Psychological and Physiologic Changes of Pregnancy Flashcards
Para
of pregnancies that reached 20 weeks or beyond (born alive or not)
Gravida
A woman who is or has been pregnant (how many times)
Primigravida
A woman who is pregnant for the first time
Primipara
A woman who has given birth to one child passed age of viability (first delivery)
Multigravida
A woman who has been pregnant previously
Multipara
Delivered more than once
Nulligravida
A woman who has never been and is not currently pregnant
Post term/post dates
Pregnancy goes beyond 42 weeks + 6 days
Preterm
Pregnancy beyond 20 weeks, but not completed the full 37 weeks + 6 days = <38 weeks
Term
beginning of 38 weeks and went to the end of the 42nd week
Viability
Capable of living outside the uterus (22-25 weeks)
Placental Function
Lungs:
O2 and C02 exchange
Placental Function
Digestive:
Absorption of nutrients
Placental Function
Liver:
Processes moms blood for iron
Placental Function
*Endocrine:
Maintains pregnancy, prevents another pregnancy, prepares breasts for lactation
Placental Function
Thermal control:
Cools/warms fetal blood
Placental Function
Immune:
Barrier against infection (cannot protect against viruses)
Fetal Surveillance
Goals:
Hx:
Goals: prevent prenatal mortality, compromise
Hx: Diabetes, renal problems -> htn? etc. This determines how often you see mother.
What is a NST?
Shows fetus is getting oxygen
Shows fetus well being (accelerations)
NST
Reactive:
Non reactive:
Reactive: 2 accelerations in 20 min period. 15 sec long, 15 bpm high
Non reactive: Poor blood supply (worrisome)
(want an active baby. Wake if necessary!)
Tone
Body position of fetus
CST
Contraction stress test
Causes contractions (to see how baby responds)
Done if NST is non reactive
Biophysical Profile (BPP)
This is a physical exam on fetus
Looking at breathing, gross body movement, tone, fluid in uterus.
Presumptive signs of pregnancy
Amenorrhea Breast changes n/v Frequency fatigue Uterine enlargement Quickening (Feel baby move) Linea negra, melasma, striae gravidarum
(These dont always mean you’re pregnant, could be endocrine problem)
Probable signs of pregnancy
Lab tests 95-98% reliable
Home pregnancy test (if neg repeat in week)
Physical signs
Goodell
Soft cervix
Chadwicks sign
Everything turns blue
Braxton Hicks
Helps uterus grow
Helps circulation
Positive signs of pregnancy
outline of fetus on U/S
Fetal heart separate from mother
Fetal movements
Visualization of fetus
Couvade syndrome
Dad has s/s of pregnancy
Cardiovascular
- Blood volume
- increased plasma and rbc (pseudo anemia)
- increased iron need
- increased clotting factor
- increased lipids
Cardiovascular
- Cardiac output
- slight increase in BP
- blood sugar elevated
- progesterone effect (vasodilator)
Supine hypotension syndrome
Vena cava/aorta compression by growing uterus
-Hypotension, dizziness, pallor
Respiratory changes during pregnancy?
Increased vascularity d/t increased estrogen*
Respiratory
-Upper
- stuffy nose
- increased mucus, epistaxis (bloody nose)
- sensitive to odors
Respiratory
-Lower
- increased O2 consumption (hyperventilation)
- enlarged circumference of chest
- elevated diaphram
Integumentary
- hyper pigmentation
- increased oil production (oily hair, sweat)
- decreased elasticity
- angiomas (tiny red mole)
- palmer erythema (red hands)
- PUPP (cool shower can help)
Neurological
- brain shrinkage
- carpal tunnel syndrome (d/t swelling)
- blurred vision
- emotional liability
Musculoskelatal
- softening of joints (waddling gait)
- postural changes
- butt sticks out (back pain)
- pressure on nerves
- dec. serum calcium (leg cramps)
Endocrine
- double metabolism: fatigue
- thyroid enlarged (T4 increased)
- parathyroid enlarged
- pituitary (refer to pp)
- adrenal (increased aldosterone and cortisol)
- pancreas cells increase in size (increased insulin prod.)
Endocrine (placental hormones)
-hCG
