Pregnancy phases Flashcards
(19 cards)
contraindications to exercising during pregnancy
- amniotic fluid leak
- cervical incompetence
- multiple gestation
- placenta abruption or previa
- premature labor
- preeclampsia/ gHTN
- severe heart or lung disease
unsafe exercise in pregnancy
- contact sports
- high fall risk activities –> skiing, gymnastics, horseback riding
- hot yoga
category I fetal heart rate
baseline 110-160
moderate variability (6-25)
no late or variable decels
+/- early decelerations and accelerations
category III fetal heart rate
absent variability + recurrent late decels
absent variability + recurrent variable decels
absent variability + bradycardia
sinusoidal pattern
causes
-fetal anemia
management of category III fetal heart rate
increased risk for fetal hypoxia
intrauterine resuscitative interventions
- oxygen administration
- IVF
- discontinuing utertonics
- may require C section
glucose phys during pregnancy
pancreatic beta cell hyperplasia
increased insulin secretion
increased insulin resistance
caused by human placental lactogen
Renal changes in preganancy
- Increased GFR
- decreased BUN
- decreased Cr
- increased urinary frequency
- mild hyponatremia
caused by
- increased CO due to progesterone
- increased ADH release
heme changes in pregnancy
-dilutional anemia due to increased plasma volume and RBCs
- prothrombotic state
- decreased protein S activity
- increased fibrinogen and coagulation factors
CV changes in preganancy
- increased CO and HR
- increased blood volume
- decreased SVR
pulmonary changes in pregnancy
- chronic resp alkalosis
- metabolic compensation (increased O2, decreased CO2)
- progesterone stimulates central resp centers
- increases tidal volume and minute ventilation
initial prenatal visit
- Rh(D) type and antibody screen
- hg/hct, MCV
- HIV, VDRL/RPR, HBsAg
- rubella and varicella immunity
- pap test
- chlamydia PCR
- urine culture
- urine protein
- inactivated flu vaccine
24-28 weeks prenantal visit
- hg/hct
- antibody screen if Rh(D) negative
- 50 g 1 hour GCT
35-37 prenatal visit
GBS culture
Active phase protraction
- cervical dilation less than 1 cm in 1hr in active phase
- commonly caused by cephalopelvic disproportion (head too large for pelvis)
Risk
- late term pregnancy
- fetal anamoly
- malposition
- maternal obesity
- excessive weight gain
- nulliparity
- AMA
- inadequate contractions
High maternal AFP
open neural tube defects
abdominal wall defects
multiple gestation
low maternal AFP
aneupoloidies
First trimester thyroid changes
- increased total T4 and mild increased free t4
- beta hcg stimulates thyroid hormone production in first trimester
- estrogen stimulates TBG; thyroid increased hormone production to maintain steady free T4 levels
TSH decreases
-increased beta hcg and thyroid hormone suppresses TSH secretion
hCG
- secreted by syncytiotrophoblasts
- preserves corpus luteum early during pregnancy
- maintains progesterone secretion until placenta is able to produce it on its own
-secretion begins about eight days after fertilization
- double every 48 hours until they peak at six to eight weeks gestation
- composed of alpha and beta subunits
- alpha is common to hCG, TSH, LH, and FSH
prolactin and amenorrhea
- prolactin inhibits GnRH
- low FSH, LH and estrogen
- low estrogen inhibits ovulation
- can have menopause like vasomotor symptoms and vulvovaginal atrophy
- patients may have dyspareunia due to epithelial thinning and vaginal dryness
treat
-nonhormonal lubricants and moisturizers
