What are the benefits of having prenatal care within the first 12 weeks?
id medical risks; basic lab work; patient education
First day of LMP -3months, +7days
Presumptive signs of pregnancy
Those signs that only the mother can feel
ex. amenorrhea, fatigue, nausea and vomiting, breast changes, quickening.
Probable signs of pregnancy
can be assessed by an experienced examiner
ex. ballottement, positive pregnancy tests
Positive signs of pregnancy
Can only attribute to the presence of a fetus
ex. sono, fetal hrt beat, fetal movement felt by someone other than the mother
What are other ways to calc due date?
Pregnancy wheels, fundal height (from pubic to top of fundus; 1 cm for each month pregnant), quickening felt at around 18 wks gestation
Why are general body system changes required during pregnancy?
to increase maternal cardiac output; to maintain uteroplacental perfusion and fetal demands.
Layers of Uterus wall include:
- Myometrium- outer Layer has longitudinal fibers that are mostly in the fundus adn assists in explelling the fetus during the birth process.
- Middle layers- forms a figure 8; constricts blood vessels after childbirth to stop bleeding.
- Inner layers- circular and located around the internal cervical os/opening; help keep the cervix closed during pregnancy
most troublesome during pregnancy; normally 10-12 cm long
palpable at symphysis pubis between 12-14 weeks; rises to umbilicus at 22-24 weeks; teaches xyphoid process at term; drops between 38-40 weeks due to lightening.
Placental profusion depends on
maternal blood flow to the uterus
How much of the total maternal blood volume is w/in the uterine vascular system at term of a normal pregnancy?
1/6 of the maternal blood volume.
What is the average rate of blood flow through the uterus?
Three causes of decreased pacental perfusion:
decreased maternal blood pressure
maternal supine position
Supine hypotention syndrome
when the inferior vena cava is compressed by the mother being in supine position.
Physiologic anemia of pregnancy
more volume and less rbcs in it; NORMAL condition of pregnancy.
gain 1500mL of blood at term (1000 mL plasma/500 mL RBC)
helps prevent bleed out after placenta detachment; can also increase chances of blood clots during pregnancy, and veracous veins.
Increased: heart size, blood volume and cardiac output
Decreased: systemic blood pressure, pulmonary vascular resistance
MOST dramatic and significant hemodynamic change during pregnancy B/C placenta profusion is TOTALLY dependent on maternal cardiac output
Systemic Vascular Resistance (SVR)
high flow, low resistance
Progestin and prostaglandins relax wall of maternal blood vessels
Diastolic more than systolic; lowest in 2nd trimester, but creeps back up in 3rd.