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Flashcards in Pregnancy Deck (122)
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1

Fertilisation means successful pregnancy

Trimester system is based on scientific model. T/F


What is a good indication that the pregnancy will last until term

No..... some estimations that only 1/3

F: only based on exprience and early understanding of pregnancy

a pregnancy completes the first trimester (13 weeks), it is very likely to last until close to the expected delivery time (term, 39-40 weeks).

2

What changes occur to mother, baby and placenta at which points

Maternal changes throughout

Embryo, foetus, viability (26 weeks), term

Placental changes- complex, mostly first half

3

What is absolute limit of infant survival

End of 2nd trimester 26-27 weeks

with modern medical science 23 weeks

4

Which things increase in a mother during pregnancy

Increased weight

Increased hormone levels / altered endocrine system

Increased blood clotting tendency

Increased basal body temperature

Increased breast size

Increased vaginal mucus production

Increased nausea and vomiting (‘morning sickness’)

5

...

....

6

What decreases during pregnancy and when

Blood pressure (2nd)

7

Why are pregnant women prone to collapsing

Decreased blood pressure

8

What other things are altered in pregnancy (not flat increase or decrease)

Altered brain function [1st & later]

Altered hormones [1st & later]

Altered appetite (quantity and quality) [1st & later] – GI imbalance

Altered fluid balance [2nd & later]

Altered emotional state [1st & later]

Altered joints [3rd]

Altered immune system [1st & later]

9

T/f implantation of the fertilised egg will occur around day 28

F! Fertilisation will occur within 24hrs of ovulation (day 14!) and implantaton would occur 3-5 days after fertilisation

10

Why can it be hard to identify when olvulaton occurred

he variability in length of the menstrual cycle was noted, making it difficult to identify (in a normal pregnancy) the exact timings of ovulation and fertilisation.

11

When is pregnancy counted

pregnancy is counted from the first day of the last menstrual period (LMP), with other events dated from this time. At least, this is the conventional timing from an obstetric-gynaecological view.

12

When would embryologist count emrbyo age from

An embryologist would start the count from fertilisation (wheter IVF or natural)... REFERRED TO AS PF (post-fertilisation)

13

What is the time difference between GA determined by LMP and the GA determined by conception

The GA determined by pregnancy will be 2-2.5 weeks longer than the embryo age

Because last menstruation would have occurred about 2 weeks (i.e. 14 days) before ovulation and fertilisation

14

Why does maternal weight change during pregnancy and when

on average will be in the range of 10-15 kg. This will include the weight of the fetus, amniotic fluid and placenta; increased fluid retention; increased nutritional stores (to feed the baby after delivery).

2nd and especially 3rd trimester

15

Why does blood clotting tendency increase and when


Why is blood clotting change in pregnancy and anomaly

From 2nd trimester

To reduce bleeding in delivery?


Anomaly because We are very used to the concept that increased blood clotting and increased blood pressure are parallel changes, as it is well established that hypertension is strongly linked to an increase in stroke and heart attacks.

In pregnancy BP decreases though

16

When does blood pressure decrease and why.
Impact

Maternal blood pressure is lowest during the second trimester,

and increases the risk of maternal fainting – so pregnant women should not stand for prolonged periods of time

17

What happens to BP during the 3rd trimester

Blood pressure tends to increase during the third trimester, but should still remain below a level that would be considered as hypertension; 120/70 mmHg would be considered normal.

18

What happens to basal body temp in pregnancy and why

Basal body temperature increases by ~0.5°C in the second half of the menstrual cycle after ovulation and is sustained into the first trimester of pregnancy, probably by the thermogenic roles of progesterone.

As the fetus increases in size, it contributes to maternal temperature, and normal maternal temperatures may exceed 38°C.

19

What happens to breast size in pregnancy and why

From first trimster

Breast size increases

dependent on increased hormone levels in the maternal circulation (human placental lactogen, prolactin, and ostrogens are all involved)

20

Why can women get increased clear discahrge in pregnancy

increased vaginal mucus production
is common and normal change in pregnancy

21

What is hyperemesis gravidarum

The most servere version of morning sickness (affects 1-2% of pregnancies whilst morning sickness generally affects 80%)

22

T/F morning sickness involves sickness specifically in themorning during pregnancies

F: ‘Morning sickness’ is not really an accurate name, as nausea and vomiting can occur at any time of day!

23

How does brain function change in pregnancy

The high levels of steroids, particularly progesterone, are thought to influence brain function during pregnancy, but due to the difficulties of doing detailed studies during pregnancy a precise understanding is lacking

Brain size actually decreases a bit! (might not have functional significance)

24

What happens to appetite during pregnancy

As the size of the uterus increases during the later stages of pregnancy, it imposes steadily increasing pressures on the gastro-intestinal system, including the stomach. This can decrease the distensibility of the stomach, and in late pregnancy the mother may need to have up to 6 smaller meals per day, rather than 3 bigger meals.

25

What happens to fluid balance in pregnancy

Kidney function changes in the mother as pregnancy proceeds leading to increased fluid retention and a higher plasma volume. BLOOD VOLUME IS 50% HIGHER THAN BEFORE PREGNANCY!

26

What happens to urination frequency in pregnancy

1st tri. increases (thought to be due to changes in the maternal hormones, regulating altered kidney function)

2nd tri. normalises

3rd increases (greatly enlarged uterus will be exerting pressure on the bladder)

27

During the 3rd trimester, the mother will be passing more urine in each visit to the toilet. T/f

F: By the third trimester, the greatly enlarged uterus will be exerting pressure on the bladder, decreasing the maximum size and volume of urine it can contain, so the mother will pass smaller volumes of urine more frequently.

28

What happens to emotional state during pregnancy

due to changes in hormone levels

motional changes linked to pregnancy can be very variable.

In some cases women are said to ‘glow’ with their pregnancy and with happiness – they are delighted to be pregnant, and the world is wonderful.

Alternatively, women may be equally happy to be pregnant, but may be emotionally very labile, crying with little or no obvious cause; or they may become clinically depressed during pregnancy, which may continue into post-natal depression.

29

Why do altered joints occur in pregnancy

Changes to the maternal pelvis, making the connections between the bones more flexible are necessary to permit the delivery of a normally-grown human infant.

30

Condequence of joint changes to materna pelvis for flexibility in pregnancy

Parallel changes are observed in other maternal joints, and these generally persist after pregnancy, causing permanent modifications to joint structure and (modestly) function.