Chapter 6 Flashcards

1
Q

What are the symptoms of pregnancy?

A

Missed menstrual period Breast tenderness
Morning sickness
More frequent urination

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2
Q

How is the delivery date calculated?

A

Delivery date calculated
from the first day of the last
menstrual period
-(40 weeks gestation)

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3
Q

When are the 1,2,3 trimesters?

A

Nine months of pregnancy are divided into 3 equal periods of 3 months (trimesters)

  • First trimester - months 1 to 3
  • Second trimester - months 4 to 6
  • Third trimester - months 7 to 9
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4
Q

When does the the most growth take place?

A

• First T most growth and development is happening

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5
Q

What is the placenta?

A

an organ formed on the wall of the uterus through which the fetus receives oxygen and nutrients and gets rid of waste products

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6
Q

What is HcG?

A

Human chorionic gonadotropin (HcG) - a hormone secreted

by the placenta

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7
Q

How can you detect if you’re pregnant?

A
Test has HcG
-HcG is detected in urine and blood
A first morning urine sample (ideal) 
-hold dipstick in the urine stream
   or dip into a sample of urine.
-Test strip changes color if hCG is present
   meaning you are pregnant.
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8
Q

What is the umbilical cord?

A

the tube that connects the fetus to the placenta

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9
Q

What is the amniotic fluid?

A

the watery fluid surrounding a developing fetus in the uterus

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10
Q

What is an ectopic pregnancy?

A

Conceptus implants outside of the uterus

PID

Endometriosis

Scarring of the oviducts that affects cilia

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11
Q

Can you save an ectopic pregnancy?

A

No, it is always non-viable

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12
Q

What are the problems related to early pregnancy?

A

Miscarriage

Stillbirth

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13
Q

What is a miss carriage?

A

Spontaneous abortion/ Chemical pregnancy

Natural causes

Can be emotionally challenging
-grief must be processed

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14
Q

When can spontaneous abortion happen?

A

Can happen at any time

-normally happens before 11 wks, if it happens later then can be really upsetting

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15
Q

What do people say if you are past the 11 weeks?

A

• Say that if you ge t past the 11 weeks/ first T you are safe

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16
Q

What is a still birth?

A

Fetus is delivered but not living

Delivery of a fetus after 28 weeks

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17
Q

What are the main pregnancy related problems?

A

Molar pregnancy

Pseudocyesis

GBS

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18
Q

What is a molar pregnancy?

A

Mass of abnormal
tissue (mass that isn’t chromosomal_

Not a true pregnancy

Women over 35 more at risk

Low vitamin A

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19
Q

What is Pseudocyesis?

A

False pregnancy

Symptoms may include:

  • amenorrhea
  • N/V
  • abdominal distension
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20
Q

What is GBS?

A

Group B streptococcal

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21
Q

What happens if GBS goes undetected/treated?

A

Preterm birth/stillbirth Prenatal testing

Antibiotic prophylaxis

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22
Q

What happens if you are + for Strep?

A

• + for strep you have to have a iv antibodies, when you a deliver tp protect baby with strep (antibodies prophylaxis)

Swab around anus and sned to lab

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23
Q

What is the D antigen (rh) incompatibility?

A

D- mother carrying D+ child (gene from father)

Not usually an issue with first pregnancy

Antibody presence identifiable by Coombs blood test

Intervention required to protect subsequent pregnancies due to maternal antibodies to D antigen after birth

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24
Q

Who is tested for D antigen?

A

everyone

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25
What is the treatment for D antigen incompatibility?
2 Rhogam (D immunoglobulin) shots given to prevent the D- mother from producing D antigen antibodies that can attack D+ baby -Week 28, and within 72 hours postpartum Non-treatment will result in hemolytic disease of the newborn, gestational death Rhogam is also given after miscarriage, amniocentesis, gestational bleeding episodes if the mother is D-
26
What are pregnancy related problems in the later stages?
``` Pregnancy-induced hypertension Risk of preterm birth Risk of maternal stroke Risk of infant death Preterm labour (before 37 weeks) -common with multiples Born with physical issues ```
27
What is the treatment for Pregnancy-induced hypertension ?
Give birth | -induction
28
What are the 3 conditions of Pregnancy-induced hypertension ?
Hypertension Preeclampsia Eclampsia
29
What are the signs of preeclampsia?
``` Severe headaches Vomiting blood Excessive nausea Ringing or buzzing sound in ears Excessive vomitingDrowsiness Smaller amounts of urine or no urine Excessive swelling of the feet and hands Protein detected in urine Blood in your urine Rapid heartbeat Dizziness Fever Double vision Blurred vision Sudden blindness Pain in the abdomen (tummy) ```
30
What happens to the foetus in the first trimester?
Develops into a fetus with most of the major organ systems present 4th to 8th week - external body parts develop 7th week - liver, lungs, pancreas, kidneys, and intestines have formed and begun limited functioning
31
When is the foetus differentiated?
12 weeks
32
What are the physical changes in the woman int he first trimester?
Large increase in levels of hormones Breasts swell and tingle -development of mammary glands for future milk production/breast feeding Need to urinate more frequently “Morning sickness”/nausea Vaginal discharges may increase Feelings of fatigue and sleepiness
33
What are the psychological changes in the first trimester?
``` Psychological changes may include: -Depression -Stress; Negative emotions -Excitement; Positive feeling ```
34
What is the fetal development during the second trimester?
Quickening occurs - women becomes aware of fetal movements - Feels like a butterfly fluttering rather than a true kicking sensation - Occurs around the end of the 14th week Fetal heart beat can be detected -Abdominal ultrasound initially Doppler
35
What are the physical changes on the woman in the second trimester?
Morning sickness tends to disappear Constipation and nosebleeds sometimes occur Edema - water retention and swelling Colostrum may come out of the nipple -Immune components
36
When does the milk come in?
2 days post partum
37
What are the psychological changes in second semester?
Psychological well-being is greater among women who have social support - Spouse/partner - Family - Friends - Agency support - Groups and programs
38
What is the fetal development during the third trimester?
Fetus opens his/her eyes Fetus’s skin is wrinkled and covered with down- like hair Fetus usually turns in uterus to assume a head- down position Fetus experiences rapid growth
39
What are the physical changes in the third trimester?
May have low energy Braxton-Hicks contractions Difficulty rising out of chairs, turning over in bed, tying shoes due to the girth of the belly
40
What are Braxton-Hicks?
Not part of labor “practice” contractions to tonify the uterus in preparation for labor Usually not painful
41
What are the psychological changes in the third trimester?
Some discomfort as weight/pressure is put on The woman’s internal organs Women who report higher levels of demonstrated affection with their partner also report lower levels of anxiety and insomnia related to later pregnancy
42
What is couvade syndrome?
“Male” pregnancy symptoms (very rare) May be caused by stress and hormonal changes in the partner May include: Indigestion, gastritis, nausea, headaches, weight gain
43
How can the partner help?
may choose to be actively involved - Can alleviate feelings of helplessness, exclusion - -Eg. Participate as birth “coach” for labor support
44
Is sex safe during pregnancy?
Intercourse can continue safely throughout the healthy pregnancy During the last weeks of pregnancy, intercourse may encourage labor
45
If having intercourse what might degrade the amniotic membranes?
Prostaglandins in semen
46
What can intercourse help with?
Intercourse is used as a method to encourage labor in women who are post-dates (overdue)
47
How can we make intercourse more comfortable for women?
Positioning changes Petting (hand-genital stimulation) Oral sex (oral-genital stimulation)
48
What must the women get in her diet?
``` protein, folic acid, calcium, magnesium vitamin A ```
49
Why is folate important?
Folate (B9) particularly important vitamin pre- pregnancy/early pregnancy to protect from neural tube defects (Spina bifida)
50
What does folate do?
Folic acid/Folate helps build healthy cells Requirements for folate increases with pregnancy (period of rapid growth)
51
What are food sources of folate?
leafy green vegetables (collards, broccoli, kale, spinach, and fruits/fruit juices such as orange juice. -Some foods are fortified with folate (grain breads and cereals)
52
What are substances that may result in birth defects?
``` Legal drugs (nicotine, alcohol) Illegal drugs (heroine) Prescription Meds (Steroids, accutane) Natural Health products (fit A) Foods (mercury) ```
53
What is a teratogen?
Substance that produces defects in fetus
54
What is FASD?
Fetal alcohol spectrum disorder | -Alcohol consumed by a woman when she is pregnant
55
What does FASD result in?
Prenatal and postnatal growth and developmental deficiencies Smaller brain, smaller eye openings, joint/limb/heart malformations, mental insufficiencies
56
What are the characteristic facial features of FASD?
Small ! Head ! Eye openings ! Chin Flatter face Shorter, wider nose Under-developed ! Outer ear ! Groove above lip
57
How can you detect FASD?
Electroencephalogram (EEG) test may be able to help detect sufferers of FASD
58
Cognitively, what are things we see with FASD?
Brains have to “work harder” Less ability to understand the meaning of a stimulus ! Less attention paid to specific tasks Poorer memories
59
Where do we see a lot of people with FASD?
Prison
60
What shunt pregnant women do to avoid parasitic illness?
Pregnant women should not change cat litter boxes - Toxoplasmosis may be transmitted by fecal matter - Mother and unborn baby can be infected - -Multi-system effects
61
What are the viral infections during pregnancy?
Rubella Infection HSV infection (herpes) HIV
62
What happens if a woman is pregnant and has HIV?
Delivery by c-section No breastfeeding HIV positive mother receives anti-retroviral drugs throughout gestation
63
What are the types of procedures that can detect brith defects?
integrated prenatal screening (IPS) first trimester screening (FTS) maternal serum screening (MSS-quad) obstetrical ultrasound at 18 weeks Amniocentesis Chorionic Villus Sampling
64
What is Amniocentesis?
13-18 weeks of pregnancy Counselling accompanies procedure -Options discussed Gold Standard for confirming diagnoses of: - Chromosomal anomalies - Genetic disorders - Gender 0.04-1.5% risk of miscarriage
65
What is CVS?
Chorionic Villus Sampling (CVS) 9-11 weeks of pregnancy Transcervical or transabdominal routes 0.04-1.5% risk of miscarriage
66
When do we consider more advanced genetic screening?
• Will always include Genetic Counselling • Either parent has a gene linked condition -eg cystic fibrosis, thalassemia, sickle cell anemia • Either parent has a genetic anomaly • You are a pregnant after the age of 35 -vgreater risk of Trisomy • You have delivered a child previously with a genetic “defect”