Pregnancy

Question 1

After ovulation, the remaining cells in the follicle form the __________ which functions to:

Answer 1

corpus lutueum, or “yellow body”

produces progesterone to prevent sloughing of the endometrial wall.

Question 2

The blastocysts (embryo) forms the ____________ (3).

Answer 2

trophectoderm, fetus, germ cells

Question 3

After implantation at day ______, the trophectoderm forms the _______.

Answer 3

Day 20-24

Placenta

Question 4

What is the zone pellucida?

Answer 4

protective barrier from viruses/bacteria

Question 5

At 7 to 10 weeks, the __________ takes over from the corpus luteum and produces progesterone

Answer 5

placenta

Question 6

Average length of pregnancy (in days)

Answer 6

280

Question 7

Gravity

Answer 7

pregnancy (of any length)

Question 8

Parity

Answer 8

pregnancy that has led to a birth of a minimum of 20 weeks

Question 9

GTPAL

Answer 9

Gravity 
Term
Preterm
Abortion (spontaneous or therapeutic) 
Living

Question 10

What hormone promotes breast growth and lactogenic properties?

Answer 10

chorionic somatomammotropin AKA human placental lactose (hPL)

Question 11

What week does nausea usually subside by? What percentage of pregnant women experience nausea?

Answer 11

week 16

80%

Question 12

uterine changes

Answer 12

uterus becomes globular in shape and softens and flexes over the cervis. cervix softens with increased vascularity and becomes a blueish color in primiparous women.

Question 13

Blood pressure

Answer 13

decreases progressively until week 24-32 secondary to effect of progesterone, prostaglandins and nitric oxide.

Question 14

when does implantation occur?

Answer 14

6-10 days after conception (which is 3-4 weeks gestation as there are 2 weeks follicular development)…

Question 15

When does fetal development begin?

Answer 15

9 weeks - embryonic period ends and fetal period begins

Question 16

When can the uterus be palpated above the pubic symphysis?

Answer 16

12 weeks

Question 17

When is fetal movement first felt?

Answer 17

18-20 weeks

Question 18

What are some breast changes in 2nd trimester?

Answer 18

colostrum development
areolae and nipples darken
striae gravidarum (stretch marks)

Question 19

What’s the pigmented line on the abdomen called?

Answer 19

linea nigra

Question 20

How much does BP drop?

Answer 20

diastolic 10-15… drop is lowest at 24-32 weeks causing dizziness and syncope.

Question 21

Why does heartburn occur?

Answer 21

uterine enlargement displaces stomach and progesterone changes esophageal sphincter

Question 22

Why are pregnant people at increased risk of gallstones?

Answer 22

bile stasis and increased cholesterol saturation

Question 23

Why do pregnant people experience dyspnea?

Answer 23

progesterone increases tidal volume which causes a drop in CO2…

Question 24

Why does thyroid hyperplasia occur?

Answer 24

increased thyroxine-binding globulin.

Question 25

What percentage of pregnant people have thyroid issues?

Answer 25

2.5-5%

Question 26

What are some complications from hypothyroidism

Answer 26

low birth weight, preterm labour, spontaneous abortion, placental abruption, HTN

Question 27

What are some complications of periodontal disease?

Answer 27

low birth weight and pre-eclampsia

Question 28

At how many weeks are FHT audible with a fetoscope?

Answer 28

17 to 19 weeks

Question 29

blood volume peaks in 3rd trimester. How much is it increased (compared to pre pregnancy).

Answer 29

30-45 %… 65% multi

erythrocyte mass 20-30% higher

hemodilution = anemia

Question 30

What are some structural and functional cardiac changes in 3rd trimester?

Answer 30

heart displaced up and left. CO and SV and force of contraction increased. HR increases by 15-20 bpm. Functional murmur can be heard in 95% pregnancies.

Question 31

Changes in PVS?

Answer 31

edema from venous congestion and lower colloid pressure. varicosities.

Question 32

MSK changes?

Answer 32

lordosis. carpel tunnel.

Question 33

What does engagement occur?

Answer 33

2 weeks before labour (primips)

Question 34

What is Nagele’s rule?

Answer 34

add 7 days to LMP and subtract 3 mo

Question 35

What are the most common causes abdominal pain in pregnancy? (early and late)

Answer 35

early: ectopic, UTI, spontaneous abortion, round ligament discomfort.
late: premature labour, placental abruption, HELLP

Question 36

What might visual symptoms indicate in pregnancy?

Answer 36

pre-eclampsia

Question 37

How soon should an RH neg patient receive rhogam after bleeding?

Answer 37

72 hours

Question 38

What coat factors are increased in pregnancy?

Answer 38

I, VII, VIII, IX, X (1 & 7 through 10)

Question 39

What might palmar erythema indicate in pregnancy?

Answer 39

hepatitis

Question 40

What is chloasma?

Answer 40

“mask of pregnancy”… pigmentation in a butterfly shape on face… benign.

Question 41

What might hyper reflexive DTR indicate?

Answer 41

pre-eclampsia

Question 42

Define the terms: presentation, fetal lie, attitude, position, variety, engagement.

Answer 42

Presentation: part of fetus that enters pelvis first
Fetal lie: orientation of fetal spine to the maternal spine (longitudinal, transverse, oblique)
Attitude: position of fetal parts in relation to each other (flexed, military, extended)
Position: location of a fetal part to the right or left of the maternal pelvis
Variety: location of the fetal back to the anterior, lateral, or posterior part of the maternal pelvis
Engagement: occus when the widest diameter of the presenting part has passed through the pelvic inlet

Question 43

What are the 4 Leopold’s manoeuvres

Answer 43

1) Place fingers on fundus. Note size, consistency, and shape.
2) Move hands to sides, note location of fetal back (long flat) vs limbs (small parts).
3) Pawlik’s manoeuvre: bend knees, grasp lower abdomen, identify vertex/shoulder/breech.
4) Face feet. Use both hands and follow fetus towards pelvis to determine shoulder vs vertex.