OB unit 1 exam

2 mor more pregnancies >20 weeks

endometrium

period of pregnancy from conception to onset of labor

labor through delivery of placenta

6 weeks (8 if c-section) after childbirth / or until reproductive organs return to pre-pregancy state

absence of menstration

3rd - 8 wek after conception

9th (12th) week to birth

prenatal age of developing baby calculated from first day of last menstrual period

• chemical / physical agent which interferes with critical embryonic / fetal development
• high temps / radiation / drugs / alcohol / cocaine / smoking / mercury / live firus vaccines

cell formed by union of ovum and sperm

spontanious or elective before 20th week gestation

irregular usually mild contractions throughout pregnancy taht become stronger in last trimester

bluish purple discoloration of cervix, vagina, and labia during pregnancy

breast fluid secreted during pregnacy and the 1st week after birth

seperationof longitudinal muscles of abdomen during pregnancy

softening of cervix during pregnancy

number of pregnancies regardless of duration or outcome

"mask of pregnancy" brownish igment of face during pregnancy

number of pregnancies that have progressed to 20 weeks or more regardless of outcome (number of pregnancies not fetuses)

after 42 weeks

after 20th week and before the start of 38th

first movement of fetus in uterus felt by mother

irregular pink/purple streaks on abd/breats/thighs resulting in tears from connective tissue

13 weeks

ingestion of nonnutritive substances (laundry starch, clay, ice) may be sign of anemia

sample of amniotic fluid

• 1st tri - chromosomal abnormalities
• 3rd - lung maturity (surfactnant levels)

16-18 weeks

• elevated - neural tube defects
• low- downs syndrome

8-12 weeks genetic diagnosis

Reactive response good (increase of 15bpm for 15 seconds)

Non-reactive Non-stress is Not good (3 negatives in a row to interpret results)

• fetal heart rate variability
• fetal breathin movements
• gross body movements
• muscle tone
• amniotic fluid volume

evaluate fetal status while under stress from contraction

• Normal weight (19.8-26) -total 25-35 lbs 3.5 lbs 1st trimester, 1lb/week 2nd&3rd
• Underweight (<19.8) -total 28-40 lbs 5 lbs 1st trimester, 1.1lb/week 2nd&3rd
• Overweight(26-29) -total 15-25 lbs 2 lbs 1st trimester, .7lb/week 2nd&3rd

• 60g in pregnancy
• Happy (hamburger)
• To (tuna)
• Consume (chicken)
• My (milk)
• Calories (cottage cheese)
• Sanely (soy beans)

• 30mg in pregnancy
• organ meats, red meats, green leafy vegetables, bran, sunflower seeds, legumes

400mcg

• take before becoming pregnant decrease risk for neuro tube defect
• beans, OJ, green leafy vegetables, fortified foods (cereals/breads)

• 1300mg <18 y/o
• 1000 >18 y/o

dairy products, dried fruits, salmon & sardines w/ bones, broccolli, dark green leafy vegetables, peanuts, almonds, refried beans

• alcohol
• caffine
• artificial sweeteners
• cholesterol

• no increase 1st trimester
• 300-400/day 2nd & 3rd trimester

• amenorrrhea, breast sensitivity,
• uterine changes, fatigue, frequency, pigmentary changes, N&V, striae, constipation, weight gain, leukorrhea, quickening

dark line midline on stomach, fades after pregnancy

lab test; ballottement; braxton hick's contractions; goodell's sign; hegar's sign; chadwick's sign

• fetal heart tones
• untrasound
• fetal movement felt by a primary care practitioner

sudden tap on the cervix during vaginal examination may cause the fetus to rise in the amniotic fluid and then rebound to its original position

compressibility of lower uterus - reflects softening of isthmus of cervix

• calendar
• standard days
• basal body temperature
• cervical mucus
• symptothermal
• abstinence

• 7-10 days after fertilization
• trophoblast (exposed cell walls of blastocyysts) secretees enzyme which allows blastocysts to enter endometrium

may cause slight spotting

2 d/o 16 cells

• 2-8 weeks
• critical time in development (CNS, heart, extremities, eyes, palate, external genitalia)
• 3rd week resp/digestive tract 1 tract; 4th week septum begins

• fetal heart tones auscaltated
• lower body develops
• kidenys produce urine
• uterus rises above pelvic rim
• risk for uti increases

• looks more human
• meconium in bowel; anus opens
• heart well developed
• testes ready for descent / vagina opens
• fetal movement detectd by mom (16-20 weeks)
• colostrum may be expressed (small amounts)
• placenta is clearly defined

• vernix
• lanugo
• sleeps, sucks, kicks
• fundus reaches level of umbilicus
• areola darken, colostrum
• postural hypotension
• pregnancy becomes "real"
• leg cramps (hypocalcemia)
• nasal stuffiness (saline spray no OTCs)
• varicose veins
• constipation

• skin red & wrinkled
• blood formation increases in bone marrow & decreases in liver
• can hear
• uterus rises above umbilicus
• diastolic b/p gradually increases 24-32 weeks (returns to prepreg levels by term) / systolic remains same as pre-preg
• glucose testing between 24-28 weeks
• 1h (if failed then 3 hour)

• can breathe, swallow, regulate temperature
• surfactant forms
• eyelids open
• greates period of weight gain
• fundus halfway betwen umbilicus/xyphoid
• fetal outline is palpable

• brown fat deposit develop
• store iron, calcium, phosphorus
• fundus at xiphoid
• breasts are full/tender
• urinary frequency returns
• swollen ankles
• dyspnea
• sleep disturbances

• occupies entire uterus
• maternal antibodies transfered to fetus
• lightening
• backaches increase
• braxton hicks intensifies

• Dirty Duncan - mother side (cotyledons) red rough surface (blood expulsion when presented first)
• shiny schultze - fetus side smooth & shiny (small gush of blood precedes placenta if presented first)

• 20-22" long 1" round
• 2 arteries (deoxygenated to placenta)
• 1 vein (o2 to vetus)
• warton's jelly - prevents compression of blood vessels

• protects fetus in uterus
• 1000-1500ml at birth
• clear - yellow ish
• no smell

• q4 weeks conception -28 weeks
• q2 weeks 28-36 weeks
• every week 36-delivery

• first day of LMP
• - 3 months
• + 7 days

• Gravida
• Term births
• Preterm births
• Abortions (loss before age of viability count to gravida not para)
• Living children

• visual disturbances
• headaches
• edema
• rapid weight gain
• pain
• S&S of infection
• vaginal bleeding
• persistant vomiting
• muscular irritability / convulsions
• decreased fetal movement

• C - chills & fever / cerebral disturbances
• A - abdominal pain
• B - blurred vision / blood pressure / bleeding
• S - swelling / sudden escape of fluids

• indicator of fetal growth
• 18-30 weeeks fundal height = aprox gestational age in weeks
• may be indicator of high risk factors (UIGR, hydoramnios, multiple gestation)

• ductus venosus - half blood bypasses liver & enters inferior vena cava
• ductus arteriosus- blood from L ventricle into aorta
• foramen ovale - R atrium into L atrium

• T - Toxoplasmosis (cat feces / undercooked meat)
• O - Other viruses (5th disease / chickenpox / lyme disease / HIV / Hep B / Group B strep)
• R - Rubella
• C - Cytomegalvirus
• H - Herpes (& other STDs)

• Blood type / RH factor
• CBCD
• VDRL ( syphylis)
• Rubella titer
• Hep B
• HIV
• AFP
• GTT (glucose tolerance test)
• Strep B
• Cultures: gonorrhea/ chlamydia/ group b strep)