Pregnancy Flashcards
(114 cards)
1
Q
stretch marks is aka
A
Striae gravidarum
2
Q
a brownish black pigment vertical strip along the midline skin of abdomen may appear is known as
A
linea nigra
3
Q
what is diastasis recti
A
separation of the rectus abdominis muscles at the midline due to tension on the abdominal with advancing pregnacy
4
Q
what weeks is the first trimester of pregnancy
A
weeks 1-end of week 12
5
Q
what does the uterus look like in the pelvis during the first trimester
A
uterus is enlarged but is confined to pelvis and retains a pre-pregnancy position
6
Q
when does the uterus become palpable just above the pelvic rom
A
week 12-14
7
Q
what weeks is the second trimester
A
weeks 13-end of 26
8
Q
what is the uterus position in second trimester
A
uterus is in the aneverted position that pushes on the bladder
-slight uterine dextrorotation to accomodate rectosigmoid structures
9
Q
when does round ligament pain start? where does it cause pain?
A
second trimester
-pain in the lower quadrants
10
Q
where is the fundal height at 12-14 weeks
A
pelvic rim
11
Q
where is the fundal height at 16 weeks
A
between the pelvic rim and the umbillicus
12
Q
where is the fundal height at 20 weeks
A
at the umbillicus
13
Q
where is the fundal height at 24-32 weeks
A
below the xiphoid process
14
Q
where is the fundal height at 36 weeks
A
right beneath the 36
15
Q
what sign is bluish color of the vagina and cervix due to increased vascularity of the pelvis
A
chadwick’s sign
16
Q
what sign indicates normal vaginal secretions that are thick, white, or more profuse
A
Leukorrhea of pregnancy
17
Q
what sign indicates softening of the cervical isthmus
A
Hegar Sign
18
Q
when does the fundal height drop
A
after 38 weeks- head is getting ready for delivery
19
Q
what is expelled as a bloody show at delivery
A
the mucus plug; protects the uterine environment from outside pathogens
20
Q
where is Adenexae palpable
A
at the corpus luteum
21
Q
what is a small nodule on an ovary in early pregnancy that disappears by mid pregnancy
A
Adnexae
22
Q
what gland in your breast becomes more prominent?
A
montgomery glands
23
Q
when do women secrete colostrum
A
2nd and 3rd trimester
24
Q
what are normal changes to the breast
A
- enlargement
- darker areola
- nipples become larger and more erectile
25
What three things confirm pregnancy
1. urine pregnancy test
2. LMP
3. ultrasound to confirm dates
26
27
what are irregular and unpredictable uterine contractions in the 3rd trimester that is RARELY associated with labor
braxton hicks contractions
28
what is vomiting with >5% loss of pre-pregnancy weight
hyperemesis gravidarum
29
what is the menstrual age aka? how is it calculated
gestational age
count the # of weeks and days from the first day of the LMP
30
Conception age is aka? how is it calculated
Fetal age
2 weeks less than the gestational age
31
what is conception age indicated for?
IVF conceptions
32
how is expected delivery date calculated?
| EDD
40 wks from the first day of LMP
| estimated date of confinement
33
how long is the pregnancy according to gestational age?
40 weeks
34
how long is the lengthh of pregnancy according to fetal age
38 weeks
35
what is Naegele rule to calculated EDD
1. begin on first day of LMP
2. subtract 3 months
3. add 7 days
4. add 1 year
36
why is gestational age 2 weeks longer?
accomodates for 2 weeks of when the women is not pregnant
37
Gravidity
number of times that a women has been pregnant
38
parity
number of times that a women has given birth >24, regardless if the child was born alive or stillborn
39
how does multiple gestation change G0P000
it is counted as 1 pregnancy, one birth but 2 children
40
What are risk factors for maternal and fetal health
| for the women and baby
* tobacco, etoh, drug use
* RX meds and OTC med use
* adequate nutritional intake or risk for diabetes
* intimate partner violence
41
what family history should be obtained?
* ethnic background of parents
* history of genetic disease
* congenital problems in babies
42
what 3 plans should be established at the inital prenatal visots
* plans for genetic testing
* plans for breastfeeding
* plans for postpartum contraception
43
what history should be obtained each visit after the initial
* fetal movement felt by the patient
* contractions
* leakage of fluid
* vaginal bleeding
44
45
what is quickening?
the first fetal movement felt around 18-24 weeks earlier in parous women
46
what does quickening feel like? when is it felt?
sit feels like fluttering wings
18-24 weeks
47
when are kicks felt? in weeks
18-25 weeks
48
when are hiccups felt
18-24 weeks
49
when are pokes felt
29 weeks
50
when are jabs felt
36 weeks
51
what physical exam should be conducted at each subsequent visit?
* vital signs (BP and weight)
* fundal height
* verification of fetal heart rate (FHR)
* fetal position
52
what components should be tested of the urine at each subsequent visit
* infection
* glucose
* protein
53
what position should the pt be in during early pregnancy
supine position
54
what position should the pt be in during late pregnancy for physical exam
semi-sitting with knees bent
55
When do you assess fetal heart tones?
after 10-12 weeks
56
when do you begin measuring the uterus?
after 20 weeks
57
why don't you want pts laying on their back late in pregnancy
compression on the aorta
58
when does blood pressure normally drop during pregnancy?
2nd trimester
59
what is melasma
mask of pregnancy
dark spots along the face or neck
60
what vital sign should be monitored prior to pregnancy
blood pressure
61
what is melasma aka
cholasma
62
what is a normal lung finding in a pregnant female? when is it seen
diaphragmatic elevation
can be seen as early as the first trimester
63
where does the apical impulse go?
rotated upward and toward the left 4ICS
64
What is the murmur that is heard over the breasts due to increased blood flow and vasculature? when in pregnancy is heard?
Mammary souffle
late pregnancy or during lactation
65
where is a mammary murmur heard best at?
2nd and 3rd ICS at bilateral sternal borders
66
what type of murmur is a mammary souffle murmur?
systolic and diastolic but only heard in systolic
67
what murmur is NEVER normal?
diastolic murmur
68
how should you investigate discrepancy between measured fundal height and expected fundal height?
ultrasound
69
what difference in expected vs measured fundal height is concerning
>4cm larger than expected or smaller than expected (+/-4cm)
70
when can fetal movement be felt by examiner?
24 weeks
71
when do you start measuring the fundal height
>20 weeks gestation
72
where do you measure the fundal height on the belly?
from the pubic symphysis to the top of uterine fundus
73
what should the fundal height measurement (in cm) match?
Roughly the weeks pregnant
74
what can cause a larger fundal height?
1. multiple gestation
2. large baby
3. extra amniotic fluid
4. uterine leiomyoma
75
what can cause low fundal height
1. small baby (interuterine growth retardation)
2. low amniotic fluid
3. missed abortion
4. fetal anomaly
76
when can you auscultate fetal heart tones?
10-12 weeks with a doppler fetal monitor
77
where should you listen to the heart for 10-18 weeks gestation
along the midline of the lower abdomen
78
where should you listen to the FHR for 18+ weeks gestation
depends on fetal position
79
what is the normal FHR
110-160
80
how should FHR vary from second to second
10-15bpm
81
when is there increased variability in FHR
late pregnancy >32weeks
82
what is cervical ectropion
the columnar cells of the inner portion of the cervix migrates to ectocervix and appears as friable darker pin or red
83
what does adnexal tenderness or masses early in pregnancy possibly indicate?
ectopic pregnancy
REQUIRED US TO RULE OUT
84
what should be examined for the anus during physical exam
external hemorrhoids
85
what should be examined for extremities physical exam
* varicositites
* edema
86
what are the leopold maneuvars used to determine?
fetal position beginning in the first trimester and readiness for vaginal delivery
87
First maneuvar
* hands on both sides of baby
* determines fetal part is located at the fundus, the upper fetal pole
88
second maneuver
hands on both sides but lower
* determines the direction the fetal bac kis facing
89
90
third maneuver
* hand on the top and bottom of belly
* determines what part of the fetus is at the lower fetal pole and descents into the pelvis
91
fourth maneuver
* hands on both sides at the lwoer end
* determines the direction and degree of flexion of the head
92
what is cephalic position
head down, facing into the vaginal canal
93
94
what is the breech position
butt down facing the vaginal canal
95
what is oblique fetal position
head down but kind of sideways
96
what is transverse fetal positon
baby is laying sideways
97
Hypertensive moms love Nifedipine
* hydralazine
* labetolol
* alpha-methldopa
* nifedipine
98
what is the frank breech position
both hips are flexed and both knees are extended
99
what is the complete breech position
both hips and knees are flexed
100
what is footling breech
one or both legs are extended below the buttocks
101
what are the 2 things required for pre-eclampsia diagnosis (way 1)
1. SBP >140 or DBP >90 after 20 weeeks on 2 occasions 4 hrs apart OR BP >160/110 within minutes
2. proteinurira >300mg/24 hours or protein:Cr >0.3 OR dipstick 1+ prtotein
102
what is the classification for diagnosing preeclampsia (second way)
new onset HTN without proteinurira but one+ of:
* thrombocytopenia
* impared liver function
* new renal insufficiency
* pulmonary edema
* new onset cerebral or visual symptoms
103
what is chronic HTN in pregnancy
SBP >140 or DBP >90
present before conception OR diagnosed before week 20
104
what is gestational HTN
SBP >140 or DBP>90
* first documented after 20 weeks
* without proteinuria or end-organ dysfunction
105
when does gestational HTN resolve by
12 weeks postpartum
106
what does HELLP syndrome stand for
H-hemolysis
E-elevated
L-Liver enzymes
L-Low
P-platelets
hemolysis, elevated liver enzymes, low platelets
107
what is the treatment of preeclampsia
delivery
108
why does preeclampsia show proteinuria
damaged placenta releases proinflammatory proteins into the circulation
108
109
what is the treatment of ectopic pregnancy
methotrexate or surgical resection
110
what is ectopic pregnancy?
implantation that occurs outside of the uterus
111
where do ectopic pregnancies most commonly occur
fallopian tube
112
what are some symptoms of ectopic pregnancy
* syncope
* hemorrhagic shock (if ruptured)
113
what is the way you can diagnose an ectopic pregnacy
-serum HCG is postive
-urine HCG is negative
