Flashcards in OB EXAM 2 Deck (202):
woman who is pregnant.
woman who has never been pregnant.
: woman who is pregnant for the first time.
woman who has had two or more pregnancies
number of pregnancies in which fetus or fetuses have reached viability (20 weeks when they are born), not the number of fetuses born.
woman who has NOT completed pregnancy with a fetus or fetuses who have reached 20 weeks gestation.
: woman who has completed one pregnancy with a fetus or fetuses who have reached 20 weeks gestation.
woman who has completed two or more pregnancies to 20 weeks of gestation or more.
pregnancy that has reached 20 weeks of gestation but ends before completion of 37 weeks of gestation.
pregnancy that has reached between 34 weeks 0 days and 36 weeks 6 days of gestation.
pregnancy that has reached between 37 weeks 0 days and 38 weeks 6 days of gestation.
pregnancy that has reached between 39 weeks 0 days and 40 weeks 6 days of gestation.
pregnancy that has reached between 41 weeks 0 days and 41 weeks 6 days of gestation.
term pregnancy is ____ - ____ weeks
preterm is before week ____
post term is a PG that reached btwn ___ weeks ___ days and beyond gestation
42 weeks & 0 days
capacity to live outside the uterus. Book says 22-25 weeks gestation.
# of pregnancies
# of term pregnancies.
# of preterm pregnancies
# of abortions. spontaneous or induced
# of living children
3 types of signs of pregnancies
presumptive signs of PG are ____ changes.
ex of presumptive signs
probable signs are ___ changes.
ex of probable signs of PG
• The softening of the lower uterine segment while the uterus remains firm.
when can you notice hegar's sign
softening of the cervical tip
when can you observe godless sign
vaginal mucosa and cervix turn violet blue color
when can you notice chadwicks sign
signs attributable only to fetal presence
positive sx of pregnancy
ex of positive signs of PG
fetal heart tones
palpate fetal movement
when is fundal height assessed?
fundal height is an indicator of?
check fundal height from ___ to ___ gestational weeks
low fundal height may be
intrauterine growth restriction
high fundal height may be?
multifetal gestation or hydraminios
too much amniotic fluid
lightening occurs between ___-___ weeks gestation
when the fundal height drops
The fetus begins to descend and engage into the pelvis
nullapara mother with lightening when?
2 weeks before onset of labor
multipara mother lightening occurs when?
time of labor occuring
pregnancy may "show" after the ___ week
increases as the uterine size increases
BV is ____ - ___ ml per min of blood at full term
- Oxygen consumption increases to
meet fetal demands
- rushing or blowing sound of maternal blood rushing through the uterine arteries, should be synchronized with maternal pulse
sound heard as blood rushes through umbilical cord. Synchronized with fetal heart rate.
o Passive movement of unengaged fetus.
- First recognition of movement.
- Mom starts to feel baby moving.
- The movement will gradually increase in intensity and frequency.
quickening can occur when?
- Tap finger of bottom of cervix to feel vibration of baby inside.
ballottement occurs when?
o Softening of lower part of uterus where cervix remains firm
o Training for labor
usually go away with movement
do not increase in intensity and frequency
braxton hicks contractions
braxton hicks contractions occur intermittently during PG, but become more defined after ____ weeks
do braxton hicks contractions dilate the cervix?
located around nipples and provides lubrication to nipples to prepare for breast feeding.
changes in breast are due to
increase in estrogen & progesterone
colostrum by ____ weeks
BV is increased ____% above pre-pregnant levels
increase in RBCs by ____%
the increase in BV is a protective measure?
to be able to hydrate maternal and fetal needs of enlarged uterus
how much blood loss in vaginal birth
how much blood loss in c section
500 cc blood loss
Women who are pregnant are 5-6x times like to develop
RISK FOR thromboembolic disease due to
increase in clotting factors
respiratory changes during PG
nasal & sinus stuffiness
c/o nose bleeds
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.
symphisis pubis to top of fundus. Dark line.
stertch marks on lower abd. And also on woman thighs and breasts. Can cause scars. They may lighten but will not go away.
increase curvature of lumbosacral area. Her center of gravity is off, so the curve allows them to remain balanced.
“Proud walk of Pregnancy”
pregnancy spans ___ calendar months
PG spans ___ lunar months
how to estimate date of birth
nagele's rule calculation:
1st day of LMP, subtract 3 months, add 7 days
♣ 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)
what happens with PICA?
anemia & prevents them from absorbing iron
as mom progresses through pregnancy, weight of abd. Contents will compress vena cava. Faintness, dizziness, nausea.
intervention for supine hypotension
turn woman on side until sx subside & VS return WNL
clean catch urine @ each visit checks for?
kick count test results should be
10 movements of fetus in 2 hours
call physician if kick counts are?
none in 12 hours
response of the fetal HR to fetal movement
non stress test
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
what considers a healthy non stress test?
¥ 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
Hypereremesis gravidum can cause:
how to treat Hypereremesis gravidum
separate fluids & solids
eat bland diet
who sweats more?
women can take tub baths when pregnant except for ?
when the membranes have ruptured
PG woman are more predisposed to ___ which are asymptomatic
how to prevent UTIs
don't ignore the feeling of needing to urinate
o Allows the muscles to stretch more during L&D. prevents urinary incontinence during PG, during labor, & later in life
how to clean the nipples after breastfeeding
can you have a dental exam during pregnancy?
when to do childbirth education programs?
3 months prior to delivery
• professionally trained as support people to support patient during delivery. Can’t do anything medical with delivery.
• Conception is the union of
a single ovum and sperm
o Implantation of the fertilized ovum in the endometrium _____ days after conception
where does fertilization occur?
upper 1/3 of fallopian tube
• An ovum is fertile for ___ after it is released
• Primary germ layers ( pg. 274)
upper layer or outermost layer of embryonic disk
ectoderm will form?
floor of amniotic cavity
what will mesoderm form?
lower layer or innermost layer
endoderm will form?
epithelial lining of resp and digestive tracts
o Substances or exposure that causes abnormal development
examples of teratogens
♣ Cigarette smoking
♣ Coumadin anticoagulant
♣ Syphilis or any STDs
o In the first ___ weeks of pregnancy there are two affects that can occur
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.
• Once born, cannot fix defects caused by ____
• Use _______ _____ instead of months because of the rate of development from week to week
Development of the embryo
day 15 until 8 weeks after conception
o 9 wks gestation until the pregnancy ends
• 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
• inner membrane that form the sac and contain fetus and the amniotic fluid
amnion and amniotic cavity
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
o precursor of the placenta-aids in transferring maternal nutrients and oxygen which diffuse through the chorion to the embryo
♣ 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
• withdrawal of amniotic fluid for genetic testing, LS ratio (breathing)
• measuring amount of amniotic fluid in amniotic sac
amniotic fluid volume test
: less than 300cc amniotic fluid, usually abnormality in renal system in neonate
: more than 2L of fluid
Umbilical cord contains
1 vein & 2 arteries
Umbilical cord is covered by?
Cord connects what?
Placenta to fetus
Carries oxygenated blood
Carries un-oxygenated blood and wastes
What covers the 3 vessels
Very thick & mushy
This is where the vessels are embedded
The maternal placental embryonic circulation is in place by day
Located on maternal side of placenta and serve as functional units
Which side is very vascular?
Functions of the placenta
Produces estrogen& progesterone
Placenta stores and excretes nutrients such as
Basis for pregnancy test
Human chorionic gonadotropin
Placental function depends on the maternal ______ supplying the circulation
When will nutrients not reach the placenta
Stage of the fetus lasts from?
9 weeks until end of PG
Fetus ability to survive outside the uterus
Viability is usually
Openings between foramen ovale and the aorta and the pulmonary artery
Fetal circulatory system
Opening to aorta
Allows oxygenated blood into aorta to send back to baby
Where liver (oxygenated blood) & vena cava
Opening between R/L atrias
Some heart beats can be detected when?
Cardiovascular system complete by the ____ week
First organ in fetus to function
After ____ weeks sufficient surfactant levels present in alveoli for survival
Active phospholipids in the amniotic fluid can be used to check for lung function
Amniocentesis checks for
Adequate surfactant level
Line alveoli of baby's lungs & cost lungs to get oxygen in
If not enough surfactant what will happen
Alveoli will stick & baby won't be able to breathe
LS ratio stands for
Used to check lung maturity
Ratio for LS
Lung maturity is reached by
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
Stressors in utero that can accelerate lung maturity
Will decrease surfactant levels
Gestational diabetes & glomerulineohritis
1 in 30 pregnancies
Examples of twins: 3!
Dizygotic or fraternal twins
Two ova are produced and fertilized by separate sperm
Dizygotic or fraternal twins
Identical twins develop from one fertilized ovum which then divides. Same sex. Same genotype
Chances of monozygotic
4 per 1000
Type of monozygotic twins in which there is incomplete embryonic separation
Chances of conjoined
1 in 50,000
When will the conjoined twins occur
13-15 days post conception
Increased risk of mulifetal pregnancies with?
Multi fetal pregnancies often end in?
Premature labor because amniotic bag may rupture
Safest prevention of STIs
Low but potential risk for STIs
Vaginal intercourse with condom
Oral sex with women wearing female condom
Mutual mastiff will without contact with semen or vaginal secretions
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
Most common STI
If left untreated chlamydia can lead to
Acute salpingitis and PID
Infant born from mothers with chlamydia
Conjunctivitis or pneumonia
How to treat baby from mom who had chlamydia
azithromycin 1gr by mouth
Treat Mom's for chlamydia with
Azithromycin and doxycycline
Instruct women with chlamydia
Sex partners be treated at saw time & no sex with themselves or others until treatment is finished
When should women be retested for chlamydia
Called "clap" or "drip"
Oldest communicable disease in US
Asymptomatic/complains of menstrual issues
Diagnosis of gonorrhea
Made by exclusions of other dx processes
Can loose what if you have gonorrhea
Specifically genital warms more frequently in PG women due to immunosuppression
Usually asymptomatic until PG, then lesions appear
Human papillomavirus HPV