Week 1 Flashcards
What could cause polyhydramnios?
Fetus with GI defect, can’t swallow fluid
Maternal diabetes
Neural tube defects i.e. spina bifida
What is the chorion?
Outer sac next to the uterine wall
What is the amnion?
Inner sac next to the fetus. It’s thin, translucent, but high in tensile strength
What protects the umbilical cord vessels?
Wharton’s jelly
What does the umbilical cord contain?
2 arteries carry deoxygenated blood from the fetus to the placenta
1 vein carries oxygenated blood to fetus
AVA
After cutting the cord, must we check for 2 arteries and 1 vein in it?
Yes
What is the function of the placenta?
- Fetal gas exchange
- Nutrition
- Excretion by fetus
- Hormone production in mother
What is the placenta made of?
Maternal/fetal tissue.
What forms the placental barrier?
Layers of fetal tissue
What can cross the placental barrier?
Food, alcohol, nicotine, drugs, etc.
What cannot cross the placental barrier?
Fetal/Maternal blood
How are materials exchanged across the placental barrier?
Only via diffusion
What does the fetal surface of the placenta contain?
Umbilical vessels and cord
What’s a teratogen?
An agent that can cause genetic abnormalities.
What period of time during human development is the embryo/fetus not susceptible to teratogens?
The first two weeks
By which week does the fetus have major organ development?
Week 8
When is the embryo most susceptible to teratogenic exposure?
Week 3 through Week 8
Where does oxygenation take place for the fetus?
At the placenta
Does the fetus use its liver while in the uterus?
No, it uses its mother’s liver
What are the three shunts?
Foramen ovale: A shunt between the right and left atrium to help the blood bypass the fetal lungs.
Ductus Venosus: A shunt connects the umbilical vein to the inferior vena cava to bypass the fetal liver.
Ductus Arteriosus: A shunt that connects the main pulmonary artery to the aorta, which bypasses the fetal lungs.
When does actual conception typically take place?
Closer to 2 weeks after LMP.
What is Nagele’s Rule?
Subtract 3 months (or add 9 months) to the LMP and add 7 days. (TEST Q)
How do we measure fundal height?
From top of pubic symphysis to fundus, in centimeters.
When is fundal height usually measured?
After 20 weeks
What does the pregnancy test measure?
Human Chorionic Gonadotropin levels (hCG)
Can false positive pregnancy tests occur?
Yes, for example from drugs and diseases
What are presumptive signs of pregnancy?
Subjective s/sx that a woman reports. They are least reliable. They may or may not be associated with pregnancy.
What are six presumptive signs of pregnancy?
- Amenorrhea
- Nausea
- Fatigue
- Urinary frequency
- Breast changes
- Quickening
What are probable signs of pregnancy?
Objective signs of pregnancy noted by examiner. They may or may not be associated with pregnancy.
What are seven probable signs of pregnancy?
- Hegar’s sign (softening lower uterine segment)
- Chadwick’s sign (bluish color of vaginal mucosa)
- Goodall’s sign (softening of cervix)
- Braxton Hick’s contractions (beginning 2nd semester)
- Positive pregnancy test
- Abdominal enlargement
- Ballottement
What is ballottement?
Pushing on the cervix to feel fetus bounce
What are Positive signs of pregnancy?
Signs noted by examiner. Can only be caused by pregnancy.
What are three examples of positive signs of pregnancy?
See baby: Ultrasound
Hear baby: Auscultate fetal heart
Feel baby: Palpate fetal movement
What are 8 physiological pregnancy changes?
- Vaginal secretions increase; candidiasis common
- Breasts increase in size, sensitivity, pigment
- Colostrum by 3rd trimester
- Increased incidence of periodontal disease
- Chest circumference increases
- RR and volume of inspired air increases
- Congestion/nasal stuffiness (due to increased fluids)
- Marked fatigue
What are 7 cardiovascular pregnancy changes?
- Blood volume increases 50% by 30th week
- Increased cardiac output and pulse (increase by 10-15 bpm)
- Decreased vascular resistance/vasodilation caused by hormones
- Postural hypotension/supine hypotensive syndrome
- Hypercoagulable state–increased thrombus risk
- Pelvic vein compression decreases blood flow to legs: venous stasis, edema, varicosities, hemorrhoids, cramps
- Physiologic anemia of pregnancy: hct >/= 35 and hgb >/=10 are considered WNL
What are four musculoskeletal pregnancy changes?
- Round ligament pain
- Pelvic joints relax: symphysis pubis separates
- Physiologic lordosis: lower back pain common
- Diastasis recti can occur
What is diastasis recti?
Separation of abdominal muscle appearing as vertical ridge from umbilicus to sternum
What are two GI Pregnancy changes?
Morning sickness in 1st semester
Smooth muscle relaxation slows peristalsis and relaxes cardiac/pyloric sphincters. This causes constipation and heartburn
Should we allow pregnant women on their back?
No, it can compress arteries/veins.
What is the main GU change during pregnancy?
Bladder pressure/frequency
Are pregnant people at risk for DVT? When are they most at risk?
Yes, and they are most at risk postpartum.
50% increase in blood volume is mostly what?
Plasma, not RBCs.
What are abnormal Hct and Hgb numbers for pregnant women?
Hct lower than 35, Hgb lower than 10
What are five pigmentation changes during pregnancy?
- Facial melasma (reddening of face cheeks)
- Palmar erythema (red palms)
- Vascular spiders (spider-looking veins)
- Striae gravidarum (stretch marks)
- Linea nigra (dark line from symphysis to top of uterus)
What does Human Chorionic gonadotropin hormone do during pregnancy?
- Is detectable on a pregnancy test
2. Preserves the corpus luteum and its progesterone production
What is the human placental lactogen hormone?
- Modulates fetal and maternal metabolism
- Develops maternal breasts for lactation
- Increases maternal insulin for fetal nutrition
What does estrogen hormone do during pregnancy?
- Enlargement of a woman’s breasts, uterus and external genitalia
- Myometrial contractility.
- Increases vascularity
- Relaxes ligaments in the joints.
- Deposits fats in the maternal abdomen.
What does Progesterone hormone do during pregnancy?
- Endometrium maintenance
- Decreases the contractility of the uterus
- Stimulates maternal metabolism and breast development.
- Nourishment in early stages
What does Relaxin hormone do during pregnancy?
Pelvic, cervical expansion and relaxation.
softens the cervix
What does Prolactin hormone do during pregnancy?
Lactation.
What does Oxytocin hormone do during pregnancy?
- Bonding
- Uterine contractions
- Let-down Reflex
What does Cortisol hormone do during pregnancy?
Insulin production
Should pregnant women take live virus vaccines?
No, they are contraindicated
