PREGNANCY Flashcards
STAGES OF FERTILIZATION
DAY 1 - FERTILIZATION
DAY 2 - FIRST CELL DIVISION (ZYGOTE)
DAY 3 - MORULA
DAY 4 - BLASTOCYSTS
Abdominal palpation to estimate fetal size, locate fetal back and parts and determine fetal position and presentation
LEOPOLD’S MANEUVER
Materials for Leopolds Maneuver
1.Drape/Linen
2.Pillows
3.Tape Measure
4.Stethoscope
5.Watch
To determine what part of the baby lies in the upper part of the uterus.
FIRST MANEUVER
To determine what part of the baby lies in the upper part of the uterus.
FIRST MANEUVER
To determine in which side of the uterus of the baby’s back is located.
SECOND MANEUVER
To determine what occupies the lower uterine segment and to determine wheter its engaged or not.
THIRD MANEUVER (Fetal Engagement)
Locates the fetal presenting part and evaluates its descent into the pelvis. This helps determine the degree of engagement and the station of the fetus in the birth canal.
FOURTH MANEUVER
Normal Fetal Heart Rate
120- 160 bpm
12- 10 weeks
DOPPLER
a medical tool called a Doppler ultrasound, which is used to assess blood flow through various vessels in the body, including those in the fetus and placenta during pregnancy. It works by emitting high-frequency sound waves that bounce off moving blood cells, producing echoes that are then processed to create a picture of blood flow.
DOPPLER
18-20 weeks
STETHOSCOPE
28 Weeks
PALPATION OF FETAL OUTLINE
Muffled sound of the blood rushing through the umbilical vessels,beating in time with fetal heart
FUNIC SOUFFLE
Maternal pulse . Sound made by the blood in the arteries of the pregnant uterus
UTERINE SOUFFLE
Once a month up to 6 month prenatal visits
6
Twice a month (7th-8th months) Prenatal visits
4
Four times a month ( whole month of 9th months) (everyweek) PRENATAL ASSESSMENT
4
TITAL NUMBER OF PRENATAL VISITS
14
The number of times a woman has been pregnant, regardless of the outcome.
Gravida (G)
The number of pregnancies that have reached viability (usually considered to be 20 weeks gestation or more).
Para (P)
Pregnancies carried to term (37 weeks or more).
Term Deliveries ( T )
Pregnancies carried to term (37 weeks or more).
Term Deliveries ( T )
Pregnancies that ENDED between 20 and 37 weeks.
Preterm deliveries (P)
Pregnancies that ended before 20 weeks, including miscarriages and elective abortions.
Aboritons ( A )
The number of living children.
Living children (L)
For example, a woman’s OB history might be recorded as G3P2012, indicating she has been pregnant three times, had two term deliveries, no preterm deliveries, one abortion, and two living children.
Example
Any complications during pregnancy, labor, delivery, or the postpartum period.
Complications
Whether deliveries were vaginal, cesarean, or assisted (e.g., forceps or vacuum).
Mode of delivery
The weights of babies at birth.
Birth weights
The time between pregnancies.
Inter-pregnancy intervals
Any interventions like fertility treatments.
Medical interventions
PURPOSE OF OB HISTORY
Taking a thorough OB history is crucial for providing appropriate prenatal care and anticipating potential complications in current or future pregnancies.
FIRST MANEUVER
Note for:
1.Shape
2.Consistency
3.Mobility
The fetal HEAD is:
1.Firm
2.Hard
3.Moves independently
The BREECH / BUTTOCKS feel:
1.Softer
2.Moves with the trunk
The fetal back on one side of the abdomen feels:
- SMOOTH
Area that provides most audible fetal heart sounds
The fetal back on one side of the abdomen
On the opposite side of the fetal back is the
FETAL LIMBS
Fetal Limbs feel
1.Knobby
2.Bumpy
If the presenting part is fixed and cannot be easily moved, it indicates engagement.
Engaged
How can you know if it is not engaged?
If the presenting part is movable and can be pushed upwards, it indicates the baby is not yet engaged.
What is the purpose / rationale of the 3rd Maneuver or Pawlicks Grip?
1.It helps identify which part of the fetus (head or breech) is presenting at the pelvic inlet. This is crucial for understanding the baby’s position in preparation for delivery.
2. Helps healthcare providers to determine if the fetal head (or presenting part) has descended into the maternal pelvis, indicating engagement. Engagement is an important sign that labor is progressing normally.
3.Knowing the presenting part and its level of engagement assists in planning the method of delivery. For instance, if the baby is in a breech position and not engaged, alternative delivery methods, such as a cesarean section, might be considered.
4.This maneuver helps in detecting abnormal fetal presentations, such as breech or transverse lie. Early detection allows for timely medical interventions to manage these situations.
Rationale or Purposes of the 4th Maneuver?
The fourth maneuver confirms the presenting part (usually the head) by feeling how deeply it has descended into the pelvis. This is important for verifying the findings of the third maneuver (Pawlik’s Grip).
2. It assesses whether the presenting part is engaged in the pelvic inlet. Engagement is defined as the fetal head reaching or passing through the pelvic brim, which is typically at the level of the ischial spines (0 station). If the presenting part is deeply engaged, it indicates that labor is progressing and the fetus is moving into the birth canal.
Leopold’s maneuvers are typically performed in the third trimester of pregnancy, usually starting around 28 weeks gestation and continuing through the remainder of the pregnancy. They are particularly useful as the due date approaches, around 36 weeks and beyond, when the fetal position becomes more relevant for planning delivery.
.
If the hands meet close together, it indicates that the fetal head is engaged. Engagement means that the widest part of the fetal head has passed through the pelvic brim and is positioned at or below the level of the ischial spines (0 station).
Engaged Fetal Head
