Flashcards in OB EXAM 2 Deck (202):
1
woman who is pregnant.
Gravida
2
pregnancy
gravidity
3
woman who has never been pregnant.
Nulligravida:
4
: woman who is pregnant for the first time.
Primigravida:
5
woman who has had two or more pregnancies
Multigravida:
6
number of pregnancies in which fetus or fetuses have reached viability (20 weeks when they are born), not the number of fetuses born.
parity
7
woman who has NOT completed pregnancy with a fetus or fetuses who have reached 20 weeks gestation.
nullipara
8
: woman who has completed one pregnancy with a fetus or fetuses who have reached 20 weeks gestation.
primipara
9
woman who has completed two or more pregnancies to 20 weeks of gestation or more.
Multipara:
10
pregnancy that has reached 20 weeks of gestation but ends before completion of 37 weeks of gestation.
Preterm:
11
pregnancy that has reached between 34 weeks 0 days and 36 weeks 6 days of gestation.
late term
12
pregnancy that has reached between 37 weeks 0 days and 38 weeks 6 days of gestation.
early term
13
pregnancy that has reached between 39 weeks 0 days and 40 weeks 6 days of gestation.
full term
14
pregnancy that has reached between 41 weeks 0 days and 41 weeks 6 days of gestation.
late term
15
term pregnancy is ____ - ____ weeks
37-42
16
preterm is before week ____
37
17
post term is a PG that reached btwn ___ weeks ___ days and beyond gestation
42 weeks & 0 days
18
capacity to live outside the uterus. Book says 22-25 weeks gestation.
viability
19
GTPAL
gravida
term
preterm
aborted
living
20
gravida =
# of pregnancies
21
term=
# of term pregnancies.
37-42 weeks
22
preterm
# of preterm pregnancies
20-37 weeks
23
aborted=
# of abortions. spontaneous or induced
24
living=
# of living children
25
3 types of signs of pregnancies
presumptive
probable
positive
26
presumptive signs of PG are ____ changes.
subjective
27
ex of presumptive signs
no period
breast tenderness
N/V
fatigue
28
probable signs are ___ changes.
objective
29
ex of probable signs of PG
hegar's sign
goodell sign
chadwick sign
30
• The softening of the lower uterine segment while the uterus remains firm.
hegar's sign
31
when can you notice hegar's sign
6 weeks
32
softening of the cervical tip
goodell sign
33
when can you observe godless sign
5-6 weeks
34
vaginal mucosa and cervix turn violet blue color
chadwicks sign
35
when can you notice chadwicks sign
6-8 weeks
36
signs attributable only to fetal presence
positive sx of pregnancy
37
ex of positive signs of PG
fetal heart tones
ultrasound
palpate fetal movement
38
when is fundal height assessed?
2nd trimester
39
fundal height is an indicator of?
fetal growth
40
check fundal height from ___ to ___ gestational weeks
18-32 weeks
41
low fundal height may be
IUGR
42
IUGR menas
intrauterine growth restriction
43
high fundal height may be?
multifetal gestation or hydraminios
44
hydraminios =
too much amniotic fluid
45
lightening occurs between ___-___ weeks gestation
38-40
46
when the fundal height drops
lightening
47
The fetus begins to descend and engage into the pelvis
lightening
48
nullapara mother with lightening when?
2 weeks before onset of labor
49
multipara mother lightening occurs when?
time of labor occuring
50
pregnancy may "show" after the ___ week
14th week
51
increases as the uterine size increases
BV
52
BV is ____ - ___ ml per min of blood at full term
450-650
53
- Oxygen consumption increases to
meet fetal demands
54
- rushing or blowing sound of maternal blood rushing through the uterine arteries, should be synchronized with maternal pulse
uterine souffle
55
sound heard as blood rushes through umbilical cord. Synchronized with fetal heart rate.
funic souffle
56
cervical changes
o Passive movement of unengaged fetus.
57
- First recognition of movement.
- Mom starts to feel baby moving.
- The movement will gradually increase in intensity and frequency.
quickening
58
quickening can occur when?
14-16 weeks
59
- Tap finger of bottom of cervix to feel vibration of baby inside.
ballottement
60
ballottement occurs when?
16-28 weeks
61
o Softening of lower part of uterus where cervix remains firm
hegar sign
62
o Training for labor
o Irregular
o Painless
usually go away with movement
do not increase in intensity and frequency
braxton hicks contractions
63
braxton hicks contractions occur intermittently during PG, but become more defined after ____ weeks
28
64
do braxton hicks contractions dilate the cervix?
NO
65
located around nipples and provides lubrication to nipples to prepare for breast feeding.
montgomery tubercles
66
changes in breast are due to
increase in estrogen & progesterone
67
stretch marks
striae gravidarum
68
colostrum by ____ weeks
16
69
BV is increased ____% above pre-pregnant levels
30-45%
70
increase in RBCs by ____%
20-30%
71
the increase in BV is a protective measure?
to be able to hydrate maternal and fetal needs of enlarged uterus
72
how much blood loss in vaginal birth
200-400 cc
73
how much blood loss in c section
500 cc blood loss
74
Women who are pregnant are 5-6x times like to develop
thromboembolic disease
75
RISK FOR thromboembolic disease due to
increase in clotting factors
76
respiratory changes during PG
nasal & sinus stuffiness
c/o nose bleeds
77
mask of pregnancy. Blochy brownish pigmentation that covers the cheek nose and forehead of a pregnant woman. Can appear up to 50-70% of women. 16 weeks of gestation & will increase until delivery. Darker complected women are more affected. The sun intensifies this. Usually after delivery this will fade.
melasma
78
symphisis pubis to top of fundus. Dark line.
linea nigra
79
stertch marks on lower abd. And also on woman thighs and breasts. Can cause scars. They may lighten but will not go away.
Striae gravidarum
80
increase curvature of lumbosacral area. Her center of gravity is off, so the curve allows them to remain balanced.
“Proud walk of Pregnancy”
81
pregnancy spans ___ calendar months
9
82
PG spans ___ lunar months
10
83
1st trimester:
1-13 weeks
84
2nd trimester
14-16 weeks
85
3rd semester
27-40 weeks
86
how to estimate date of birth
nagele's rule
87
nagele's rule calculation:
1st day of LMP, subtract 3 months, add 7 days
88
♣ Consuming non food substances such as clay, soil, laundry detergent, food substances with no nutritional values, ice, baking soda, or baking powder, or corn starch)
PICA
89
what happens with PICA?
anemia & prevents them from absorbing iron
90
as mom progresses through pregnancy, weight of abd. Contents will compress vena cava. Faintness, dizziness, nausea.
Supine hypotension
91
intervention for supine hypotension
turn woman on side until sx subside & VS return WNL
92
clean catch urine @ each visit checks for?
glucose
protein
nitrates
leukocytes
93
kick count test results should be
10 movements of fetus in 2 hours
94
call physician if kick counts are?
none in 12 hours
95
response of the fetal HR to fetal movement
non stress test
96
babies HR should do what during non stress test?
should increase 15 BPM when we have fetal movement and needs to remain elevated for 15 seconds
97
what considers a healthy non stress test?
2 accelerations
98
¥ Signs of potential complications Pg. 314
o #1- vaginal bleeding
o discharge from vagina
o decrease or no fetal movement
o sudden weight gain
o severe vomiting or HA
o C/O fever & chills
o Diarrhea or c/o abd. Cramping
o c/o burning at urination
99
Escessive vomiting.
Hypereremesis gravidum
100
Hypereremesis gravidum can cause:
weight loss
electrolyte def.
ketonuria
esophageal rupture
101
how to treat Hypereremesis gravidum
IV therapy
eat freq.
separate fluids & solids
eat bland diet
102
who sweats more?
women!
103
women can take tub baths when pregnant except for ?
when the membranes have ruptured
104
PG woman are more predisposed to ___ which are asymptomatic
UTIs
105
how to prevent UTIs
drink water
personal hygiene
eat yogurt
don't ignore the feeling of needing to urinate
106
o Allows the muscles to stretch more during L&D. prevents urinary incontinence during PG, during labor, & later in life
kegel exercises
107
how to clean the nipples after breastfeeding
warm water
108
can you have a dental exam during pregnancy?
YES
109
when to do childbirth education programs?
3 months prior to delivery
110
• professionally trained as support people to support patient during delivery. Can’t do anything medical with delivery.
doulas
111
• Conception is the union of
a single ovum and sperm
112
o Implantation of the fertilized ovum in the endometrium _____ days after conception
6-10
113
where does fertilization occur?
upper 1/3 of fallopian tube
114
• An ovum is fertile for ___ after it is released
24 hours
115
• Primary germ layers ( pg. 274)
ectoderm
mesoderm
endoderm
116
upper layer or outermost layer of embryonic disk
ectoderm
117
ectoderm will form?
nervous system
tooth enamel
nails
hair
floor of amniotic cavity
118
middle layer
mesoderm
119
what will mesoderm form?
bones
teeth
muscles
cardiovascular system
kidneys
120
lower layer or innermost layer
endoderm
121
endoderm will form?
epithelial lining of resp and digestive tracts
122
o Substances or exposure that causes abnormal development
teratogens
123
examples of teratogens
♣ Cigarette smoking
♣ Cocaine
♣ Coumadin anticoagulant
♣ Rubella
♣ Syphilis or any STDs
♣ Alcohol
124
o In the first ___ weeks of pregnancy there are two affects that can occur
2
125
examples of the 2 things that can occur
♣ The baby can be exposed to a teratogen and will die bc too many cells damaged
♣ The baby can be exposed but only a few cells affected it does not have an ill effect on the baby.
126
• Once born, cannot fix defects caused by ____
teratogens
127
• Use _______ _____ instead of months because of the rate of development from week to week
gestational weeks
128
Development of the embryo
Lasts from
day 15 until 8 weeks after conception
129
o 9 wks gestation until the pregnancy ends
fetus
130
mucous plug
operculum
131
• fetal membrane closest to the uterine wall and gives rise to the placenta contains the major umbilical blood vessels as they branch out over the surface of placenta-will become chorionic membrane
chorion
132
• inner membrane that form the sac and contain fetus and the amniotic fluid
amnion and amniotic cavity
133
what is the significance of the amnion and amniotic cavity
o It is a good cushion for this baby
o Helps to control temperature
o It promotes symmetrical growth of the fetus
134
o precursor of the placenta-aids in transferring maternal nutrients and oxygen which diffuse through the chorion to the embryo
yolk sac
135
♣ Fluid that baby is in in the amniotic sac
♣ Cushions embryo/fetus
♣ Controls temperature
♣ Promotes growth
♣ Prevents fetal adherence to amnion
♣ Allows freedom of movement to amnion
♣ Contain fetal cells that can provide important info about fetus
amniotic fluid
136
• withdrawal of amniotic fluid for genetic testing, LS ratio (breathing)
amniocentesis
137
• measuring amount of amniotic fluid in amniotic sac
amniotic fluid volume test
138
: less than 300cc amniotic fluid, usually abnormality in renal system in neonate
oligohydramnios
139
: more than 2L of fluid
poligohydramanous
140
Umbilical cord contains
3 vessels
1 vein & 2 arteries
141
Umbilical cord is covered by?
Whartons jelly
142
Cord connects what?
Placenta to fetus
143
Carries oxygenated blood
Umbilical vein
144
Carries un-oxygenated blood and wastes
Arteries
145
What covers the 3 vessels
Very thick & mushy
This is where the vessels are embedded
Whartons jelly
146
The maternal placental embryonic circulation is in place by day
17
147
Located on maternal side of placenta and serve as functional units
Cotyledons (lobes)
148
Which side is very vascular?
Moms side
149
Functions of the placenta
Produces estrogen& progesterone
150
Placenta stores and excretes nutrients such as
Carbs
Ca
Iron
151
Basis for pregnancy test
Human chorionic gonadotropin
152
Placental function depends on the maternal ______ supplying the circulation
Blood pressure
153
When will nutrients not reach the placenta
Low BP
154
Stage of the fetus lasts from?
9 weeks until end of PG
155
Fetus ability to survive outside the uterus
Viability
156
Viability is usually
22-25 weeks
157
Openings between foramen ovale and the aorta and the pulmonary artery
Fetal circulatory system
158
Opening to aorta
Ductus arteriosus
159
Allows oxygenated blood into aorta to send back to baby
Ductus arteriosus
160
Where liver (oxygenated blood) & vena cava
Ductus venosus
161
Opening between R/L atrias
Foramen ovale
162
Some heart beats can be detected when?
7 weeks
163
Cardiovascular system complete by the ____ week
8th
164
First organ in fetus to function
Heart
165
After ____ weeks sufficient surfactant levels present in alveoli for survival
34 weeks
166
Active phospholipids in the amniotic fluid can be used to check for lung function
Pulmonary surfactants
167
Amniocentesis checks for
Adequate surfactant level
168
Line alveoli of baby's lungs & cost lungs to get oxygen in
Surfactants
169
If not enough surfactant what will happen
Alveoli will stick & baby won't be able to breathe
170
LS ratio stands for
Lecithin sphinomyelin
171
Used to check lung maturity
LS ratio
172
Ratio for LS
2:1
173
Lung maturity is reached by
35 weeks
174
This will cause a decrease flow to the placenta and cause hypoxia in the baby but will cause the baby to increase the surfactant level
Maternal hypertension
175
Stressors in utero that can accelerate lung maturity
Maternal HTN
Placental dysfxn
Infection
Corticosteroids use
176
Corticosteroids increase
Surfactant
177
Will decrease surfactant levels
Gestational diabetes & glomerulineohritis
178
Twins ratio
1 in 30 pregnancies
179
Examples of twins: 3!
Dizygotic or fraternal twins
Monozygotic
Conjoined
180
Two ova are produced and fertilized by separate sperm
Dizygotic or fraternal twins
181
Identical twins develop from one fertilized ovum which then divides. Same sex. Same genotype
Monozygotic
182
Chances of monozygotic
4 per 1000
183
Type of monozygotic twins in which there is incomplete embryonic separation
Conjoined
184
Chances of conjoined
1 in 50,000
185
When will the conjoined twins occur
13-15 days post conception
186
Increased risk of mulifetal pregnancies with?
Fertility drugs
187
Multi fetal pregnancies often end in?
Premature labor because amniotic bag may rupture
188
Safest prevention of STIs
Abstinence
189
Low but potential risk for STIs
Wet kissing
Vaginal intercourse with condom
Oral sex with women wearing female condom
Mutual mastiff will without contact with semen or vaginal secretions
190
High risk for STIs
Unprotected sex --oral anal contact
Multiple sex partners
Sex that causes tissue damage or bleeding
Oral sex on man or woman without latex or plastic barrier
191
Most common STI
Chlamydia
192
If left untreated chlamydia can lead to
Acute salpingitis and PID
193
Infant born from mothers with chlamydia
Conjunctivitis or pneumonia
194
How to treat baby from mom who had chlamydia
azithromycin 1gr by mouth
195
Treat Mom's for chlamydia with
Azithromycin and doxycycline
196
Instruct women with chlamydia
Sex partners be treated at saw time & no sex with themselves or others until treatment is finished
197
When should women be retested for chlamydia
3-4 months
198
Called "clap" or "drip"
Oldest communicable disease in US
Asymptomatic/complains of menstrual issues
Gonorrhea
199
Diagnosis of gonorrhea
Made by exclusions of other dx processes
200
Can loose what if you have gonorrhea
Reproductive abilities
201
Specifically genital warms more frequently in PG women due to immunosuppression
Usually asymptomatic until PG, then lesions appear
Human papillomavirus HPV
202