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O&G > dg of early and late pregnancy > Flashcards

dg of early and late pregnancy Flashcards

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1
Q

define pregq

A

phsyiological process in femals involed w/ the development of the femal sexual cell and course of growth of the embryo/fetus in maternal body

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2
Q

how long does pregnancy last for

A

9 months
40 weeks
280 days

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3
Q

pregnancy stages

A

early=2 weeks
mid= 13-27
late=27 weeks plus
term 37-42 weeks

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4
Q

3 trimesters of pregnancy

A

1st= 12 wks
2nd= 13-28wks
3rd=29-40wks

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5
Q

how to calculate the estimated due date

A

naegele’s rule

based on last menstrual period

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6
Q

naegel’s rule for april - dec

A

add7 days
minus 3 months
add one year

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7
Q

naegele’s rule jan0march

A

add 7 days

add 9 months

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8
Q

why is naegele;s rule innacurate

A

not everyone’s period cycle is 28 days

not everyone’s gestational period lasts 280 days

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9
Q

principles for dg

of early preg (1st trimester)

A

1) history & subjective symps
2) objective symps
3) immune tests
4) US

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10
Q

1) history & subjective symps of early preg

A

1) amenorrhea
2) morning sickness
3) urinary symptoms
4) breast sensation
5) fatigue

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11
Q

1) amenorrhea in early preg

A

1st and most important symp

other causes
- medications
chronic diseases
emtional tension

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12
Q

2)morning sickness in early preg

A

worst in the 6th week and stops after 12 wks

caused by

  • HCG
  • delayed gastric emptying
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13
Q

3)urinary symptoms

in early preg

A

frequency
nocturia

caused by increased pelvic circ
enlarged uterus increases pressure on the bladder

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14
Q

4) breast sensation in early preg

A

full
prickling sensation
pain

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15
Q

objective signs of early pregnancy

A

mastodynia
constipation(d/2 smooth muslce relaxing)
weight gain
pelvic changes

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16
Q

what is mastodynia

A

aka mastalgia is pain in the breast

caused by :
development of mammary duct and alveolar system

increased circulation and breast engorgment
+ larger breasts
+ darker areola

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17
Q

what are the pelvic changes in “dg of early pregnancy”

A

chadwick’s sign
vaginal sign
cervical sign
uterine sign

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18
Q

what is the chadwick sign in “dg of early pregnancy”

A

early preg sign 6-8 weeks

vagina and labia turn blue

d/2 accum of estrogen

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19
Q

what are the cervical signs of early pregnancy

A

softening and blue coloration

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20
Q

uterine signs of early pregnancy

A

enlarges and softens

  • hegar’s sign
  • palmar sign
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21
Q

hegars sign in “dg of early pregnancy”

A

*lower uterine segment above the cervix becomes so soft that when compressed between two fingers ( one abdominally other trans vaginally) its wall cannot be felt or feels extremely thin.

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22
Q

palmar’s sign in “dg of early

pregnancy”

Study These Flashcards
A

rythmic uterine contraction elicited in bimanual exam at 4-8 wks

23
Q

imunological tests in “dg of early

pregnancy”

Study These Flashcards
A

measure HCG made by placenta

hcg antigen detected in urine/blood 8-9 days after fertilization

24
Q

when do hcg levels peak in “dg of early

pregnancy”

Study These Flashcards
A

2nd and 3rd months of pregnancy

Double every 2 days in 1st 10 wks

25
list the types of ultrasonography in pregnancy
trans vaginal abdominal
26
when is the gestational sac seen on US in “dg of early | pregnancy”
5-6 wks after LMP or 30-35 days gestation by trans vaginal US
27
when is fetal heart beat seen on US in “dg of early | pregnancy”
7th week doppler can also be used
28
when is fetus seen on US in “dg of early | pregnancy”
8th week
29
describe a true gestational sac
eccentric locatino round and regular shape double ring sign yolk sac and fetal pole size increases 1mm/day
30
significance of a pseudo GS
suggests ectopipc pregnancy
31
describe a false gesyational sac
central location irregular shape absent double ring sign absent yolk sac and fetal pole lack of size increase
32
what parameters are used to dg late pregnancy (2nd-3rd trimesters)
``` symptoms] general exam abdominal exam vaginal exam US exam ```
33
symptoms in late pregnancy
- amenorrhoea - abdominal enlargement -loss of nausea and vom after 12 wks - reduced HCG after 12 wks - fetal movement after 20 wks - braxton hicks - palpation of fetal parts - fundal height
34
what is fundal height
distance from the pubic bone to the top of the uterus measured in centimeters. After 20 weeks of pregnancy, your fundal height measurement often matches the number of weeks you've been pregnant.
35
what is observed on gen exam in late preg
chloasma at the 24th week increased breast enlargment
36
define chloasma in “dg of late | pregnancy”
mask of pregnancy is a tan or dark skin discoloration d/2 hormone change
37
abdominal exam in late pregnancy inspection
inspection - striae - linea nigra( from xiphoid process to pubic symphisis)
38
abdominal exam in late pregnancy palpation
increased fundal hehight ovoid shape uterus braxtonhicks active fetal movment: 20WKS palpation of fetal parts 20WKS
39
fundal height at 16 wks
betw/ pubic symphisis and umbilicus
40
fundal height at 22-24 wks (5-6mo)
umbilical level
41
fundal height at 28 wks (7mo)
between lower 1/3 and upper 2/3 of abdomen
42
fundal height at 32nd wk (8mo)
upper and mid 3rd of abdomen
43
fundal height at 36 wks (8-9mo)
at xiphoid cartilage
44
what is then accepted variation of fundal height
plus or minus 2 cm
45
what are braxton hicks contractions
painless tightening of the uterine muscles for 1-2 hrs preparing body for birth No cervical changes No rupture
46
what is the purpose of palpation of fetal parts in “dg of late pregnancy”
1) dg pregnancy in late stage | 2) ID fetal position, lie and presentation
47
what is fetal lie
long axis of fetus in relation to long axis of mother
48
types of fetal lie
longitudinal - fetal and mother lies are parralell (vertex or breach) transverse - fetal lie crosses mother's lie vertically (shoulder)
49
what is fetal presentation
refers to the part of the fetus that first descends into the pelvis head presentation 95% breech presentatinon 3-5% shoulder presentation
50
indication for US investigation in “dg of late | pregnancy”
check amniotic fluid volume - oligoydromnious - polyhydromnious determine fetal number( mx gestation) assertain fetal anatomy ( birth defects) assertain integrity of cervical canal fetal organ anatomy ( doppler for heart defects) view placental anatomy
51
US fetal parameters in “dg of late | pregnancy”
HC: head circ BPD: BIPARIETAL DIAMETER AC: abdomincal circ FL: femur length
52
BPD values in “dg of late pregnancy”
1st TM: greater than 3 cm 28th wk (7 mo): 7cm 32nd wk (8mo): 8cm increaseing 0.2 cm / wk
53
FL values in “dg of late | pregnancy”
2-3cm less than BPD

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