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Changes of Pregnancy
Test 2
| Question | Answer |
|---|---|
| When do changes of pregnancy begin? | first week |
| Does pregnancy affect all systems of the body? | yes |
| What causes the increase in the size of the uters in the first trimester? | * increases vascularity & vessel dialation *hyperplasia & hypertrophy(length & thickness) *Developlment of dicidua |
| After the third month what causes uterine enlargment? | mechanical pressure of growin fetus |
| Weight of uterus (pre-pregnant & the end of pregnancy)? | 60 grams (2oz) ..... 1000 grams (2.2lbs) |
| Location of fundus at 12-16 weeks? | symphysis pubis |
| Location of fundus at 22-24 weeks? | Umbilicus |
| Location of fundus at 36 weeks? | Xiphoid Process |
| *Lightening | Fetal head settles into the pelvis |
| Hegars Sign | softening of the uterine isthmus (just above cervix) |
| McDonalds Sign | easy flexion of the fundus on the cervix |
| Braun von Fernwalds Sign | softening and slight fullness of the fundus near the area of implantation |
| Piskaceks Sign | Soft "tumor-like" enlargment |
| *Uterine Souffle | maternal blood flowing through uterine arteries to the placenta heard with ultrasound device (equals maternal pulse) |
| *Funic Souffle | caused by fetal blood flowing through the umbilical cord (equals fetal heart rate) |
| What forms to add strength to the uterine wall? | fibrous and elastic tissue |
| Uterine thickness at conception, end of first trimester and at term | conception- 1cm, *end of 1st trimester- 2cm *term- 0.5cm |
| *Braxton Hicks Cxs | Irregular, painless uterine cxs (happen throughout pregnancy) |
| *Quickening | Maternal perceptions of fetal movement*Multiparous at 14-16wks *Nulliparous 18 wks |
| Goodells Sign | cervical softening in response to increases estrogen and progesterone |
| Operculum | Mucous plug- obstructs or obliterates the cervical canal |
| Chadwicks Sign | color change of cervix and vagina from light pink to deep blue-violet color |
| Leukorrhea | thick white discharge increased during pregnancy |
| Vaginal pH | decreases- becomes more acidic to precent bacterial infections but increases incidence of yeast infections |
| Progesterone production | Produced by corpus luteum for the 1st 10-12wks. *once the placenta is developed it takes over in progesetrone production |
| What the function of progesterone during pregnancy? | Maintain the endometrium *MAINTAINS THE PREGNANCY |
| What hormones are responsible for mammary gland changes? | estrogen and progesterone |
| What are the subtle firt changes at the beginning of pregnance in the mammary glands? | feeling of fullness, tingling or tenderness |
| *Striae Gravidarum | stretch marks |
| Montgomery Tubercles | enlarged sebaceous glands in the breast tissue |
| Changes of alveolar cells in the mammary glands at 6 weeks | thin clear pre-colostrum fluid |
| Changes of alveolar cells in the mammary glands at 12 weeks | a yellow secretion can be manually expressed |
| Changes of alveolar cells in the mammary glands in the third trimester | colostrum (pre-milk fluid) |
| Changes of the heart | pushed up and to the left and rotated anteriorly |
| Heart murmurs | *systolic cardiac murmurs are normal *Diastolic murmurs are abnormal |
| Heart rate | increases 10-15/min |
| Palpitations during pregnancy | normal |
| Blood pressure | rises during the 2nd trimester and then returns to first trimester levels *increases 5-10mm/hg |
| Cause of dependent edema and varicose vein formation | increased venous pressure usually in the lower extremities |
| Vena Caval Syndrome | pressure on the inferior vena cava when in supine position. Causes reflex bradycardia and decreased cardiac output (some women show increases BP) |
| Clinical manifestations of vena caval syndrome | dizzines, pallor, clamminess |
| Increase in blood volume | begins in first trimester @10-12wks, peaks in 3rd trimester @32wks (1500cc) |
| Plasma level at 32wks | 1000cc |
| RBC at 32wks | 450cc |
| Physiologic Anemia (pseudoanemia) | hemodilution r/t greater increase of plasma than RBC |
| WBC increase | occurs in 2nd trimester *5000-1200 |
| Respiratory effects of increases vascularization r/t increased estrogen | *Nasal and sinus stuffiness *Epistaxis *Voice Changes |
| Respiratory rate changes | increases slightly by 2 breaths/min |
| Chest circumference | increases by 6cm *rib cage flares *decrease in vertical diameter *increase in anterior-posterior and transverse diameters |
| Bladder shape | changes from convex to concave |
| BUN and serum creatinine | Decreased due to increased renal function |
| Glycosuria | common in the second half of pregnancy |
| Hyperpigmented areas | Areola, Nipples, Perianal |
| Linea Nigra | pigmented line that extends from the symphisis pubis to the top of the fundus- begins in the 3rd month in primagravidaand rises with fundus; earlier on multigravidas and entire line appears |
| Melasmah Gravidarum (Facial Chloasma) | Blotchy irregular brownish hyperpigmentation on face - more prominent in dar-haired women |
Created by:
jas067
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