The head is very large about half the size of the foetus and the rain starts regulating the heart beat which has been beating independently of the nervous system up until now
8. Tooth buds appear for the baby teeth
9. The foetus begins small, random movements
10. During the dirts trimester the possibly of a miscarriage is at its highest

Question 24

Week 19-21

Answer 24

1. The foetus can hear
2. The oil glands in the skin called sebaceous glands begin to work
3. The foetus is more active and continues to move and float around
4. The mother may feel fluttering in the lower abdomen which is called quickening
5. The foetus at this stage has the reflex ability to suck, swallow and grasp whilst possibly experiencing hiccups

Question 25

Week 27-30

Answer 25

1. The brain grows rapidly
2. The nervous system is developed enough to control some body functions
3. Eyelids can open and close, eyelashes and eyebrows are present and the foetus has a good head of hair
4. The respiratory system while immature produces surfactant which helps the air sacs fill with air
5. The thin, red, wrinkled skin of the foetus is covered with a white substance called vernix caseosa that protects the skin from drying action of the amniotic fluid

Question 26

Pre term infants - mortality

Answer 26

1. At 28 weeks more than 90% of babies can survive outside of the uterus if provided with high quality medical care
2. Babies born at this time will likely experience serious health complications such as heart and respiratory problems and long term intellectual and developmental disabilities

Question 27

Week 35-37

Answer 27

1. Lanugo disappears from the face but remains on the head
2. The foetus keeps gaining weight but will possibly not get much longer
3. Muscle tone is developed and the foetus can turn and lift its head
4. The skin is not as wrinkled as fat forms under the skin
5. The foetus has fully formed limbs with fingernails and toenails
6. Definite sleeping patterns are now evident
7. The heart, lungs and blood vessels are complete
8. Muscles and bones are fully developed
9. The foetus has soft earlobes with little cartilage

Question 28

Common pregnancy symptoms

Answer 28

1. Tiredness
2. Morning sickness
3. Braxton hicks contractions – occasional, irregular and often painless contractions that occur several times per day
4. Peripheral oedema can be caused by inferior vena cava syndrome resulting from compression of the inferior vena cava and pelvic veins by the uterus leading to increased hydrostatic pressure in lower extremities
5. Low blood pressure often caused by compression of both the inferior vena cava and the abdominal aorta
6. Increased urinary frequency caused by increased intravascular volume and compression of the bladder by the expanding uterus
7. Urinary tract infection
8. Constipation
9. Varicose veins caused by relaxation of the venous smooth muscle and increased intravascular pressure
10. Haemorrhoids which are swollen veins at or inside the anal area caused by impaired venous return, straining associated with constipation, or increased intra-abdominal pressure in later pregnancy
11. Regurgitation, heartburn and nausea caused by relaxation of the cardiac sphincter
12. Stretch marks
13. Breast tenderness
14. melasma which is discolarisation
15. back pain
16. pelvic girdle pain

Question 29

3rd trimester

Answer 29

1. The uterus takes up much of the abdomen
2. The correct position of the uterus for pregnancy is anteverted and antexlefted

Question 30

complications

Answer 30

1. Urinary tract infections
2. Hypertension
3. Gestational diabetes
4. Obesity and weight gain
5. Mental health conditions
6. Iron deficiency
7. Anaemia
8. Deep vein thrombosis
9. Obstetric cholestasis – itching
10. Hypermesis gravidarum – severe nausea and vomiting
11. Infections

Question 31

Screening tests for mother

Answer 31

1. FBC
2. Group and screen
3. MSU
4. Infectious diseases – hiv, hep b, syphillis
5. Thalassemia screening
6. GDS
7. Chlamydia

Question 32

Screening tests for foetus

Answer 32

1. Trisomy - downs, Edwards, pataus syndrome
2. Higher risk screening
3. Counselling

Question 33

Screen tests for baby

Answer 33

1. NIPE performed within the first 72 hours of birth and again at 6 weeks and focuses on abnormalities of eyes, heart, hips, tests in males and general appearance
2. Newborn blood spot test

Question 34

Common problems

Answer 34

1. Spotting or light bleeding
2. Constant vomiting
3. Leaking fluid
4. Painful urination
5. Persistent severe headache
6. Swelling in face, hands or legs
7. Contractions or cramps
8. Itching
9. Sharp or continuing abdominal pain
10. Pelvic pain
11. Blurred vision
12. Baby movements slow
13. High temperature