-
Known teratogens to avoid
- Warfarin (Coumadin) - anticoagulatant
- Isotreinoin (Accutane) - VitaA acne
- Gold salts - Aurothioglucose arthritis
- Lithium (Eskalith) -manic depression
- Diazepam (Valium)- anxiety disorders
- Phenytoin (Dilantin) - antiseizure
- Tetracycline - antibacterial, antifungal
- Diethylstilbestrol - estrogen
- DES (stilphostrol) - non-steroidal estro
- Live virus vaccine -antiviral
- Folic Acid Antagonists - Vitamin B complex
-
Can cause birth defects (prescribed meds, street drug, alcohol, disease that the mother is exposed during pregnancy)
Teratogens
-
Healthy lifestyle before pregnancy means?
Low-fat, high-fiber diet rich in vegetables and fruits; exercising at least 3 times a week and getting to within 15lbs of one's ideal weight
-
All women who possibly could be pregnant should have an intake of?
400 mcg of folic acid (B a vitamin supplement) and/or fortified foods, and eat a healthful diet.
-
Tests that are completed during pregnancy
Syphilis, Hep B, HIV, Chlamydia, gonorrhea, HPV, and herpes simplex
-
Low-birth weight complication is
smoking
-
Illicit drugs can lead to
Abnormalities and disorders
-
The condition of carrying an offspring within the body
Pregnancy
-
Sexual act that delivers sperm to the cervix by ejaculatoin of the erect penis
Coitus or Copulation
(Fertalization)
-
Union of the ovum and sperm
Fertalization
(Fertalization)
-
Fertalized ovum
Zygote
(Fertalization)
-
Mass of cells resembling a mulberry
Morula
(Fertalization)
-
Cluster of cells that will develop into an embryo
Blastocyst
(Fertalization)
-
Embedding of a fertalized egg into the uterine lining
Implantation
(Implantation)
-
The endometrium after implantation
Decidua
(Implantation)
-
Outer fetal membrane formed by a trophoblast
Chorion
(Implantation)
-
Inner fetal membrane originating from a blastocyst
Amnion
(Implantation)
-
Fine hair covering body of the fetus is
Lanugo
(Amniotic fluid)
-
White, creamy covering of the fetus's body is
Vernix caseosa
(Amniotic fluid)
-
-
Rapid cell division & differentiation
Germinal layers form
Week 1 & 2 (Preembryonic or Germinal stage)
-
Primitive nerous system
Eyes
Ears
RBCs present
Heart begins to beat day 21
Week 3 (Embryonic Stage)
-
Half the size of a pea
Brain differentiates
GI tract begins to form
Limb buds appear
Week 4
- Wt 0.4g
- L 4-6mm
- (Crown-rump C-R)
-
Cranial nerves present
Muscles have innervation
Week 5
L 6-8mm (C-R)
-
Fetal circulation
Liver produces RBCs
Cental autonomic nervous system forms
Primitive kidneys form
Lung buds present
Cartilage forms
Primitive skeleton forms
Muscles differentiate
Week 6
L 10-14mm (C-R)
-
Eyelids form
Palate and tongue form
Stomach formed
Diaphram formed
Arms legs move
Week 7
L 22-28mm (C-R)
-
Resembles human being
Eyes moved to face front
Heart development complete
Hands and feet well formed
Bone cells begin replacing cartilage
All body organs have begun forming
Week 8
- Wt 2g
- L 3cm (1.5in) (C-R)
-
Finger and toenails form
Eyelids fuse shut
Week 9 (Fetal stage)
-
Head growth slows
Islets of Langerhans differentiate
Bone marrow forms, RBCs
Bladder sac forms
Kidneys make urine
Week 10
Wt 14g (1/2oz)
-
Tooth buds appear
Liver secretes bile
Urinary system functions
Insulin forms in pancreas
Week 11
-
Lungs take shape
Palate fuses
HB heard with Doppler
Ossification established
Swallowing reflex present
Exnternal genitalia, male/female, distinguished
Week 12
- Wt 45g (1.5oz)
- L 9cm (3.5in) (C-R)
- 11.5cm (4.5in) (C-H)
-
*Meconium forms in bowels
Scalp hair appears
Frequent movement
Skin thin, pink
Sensitive to light
200mL amniotic fluid
(Amniocentesis possible)
*Fecal material stored in the fetal intestines - The earliest stools of the infant (bile, mucus and epithelial cells)
Week 16 (Second trimester)
- Wt 200g (7oz)
- L 13.5cm (5.5in) (C-R)
- 15cm (6in) (C-H)
-
*Myelination of spinal cord begins
Peristalsis begins
Lanugo covers the body
Vernix Caseosa covers the body
Brown fat begun
Sucks and swallows amniotic fluid
HB heart with a fetoscope
Hands can grasp
Regular schedule of sucking, kicking, and sleeping
*development, formation of the myelin sheath around a nerve fiber - maturation of nerve cells whereby myelin is formed
Week 20
- Wt 435 g (15oz)
- L 19cm (7.5in) (C-R)
- 25cm (10 in) (C-H)
-
Alveoli present in lungs, begin producing *surfactant
Eyes completely formed
Eyelashes and eyebrows appear
Many reflexes appear
Change of survival born
*Reduces surface tension of fluid in the lungs and helps make the small air sacs in the lungs (Alveoli) more stable. keeps them from collapsing when individual exhales - helps to not stick
Week 24
- Wt 780g
- (1lb, 12oz)
- L 23cm (9in) (C-R)
- 28cm (11in) (C-H)
-
Subcutaneous fat deposits begun
Lanugo begins to disappear
Nails appear
Eyelids open and close
Testes begin to descend
Week 28 (Third trimester)
- Wt 1200g
- (2lb, 10oz)
- L 28cm (11in) (C-R)
- 35cm (14in) (C-H)
-
More reflexes present
CNS directs rhythmic breathing movements
CNS partially controls body temperature
Begins storing iron, Calcium, phosphorus
Ratio of the lung surfactants *lecithin and sphingomyelin (L/S) is 1.2:2
Week 32
- Wt 2,000g
- (4lb, 6.5oz)
- L 31cm (12in) (C-R)
- 41cm (16in (C-H)
-
A few creases on soles of feet
Skin less wrinkled
Fingernails reach fingertips
Sleep-wake cycle fairly definite
Transfer of maternal antibodies
Week 36
- Wt 2,500-2,750g
- (5lbs, 8oz)
- L 35cm (14in) (C-R)
- 48cm (19in) (C-H)
-
-
Lanugo only on shoulders and upper back
Creases cover soles
Vernix mainly in folds of skin
Ear cartilage firm
Less active, limited space, Ready to be worn
Week 40
- Wt 3,000-3,600g
- (6lb, 10oz-7lb, 15oz)
- L 50cm (20in) (C-H)
-
Cardiovascular system consists of
Fetal circulation
- Ductus venousus
- Foramen ovale
- Ductus arteriosus
Hematologic Development
-
A flap opening the atrial septum that allows only right to left movement of blood is
*
Foramen Ovale
-
Fetal vessel connecting to the pulmonary artery to the aorta
Ductus arteriosus
- PA
- Pulmonary artery to aorta
-
Branch of the umbilical vein that enters the inferior vena cava
Ductus venosus
UI
-
Painless contractions (about 16 weeks or later) are irregular uterine contractions occuring throughout pregnancy is
Braxton-Hicks contractions
-
Most obvious physiological occur in the
Reproductive system
-
Striae gravidarum
Stretch marks
-
Softening of the uterine isthmus about the 6th week of pregnancy, noted during a pelvic exam is
Hegar's sign
a probable sign of pregnancy
-
A pigmented line on the abdomen from the umbilicus to symphysis pubis is
Linea nigra
-
Mask of pregnancy - a darkening of the skin of the forehead and around they eyes is
Cholasma
-
An antibody rich yellow fluid secreated by the breasts during the last trimester and the first 2-3 days after birth, gradually changes to milk a few days after delivery
Colostrum
-
Naturally secreted by the ovary in the second two weeks of menstrual cycle - a female hormone important for the regulation of ovulation and menstration
Progesterone
--used to cause menstral periods in women who have not reached menopause but are not having periods due to the lack of progesterone in the body
-
Excretion of glucose in the urine
Glycosuria
-
GFR
Glomerular filtration rate
begins rising in the 2nd trimester
-
(Cervix - 8 weeks)
Softening of the cervix
Goodell's sign
-
(Cervix - 8 weeks)
A purplish-blue color of the cervix and vagina caused by the increased vascularity is
Chadwick's sign
-
Loss of pregnancy before the age of viability (20 weeks)
Abortion
-
Gravida, para/term, preterm, abortions, living
GP/TPAL
Examples
- Mary Jo is
- G2 P1/T2 P0 A0 L2
Second pregnancy (G2), one delivery (P1)/ two infants at term (twins) (T2), both living
Susan G4 P2/T1 P1 A1 L2
Fourth pregnancy, two deliveries/one term infant, one preterm infant, one abortion, two living children
-
Pregnancy regardless of duration includes present pregnancy
Gravida
-
Delivery (birth) after 20 weeks gestation, wheter infant born alive or dead or number of infants born
Para
-
Delivery after 20 weeks gestation but before 38 weeks (full-term)
Preterm
-
A pregnancy between 38 and 42 weeks gestation
Term
-
Never been pregnant
Nulligravida
-
Pregnant for the first time
Primigravida
-
Pregnant 2 or more times
Multigravida
-
Never having delivered an infant after 20 weeks gestation
Nullipara
-
Has delivered once after 20 weeks gestation
Primipara
-
Has delivered twice or more after 20 weeks gestation
Multipara
-
Delivery after 42 weeks gestation
Postterm
-
Month
6 (June)
-3 months
3 (March)
Day
28
+7 days
35
1st day of Women's LMP
Naegele's Rule - Calculating EDB
- Take the date of the 1st day of the LMP
- Subtract 3 mths
- Add 7 days
LMP was June 28 calculation above
-
Measurements used an EDB
- Uterine size
- date of quickening
- Date when the fetal HB was heard
- Ultrasound fetal measurements
-
-
Gestation Calculation Wheel
Vagistat
-
A membranous vascular organ connecting the fetus to the mother is?
What does it do?
Placenta
- Produces hormones
- Supplies fetus w/ oxygen and food
- Transports waste products
-
The three major functions of the placenta
Transport, endocrine, metabolism
-
Endocrine secretes five hormones
- hCG - human chorionic gonadotrophin
- hPL - human placenta lactogen
- Estrogen
- Progesterone
- Relaxin
-
Fetal development divded in to three stages they are
- Embryonic and germinal stage - 1-2
- Embryonic - 3 week
- Fetal stage - 9 week
-
Second trimester begins on week
16
-
Third trimester begins on week
28
-
The primitive heart begins at
21 days or week 3
-
Factors affecting psychological response
- Body image
- Financial situation
- Cultural expectations
- Emotional security
- Support from significant other
-
Return visits for q 4 weeks should be at
28 weeks
-
AFB testing is accepted as the standard of care and must be offered to pregnant women between ___ and ___ weeks of pregnancy
16-20
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