1: Prenatal care Flashcards
(62 cards)
Bluish discoloration of vagina and cervix
Chadwick sign
Softening and cyanosis of the cervix at or after 4 wk
Goodell sign
Softening of the uterus after 6 wk
Ladin sign
B-hCG timeline
will rise to a peak of 100,000 mIU/mL by 10 weeks of gestation, decrease throughout the second trimester, and then level off at approximately 20,000 to 30,000 mIU/mL in the third trimester.
A viable pregnancy can be confirmed by ultrasound, which may show the gestational sac as early as ?? on a transvaginal ultrasound or at a β-hCG of ??
5 weeks
1,500 to 2,000 mIU/mL
baby considered an embryo until ?? weeks gestation, then fetus
8 weeks
trimesters
The first trimester lasts until 12 weeks but is also defined as up to 14 weeks’ GA, the second trimester lasts from 12 to 14 until 24 to 28 weeks’ GA, and the third trimester lasts from 24 to 28 weeks until delivery.
parity (P)
the number of pregnancies that led to a birth at or beyond 20 weeks’ GA or of an infant weighing more than 500 g.
a woman who has given birth to one set of preterm twins, one term infant, and had two miscarriages would be a
G4 P1-1-2-3
fetal movement or “quickening” occurs between
16 and 20 weeks
ways to estimate GA: auscultation of FHR at how many weeks?
20 weeks by nonelectronic fetoscopy or at 10 weeks by Doppler ultrasound
how does cardiac output change during pregnancy?
increases by 30-50%
- most during 1st trimester
- increase in SV then maintained by increased in HR
how does SVR and BP change during pregnancy?
SVR decreases–>BP decreases (5-10/10-15 mmHg decrease)
- due to elevated progesterone–>smooth muscle relaxation
- returns to prepreg BP at 24 weeks
how do lung volumes change during pregnancy?
30% to 40% in tidal volume (VT)–>same RR so 30-40% increase in minute ventilation–>increase in alveolar (PAO2) and arterial (PaO2) PO2 levels and a decrease in PACO2 and PaCO2 levels.
total lung capacity (TLC) is decreased by 5% due to the elevation of the diaphragm
how does PaCO2 change in pregnancy?
decreases to about 30 mmHg (from 40)
-leads to an increased CO2 gradient between mother and fetus which facilitates oxygen delivery to the fetus and carbon dioxide removal from the fetus
Dyspnea of pregnancy occurs in 60% to 70% of patients; possibly secondary to ??
decreased PaCO2 levels, increased VT, or decreased TLC.
morning sickness, due to ??
N/V typically resolves by ??
elevation in estrogen, progesterone, and hCG; possibly hypoglycemia
14-16 wks gestation
Hyperemesis gravidarum
severe form of morning sickness associated with weight loss (≥5% of prepregnancy weight) and ketosis.
how do kidneys change in pregnancy?
GFR?
RAAS?
increase in size, ureters dilate–>increase rates of pyelo
GFR increases by 50% early–>BUN/Cr decrease by 25%
-increase in RAAS–>increased aldo–>increase Na+ reabsorption (but plasma Na+ levels don’t increase due to increased GFR)
anemia of pregnancy
plasma volume increases by 50%, the RBC volume increases by only 20% to 30%, which leads to a decrease in the hematocrit, or dilutional anemia
WBC in preg?
platelets?
WBCs increase to 6-16 million/mL
platelets decrease (100-150 million/mL)(dilute/destruction)
pregnancy is a hyper coagulable state due to ?
elevations in the levels of fibrinogen and factors VII–X
actual clotting and bleeding times do not change, but increase in thromb/emb events
Fetal well-being has been correlated with maternal serum ? levels
estrogen;
low estrogen levels being associated with conditions such as fetal death and anencephaly.
(preg is hyperestrogenic state; mostly produced in placenta, some ovaries)
the alpha subunit of hCG is identical to alpha subunit of
LH, FSH, TSH
beta subunits are different
