1. Contraindicated vaccinations during pregnancy
    • MMR
    • OPV
    • Flu with nasal spray
  2. Allowed vaccinations during pregnancy
    • Hep B (only if they’ve been exposed)
    • H1N1
    • Health Promotion
  3. What is a teratogen?
    Any substance or agent that can cause abnormalities in fetal development
  4. ____ ____ cross the placental barrier and can cause harm to fetus
    Most drugs
  5. Smoking can cause _____
    Low birth weight and prematurity
  6. Alcohol can cause ____
    Growth retardation and FAS
  7. Life begins____
    At conception
  8. Mitosis is
    Normal process of cell division- body cells
  9. Meiosis is
    Cell division that only occurs in reproductive cells.
  10. Cellular division of the sperm is called
  11. Cellular division of the ovum (egg) is
  12. Each sperm has ____ chromosomes
  13. Sperm can have _______ sex chromosomes
    X or Y
  14. Ova have _____ chromosomes
  15. Ova only have _____ sex chromosomes
  16. ____ sperm develop from one sperm cell
  17. ____ ova develop from 1 egg cell
  18. Fertilization occurs when
    Sorry successfully penetrates an ovum
  19. Fertilization occurs in the ______ of the Fallopian tube, the area ______ to the ovary.
    • 1) outer third
    • 2) closest
  20. The egg can survive ____ after OVULATION
  21. Sperm can survive _____ after ejaculation
    5 days.
  22. Sex determination occurs _____
    At fertilization.
  23. A fertilized cell is called (Sperm and Ova join)
    A zygote
  24. The size of the zygote_____
    Never changes.
  25. After three days the fertilized cells go through a cleavage and are known as
    A morula
  26. The inner layer of the morula that will form the embryo is called
  27. The outer layer of the morula that develops into the chorion is called
  28. Zygotes implant into the ____
  29. After implantation, the endometrium is called
  30. The deidua basalis is
    The area immediately under the blastocyst. Forms the maternal side of the placenta
  31. The chorion is the ___ of the fetal membrane
    Outer layer
  32. The amnion is the ____ of the fetal membrane
    Inner layer
  33. The chorion envelopes the
    Amnion, embryo, and yolk sac
  34. The Amnion
    Surrounds and protects the embryo and grows until it sticks to the chorion.
  35. The amnion contains ____ ml of fluid at 10 weeks.
  36. The amnion contains ____ ml of fluid at term
  37. Functions of the amniotic fluid
    • Equalizes pressure
    • Protects and cushions
    • Maintains even temp and fluid for the fetus to swallow
    • Allows movement and normal growth
    • Lubricates and prevents sac from sticking to fetus.
  38. Yolk sac functions
    • Functions only during embryonic development
    • Initiates production of RBC until 6 weeks when the liver takes over.
  39. What is the placenta
    Organ that provides nutrients, oxygenation, and waste removal for the fetus
  40. The placenta has
    1 umbilical vein and 2 umbilical arteries.
  41. The umbilical vein
    Carries oxygenated blood to fetus
  42. The umbilical arteries
    Carry deoxygenated blood and waste from fetus.
  43. The placenta produced 4 hormones:
    • Estrogen
    • Progesterone
    • hCG
    • hPL
  44. Estrogen
    Stimulates uterine growth, helps with lactation, causes some physical changes during pregnancy
  45. Progesterone
    Maintains uterine lining, reduced contraction, and hell’s prepare for lactation.
  46. hCG
    Causes continued production of estrogen and progesterone to sustain pregnancy
  47. hPL
    Helps to make more glucose available to fetus to accommodate growth
  48. Relaxing
    Softens connective tissue in pelvis
  49. What does Wharton’s jelly do
    Protects the umbilical cord vessels ( arteries and veins)
  50. How long is the umbilical cord
  51. Zygote is what stage
    Fertilization -3weeks
  52. Embryo is what stage
  53. Fetal is what stage
    Week 9- delivery.
  54. Fetal development occurs
  55. What are the three shunts needed in fetal circulation.
    • Ductus arteriosus
    • Ductus venosus
    • Foraminifera ovale.
  56. Describe ductus arteriosus
    • Diverts blood from pulmonary artery to aorta
    • (Lungs -body)
  57. Describe ductus venosus
    • Diverts blood from the liver to the inferior vena cava
    • (Body- heart)
  58. Describe foremen ovale
    Connects right atria to left atria
  59. Describe monozygotic twins.
    • Identical
    • Come from one egg (mono)
    • Same sex
    • Share placenta and chorion but have separate amnions
  60. Describe dizygotic twins
    • Fraternal
    • Two eggs fertilized by two sperm
    • May not be the same sex
    • 2 separate placentas, chorions and amnions
  61. What is fundal height
    When uterus is just below xiphoid process
  62. Progesterone continues to be produced for up to _____ weeks to maintain pregnancy
  63. A mucus plug is formed in the ___
  64. During dilation, ____ be expelled from the cervix
    Mucus plug
  65. During pregnancy the _____ of the vagina may change to protect from infections.
  66. Chadwicks sign appear because of
    Increased vascular congestion
  67. Describe colostrum
    • High in protein, vitamins, and minerals
    • Provides immunity to baby
    • Helps baby cleanse GI tract
  68. During pregnancy _____ increases
    • Circulating blood volume
    • Pulse rate
  69. What is vena cava syndrome
    Occurs due to weight of the uterus. Reduced blood return to heart and can lead to fetal hypoxia
  70. Oxygen consumption _____ during pregnancy
  71. Changes in the GI system
    • N/v
    • Constipation from decreases motility and pressure from uterus
    • Gas and heart burn
    • Increases appetite and thirst
  72. Pregnant women need ____ glasses of fluids a day
  73. Linea nigra
    Brown lines on belly
  74. Chloasma
    Pregnancy mask
  75. Striae
    Stretch marks
  76. Presumptive signs of pregnancy
    • Amenorrhea
    • N/v
    • Changes in breast
    • Urinary frequency
    • Fatigue/sleepiness
    • Abdominal enlargement
    • Quickening
  77. Probably signs of pregnancy
    • Goodells sign- softening of cervix
    • Hegars sign- softening of lower uterus
    • Chadwicks- blue discoloration due to increased BL food
    • Uterine enlargement
    • Braxton Hicks contractions
    • Increased pigmentation
    • Ballottement- rebounding of the fetus
    • Positive pregnancy test
  78. Positive signs of pregnancy
    • Heart beat of fetus
    • Rate goes down in latter part of pregnancy
    • Ultrasound
    • Fetal movements
    • FHT
  79. Normal heart rate for fetus early pregnancy
  80. Normal heart rate for fetus later pregnancy
  81. Gravida is
    Total number of pregnancies
  82. Para is
    Births that reach 20 weeks
  83. Preterm is
    Delivery after 20 weeks but before 38
  84. Term is
    Pregnancy between 38-42 weeks
  85. Post term is
    Delivery after 42 weeks
  86. Abortion is
    Including induced and spontaneous (miscarriage)
  87. Gestation age is
    Calculated from first day of last missed period
  88. Glucose tolerance test at ____
    6-7 months
  89. Estimate date of delivery
    First day of LPM - 3 months + 7 days
  90. TPALM

    • Term
    • Preterm
    • Abortions
    • Living
    • Multiples
  91. Pregnant women should increase daily calorie intake by
    300 calories a day
  92. Four main nutrients needed during pregnancy
    • Protein- metabolic needs
    • Calcium- bones and lactation
    • Iron- fetal requirements and RBC
    • Folic Acid- to prevent neural tube defects and RBC production
  93. Total weight gain recommended
    • 25-35lbs
    • Less if overweight
    • More if underweight
  94. Hyperemesis gravidarum
    • Severe n/v during pregnancy that goes last first trimester
    • Caused by increased hCG and stress
  95. Threatened abortion
    Closed cervix. Spotting no tissue passed. Membrane intact
  96. Inevitable abortion
    Bleeding/cramping. Some cervical dilation with possible rupture of membranes.
  97. Incomplete abortion
    Cervix dilated. Passage of some tissue. Bleeding heavy and cramping severe
  98. Complete abortion
    • All
    • Products of conception are expelled. Cervix closes and bleeding stops.
  99. Missed abortion
    Fetus dies in uterine but is not expelled. Cervix closed. Not FHT.
  100. Recurrent abortion’s
    Series of 3 or more of any kind
  101. Observe for ____ with abortion
  102. _____ is given time Rh negative mothers
  103. Incomplete cervix
    • Painless dilation of cervix in 2nd trimester. Might cause habitual abortions
    • Treated by cerclage( suturing cervix closed)
  104. Ectopic pregnancy
    Pregnancy where implantation occurs outside of uterus
  105. Causes of ectopic pregnancies
    • Scarring from IUD
    • Infection
    • Defects
    • Adhesions
    • Endometriosis
    • Abnormal hormones.
  106. S/s ectopic pregnancy
    • *appear within 5 weeks of missed period *
    • Lower quad pain
    • Sudden severe lower pain
    • Vagina bleeding
    • Possible shock
  107. Hydatidiform mole
    • Molar pregnancy
    • Malformation in development of placenta. Chorionic villa abnormally increase and develop cyst like sacs that look like grapes

    *can lead to cancer.
  108. S/s of hydatidiform mole
    • No FHT
    • Vaginal bleeding
    • Fundal height greater that expected
    • S/s of PIH
    • Servers vomiting
    • High hCG
    • Snowstorms on US
  109. Treatment for molar pregnancy
    • Evacuate uterus
    • Hysterectomy
    • Avoid pregnancy for 1 year
    • Give rhogam
    • Test hCG
  110. Placenta previa
    Vaginal bleeding that occurs in late pregnancy. Placenta implants and develops in lower uterine segment and overlies the cervical os.
  111. Classifications first placenta previa
    • Complete
    • Partial
    • Low lying
  112. Complete placenta previa
    Placenta completely covers cervical os
  113. Partial placenta previa
    Partially covers cervical os
  114. Low lying placenta previa
    Placenta within 2-3cm of cervix.
  115. S/s placenta previa
    • Painless vaginal bleeding
    • Fetal distress and hypoxia
    • Abnormal baby presentation.
    • Infection
  116. Treatment for placenta previa
    • Avoid pelvic exams
    • C section if complete
    • C section if partial
    • If low lying- vaginal delivery but c section is preferred.

    Steroids early on.
  117. Abruptio placentae
    Premature separation of placenta from uterine wall. Can be partial or compete. Causes fetal distress.
  118. S/s of abruptio placentae
    • Vaginal bleeding
    • Severe pain
    • Rigid board like abdomen
    • FHT los or absent
    • Sudden fetal inactivity
    • Hemorrhage
  119. Treatment for abruptio placentae
    • C section
    • Bloood snd clotting factor replacement
  120. Gestational hypertension
    • Aka toxemia or pregnancy induced hypertension.
    • Cause unknown.
  121. S/s PIH
    • Appears after 20 weeks
    • Hypertension BP greater than 140/90
    • Or bp 30/15 higher than prepreg bp
    • Edema
    • Proteinuria
    • Oliguria
    • Blurred vision
    • Ha
    • Seizures
  122. Four classifications for PIH
    • Preeclampsia
    • Mild
    • Severe
    • Exclampsia
  123. Eclmapsia is Diagnosed when
    Convulsive stage begins
  124. Goal bs for pregnant women
  125. Gestation diabetes
    • Developes because of pregnancy in 2nd or 3rd trimesters.
    • Diagnosed with GTT 24-28 weeks
    • Goal BS 70-105
    • Toxoplasmosis (neuro damage low weight)
    • Other.. hiv, hep b, tb, and group b step. (Tested around 30 weeks )
    • Rubella (microcephaly, MR)
    • Cytomegalovirus (mr, Blindness, deafness)
    • Herpes virus ( neuro effects- requires c section. May cause death)
  127. RH incompatibility
    • Rh factor is either present or absent in the blood
    • Mother and baby blood usually doesn’t mix but if it does and Rh is there, body will produce anti bodies.
    • Antibodies are permanent.
    • Can cross placenta and destroy fetal RBC
  128. Treatment for RHA INCOM.
    • Rhogam at 28 weeks and within 72 hrs of delivery
    • Not beneficial if sensitization has already occurred.
  129. FAS causes
    • Mr
    • Growth retardation

    S/s flat nasal bridge, thin upper lip, poorly formed grove above lip, microcephaly, short eye tissue Mc jittery nature.
  130. Drug addiction
    • Small weight
    • Withdrawal symptoms
    • Some defects
    • Neuro defects
  131. Preterm labor
    • Begins after 20 weeks but before 37
    • Causes vary

    • S/s
    • Contractions, PROM, cervical dilation and effacement

    • Tx
    • Depends.
    • Attempts to stop labor of dilated less than 4cm
    • Not stopped if health is at risk.
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