Pregnancy

Question 1

how long until full term?

Answer 1

37 weeks

Question 2

what are the three phases of embryonic development

Answer 2

germinal (fertilization to 2 weeks)
embryonic (2-8wks)
fetal (8wks-birth)

Question 3

what are common symptoms of the first trimester

Answer 3

N/V, fatigue, backaches, mood swings, stress

Question 4

what are common symptoms of the second trimester

Answer 4

pain in abdomen and groin, backache, tingling in hands and feet, SOB

Question 5

what are common symptoms of the third trimester

Answer 5

SOB, frequent urination, heartburn, swelling, trouble sleeping

Question 6

what are the weeks associated with the trimesters

Answer 6

0-13
14-27
28-37-40

Question 7

many of the physiologic and morphologic changes of pregnancy persist _______ after postpartum

Answer 7

4-6 weeks

Question 8

what are the FITT recommendations from the American College of Obstetricians and Gynecologists (2015)

Answer 8

• moderate intensity at RPE 13-14
• 20-30 min per day
• most/every day of the week

Question 9

aerobic and strength training how many days per week and beginning when for pregnant patients

Answer 9

3-4 d/w starting late first trimester or second trimester

Question 10

T/F: high intensity exercise is associated with increased risk of preterm birth and/or low birth weight

Answer 10

false

Question 11

what are three things to avoid in exercise guidelines for pregnant patients

Answer 11

1. avoid single leg weight bearing as it may shift the pubic symphysis or SIJ
2. avoid supine and prone
3. avoid valsalva as it may increase pressure on the uterus and pelvic floor

Question 12

what is a simple recommendation that pregnant patients should add to their exercise routine

Answer 12

engage the pelvic floor during exercise

Question 13

what is diastasis recti and how does it impact treatment after pregnancy

Answer 13

separation of the RA in the midline at the linea alba due primarily to hormonal changes

can result in lack of support for trunk and L spine

Question 14

what are the three common pelvic floor laxity dysfunctions

Answer 14

cystocele, rectocele, and uterine laxity

Question 15

what is supine hypotension syndrome

Answer 15

increased pressure on IVC in supine from enlarged uterus/fetus leading to lightheadedness and dizziness while in supine and relieved with L sidelying

Question 16

what two things must occur anatomically for the patient to be “ready” to give birth

Answer 16

10cm dilation and 100% effacement

Question 17

what is the difference between Braxton-Hicks contractions and uterine contractions

Answer 17

BHC

• less severe (can talk through the pain)
• irregular or irrhythmic
• brought on by exercise likely
• relieved with rest and drinking cool water

Question 18

how long do uterine contractions last

Answer 18

30-70 seconds

Question 19

what five conditions are commonly associated with premature membrane rupture

Answer 19

1. breech
2. multiple gestation
3. amniotic fluid infection
4. intrapartum fetal distress
5. preceding preterm birth

Question 20

what is incompetent cervix

Answer 20

painless cervical dilation in the 2nd or early 3rd trimester with prolapse into the vagina

Question 21

what is placenta previa

Answer 21

placenta low/near the cervix - if it separates from the uterus during labor it can cause bleeding, shock, and death to the mother or prematurity or death to the fetus

Question 22

what are the consequences of maternal hypertensive disorders

Answer 22

deterioration of organ and system function

Question 23

what are the consequences of fetal hypertensive disorders

Answer 23

reduced utero-placental perfusion

Question 24

what are the four types of hypertensive disorders in pregnancy

Answer 24

gestational HTN, preeclampsia, eclampsia, chronic HTN

Question 25

what is gestational HTN

Answer 25

BP >140/90 for first time during pregnancy, no proteinuria, and BP returns to normal <12 weeks postpartum

Question 26

what defines preeclampsia

Answer 26

BP 140/90 after 20 wks gestation, proteinuria, ^serum creatinine, low platelets, ^liver enzymes

Question 27

what are symptoms of preeclampsia (5)

Answer 27

``` persistent HA visual disturbances swelling in hands, ankles, legs R side pain under ribs severe heartburn ```

Question 28

what is eclampsia

Answer 28

seizures, medical emergency, requires immediate delivery

Question 29

multiple gestation results in a higher risk of what

Answer 29

premature onset of labor and birth

Question 30

when does gestational DM usually begin

Answer 30

20-24 weeks

Question 31

what is a simple correction that can be made to patients who wish to lay supine if we want to avoid supine hypotension syndrome

Answer 31

pillow under the right hip to tilt the fetus off the IVC

Question 32

what are three considerations for AROM instruction in pregnant patients

Answer 32

1. one limb at a time 2. avoid extremes of motion or stretching 3. no active abs - no leg lifts/sit ups

Question 33

exhaustive list of the roles of the PT s/p NVD (8)

Answer 33

- posture - PFM strength - diastasis recti correction - ab strength - aerobic and functional strength - pain mgmt - post-epidural complications - screen for postpartum anxiety and depression

Question 34

post operative care of the cesarean patient should include all of the same considerations from NVD and what else (3)

Answer 34

1. breathing/coughing instruction 2. pain mgmt 3. early mobilization and muscle pumping

Question 35

the APTA recommends ____ weeks of "fourth trimester" care

Answer 35

12