Pregnancy

Question 1

When do the terminal villi form?

Answer 1

▪️20 weeks

Question 2

When does the fetal skin become impermeable?

Answer 2

▪️16 weeks

Question 3

Amniotic fluid

Answer 3

▪️produced by fetal urine
▪️swallowed and bathes lungs
▪️increases to peak of 800ml at 30 weeks
▪️reduces to 400ml at 40/42 weeks

Question 4

Limb formation

Answer 4

▪️4-13 weeks

▪️fetal movements from 16-24 weeks and increases from 25 weeks

Question 5

When is suckling observed in an foetus?

Answer 5

▪️17 weeks

Question 6

When does hair begin to grow in a foetus?

Answer 6

▪️20 weeks

Question 7

When is rotation and herniation of the gut complete?

Answer 7

▪️12 weeks

Question 8

When do kidneys begin to produce urine?

Answer 8

▪️16 weeks

Question 9

Renal development complete at?

Answer 9

▪️36 weeks

Question 10

When does external genitalia appear?

Answer 10

▪️12 weeks

Question 11

Primiparous

Answer 11

▪️fist pregnancy

Question 12

Multiparous

Answer 12

▪️subsequent pregnancies

Question 13

Gradidity

Answer 13

▪️number of times been pregnant

Question 14

Parity

Answer 14

▪️number of pregnancies beyond 20 weeks

Question 15

G3P1

Answer 15

▪️G- gravidity, been pregnant 3 times

▪️P- parity, 1 pregenacy beyond 20 weeks

Question 16

3 Trimesters

Answer 16

▪️1- <12 weeks
▪️2- 12-24weeks
▪️3- >24 weeks

▪️term 37-40 weeks
▪️preterm <37 weeks
▪️post term >40 weeks

-pregnancies not allowed to go beyond 42 weeks

Question 17

Calculating an estimated due date (EDD)

Answer 17

▪️LMP- last menstrual period

▪️CRL- cranial rump length

Question 18

Nutritional advice for pregnant women

Answer 18

▪️folic acid 400mcg - prevents spina bifida
▪️multivitamins- not VA- toxic in excessive amounts
▪️minimal increase in calories (300Kcal)
▪️stop smoking and alcohol

Question 19

Physiological changes in pregnancy

Answer 19

▪️Resp
-increased tidal vol, respiratory rate 
-max inspiratory vol in 3rd rimester reduced 
▪️GI
-delayed gut motility 
-constipation 
-increased ALP (release of phosphate for mineralisation of bone)
▪️Renal
-increased blood flow, GFR
-proteinuria <30mg
-glycosuria 
▪️skeletal 
-osteopenia 
-increased osteoblasts activity 
▪️CVS
-increased HR, SV, CO, blood volume 
-common iron deficiency

Question 20

Hormonal changes of pregnancy

Answer 20

▪️progesterone
-uterine dormancy
-thickens cervical mucus
▪️oestrogen
-thickens vaginal epithelium and vaginal discharge (acidic)
-increases prostaglandin production and oxytocin receptors
▪️relaxin
-softens ligaments/ joints instability (relax pelvis for labour)
-vasodilation

Question 21

When does labour start?

Answer 21

▪️painful uterine contraction >1in 10 minutes

▪️descent of the presenting part of foetus

Question 22

Oxytocin receptor and Calcium importance in labour

Answer 22

▪️up regulates calcium channels

▪️calcium influx tracellular release from sarcoplasmic reticulum (SR) causing smooth muscle contraction

Question 23

Stages of labour

Answer 23

▪️1st
-latent phase- up to 3cm dilated 
-active phase- from 3cm to 10cm 
▪️2nd
-from full dilation to delivery of foetus 
▪️3rd 
-from birth to delivery of placenta

Question 24

Breast and lactation

Answer 24

▪️oestrogen promotes fat deposition and glandular ducts
▪️progesterone and hPL increases alveoli
▪️prolactin increases in pregnancy but it affects are inhibited by oestrogen
▪️after birth oestrogen and progesterone levels fall therefore lifting the inhibition
▪️suckling stimulates prolactin and oxytocin release
-P-promotes alveoli filling with milk
-O-causes ejection of milk