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Changes of Pregnancy

Test 2

QuestionAnswer
When do changes of pregnancy begin? first week
Does pregnancy affect all systems of the body? yes
What causes the increase in the size of the uters in the first trimester? * increases vascularity & vessel dialation *hyperplasia & hypertrophy(length & thickness) *Developlment of dicidua
After the third month what causes uterine enlargment? mechanical pressure of growin fetus
Weight of uterus (pre-pregnant & the end of pregnancy)? 60 grams (2oz) ..... 1000 grams (2.2lbs)
Location of fundus at 12-16 weeks? symphysis pubis
Location of fundus at 22-24 weeks? Umbilicus
Location of fundus at 36 weeks? Xiphoid Process
*Lightening Fetal head settles into the pelvis
Hegars Sign softening of the uterine isthmus (just above cervix)
McDonalds Sign easy flexion of the fundus on the cervix
Braun von Fernwalds Sign softening and slight fullness of the fundus near the area of implantation
Piskaceks Sign Soft "tumor-like" enlargment
*Uterine Souffle maternal blood flowing through uterine arteries to the placenta heard with ultrasound device (equals maternal pulse)
*Funic Souffle caused by fetal blood flowing through the umbilical cord (equals fetal heart rate)
What forms to add strength to the uterine wall? fibrous and elastic tissue
Uterine thickness at conception, end of first trimester and at term conception- 1cm, *end of 1st trimester- 2cm *term- 0.5cm
*Braxton Hicks Cxs Irregular, painless uterine cxs (happen throughout pregnancy)
*Quickening Maternal perceptions of fetal movement*Multiparous at 14-16wks *Nulliparous 18 wks
Goodells Sign cervical softening in response to increases estrogen and progesterone
Operculum Mucous plug- obstructs or obliterates the cervical canal
Chadwicks Sign color change of cervix and vagina from light pink to deep blue-violet color
Leukorrhea thick white discharge increased during pregnancy
Vaginal pH decreases- becomes more acidic to precent bacterial infections but increases incidence of yeast infections
Progesterone production Produced by corpus luteum for the 1st 10-12wks. *once the placenta is developed it takes over in progesetrone production
What the function of progesterone during pregnancy? Maintain the endometrium *MAINTAINS THE PREGNANCY
What hormones are responsible for mammary gland changes? estrogen and progesterone
What are the subtle firt changes at the beginning of pregnance in the mammary glands? feeling of fullness, tingling or tenderness
*Striae Gravidarum stretch marks
Montgomery Tubercles enlarged sebaceous glands in the breast tissue
Changes of alveolar cells in the mammary glands at 6 weeks thin clear pre-colostrum fluid
Changes of alveolar cells in the mammary glands at 12 weeks a yellow secretion can be manually expressed
Changes of alveolar cells in the mammary glands in the third trimester colostrum (pre-milk fluid)
Changes of the heart pushed up and to the left and rotated anteriorly
Heart murmurs *systolic cardiac murmurs are normal *Diastolic murmurs are abnormal
Heart rate increases 10-15/min
Palpitations during pregnancy normal
Blood pressure rises during the 2nd trimester and then returns to first trimester levels *increases 5-10mm/hg
Cause of dependent edema and varicose vein formation increased venous pressure usually in the lower extremities
Vena Caval Syndrome pressure on the inferior vena cava when in supine position. Causes reflex bradycardia and decreased cardiac output (some women show increases BP)
Clinical manifestations of vena caval syndrome dizzines, pallor, clamminess
Increase in blood volume begins in first trimester @10-12wks, peaks in 3rd trimester @32wks (1500cc)
Plasma level at 32wks 1000cc
RBC at 32wks 450cc
Physiologic Anemia (pseudoanemia) hemodilution r/t greater increase of plasma than RBC
WBC increase occurs in 2nd trimester *5000-1200
Respiratory effects of increases vascularization r/t increased estrogen *Nasal and sinus stuffiness *Epistaxis *Voice Changes
Respiratory rate changes increases slightly by 2 breaths/min
Chest circumference increases by 6cm *rib cage flares *decrease in vertical diameter *increase in anterior-posterior and transverse diameters
Bladder shape changes from convex to concave
BUN and serum creatinine Decreased due to increased renal function
Glycosuria common in the second half of pregnancy
Hyperpigmented areas Areola, Nipples, Perianal
Linea Nigra pigmented line that extends from the symphisis pubis to the top of the fundus- begins in the 3rd month in primagravidaand rises with fundus; earlier on multigravidas and entire line appears
Melasmah Gravidarum (Facial Chloasma) Blotchy irregular brownish hyperpigmentation on face - more prominent in dar-haired women
Created by: jas067
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