Pregnancy Part 1 Flashcards
what does LM mean?
last menstrual period
what weeks are trimester 1,2, and 3 ?
one is 0-13
two is 14-26
three is 27-40
embryo versus fetus ?
embryo is 0-8 weeks
fetus is after 8 weeks
miscarriage vs stillbirth
miscarriage 0-20 weeks
stillbirth after 20 weeks
US ranks ___ out of 36 countries for infant mortality
33 (not good at all)
to improve infant mortality, it is important to decrease ______.
low birth weight
the desirable birth weight is ______ grams or ______lb. and oz.
3500-4500 grams
7 lb. 12.oz - 10 lb.
what is gestational age?
from date of conception
average pregnancy is 38 weeks
what is menstrual age
assessed fro first day of last period
average pregnancy is 40 weeks
what are the two phases of physiological changes in pregnancy
maternal anabolic changes
maternal catabolic changes
what are some maternal anabolic changes and when do they occur
first half of pregnancy
- blood volume expands
- buildup fat, nutrients, glycogen stores
- growth of some maternal organs
- increased appetite
- decreased exercise tolerance
- increased anabolic hormones
what are some maternal catabolic changes and when do they occur
occur in second half of pregnancy
- mobilization of fat/nutrient stores
- increase production and blood levels of glucose, TG, FA, decreased glycogen stores
- accelerated fasting metabolism
- increased appetite and food intake decline near term
6.increase of catabolic hormones
during pregnancy the body water increases from ___ to ___ which is about ____ lbs. where does this fluid come from?
7L to 10L
15-22 lbs
intracellular, blood, and extracellular volume, and amniotic fluid
what is the dilution effect
some vitamins and minerals becoming diluted bc of increased body water
what is edema
swelling due to accumulation of extracellular fluid
not problematic in pregnancy
what maintains early pregnancy by stimulating the corpus lute to produce estrogen and progesterone. also stimulates growth of the endometrium
hCG
human chorionic gonadotropin
what maintains the impact, stimulates growth of the endometrium and its secretion of nutrients, relaxes smooth muscles in the uterine blood vessels and GI tract, stimulates breast development, and promotes lipid deposition
progesterone
what increases lipid formation and storage, protein synthesis, and uterine blood flow that promotes uterine and breast duct development
estrogen
what Increases maternal insulin resistance to maintain glucose availability for fetus; promotes protein synthesis and lipolysis for energy for maternal use
Human chorionic somatotropin (hCS)
what Supports fetal growth & development by triggering metabolic changes that increase the availability glucose & amino acids
human placental lactogen
what may participate in the regulation of appetite and lipid metabolism, weight gain, and utilization of fat stores
leptin
maternal nutrition must be available for fetal growth at the times the ________ for development
genes are expressed
______ is the preferred fuel for the fetus
glucose
in first half of pregnancy, high levels of _______ stimulate insulin production, increases conversion of glucose to glycogen and fat for storage
estrogen and progesterone
in second half of pregnancy, increased levels of _________ inhibit conversion of glucose to glycogen and fat. this increases maternal production of glucose by the liver
hCS and prolactin
what causes women to be slightly glucose intolerant in the 3rd trimester of pregnancy?
diabetogenic effect of pregnancy
with fasts more than ___ hours, pregnant women have _____ fasting metabolisms to spare glucose for the fetus.
12
accelerated
Prolonged fetal utilization of ketones
associated with ________
abnormal growth & impaired
intellectual development
Increased _______ is needed during pregnancy for synthesis of new maternal & fetal tissues. This is conserved during pregnancy by
reducing _______ excretion
protein
nitrogen
fat stores accumulate in the ___ half of pregnancy and there is enhanced fat mobilization in the ___ half
what blood lipid levels increase and what for
1st
2nd
TG
cholesterol for placenta and fetus
sodium in the body is _____ how?
increased
high aldosterone secretion helps retain sodium
development of placenta _____ fetal development
preceeds
what are functions of the placenta
hormone and enzyme production
nutrient and gas exchange between mother and fetus
removal of waste from fetus
barrier to some harmful compounds
what is the structure of the placenta
disc shaped
3-4 layers of cells separating maternal and fetal blood
nutrient transfer across the placenta is affected by _____.
size and charge
-small with little or no charge
lipid solubility
-lipids more easily
concentration of nutrients
what is transferred by passive diffusion?
Water, some amino acids, glucose, free fatty acids, ketones, vitamins E & K, sodium, chloride, gases
what is transferred thru facilitated diffusion?
some glucose
iron
vitamins A and D
what is transferred by active transport?
water soluble vitamins
some minerals
amino acids
what is transfeerred by endocytosis?
immunoglobulins
albumin
nutrients are first used for _____ then _____ then lastly _____
mother
placenta
fetus
The rate of growth & development is
higher during_____ than any other period of life
gestation
critical periods are most intense in cells multiplying during _____
1st two months (organs and tissues form)
_____________ is the
primary stimulator of fetal growth and Levels are decreased by maternal
undernutrition
Insulin-like growth factor (IGF-1)
reduced fetal growth causes High risk of illness and death for newborns
who experience ____________
intrauterine growth
restriction (IUGR)
SGA
small for gestational age
dSGA
disproportionately small for gestational age
pSGA
proportionately small for gestational age
AGA
appropriate for gestational age
LGA
large for gestational age
pSGA versus dSGA
pSGA - weight, length, and head circumference below 10th percentile
dSGA - weight below 10th percentile but normal length and head circumference
what are causes of dSGA and what are the risks?
- malnutrition in 3rd trimester
- short term malnutrition or low weight gain or weight loss
- look thin, wrinkly, with small abdominal circumferences
- hypoglycemia, hypocalcemia, hypothermia at birth
pSGA cause and risks?
long term malnutrition in utero
- look small but well-proportioned
- reduced cells in organs and tissues
- catch up growth is harder for these infants
LGA is classified as above the ___ percentile and a greater birthweight than ______.
related to _________
increases risks of ______
90th
4500 (10lb)
prepregnancy obesity
excessive weight gain during pregnancy
c section, postpartum hemorrhage, shoulder dystocia
nutrition risk factors for miscarriages
underweight prior to pregnancy
high levels of oxidative stress in 1st half of pregnancy
infants born preterm have higher risk of ____________.
neurological problems and low IQ
attention/hyperactivity disorders
congenital malformations
cerebral palsy
death
risk factors for preterm deliveries
genital tract infections
not enough uterine placental blood flow
placental abruption
high stress
risk factors for preterm deliveries
pre pregnancy underweight
ow weight gain
women who are obese
chronic inflammation and oxidative stress
possible nutritional protective factors to try and prevent preterm delivery
prenatal MVI and folic acid supplements and adequate folate intake
fish 2-3 servings a week
exercise during pregnancy
the ability of the fetus to modify gene functions when exposed to adverse conditions that threaten its immediate chances of survival
developmental plasticity
