pregnancy Flashcards
gallbladder changes
delayed, slowed, incomplete emptying
thick bile, increased gallstone risk
cavities and dental problems caused by
inc salivation and pH change
more vitC needed
anemia common, with SOB, fatigue due to
inc RBC volume 33%
rx: B12, green leafy veg, egg, beef, turkey
1st try nausea caused by
DEC stomach acid, INCR gastrin
emptying slows, fetal pressure
1st tri nausea tx
cal/mag citrate, enzymes, choline
fertilized ovum
zygote
ball of cells, 3 day post conception
morula
_____ is cells when they become implanted into the uterus
blastocyst
life at wk 2-8 post conception is called :
embryo
life at 8-9 wk post-conception til birth is called:
fetus
ages from birth-2m is called
neonate
ages from 2m-2y is called
infant
ages walking-2y are called
toddler
ages 2.5-12/13y are called
child
ages 9-14y are called
preadolescent
adolescent ages (m/f)
f: 10-18
m: 15-20
weight gain avg during preg
30 lb
bt 15-50lb
time since onset of LMP (2w pre fert)
Gestational age
actual age of fetus since fertilization
Embryonic age
__ wk of embryonic age is __ wk of gestational age
1st
3rd
nagel’s rule (due date)
LMP + 9m + 7d
LMP - 3m + 7d
nidation spontaneous abortion cervical lesion placenta previa Can all cause:
Bleeding in pregnancy
early bleeding cause
miscarriage
ectopic preg
implantation
infx
late bleeding cause
placenta previa (no pn) or abruptio (pn)
stomach flu liver dz gb dz infx All ddx for:
morning sickness
hyperemesis gravidarum can lead to
seizure (electrolyte imbalance), dehydration
to rule our pancreas, thyroid, gb and liver issues with HG you must
percuss abdomen, check liver borders
weak, heavy legs, contrx with pn, stalled labor, ant abd and leg pn
buckled sacrum
tx: 3x S->I down sacrum
L2, S2 dx
urinary incontinence
MCC ectopic preg
PID
usually RIGHT tube affected
ruptured corpus lute cyst
tube/ovary torsion
threatened/incomplete abortion
Ddx for:
Ectopic preg
MCC of 2nd tri loss
cervical incompetence (premature dilation) painless, gradual, tx with bed rest
spontaneous abortion/miscarriage occurs when
<20w
back pn, maybe bleeding
placenta attaches lower, usually in multiparae women, painless bleeding in 3T
placenta previa
tx: c-sec
premature separation from uterine wall in last 12w
abruptio placenta
BV and other parts of placenta grow too deeply into uterine wall
placenta accreta
amniotic fluid not brought in thru baby nose/mouth, too much AF in uterus
polyhydramnios (bigger belly)
-some AF excreted thru kidneys
amniotic fluid NOT excreted thru kidneys, too little AF in uterus
oligohydramnios (bumpy belly)
HTN, swelling, proteinuria >20w
preeclampsia
B6, mg
HELLP
Hemolysis
Elevated Liver enzymes
Low Platelets
mom older and overweight with blurry vision, fatigue, freq resp infx, n/v, weight loss
gestational diabetes
-no PPP
preg DM1 moms at inc risk of (5)
diabetic ketoacidosis 10+lb baby macrosomia hypoglycemia birth injury
3rd tri dark urine, itching on hands/feet/yellowish, inc bile salts
intrahepatic cholestasis of pregnancy
-usually resolves 48-96h postpartum
3rd tri sudden onset 7TH CN (facial) + temporal bone from inc fluid, swelling, dec IS, tase lost (CN VII)
Bells Palsy
bells palsy in mom ddx
lyme dz, stroke, shingles (HZ), sublux
often occurs with DM
meralgia paresthetica MC occurs when
3rd tri
DT pn injections or knees up position, M/S issues at L5/S1/S2, foot drop, femoral/obturator neuropathy, usually unilateral
obstetric palsy aka traumatic neuritis
innervates fallopian tubes
infertility, ectopic preg, miscarriage, ovary/uterus/teste issues
T12 sublux
infertility, innervates prostate
L4
infertility, 2T miscarriage, innervates cervix
sacrum/coccyx sublux
keep getting preg but lose baby bt 7-8w
anterior coccyx
Dz that causes inc risk of fetal death, IUGR, preterm delivery
syphilis
1/3 infected stillborns
bact infx causing preterm labor, PROM
mycoplasma
Rh factor
issue if mom Rh- dad Rh+
RHOGAM shot after 28w and again after delivery
rhesus or ABO incompatibility causes
erythroblastosis fetalis
asthma is worst during weeks ___ - ___, sometimes gets better with preg
24-36
warm, anxious, weakness, rapid HR
weight LOSS, preeclampsia, severe HG
loss of concentration
hyperthyroiditis (graves)
anemia, PP bleeding, myopathy/cramping
mem loss, miscarriage, constipation
weight GAIN, tired, low BW, CHF, cold intolerance
Hypothyroiditis (hashimotos)
prolactin (produce/prohibit)
ANTERIOR pituitary
PROduces milk, min of suckling to cause
PROhibits ovulaiton
oxytocin (milk out baby out)
POSTERIOR pituitary
milk let down, via suckling
causes uterine contractions
stage one of labor
onset through 10 cm
latent: 0-3cm
active: 3-10cm
stage 2 of labor
full dilation to delivery of baby
stage 3 of labor
delivery of placenta and fetal membranes
false labor
- irregular contractions that dont get closer, strengthen or lengthen
- stop with rest
- felt in LOWER abd
true labor
- regular contractions, getting closer, unaffected by movement
- gradually strengthen and lengthen
- felt in UPPER abd then move DOWN
cardinal movements of labor
engagement descent flx int rotation ext external rotation expulsion
if baby hasn’t turned in 2w of websters suspect:
wrapped/short cord, scoliosis, congenital anomaly
slowing and decreasing contx intensity (exhausted uterus) caused by bandl’s ring, cervical dystocia, uterine colic
hypotonic uterine intertia
breech with arms flexed, both legs extended
frank breech
muscle constriction at jxn of upper and lower uterine segments, restricts fetal or placental descent
bandl’s rings
rigid, previous sx, scarring, lack of neural supply
edema trapped with pushing
Cervical dystocia
infx assoc with preg dt retained placental components, moms temp >100.4 for 2d after 24h pp
puerperal sepsis
6-7%, doubles with c-sec
used to increase milk supply
galactogogues
3 breastfeeding problems babies can experience
oral aversion (desensitize)
tongue thrusting
suck/swallow incoordination
will only eat in football hold indicates
AS occiput
mastitus tx
continue nursing
1h/d cabbage bra, warm compress/massage
dandelion tea
orbicularis oris levator labii superioris depressor labii inferioris levator anguli oris depressor anguli oris Are all:
Latching muscles
tongue movement/sucking control
CN XII
hypoglossal
swallow control
CN IX, X
glossopharyngeal, vagus
gag reflex
CN X
vagus
signs to indicate ok to introduce solids
sit without support
no tongue thrust with food in mouth
reach for food/show interest
teeth (variable)
