Week 4 - First Trimester Flashcards
which dermatological change reverses after delivery?
cholasma
cholasma
melanocytes stimulated by estrogen & progesterone
usually found on face and other sun exposed areas
reverses after delivery
linea nigra
increased melanocyte production
on Conception Vessel (TCM)
DOES NOT REVERSE AFTER DELIVERY
normal CV changes in 1st trimester that mimic heart disease?
- dyspnea (@ rest & before 20 wks gestation)
- altered heart sounds
- peripheral edema
- mild tachycardia
- JVD
physiology behind constipation?
changes in SI motility
changes in mechanical forces lead to increased intragastric pressure and a changed angle of the gastroesophageal junction
what is Naegel’s Rule?
estimated date of delivery
40 weeks from LMP (most popular)
LMP + 1 year + 7 days - 3 months
standard deviation of 13 days
which preconception supplement has potential to be teratogenic?
vitamin E - avoid high doses (heart problems in fetus)
vitamin A - toxicity in first 6 wks of fetal development (>10,000 IU/d)
what is the dose & efficacy of vitamin B6 for hyperemesis?
pyridoxine
25mg q 8h effective for NVP BUT NO EFFECT ON HYPEREMESIS
dose of ginger for n/v
350mg gel capsule as effective as 25mg B6
250mg 4x/d
safety of conventional tx of candida during pregnancy?
monistat, canesten
antifungals that are local and not absorbed into bloodstream are considered safe in pregnancy
what lab evaluation(s) would you do for first trimester bleeding?
bHCG
- ectopic pregnancies do not show typical doubling seen in intrauterine pregnancies
- nonviable pregnancies will show lower levels than expected for dates
- follow levels serially every 48hrs
normal pregnancy levels of bHCG
hCG doubles approximately every 48 hrs
hCG levels in spontaneous abortion?
hCG will fall
hCG levels in ectopic pregnancy?
hCG will rise inappropriately (i.e. not usual doubling)
hCG levels in molar pregnancy?
hCG level extremely high
what are symptoms of a threatened miscarriage?
scant amount of bleeding mild amount of uterine cramping internal os of cervix closed no passage of tissue and no presence of tissue in the vagina fetal heart rate is present variable clinical course
what are symptoms of incomplete miscarriage?
heavy bleeding
severe uterine cramping
passage of tissue
open cervix with tissue in cervix
symptoms of complete miscarriage?
slight bleeding or no bleeding mild cramping passage of tissue possible to have tissue left in vagina cervical os is closed uterus is smaller than expected for dates of pregnancy
symptoms of inevitable miscarriage
moderate amount of bleeding
moderate cramping
cervical os is open
no passage of tissue or tissue in the vagina
when is trimester 2?
weeks 13-28
what does fetal development look like at week 16?
skin begins to form and is translucent
meconium forms - first BM
sucking motion begins
4-5 inches long & weighs 3 oz
what does fetal development look like at week 20?
lanugo, hair, nails form
babe can hear & swallow
6” long, weighs 9 oz
what does fetal development look like at week 24?
lungs formed taste buds developed on tongue girl: all eggs for lifetime now formed boy: testicles descent into scrotum 12" long & weighs 1.5 lbs
normal RR for a pregnant woman
~20 breaths per minute
