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Antepartum
Childbearing
| Term | Definition |
|---|---|
| GTPAL | Gravida, Term, Preterm, Abortion, Living Children |
| Signs of Pregnancy | Amenorrhea,n&v, fatigue, increased urination, breast&skin changes, quickening |
| Chadwick's sign | Cervix turns blue/purple |
| Goodell's Sign | Softening of cervix |
| Hegar's sign | Softening of lower uterine segment |
| Ballottment | Push and baby floats up and back down |
| Leopold's movement | palpation of fetal movement |
| Pregnancy test | Measures HCG levels (cause n&v) |
| McDonald's Movement | Measures uterine enlargement (pubic symphasis to top of funds) 8weeks = 8 cm |
| Nagele's Rule | First day of last menstrual period (LMP) - 3 months + 7 days = EDD, EDC |
| Positive signs of pregnancy | Auscultation of heart sounds (fetoscope/Doppler), fetal movement felt by examiner, visualization of fetus |
| Pregnancy length | 10 months, 40 weeks, 280 days |
| Oogenesis | Oocyte mature and located in graafian follicle |
| Progesterone | Relaxes smooth muscle and allows for planting |
| Cortical Reaction | Prevents other sperm from entering |
| 3 days | Time to travel from ovary to uterus |
| Preembryonic Stage | First 14 days of development (Cleavage-Blastomeres from Modula - blastocyst-trophoblast) |
| Blastocyst | Develops into embryonic disc and amnion |
| Trophoblast | Develops into chorion |
| Fraternal Twins | Two oval and two sperm - dizygotic |
| Identical | Single fertilized ovum - monozygotic |
| Implantation | 7-10 days after fertilization, blastocyst burrows into endometrium. Now called embryo and endometrium called decidua |
| Primary germ layers | Ectoderm, mesoderm, endoderm |
| Ectoderm | Forms brain and CNS |
| Mesoderm | Forms bones, CT, heart, and BVs |
| 3rd gestational week | Heart begins to form |
| 4th gestational week | Heart begins to beat and circulate |
| Endoderm | GI and Respiratory systems |
| Fetal movement can be felt by examiner | |
| Tetragons | Smoking, drinking, and other toxic influences |
| Chorion | First embryonic membrane to form, develops from trophoblast and will change into placenta |
| Amniotic fluid | In amnion, Neutral temp. Environment, allows for symmetrical growth, and space for fetal movement, cushions, space for umbilical cord |
| Umbilical cord | Provides circulatory pathway from chronic villi to embryo; 2 arteries carry deoxygenated blood and vein carries oxygenated blood |
| Yolk Sac | 8-9 days after conception, forms primitive blood cells and becomes part of umbilical cord |
| Wharton's Jelly | A gelatinous substance that provides insulation and protection within the umbilical cord |
| Placenta | Place of metabolic and nutrient exchange |
| Duncan "dirty" | Maternal portion - Attaches to uterus |
| Shultz "shiny" | Fetal portion |
| 9 weeks | Considered fetus |
| 10 weeks | Placenta takes over function |
| Placental function | Gas exchange, nutrient exchange, Endocrine functions (decrease HCG, Human Placental Lactogen (ensures proteins, glucose, and minerals available) estrogen (enlargement of tissues in mom) progesterone (relaxes smooth muscles) |
| Fetal Stage | 9 Week's to birth; every organ system, structure present, gestation time to refine structures and perfecting function |
| 8-12 Weeks | Males begin producing testosterone |
| 24 weeks | Viability (decent chance of fetus surviving) begin seeing breathing on ultrasound (swallowing amniotic fluid- will form mirconium) |
| 28 weeks | Lungs better able to have gas exchange |
| 36 Week's | Lanugo begins to disappear |
| Early pregnancy | Nutritional deficiencies with cellular division causes permanent fetal damage |
| Late pregnancy | Nutritional deficiencies lead to problems with low birth weight |
| 1st Trimester | Doesn't need to increase calories |
| 13 weeks through delivery (2nd and third trimester) | increase 300 calories/day |
| Folacin/Folic Acid | 600mcg/day; green veggies, liver, peanuts, whole grains |
| Folacin Deficiencies | Leads to neural tube defects (such as spina bifida) |
| Iron | Take with food to reduce nausea, take with acidic beverage (OJ), don't take w/ milk, antacids, or caffeine |
| Sodium | Causes fluid retention, caution with edema, b/c indicates preeclampsia, may need some extra sodium in order to keep water in cell because lack of sodium will dehydrate |
| Maternal Weight Gain | 22-28lbs |
| Underweight | 28-40lbs (<18.5) |
| 1-6 months | Fetus dependent on what mom eats |
| Normal | 25-35lbs BMI 18.5-24.9 |
| Overweight | 15-25lbs BMI 25-29.9 |
| Obese | 11-20lbs BMI >30 |
| 1 Trimester | 2-4lbs |
| 2&3 Trimester | ~1lb/week |
| 35lbs | Optimal pregnant teen weight gain |
| Fluid Retention | >2lbs/week (abnormal swelling) |
| Caffeine | Restrict to 200mg/day |
| Hyperemesis Gravdarum | Constant vomiting - can't even keep water down - r/t hormone changes and allergic rxn to fetal proteins |
| GA | 39 1/7 = 39 weeks and 1 day |
| Gravida | How many times pregnant (includes abortions, miscarriages, current) |
| Para | How many delivered over 20 weeks |
| Term | How many past 37 weeks |
| Stillborn | Born w/o heart beat after 20 weeks |
| LC | Living |
| gravida 3 - Para 2 | Ex: 3/2 |
| Shark, shrimp, crab, tuna | SaltH2O fish to avoid |
| Breast changes | Increase size and darker nipples due to progesterone, estrogen, and lactin |
| Mucous plug | Prevents organisms from entering |
| 1/month until 28 weeks, q2weeks until 36th week, qweek until labor | How often for visits during pregnancy |
| 3 father phases | Announcement, moratorium, focusing |
| Couvade syndrome | Partner may experience pregnancy symptoms and discomforts to pregnant partner |
| 3rd trimester | Sexual desire increases |
| Fetal Fibronectin (FFN) | Glycoprotein; Presence between 20-34 weeks (strong indicator of pre-term delivery in next 2 weeks) |
| Dehydration, sex, recent cervix check | Can cause pre-term labor |
| Betamethazone | Corticosteroid given to stop pre-term delivery (2 doses IM 24h apart) |
| Rehydrate, Betamethazone, Mg Sulfate, Turbuteline, Antiobiotics | Tx of Preterm Labor |
| Magnesium Sulfate | Given 4-6 grams initially then 2g/h IV to relax smooth muscle and cease contractions (5-7 magnesium levels = therapeutic) |
| Magnesium Sulfate Toxicity | Decreased reflexes, respirations, urinary output |
| Magnesium sulfate side effects | n&v, weakness, just "feel bad all over", sweaty |
| Turbuteline | Relaxes smooth muscle of uterus and bronchodilator given SubQ |
| Antibiotics | Proactive since don't have group beta strip tests |
| Premature Rupture of Membranes | Rupture before 37 weeks |
| Incompetent Cervix | Painless cervical dilation in 2nd trimester |
| Preeclampsia | Progressive disorder that occurs after 20 weeks gestation (usually in last 10 w, during labor, or first 48h after birth) Proteinuria present |
| Eclampsia | Seizure in the presence of preeclampsia |
| Chorionic Villus Sampling (CVS) | Sample of chorionic villi from the edge of the placenta |
| Amniocentesis | Needle inserted into the uterine cavity through maternal abdomen |
| Mature Lungs | Lecithin/Sphingomyelin ratio >2:1 |
| Immature Lungs | L/S ration <2.1 |
| Alpha-fetoprotein (AFP) | Fetal serum protein present in maternal serum and amniotic fluid (maternal serum AFP peaks @ 30w; Amniotic peaks @15w) |
| Quad Screen | Can predict neural tube defects/down syndrome, estriol, hCG, inhibin A (hormone) |
| Abnormality Present | Low MSAFP and estriol |
| Trisomy 21 | High levels of HCG and inhibin A |
| Neural Tube Defect | Decreased estriol |
| Daily Fetal Movement Count (DFMC) | Kick count |
| Amniotic Fluid Index (AFI) | Amount of amniotic fluid in uterus is an indicator of fetal well-being (kidneys are being perfused) |
| NonStress Test | Requires fetal monitor and observe for accelerations of fetal heart rate in response to fetal movement |
| Reactive NST | 2 or more accelerations of FHR w/n 20m |
| Nonreactive NST | <2 accelerations of FHR w/n 20m |
| Contraction Stress Test (CST) | Used in @risk pregnancies (nonreactive NST & post dates) observe response of FHR to contractions |
| Negative CST | No late decelerations occur after any contraction |
| Positive CST | Late decelerations occur w/ @least 2/3 contractions |
| Equivocal | Late decelerations w/ a single contraction |
| Biophysical Profile (BPP) | Fetal breathing movements, gross body movements, fetal tone, reactive FHR, amniotic fluid volume (2pts/criteria=10pts) |
| Fetal OH Syndrome Damage Degrees | 1- CNS damage 2- facial malformations 3-growth retardation |
| Crystal Meth During Pregnancy | The Walk Away Drug |
| <11 | Iron 1st & 3rd trimester |
| <10 | Iron 2nd trimester |
| Placenta Accreta | serious pregnancy condition that occurs when blood vessels and other parts of the placenta grow too deeply into the uterine wall. |
| Chromosomal Abnormalities | #1 Reason for abortions |
| Ectopic Pregnancy | Embryo implanted outside uterine cavity; most often in fallopian tube |
| Ectopic Drug Therapy | Methotrexate (dissolves embryo but preserves fallopian tube) |
| Hydatidiform Mole | Non-viable pregnancy in which sperm duplicates on itself or 2 sperm fertilize 1 egg |
| Hydatidiform Mole | hCG extremely elevated; monitor levels for 1 year after incident |
| Placenta Previa | e placenta is located low in the uterus. The placenta might partially or completely cover the cervix |
| Abruptio Placenta | placenta peels away from the inner wall of the uterus before delivery |
| HELLP Syndrome | Hemolysis, Elevated Liver enzymes, Low Platelets |
| Preeclampsia | Only cure is birth of fetus and removal of placenta |
Created by:
TedMed
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