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Flashcards in Pregnancy Deck (59)
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1

Presumptive signs of pregnancy

Changes felt by the woman (breast, no period, N/V, urinary freq, fatigue, "flutters")

2

Probable signs of pregnancy

Changes observed by an examiner (goodell sign, chadwick sign, hear sign, positive test, braxton hicks contractions)

3

Goodell sign

Softening of the cervix

4

Chadwick sign

Bluish discoloration of the cervix

5

Hegar Sign

Softening of the uterine isthmus

6

Braxton Hicks contractions

Myomas and other tumors

7

Positive signs of pregnancy

Changes attributed only to the fetus (visualization of fetus, fetal heart tones on doppler, fetal movements palpated or visible)

8

Where is the fundus at 22-24 weeks gestation?

At the level of the umbilicus

9

Where is the fundus at term?

At the level of the xiphoid process

10

What is used as an estimate for the duration of pregnancy?

Fundus Height

11

Cervial changes during pregnancy

Multipara (oval), nullipara (rounded), increased vascularity, goodell sign

12

Vaginal changes during pregnancy

Mucosa thickens and connective tissue loosens in prep for delivery, chadwick sign, mucous plug (operculum) barrier against bacteria, secretions are more acidic

13

Breast changes during pregnancy

Enlargement, sensitivity, tingling, heaviness in response to increased estrogen and progesterone, nipples and areolae become more pigmented, sebaceous glands might be visible (montgomery tubercles), blood vessels are more visible, stretch marks may appear, colostrum

14

Striae gravidarum

Stretch marks

15

Cardiovascular changes during pregnancy

Blood volume increases by 40-50%, cardiac output increases, slight cardiac enlargement as a result of increased blood volume and output, increase in fibrinogen and factors VII VIII IX and X

16

Pulse increase during preg

Between 14-20 weeks and persists to term

17

BP decrease/increase during preg

Decreases during 1st trimester, continues to drop until 24-30 weeks, gradually increases and returns to prepreg levels by term

18

Respiratory changes during preg

Ligaments of the rib cage relax as a result of estrogen, diaphragm is displaced, chest breathing replaces abdominal breathing, decreased tolerance for apnea and hypovent, upper respiratory tract becomes more vascular as a result of elevated levels of estrogen (sinus stuffiness and nosebleeds)

19

Renal changes during preg

Larger volume of urine is held and urine flow is slow due to ureteral obstruction, increased risk of UTI bc pressure by gravid uterus on ureters and increased blood flow to kidneys

20

Pressure on bladder during preg

Pressure during 1st, symptoms decrease during 2nd, presenting part descends in 3rd and symptoms increase

21

Integumentary changes during preg

Hyperpigmentation (nipples, areolae, axillae, vulva), stretch marks and linea nigra, palmar erythema, mild itching, angiomas (vascular spiders) of neck, thorax, face, arms, facial melasma (chloasma or mask of preg) blotchy, brownish, hyperpig of skin over cheeks, nose, and forehead

22

Musculoskeletal changes during preg

Increasing weight of the fetus causes the mother's posture to change, center of gravity shifts forward, extra strain on muscles, ligaments and joints in the lower back

23

GI changes during preg

N/V proportional to hCG levels and decreases in the second and third trimesters, delayed gastric emptying bc decreased peristalsis, hemorrhoids bc constipation and pressure on vessels, emptying time of gallbladder decreases may lead to stones, cardiac sphincter relaxes so HB, anesthesia should always assume a full stomach

24

Normal weight women before pregnancy will gain how much?

25-35 pounds

25

Underweight before preg

get to normal weight then 28-40 pounds

26

Overweight before preg

15-25 pounds

27

Prenatal visits

Every 4 weeks up to 28 weeks, every 2 weeks from 29-36 weeks, every week from 37 weeks to birth

28

Goals of antepartum testing

Identify fetuses at risk for injury caused by acute or chronic interruption of oxygenation, identify oxygenated fetuses so unnecessary interventions can be avoided

29

Monitoring begins when?

By 32-34 weeks of gestation

30

Ultrasounds

High freq sound waves, waves deflect off tissue in abdomen, noninvasive, painless, no known harmful effects to mother or baby