- check on baby's well being
- breathing pattern ect
- ideal score 8-10
when does fertilization take place?
- when the sperm meets the ovum
- only takes 1 sperm
presumptive signs of pregnancy?
- breast tenderness
- deepening pigmentation (chloasma) primary in darker ppl
- urinary frequency
probable signs of pregnancy
- godwell's sign-softening of the cervix and vagina b/c of increased vaginal congestion.
- chadwick's sign- purpulish, bluish discoloration of cervix, vagina, vulva b/c increased vascular congestion.
- hegar's sign-softening of the lower uterine segment
- mcdonalds sign-uterus flexing against cervix
- braxton hicks contractions- irregular painless uterine contractions that begin in the 2nd trimester.
positive signs of pregnancy
- audible fetal heartbeat- detected at 10 wks by fetal doppler
- fetal movement felt by examiner
- ultrasound visualization of fetus
1st trimester physiological changes
- pigementation changes (chloasma)
- enlarged abdomen
- small wt gain
- enlarged uterus presses on bladder
2nd trimester physiological changes
- groin pain
- sexual pleasure and desire increases
- white discharge
- orthostatic HPT
- perineal itching
- center of gravity changes
- pressure on bladder and rectum
- leg muscle spasm
- mood swings
- slowed GI motility
- itchy skin
- stuffy nose
- enlarged breast
- tingling fingers
3rd trimester physiological changes
- tires easily
- colostrum may leak from breast
- voice changes
- pressure on stomach and diaphragm
- venous congestion
- uterus drops
1 trimester labs
- blood type
- Rh factor
- antibody screen
- rubella titer
- tb screening-ppd or serum blood test quantiferon
- hep B
- U/A and culture
- vaginal culture
- hemoglogin A1c
- CF/genetic markers
2nd trimester labs
- serum alpha fetoprotein
- blood glucose
3rd trimester labs
- GBS culture
- real time U/S
- doppler blood flow
- cervical fetal fibronectin
- repeat STI,CBC, RPR, NST's, BPP, AFI
- process of mitosis in sperm: sperm gives X or Y chromosome to determine sex
- gametogenesis-begins at ovulation and is complete when fertilization happens.
- covers and cushions the AVA and keeps them separate
- develops from thromboblasts and envelops the amnion, embryo and yolk sac
- thick membrane with villi on outer surface; villi or fingerlike projections from fetal portion of placenta
implantation of zygote
- in the posterior upper portion of uterine wall
estrogen levels and functions
- stimulates uterine growth
- increases blood flow to the uterine vessels
- increases skin pigmentation, vascular changes in skin/mucous membranes of nose/mouth, increases salivation.
breast changes due to what hormones?
- estrogen and progesterone stimulate dev. of breast ducts to prep for lactation.
common signs of hydatidiform mole?
- rapid uterine growth
- excess hyperemesis gravidarum
- failure to detect fetal heart activity
- unusually early development of GH
- higher than expected Hcg
- distinct snowstorm pattern on ultrasound with no evidence of developing fetus
- placenta in lower uterus instead of upper portion
- painless bright red bleeding
- no vaginal exam due to risk of bleeding
- gradual or abrupt onset of pain and uterine tenderness
- possible low back pain
- uterine feels firm and boardlike
- irratible, frequent contractions
preterm labor and bedrest teaching
- record fetal kick counts daily
- report fewer than 10 kicks in a 12 hr period
- fetal movement felt by mother, usually at 16 wks
- helps prevent neural tube defects
- 0-4 mos 400mcg or 0.4 mg
- 4-9 mos 600-800 mcg or 0.6-0.8 mg
what causes heart burn in early pregnancy?
increased progesterone relaxes esophogeal sphincter
why is rhogam D immune globin given?
- Given one erythorblastosis fetalis occurs- A condition that occurs when maternal anti-Rh antibodies cross the placenta and destroy fetal erythrocytes.
- Also given after amniocentesis.
Non stress test
- Is a test done to check fetal health
- It monitors the fetus heart rate with contractions
- Nonstress test means no stress is produce.
Weight gain in pregnancy
- Normal weight people should only gained 25 to 35 pounds
- Obese woman should only gained 11 to 20 pounds
- S/S: Lower of Domino pain and light vaginal bleeding.
- It's a loping to Brookeshire 's; sudden severe lower abdominal pain, vaginal bleeding, signs of hypovolemic shock, and shoulder pain.
- Treatment; priority is to control bleeding, no action, methotrexate to inhibit cell division, surgery to remove pregnancy from tube.
- AVA- Two arteries and a vein in umbilical cord to support fetus.
- Ductus Venosus- Diverts blood away from the liver as it returns from placenta.
- Foreman Ovale- Diverts blood from the right atrium directly to the left atrium rather than circulating to lungs.
- Ductus arteriosus- Diverts blood from pulmonary artery into aorta.