W - Antepartum Flashcards
weeks 1-4
Whats a pregnancy duration and the 3 trimesters?
40 weeks - from last menstrual period (LMP) to labour
1st: 1- end of wk 12
2nd: 13 - end of wk 27
3rd: after wk 28
Whats Gravida, Para, EDD?!!!!!
How to calculate EDD?
Gravida: woman who is/has been preggy
Para: number of pregnancies that reached viability (???), regardless whether infant was born alive
Expected Date of Delivery (EDD) = LMP - 3 mths + 7 days
What are the presumptive signs (subjective) of pregnancy? (9)
- Breast tenderness (3 - 4 weeks)
- Nausea and vomiting (4 - 14 weeks)
- Amenorrhea/No period (4 weeks)
- Breast enlargement (6 weeks)
- Urinary frequency (6 - 12 weeks)
- Uterine enlargement (7 - 12 weeks)
- Fatigue (12 weeks)
- Hyperpigmentation of skin (16 weeks)
- Fetal movements (quickening) (16 - 20 weeks)
What are the Probable signs (Objective) of pregnancy? (6)
- Positive pregnancy test (4 to 12 weeks)
- Goodell’s sign - softening of the cervix (5 weeks)
- Chadwick’s sign - bluish-purple coloration of the vaginal mucosa and cervix (6 to 8 weeks)
- Hegar’s sign - softening of the lower uterine segment or isthmus (6 to 12 weeks)
- Abdominal enlargement (14 weeks)
Braxton Hicks contractions (16 to 28 weeks) - Ballottement (16 to 28 weeks)
What are the Positive signs (Objective) of pregnancy? (3)
- Ultrasound verification of embryo or fetus (4 to 6 weeks)
- Fetal movement felt by experienced clinician (20 weeks)
- Auscultation of fetal heart tones via Doppler - can estimate blood flow (10 to 12 weeks)
Common Discomforts of pregnancy? (2)
- enlargement of uterus puts pressure on organs causing:
- stomach: heartburn
- bladder: pee more
- veins: varicose veins, hemorroids (swollen or inflamed veins in the rectum or anus)
- nerves: leg cramps - pregnancy hormones -> vomiting, nausea, backpain
What are the key assessments during Prenatal visits? (4)
- mother’s weight & BP compared to baseline
2.urine testing for ketones, proteins, glucose, nitrates (UTI) - fundal height
- fetal HR & movement
What are the recommended prenatal visits frequency for a successful pregnancy outcome? (3)
- every 4 wks till wk 28
- every 2 wks from wk 28-36
- every wk from wk 37 till birth
What are the common causes of Bleeding in Pregnancy? (1st, 2nd, 3rd tri)
1st tri:
Spontaneous abortion/ miscarriage:
- threatened (miscarriage is likely to happen but not yet)
- inevitable (same as threatened, but higher chance that it will occur because pregnancy cannot continue)
- complete (miscarriage happened and all the parts are expelled)
- missed (miscarriage happened but no parts came out of the mothers body)
- incomplete (miscarriage happened and some part came out only, not completely)
- ectopic (fertilized egg implants outside the uterus) & abdominal (fertilized egg implants and grows in the abdominal cavity) pregnancy
2nd tri:
- early cervical dilation
- gestational trophoblastic disease (abnormal growth of cells inside the uterus after conception)
- disseminated intravascular coagulation (blood clots form throughout the body’s small blood vessels)
3rd tri
- abruptio placentae (placenta partially or completely separates from the inner wall of the uterus before childbirth)
- placenta previa (placenta partially or completely covers the cervix: opening to the uterus)
- preterm labour
Nursing management for spontaneous abortion?
- continued monitoring
- pad count
- vaginal bleeding
- pain level
- preparation of procedure
- meds - support
- physical & emotional
- stress that the woman is not the cause
- grief support
- verbalise feelings
- community support grp
Danger signs during pregnancy? (7)
- Vaginal bleeding
- Persistent vomiting
- Chills and fever
- Ruptured amniotic sac
- Abdominal or chest pain
- Hypertension, excessive weight gain, eye changes, edema
- Increase or decrease in fetal movement
What are the common pregnancy complications that require medical attention? (3)
- Bleeding during pregnancy
- Gestational diabetes
- PIH
What’s the difference between pre-eclampsia & eclampsia?
Pre-eclampsia:
- elevated BP of >140/90
- after 20 wks gestation or during postpartum
- with proteinuria / end-organ failure
Eclampsia
- progressed from pre-eclampsia to seizures, before, during or after labour
Signs of pre-eclampsia? (7)
- high BP
- proteinuria
- decreased urinary output
- visual changes
- headache, confusion
- peripheral & pulmonary edema
- epigastric pain
Eclampsia complications? (8)
Effects on mother:
1. Placental abruption
2. stroke
3. HELLP Syndrome:
- Hemolysis = breakdown of RBCs -> anemia
- Elevated Liver enzymes = liver damage
- Low Platelets -> slow blood clotting when thrs bleeding
4. postpartum hemorrhage (excessive bleeding after giving birth)
Effects on fetus:
1. preterm birth
2. fetal death
3. IUGR
