Unit III Flashcards
EDC (EDD)
estimated date of confinement/delivery
term gestation
38weeks
1st trimester
Last menstrual period - 13weeks
2nd trimester
13-28weeks
3rd trimester
38-40weeks
prenatal period
day became pregnant - baby is born
a partnership approach to health care decision making between health care decision making between health care provider and family (home birth, no drugs)
family-centered maternity care
GP
Gravida = # of pregnancies
Para (parity) = # of births (birth after 20wks at least)
GTPAL
Gravida = # of total pregnancies
Term = term deliveries (38wks)
Preterm deliveries (20-38wks)
Abortions = spontaneous, miscarriage, planned
Living Children = currently
woman whos never been pregnant
Nulligravida
woman who is pregnant for first time
Primigravida
woman who is or has been pregnant for at least a second time
multigravida
moment in pregnancy when the mother starts to feel or perceive fetal movements in uterus
quickening
mother times how long it takes for you to feel 10 distinct movements in 2hours
3rd trimester
“kick counts”
leopold’s maneuvers
determine positiuon of baby
nonmedical person, birth coach
doula
procedure where amniotic fluid is removed from uterus for testing or treatment
often done on women 35 and older
amniocentesis
amniocentesis determines:
- fetal lung development
- hemolytic disorders
- infection in amniotic fluid
- interuterine environment
sympathetic pregnancy, partner experiences some of same symptoms and behaviors as mother
couvade syndrome
chorionic villus sampling
prenatal test, chorionic villi is removed from placenta for testing
10-12 wk gestation only
results in 2weeks usually
chorionic villus sampling (CVS) detects:
- chromosomal abnormalities
- DNA testing
- **Cystic fibrosis
- does not test for neural tube deffects
Percutaneous umbilical blood sampling (PUBS)
examines blood to detect chromosome abnormalities and blood disorders
can put plts, blood in whle doing procedure
PUBS detects:
- fetal anemia
- iron deficiency
- after 17weeks
Triple Marker Screening test:
- AFP
- HcG
- Estridol
Quad marker screening
also screens level of inhibin A
better test for down syndrome
Triple marker screening detects:
- Spina bifida
- down syndrome
15-20th week
Non-Stress Test (NST)
monitor fetus HR
normal 20 min (15/15)
Fetus <32weeks (10/10)
Amniotic fluid index (AFI)
estimate of amniotic fluid and is an index for the fetal well being
normal (8-18)
AFI of <5
Olighydramnious = higher association with fetal mortality
AFI of >20-24
polyhydraminus = neural tube defects, fetal malformations
Components of Biophysical profile (BPP):
- nonstress test
- fetal breathing mvmt
- fetal mvmt
- fetal tone
- determination of amniotic fluid volume
BPP reasurring values:
8-10
BPP non-reasurring values:
6 or less
Naegele’s Rule
1st day of LMP - 3months + 7days
reported (subjective) symptoms of being pregnant from mother
Presumptive
breast enlargement in pregnancy is due to:
increase in estrogen
milk glands increase in size
physiologic anemia in pregnancy is due to:
hemodilution takes place during the first and second trimester as plasma volume increases disproportionately to red cell mass
is probably a physiologically adaptive mechanism to prevent post partum hemorrhage. Pregnancy changes the plasma levels of many clotting factors, such as fibrinogen, which can rise up to three times its normal value. Thrombin levels increase. Protein S, an anticoagulant, decreases
hypercoagulability
happen in pregnancy because the pregnancy hormone progesterone causes the muscular walls of the veins (blood vessels) to relax.
Gravity and your growing baby put pressure on the veins in your pelvis and on the large blood vessels. Veins have valves that stop the blood that is returning to your heart from flowing backwards. When these valves don’t work properly the blood vessels become congested with the extra blood. The walls of the vein start to stretch and sag and the vein swells, making it visible under your skin.
edema, varicose veins, hemorrhoids
These changes may be triggered by hormonal changes during pregnancy, which stimulate a temporary increase in your body’s production of melanin, the natural substance that gives color to hair, skin, and eyes. Sun exposure plays a role, too.
skin color changes during pregnancy
may be caused by rapid weight gain and/or genetics
stretch marks (striae gravidarum)
nasal membranes swell when a large amount of estrogen is in the body.
With blood volumes increasing up to 40%, the nose will have more than its share of blood.
nasal/sinus congestion in pregnancy
Hormonal and mechanical changes increase the risk of urinary stasis and vesicoureteral reflux. These changes, along with an already short urethra (approximately 3-4 cm in females) and difficulty with hygiene due to a distended pregnant belly, increase the frequency of
urinary tract infections (UTIs) in pregnancy
pregnancy hormones stimulate your kidneys to expand and produce more urine, which helps your body get rid of extra waste more quickly. And as your baby gets bigger and bigger, his weight may press on your bladder, so you’ll need to go more frequently.
increased urine output in pregnancy
Your gums are more likely to become inflamed during pregnancy in part because of hormonal changes that make them more sensitive to the bacteria in plaque.
gingivitis in pregnancy
An increase in the hormone progesterone during pregnancy contributes to this by slowing the waves of muscle contractions that move food down the digestive tract. Digestion is slowed so that nutrients have more time to be absorbed in order to supply the developing fetus. As the uterus grows larger and presses on the lower bowel, this can also add to this.
second semester
constipation in pregnancy
When the stomach’s contents, including stomach acid, back up into the tube that brings food to the stomach (the esophagus), it can cause a burning sensation at the level of your heart.
second trimester
heartburn in pregnancy
High levels of estrogen can cause the cholesterol levels in bile to spike, which can lead to the development of these.
gallstones in pregnancy
- Steady, increasing pain in the upper right portion of your abdomen, especially after eating a fatty meal
- Pain between your shoulder blades or under your right shoulder
- Abdominal pain that lasts more than five hours
- Nausea and vomiting
- Fever or chills
- Yellowing skin (jaundice)
- Stools that are clay-colored
symptoms of gallstones
refers to the side-to-side movement that occurs with normal forward ambulation.
waddle gait in pregnancy
Higher levels of hormones called androgens are at least partly responsible for these because they can prompt the sebaceous glands in your skin to get bigger and boost production of an oily substance called sebum.
increase in acne in pregnancy
low blood sugar. If you feel nauseated or battle with morning sickness so often that it interferes with the amount of food you eat
in some women, the hormonal changes that accompany pregnancy interfere with the way your body uses insulin, another hormone. Those hormonal changes may also create hypoglycemia-like symptoms, so it’s important to see your doctor for an official diagnosis.
hypoglycemia in pregnancy
Risks of hyperglycemic mother:
- birth defects
- macrosomia
- neonatal hypoglycemia
- still birth
a bacteria found commonly in genital and rectal tracts of females (30-40%) Mom will be treated with antibiotics during labor to prevent transmission to baby
diagnosed 35-37wks
Group B beta Strep (GBBS)
given to pregnant woman whose blood type is Rh- and baby that is Rh+ to keep the baby’s blood from interacting with mother
Prevents moms blood from being sensitized by babys Rh+ blood and in turn producing antibodies that cross placenta and destroy babys blood and allows mom to have a second baby (possible Rh+)
RhoGam
given during her 28th week and 72 hours after giving birth
can be objectively be assessed by practitioner
(linea nigra, urine or blood test, melasma-pregoface, chadwicks, Goodells sign)
Probable
fetal heart beat (4-6wks ultrasound)
Physician palpates movements
positive sign of pregnancy
bluish discoloration of the vaginal mucosa due to increase in blood flow
Chadwicks sign
examined by papation of uterus, looking for softening of tissues
Goodell’s sign
how often do you see your doctor during first and second trimester
once per month
how often do you see your doctor during third trimester?
every two weeks
What is the leading cause of infant death and mortality rates?
congenital malformations and chromosomal abnormalities
