Signs Of Pregnancy, GTPAL

Question 1

Probable Signs of Pregnancy

Answer 1

Poitive preg test
Return of fetus whn tapped (ballottement)
Outline of fetus palpable
Braxton Hicks
A softening of cervix (Goodell’s signs)P
Bluish color to cervix (Chadwick’s sign)
Lower uterine segment softens (Hegar’s sign)
Enlarged uterus

Question 2

Positive signs of Pregnancy

Answer 2

Fetal movements by HCP
Doopler
Ultrasound of fetus

Question 3

How to determine estimated due date

Answer 3

Naegele’s rule

1st day of last menstrual period + 7 days - 3 months + 1 yr = _________

Question 4

What does GTPAL stand for

Answer 4

Gravidity — number of pregnancies, including the current one, twins only count once
Term — pregnancies carried to term. 37 weeks gestation, twins only count once
Preterm — preterm births, betwen 20 and 36+6 weeks gestation, twins count only once
Abortions — abortions PRIOR 19+6 weeks (*miscarriages, *elective termination); if abortion or miscarriage was after 20 weeks gestation, it is included under P
Living Children — current number of alive children, twins count twice

Question 5

this is when the pelvic joints become stiff or move unevenly. Can occur at the front of the pubic bone, perineum or the lower back. It hurts and causes severe dysfunction!

Answer 5

Symphysis pubis dysfunction (SPD)-Also known as pelvic girdle pain

Question 6

Extreme ‘morning sickness’ ● INTENSE, intractable,
nausea AND vomiting during pregnancy

Answer 6

Hyperemesis Gravidarum

Question 7

• nausea may cause vomiting
• nausea that subsides around 20 weeks
• vomiting does not cause dehydration
• can keep some food down

Answer 7

Morning Sickness

Question 8

• nausea with excessive, persistent vomiting
• nausea & vomiting does not subside
• severe vomiting that can cause dehydration, weight loss, electrolyte imbalances
• cannot keep any food down

Answer 8

Hyperemesis Gravidarum

Question 9

When Blood pressure >140/90
○ 2 times
○ 4 hrs apart

> 20 weeks gestation

• there is protein in urine
• leads to seizures

Answer 9

Preeclampsia

Question 10

Risk Factors for PreEclampsia

Answer 10

● Multiple fetuses ● Chronic HTN ● Gestational HTN ● Obesity ● Increased age ● African American ethnicity ● FH of PreE ● Prior PreE in previous pregnancy ● DM Type 1 and 2, GDM ● Use of in vitro fertilization ● Autoimmune disorders ● Kidney disease

Question 11

What are signs and symptoms of preEclampsia

Answer 11

Increased BP
Weight gain
Proeinuria
Facial puffiness
Pedal edema

Question 12

Therapeutic management of pre-eclampsia

Answer 12

● Delivery

● Prepare for a preterm baby
○ Mag sulfate → prevent seizures in mom
○ Betamethasone → Help develop baby’s lungs

● Antihypertensives…..

Question 13

What are antihypertensives to give during pregnancy

Answer 13

1. Labetalol
2. Nifedipine
3. Hydralazine

Question 14

What are antihypertensives NOT to give during pregnancy

Answer 14

1. ACE -INHIBITORS (-prils)
2. ARBS - can cause oligohydramnios, fetal growth restriction, and more! (-artan)

Question 15

What are the Classic Triad of PreEclampsia

Answer 15

1. Rising BP
2. Proteinuria
3. Edema

Question 16

Parameters on when to develop with preeclampsia

Answer 16

● PreE without severe features: Delivery at or above 37 weeks gestation. ● PreE with severe features: Delivery at or above 34 weeks gestation.
● Eclampsia: Delivery is ideally not until 34 weeks, but if mother is not
tolerating, delivery can be indicated before 34 weeks.
● HELLP Syndrome: ASAP!!