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OB > Chapter 15: Pregnancy > Flashcards

Chapter 15: Pregnancy Flashcards

1
Q

first stage of pregnancy timing and what happens?

A
  • first 1-2 weeks pre-embryonic
  • zygote –> blastomere –> morula –> blastocyst
  • implantation occurs
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2
Q

what is a blastocyst?

A
  • cluster of dividing cells made by a fertilized egg
  • beginning of differentiation
  • implants on endometrium (inner uterus lining)
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3
Q

second stage of pregnancy timing and what happens?

A
  • week 2-8 embryonic
  • Formation and development of organs (organogenesis)
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4
Q

what is an embryo?

A

differentiation is completed

Blastocyst differentiates into 3 germ layers (ectoderm, mesoderm, endoderm), where organs and other structures will originate

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5
Q

third stage of pregnancy timing and what happens?

A
  • 9-38 weeks fetal
  • Rapid growth
  • Refinement of organs and structures created in embryonic stage
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6
Q

why is fetal circulation different?

A
  • fetus has other routes bc lungs and liver not fully developed
  • connected to placenta vein and arteries
  • Ductus venosus (bypass liver) → foramen ovale (bypass lungs) → ductus arteriosus (bypass lungs)
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7
Q

placenta functions?

A
  • circulation
  • protection
  • hormone production
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8
Q

first hormone produced by placenta
HCG

A
  • signals corpus luteum to continue excreting progesterone and estrogen
  • keeps uterus and endometrium good environment for pregnancy
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9
Q

second hormone produced by placenta
HCS

A
  • metabolism: increases mom’s insulin resistance and increases circulating glucose
  • breasts lactation
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10
Q

third hormone produced by placenta
progesterone

A
  • breast development
  • changes metabolism
  • relaxes uterine muscles
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11
Q

fourth hormone produced by placenta
estrogen

A
  • breast development
  • contraction of uterus
  • uterine growth
  • blood flow to placenta and uterus
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12
Q

fifth hormone produced by placenta
relaxin

A
  • prepare endometrium for implantation
  • softens cervix at end of pregnancy
  • joint laxity
  • optimize circulatory system during pregnancy
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13
Q

skin changes during preg

A
  • striae
  • linea nigra
  • chloasma
  • palmar erythema
  • telangiectasias
  • spider angiomas
  • thicker and abundant hair
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14
Q

exocrine changes during preg

A
  • Thyroid hormones increase
  • Pancreas cells reduced responsiveness to insulin and greater insulin production
  • Adrenal glands increase cortisol and aldosterone
  • Pituitary gland produces prolactin and oxytocin
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15
Q

respiratory changes during preg

A
  • Increased tidal volume → mild hyperventilation → respiratory alkalosis (all normal but can cause dyspnea)
  • congestion of mucous membranes
  • deepening of voice
  • frequent nose bleeds (epistaxis)
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16
Q

cardiovascular changes during pregnancy

A
  • Increased cardiac output, increased HR, increased stroke volume = minor hypertrophy
  • H&H decreases = pseudoanemia
  • WBC elevated
  • BP decreases
  • Sometimes S1 split, systolic murmur, third heart sounds, diastolic murmur
17
Q

urinary changes during preg

A
  • Larger kidneys
  • Small amounts of glucose and protein sometimes spilled into urine
  • More thirsty, need to pee more
18
Q

reproductive changes during preg

A
  • Breasts more sensitive to pain, darkening nipples and areolas, montgomery tubercles hypertrophy
  • Ovaries produce progesterone, estrogen, and relaxin
  • Uterus grows, size in cm = weeks of gestation (34 weeks gest = 34 cm)
  • Braxton hicks contractions: fake, resolved with rest or hydration
  • Hegar’s sign, Goodell’s sign, Chadwick’s
  • Leukorrhea: white, thick discharge
19
Q

musculoskeletal changes during preg

A
  • Lordosis
  • Softening of joints
  • Symphysis pubis dysfunction
  • Ligaments may stretch and spasm: sharp, brief, unilateral
  • Diastasis recti: muscles separate and part of bowel protrudes through
20
Q

GI changes during preg

A
  • Reduced peristalsis → constipation, gallstones, heartburn
  • Increased metabolic needs
21
Q

initial visit during pregnancy when and what?

A
  • 6 weeks
  • rubella
  • pap test if due
  • CBC
  • Rh factor
22
Q

monthly visits until how many weeks gestation?

A

27 weeks

23
Q

every other week visits when?

A

27-36 weeks

24
Q

weekly visits when?

A

36-40 weeks

25
Q

trisomies screening

A

11-13 wks

26
Q

neural tube screening

A

15-16 weeks

27
Q

3D ultrasound screening

A

16-20 weeks

28
Q

oral glucose tolerance test when

A

24-28 weeks

29
Q

Rh factor screening again with TDaP when?

A

28 weeks

30
Q

H&H and STI testing when?

A

28-36 weeks

31
Q

group b strep and vagina culture when?

A

35-37 weeks

OB (7 decks)

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