-
Where is the fundus height at
At 12, 16, 20, 26, and 37-40 weeks?
- 12 weeks - (just above) pubic symphysis
- 16 weeks - between public symphysis & umbilicus
- 20 weeks - umbilicus
- 26 weeks - xiphoid process
37-40 weeks - Regression in fundal height (dropping)
-
Chadwick’s Sign
- Discoloration (blue to purple) of the vagina & labia
- Earliest signs of pregnancy
- Due to increased blood flow to area
A presumptive sign of pregnancy
-
Why are pregnant women more prone to yeast infections?
Vagina cells increase in glycogen
- This causes an increased discharge
- But prevents growth of harmful bacteria
-
Early pregnancy stages are maintained with
progesterone secreted from the _____ for first ______ in pregnancy
After the ______ is developed, it take over the progesterone production
- corpus luteum
- 6-7 weeks
- placenta
-
Progesterone is the considered _____
the “hormone of pregnancy”
-
During pregnancy, the breasts & nipples become larger because of
Increased vascularity
-
Colostrum
Thick yellowish fluid secreted from nipples rich in antibodies
Begin at 12-16 weeks of pregnancy
Can be readily expressed from 3rd trimester
-
Medical term for stretch marks
What are they?
Straie Gravidarium
Lineal tears in connective tissue
-
Total blood volume during pregnancy increases ____ %
Why?
40-60%
- Transports nutrients & oxygen to placenta
- Demands of expanded maternal tissues
Functions as a reserve to protect women from effects of blood loss during birth
-
Physiologic Anemia aka Pseudo-anemia of
Pregnancy
Dilution of in RBC concentration in plasma
Due to pronounced plasma volume increase NOT decrease in RBC
Hematocrit Levels
Normal non-pregnant female is 12-15 g/dL
2nd trimester is less than 10.5 g/dL
1st & 3rd trimester is less than 11 g/dL
-
Cardiac Output Increases in pregnancy because
Why does the BP stay the same?
Increase is mostly based on amount of blood
- Placenta gives blood more room to go
- Heat from fetus causes vasodilatation
- Progesterone relaxes smooth muscle
- Prostaglandins decrease angiotensins ability to constrict vessels
-
Five Major Changes in Blood Flow during pregnancy
Altered to include the uterus & placenta
More blood circulates thru kidneys (more waste generated by mother & fetus)
Skin requires increased circulation to dissipate
Blood flow to breasts increases causing engorgement & dilated veins
Varicose Veins of legs, vulva, or rectum (hemorrhoids)
-
Supine Hypotension aka Vena Cava Syndrome
Decrease in BP when lying flat on back
Due to extra weight pushing down on vena cava & descending aorta
Mother feels light headed & faint
Turn mother on lateral recumbent position
-
Excessive salivation experienced by some during pregnancy
Ptyalism
-
Gallbladder changes during pregnancy
Becomes hypotonic causing emptying time to prolong
Becomes thicker bile
Increases chances of gallstones
-
Linea Nigra
Dark vertical line appearing on abdomen of pregnant women
Line runs vertically down midline
Caused by increased production of melanocyte stimulating hormone by placenta
More common in women with darker complexions
Disappears within few months after delivery
Latin “black line”
-
What happens to the thyroid gland during pregnancy
- Thyroid Gland Enlarges
- Increases in activity 25%
- Increase in pulse & heat intolerance
-
Parathyroid Gland is Important for ______ during pregnancy
Calcium Homeostasis
-
Explain quickly how Gestational
Diabetes happens
- In the 2nd half of pregnancy
- Maternal tissue sensitivity to insulin declines
- Mother uses fat stores to meet energy needs
The higher amounts of glucose in blood is for fetal energy
These higher glucose levels stimulates the pancreas to make more insulin
Gestational Diabetes is due to inadequate insulin production
-
Human Chorionic Somatomammotropin (hCS) aka
Human Placental Lactogen (hPL)
An insulin antagonist (reduces sensitivity of maternal cells to insulin)
Thus decreases maternal metabolism of glucose
This frees glucose for fetus
-
As maternal body water increases
List some outcomes
Edema (in the feet &legs) especially at end of the day
Carpal Tunnel due to fluid retention
-
List guidelines for weight gain during pregnancy and loss after pregnancy
- 1st trimester
- 2-4 pounds
- (1-1.5 lbs stated in lecture)
- 2nd & 3rd trimester
- 1 pound per week
- (0.88 lbs stated in lecture)
- Total Gain
- 25-35 pounds for women at normal BMI
- Weight Loss
- Usually lose 12 lbs immediately after birth
- 9 lbs after two weeks
- 5 lbs more in six months
-
During pregnancy resistance to infection _____
But autoimmune diseases during pregnancy
Why is this?
decreases
improve
allowing foreign object (fetus) grow
-
List out presumptive, the probable, and the positive signs of pregnancy
- Presumptive
- Nausea & Vomiting
- Fatigue & Drowsiness
- Urinary Frequency
- Breast & Skin Changes
- Chadwick’s Sign
- Fetal Movement (not felt until 2nd trimester)
- Amenorrhea
Probable
- Cervical
- Softening (found during pelvic exam)
- Probable
- Change in Uterus (Hagar’s Sign, Ballottment) Braxton Hicks Contractions
- Pregnancy Tests
- Postive
- Auscultation of Fetal Heart Sounds (16-20 weeks)
- Fetal Movements Felt by Examiner
- Visualization of Fetus via ultra-sound
-
Uterine Soufflé
- Soft blowing sound auscultated over uterus Sound of blood circulating thru dilated uterine vessels
- Heard late in pregnancy
-
The absence of menstruation
Amenorrhea
-
Subtle fetal movements between 16-20 weeks
Movements increase in intensity with progression
Quickening
-
Hagar’s Sign
- Uterus so soft can be flexed against cervix
- 6-8 weeks after menses
-
Ballottement
- Rising of fetus in amniotic fluid & rebounding to same position
- Takes place when pushing up cervix during exam
- You can feel the rebound
-
Tightening in the abdomen that comes and goes
Feels like mild menstrual cramps
Braxton Hicks Contractions
-
Characteristics that make Braxton Hicks unlike true labor
- Usually not painful
- Don’t happen at regular intervals
- Don’t get closer together
- Don’t increase when you walk
- Don’t last longer as they go on
- Don’t feel stronger over time
- Occur throughout pregnancy
-
False Labor
3rd trimester Braxton Hicks Contractions that are mistaken as early labor
They become more frequent in 3rd trimester, causing discomfort for mother
-
Gravida
Number of times pregnant regardless of duration
- Primagravida – Pregnant for 1st time
-
- Multigravida – Pregnant more than once
-
Parity (Para)
Number of pregnancies that have ended at 20 weeks or more
Regardless of infant being alive or dead
Nullipara (none), primipara (1), multipara (more than 2)
-
Acronym that gives complete description of all pregnancy outcomes
GTPAL
- Gravida
- Term Births
- Pre-Term Births
- Abortions (Terminations, Spontaneous)
- Living Children
-
Fetal Heart Rate
110-160 bpm
-
Treatments for Morning Sickness (as discussed in lecture)
- Have a little protein before going to bed
- Eat saltines in morning before your feet hit the ground
- Small meals
- Drink liquids separately from meals
- Some advice taking vitamin B (talk to doc about that)
-
Complication of pregnancy characterized by severe nausea, vomiting, weight loss, and electrolyte imbalance
Hyperemesis Gravidarum
NOT the same thing as morning sickness
-
What causes heartburn during pregnancy?
Ways to treat it
- Diminished gastric motility
- Compression of stomach
- Esophageal sphincter relaxes
- Treatments
- Antacids (liquids are better)
- Avoid high salt content food
- Sit up for meals
- Ditch the coffee
-
Men exhibiting pregnancy symptoms (fatigue, nausea, vomiting)
Related to stress, anxiety, & empathy
Couvade
-
Practice of eating nonfood or some food components not part of normal diet
-
Caffeine Intake during pregnancy
less than 200 mg/day
6 oz coffee = 100 mg caffeine
-
What happens to iron supplement intake after pregnancy?
Continue taking them for 2-3months to replenish stores depleted during pregnancy
-
What are the 3 phases of a Contraction
Cycle
- Increment
- Begins in fundus & spreads thru uterus
- Peak (Acme)
- Contraction most intense
- Decrement
- Decreasing intensity as uterus relaxes
-
Contractions can be described in terms of
- Frequency
- Measured in “minutes apart”
- Frequency = Duration + Interval
- Duration
- How long contractions last
- Interval
- In between time / uterine relaxation occurs
- Period between end of one contraction & beginning of next
- Fetal exchange of oxygen, nutrients & waste occur
- Intensity
- (mild, moderate, strong)
-
Effacement
Thinning & shortening of cervix
Starts a cylindrical structure but merges with lower uterus as it thins
Measured as a percentage (100% effaced)
-
Dilation
- Opening of the cervix
- Expressed in cm (10 cm is full dilation)
-
During labor & birth, mother should be in a position other than _____ in order to let blood return to heart
Supine
-
Changing shape of fetal head to adapt to size &
shape of pelvis
Molding
-
List premonitory (warning) signs of labor
Braxton Hicks Contractions increase in frequency & become
Vaginal Secretions increase of clear, nonirritating secretions
- Lightening (Dropping)
- Bloody Show
- Nesting
- Small Weight Loss
- 2.2 -6.6 kg (1-3 pounds)
-
Lightening
- aka Dropping
- Fetus descends toward pelvic inlet
- Most noticeable in nulliparas
Usually occurs 2-3 weeks before onset of labor
-
Bloody Shoe
Mixture of thick mucus with pink or brown blood
- Caused due to cervix beginning to soften,
- dilate, & efface slightly (Ripening)
This change in cervix causes mucus plug to come out
Blood comes from vessels in cervix as it changes
-
Lochia
vaginal discharge after giving birth (puerperium) containing blood, mucus, and uterine tissue
- Lochia Rubra
- Discharge is red
- Containing lots of blood
- Lasts up to day 5
- Lochia Serosa
- Brownish or pink in color
- Contains contains serous exudate, erythrocytes, leukocytes, and cervical mucus
- Lasts up to 10th day
- Lochia Alba
- Whitish or yellowish-white
- Contains leukocytes, epithelial cells, cholesterol, fat, and mucus
- Weeks 2-7 after birth
-
Medical Terms for the "mask of pregnancy"
Chloasma or Melasma
|
|
