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physiologicpregnancy
Physiologic adaptations to pregnancy c13 ob
| Question | Answer |
|---|---|
| abortion | spontaneous/elective termination of pregnancy before 20th week of gestation. Spontaneous = miscarriage |
| amenorhea | absence of menstruation |
| braxton hicks contractions | irregular, mild uterine contractions occurring during pregnancy and becoming stronger in last trimester |
| chadwick's sign | bluish purple discoloration of cervix, vagina and labia during pregnancy as a result of inc. vascular congestion |
| colostrum | breast fluid secreted during pregnancy and the 1st week after childbirth |
| diastasis recti | separation of the longitudinal muscles of the abdomen (rectus abdominis) during pregnancy |
| goodell's sign | softening of the cervix during pregnancy |
| gravida | a woman who is or has been pregnant, regardless of the duration or outcome of the pregnancy. |
| hyperemia | excess of blood in a part of the body |
| melasma | brownish pigmentation of face during pregnancy also called chloasma or "mask of pregnancy" |
| multipara | woman who has delivered 2+ pregnancies at 20 or more weeks of gestation |
| nullipara | woman who has never completed a pregnancy beyond a spontaneous or elective abortion |
| para | number of pregnancies that have progressed to 20 or more weeks at delivery, weather the fetus was born alive or was stillborn |
| physiologic anemia of pregnancy | dec. in hemoglobin and hermatocrit values caused by dilution of erythrocytes by expanded plasma volume rather than by an actual dec. in erythrocytes or hemoglobin |
| postterm birth | birth that occurs after 42 weeks of gestation |
| preterm birth | birth that occurs after the 20th week and before the start of the 38th week of gestation |
| primigravida | woman who is pregnant for the first time |
| primipara | woman who has delivered one pregnancy of at least 20 weeks |
| quickening | first movements of fetus in the uterus felt by the mother |
| striae gravidarum | irregular pink to purple streaks on abdomen, breasts or thighs resulting from tears in the connective tissue (stretch marks) |
| term birth | birth that occurs between 38th and 42nd weeks of gestation |
| trimester | division of pregnancy; one of three equal parts of 13 weeks each. |
| The uterus grows during pregnancy due to __ and ___. | hyperplasia and hypertrophy. (1st, 2-3, respectively) |
| Where can the fundus be felt at 12 weeks gestation | above the symphysis pubis |
| At 16 weeks, where is the fundus located? | midway b/w symphysis pubis and umbilicus |
| During what gestation week does the uterus reach the umblilicus? | 20 weeks |
| At 36 weeks the uterus is located | at the xiphoid process and is the highest point it will reach. causes SOB |
| lightening | descent of fetal head into pelvic cavity, reducing pressure on the diaphragm and making breathing easier |
| false labor | when braxton hicks contractions are thought to be the onset of early labor |
| bloody show | when the mucous plus, plus small amount of blood dislodged when cervix begins to thin and dilate |
| In the first 6 to 7 weeks of pregnancy the major function of the ovaries is to? | secrete progesterone (hormone of pregnancy) |
| Cardiac position in late pregnancy | upward and more lateral for heart sounds, since it enlarges slightly to handle inc. workload |
| most common variation of heart sounds in pregnancy? | splitting of the first heart sound and a systolic murmur found in 90% of pregnant women. additional 3rd heart sound often heard bc rapid filling during diastole. |
| total blood volume increase during pregnancy | inc. of 30-50%. |
| plasma volume increase during pregnancy | 40-60%. |
| The increased blood volume is needed for? | transport nutrients/oxygen to placenta for fetus and to meet demands of expanded maternal tissue in uterus and breasts. protection for postbirth blood loss |
| iron deficiency anemia in pregnancy | when hemoglovin less than 11 g/dL in 1st and 3rd. or less than 10.5 in 2nd. |
| Effect of pregnancy on HR | inc 10-20 bpm |
| Peripheral vascular resistance dec. during pregnancy due to? | smooth muscle relaxation in vessel walls. uteroplacental unit - inc circ. area. fetal heat production - vasodilation. dec responsiventess of angiotensin II receptors. inc. nitric oxide levels - vasodilation. |
| supine hypotensive syndrome during pregnancy | dec. venous return when laying down. bc wt of uterus partially occludes vena cava symptoms inc. faintness, lightheadedness, dizziness, nausea and agitaition. placenta blood flow red. if prolonged supine position could cause fetal hypoxia. |
| suggested sleep position for pregnancy and why | right lateral recumbent position to prevent supine hypotension |
| During pregnancy plasma fibrinogens inc 50% this allows - | dec. risk of hemorrhage, b/c inc clotting during childbirth. risk for clots in legs esp. in woman who stand/sit for long periods of time. |
| respiration changes in pregnancy | same RR but deeper breaths |
| Progesterone/estrogen effect on breathing | feel need to take breaths, sinus and nasal stuffiness, nosebleeds and voice changes |
| ptyalism | excessive salivation - combat by eating small, frequent meals, gum chewing and oral lozenges. |
| teeth and pregnancy | unchanged |
| gums and pregnancy | elevated estrogen inc. risk of bleeds and gingivitis |
| pyrosis | heartburn - inc during pregnancy due to LES tone dec bc of progesterone. |
| glycosuria and proteinuria in pregnancy | common in pregnancy not necessarily a kidney problem - renal function tests may be misleading. risk for uti's |
| palmar erythema | redness of palms or soles of feet - clinically insignificant and disapper shortly after childbirth |
| hair loss postpartum | 1-4 months postpartum hair follicles return to normal resting phase and loss will not continue. |
| fetal calcium needs and affect on mother | inc need by fetus causes inc absorption from intestines in first trimester and then stored to meet later needs. no loss of maternal bone density. |
| wide stance and waddling gait in late pregnancy means.. | relaxed pelvic joins and compensation for changing center of gravity |
| progressive lordosis w/ backache in late pregnancy | inc uterus causes mother to lean backwards to maintain balance. |
| oxytocin and pregnancy | stimulates contraction of uterus, but during inhibited by progesterone. also stimulates milk ejection reflex after childbirth |
| prolactin | from anterior pituitary - increases in pregnancy to prepare breasts to produce milk |
| pregnancy and glucose | glucose levels are 10-20% lower. fetus uses mother glucose, freq small meals |
| hCG | human chorionic gonadotropin. produced in early pregnancy by trophoblastic cells surrounding embryo. stimulates corpus luteum to produce prog/est unti placenta developed at about 11 wks gestation. also causes + preg test |
| estrogen functions during pregnancy | stim. uterine growth. inc blood supply to uterine vessels. aids in developing ductal system in breasts. hyperpigmentation. vascular changes in skin. inc salivary gland activity. hyperemia of gums and nasal mucous membranes. |
| major functions of progesterone in pregnancy | maintain endometrial layer for implantation of fertilized ovum. prevent abortion by relaxing muscles. prevent tissue rejection of fetus. stim devlop of lobes/lobules in breasts. facilitate deposit of maternal fat stores for energy reserve. |
| human placental lactogen hPL (human chorionic somatomammotropin hCS) | inc. availble glucose for fetus by reducing sensitivity of maternal cells to insulin. |
| relaxin | produced by corpus luteum and placenta. inhibits uterine activity, softens connective tissue in cervix and relaxes pelvic joints. |
| water retention and pregnancy | inc. water required. risk for dependent edema. risk for carpal tunnel syndrome. |
| gestational diabetes | due to inability to inc insulin production causing hyperglycemia. inc. insulin needed for mother glucose needs, bc fetus taking glucose and lower sensitivity to insulin. |
| vision changes in pregnancy | mostly in third trimester, corneal edema and thickening. returns to norm by 6 weeks PP - contact wearers may have discomfort, no new Rx until after corrects. women with glaucoma may see improvement due to pressure changes. |
| a definitive diagnosis of pregnancy can be based only on ___ | positive signs |
| presumptive indications of pregnancy | mainly subjective changes woman experiences. least reliable. amenorrhea, nausea. vomiting. fatigue. urinary frequency. breast/skin changes, vaginal/cervical color changes. fetal movement. |
| probable indications of pregnancy | objective finding. abdominal enlargement. cervical softening, ballottement, braxton hicks contractions, palpation of fetal outline, uterine souffle, pregnancy tests |
| funic souffle | soft purring sound heard over umbilical cord that corresponds to fetal HR |
| positive indications of pregnancy | auscultation of fetal heart sounds, fetal movements felt by examiner, visualization of embryo or fetus. |
| Hegar's sign | at 6-8 weeks after last menses, lower uterine segment (isthmus) soft enough to be compressed to the thinness of paper. |
| radioimmunoassay | radioactively labeled markers are used to detect antibodies against beta subunit hCG in blood or urine. most sensitive pregnancy test available accurate before first missed menstrual period. |
| agglutination inhibition test | can be at home test. uses antibodies to detect beta subunit of hCG in blood or urine. quick for early diagnosis of pregnancy. detect hCG in serum at very low concentrations as early as 3-5 days after conception. |
| radioreceptor assay | accurate 6-8 days after conception. sensitive used to detect small amts of hCG such as in ectopic pregnancies. can be at home test. blood or protein in urine can cause false positive. |
| How early can the fetal heart sounds be heard with a fetoscope? | 18-20 weeks gestation |
| How early can a doppler detect heart motion and make sound that is audible? | 10 weeks gestation |
| fetal heart rate ranges | between 110 and 160 bpm during third trimester. |
| obstetric history include | Gravida, para, abortions and living children. wt. of infants, length of gestation. labor exp., delivery type, loc of birth, caregivers. anesthesia type and any probs. complications (hypertension...)infant feed method, other |
| GTPAL | gravida, term births, preterm births, abortions, living children |
| Nagele's rule | used to establish EDD. subtract 3 months, add 7 days to first day of the last normal mentrual period (LNMP) |
| blood pressure that may indicate preeclampsia in pregnant women | 140/90 |
| Respiratory rate during pregnancy | 16-24 bpm |
| normal temperature during pregnancy | 97.8 to 99.6 |
| leopold's maneuvers | systematic method to palpate fetus through abdominal wall during later part of pregnancy to determine location and presentation of fetus. |
Created by:
FSclafani
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