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Pregnancy and Embryonic Development Chapter 18

Zygote fertilized egg
Egg fertilization is... 12–24 hours after ovulation
Parturition childbirth
Primary germ layers Ectoderm: skin and nervous system Mesoderm: muscles and bones Endoderm: linings of organs and glands
Amnion fluid-filled sac; attached to embryo by umbilical cord
tubal ligation the fallopian tubes are cut and tied off, preventing ova from reaching the uterus.
Obstetrics Field of medicine that deals with pregnancy (prenatal), delivery of the baby, and the first six weeks after delivery (postpartum period)
First Trimester begins on the first day of your last period and lasts until the end of week 12; Urinary frequency due to increasing size of uterus, creates pressure on bladder
Second Trimester from week 13 to week 28 - roughly months four, five and six; Uterus rises up out of the pelvis and pressure on bladder is relieved
Third Trimester time period extending from the 28th week of gestation until delivery; Frequency returns due to pressure of baby’s head on bladder
Amenorrhea Absence of menstruation Menstruation stops as a result of hormonal influence during pregnancy
Chadwick’s sign Cervix and vagina take on a bluish-violet hue due to local venous congestion
Goodell’s sign Cervix softens in consistency in preparation for childbirth
Leukorrhea Thick, white vaginal discharge during pregnancy
Changes in the vagina Vagina takes on same bluish-violet hue of the cervix during pregnancy Increase of glycogen in vaginal cells Causes increased vaginal discharge and heavy shedding of vaginal cells
Chloasma Hyperpigmentation (brown patches) seen on forehead, cheeks, and bridge of nose Known as the “mask of pregnancy”
Linea nigra Darkened vertical midline between the fundus and the symphysis pubis on the abdomen
Striae gravidarum Stretch marks on the abdomen, thighs, and breasts that occur during pregnancy
Quickening Movement of fetus felt by the mother Occurs around 18 to 20 weeks’ gestation Described as a faint abdominal fluttering
Hegar’s sign Softening of the lower segment of the uterus
Braxton Hicks contractions Irregular contractions of the uterus May occur throughout the pregnancy and are relatively painless
Ballottement Technique of using the examiner’s finger to tap against the uterus, through the vagina, to cause the fetus to “bounce” within the amniotic fluid and feeling it rebound quickly
Fetal heartbeat Detected by ultrasound at approximately 10 weeks’ gestation Detected by fetoscope at 18 to 20 weeks’ gestation Rate can vary from 120 to 180 beats per minute
Identification of embryo or fetus by ultrasound Can be detected as early as 5 to 6 weeks with 100 percent reliability Provides earliest positive confirmation of a pregnancy
Fetal movements felt by examiner Palpable by physician/examiner by the second trimester of pregnancy
Birth date for the baby Expected date of confinement (EDC) Expected date of delivery (EDD) Expected date of birth (EDB)
Nagele’s rule for calculation of date Subtract 3 months from beginning of last menstrual period (LMP) Add 1 year and 7 days to date = expected date of delivery
Temporary discomforts of pregnancy Backache, Edema, Fatigue, Heartburn, Hemorrhoids, Nausea, Varicose Veins
Abortion Termination of a pregnancy before the fetus has reached a viable age, that is, an age at which the fetus could live outside of the uterine environment
Abruptio Placenta Premature separation of a normally implanted placenta from the uterine wall After the pregnancy has passed 20 weeks’ gestation or during labor
Ectopic Pregnancy Abnormal implantation of a fertilized ovum outside of the uterine cavity Also called a tubal pregnancy Approximately 90 percent of all ectopic pregnancies occur in the fallopian tubes
Placenta Previa Condition of pregnancy in which the placenta is implanted in the lower part of the uterus Precedes the fetus during the birthing process
Gestational Diabetes Disorder in which women who are not diabetic before pregnancy develop diabetes during the pregnancy Develop an inability to metabolize carbohydrates (glucose intolerance), with resultant hyperglycemia
Hydatidiform Mole Abnormal condition that begins as a pregnancy and deviates from normal development very early Diseased ovum deteriorates (not producing a fetus) Chorionic villi of placenta changes to a mass of cysts resembling a bunch of grapes
Gestational Diabetes Risk factors Obesity Maternal age over 30 years History of birthing large babies Usually over 10 pounds Family history of diabetes Previous, unexplained stillborn birth Previous birth with congenital anomalies (defects)
Hydatidiform Mole Also called molar pregnancy, hydatid mole Growth of this mass progresses much more rapidly than uterine growth with a normal pregnancy
Hyperemesis Gravidarum Abnormal condition of pregnancy characterized by severe vomiting that results in maternal dehydration and weight loss
HELLP Syndrome (Hemolytic anemia, Elevated Liver enzymes, and Low Platelet count) Serious obstetrical complication that occurs in approximately 10 percent of pregnant women with pre-eclampsia or eclampsia
HELLP Syndrome Diagnosis Complete blood cell count Liver function tests
Incompetent Cervix Condition in which cervical os dilates before the fetus reaches term, without labor or uterine contractions Usually occurs during second trimester of pregnancy Results in spontaneous abortion of fetus
Pregnancy-Induced Hypertension (PIH) Development of hypertension during pregnancy in women who had normal blood pressure readings prior to pregnancy
Three categories of PIH Gestational hypertension, Pre-eclampsia, Eclampsia
Eclampsia Most severe form of hypertension during pregnancy Evidenced by presence of seizures
Pre-eclampsia Develops after 20 weeks’ gestation with proteinuria or edema
Gestational hypertension Develops after 20 weeks’ gestation with no signs of edema or proteinuria
Rh Incompatibility Incompatibility between an Rh-negative mother’s blood with her Rh-positive baby’s blood Causes mother’s body to develop antibodies that will destroy the Rh positive blood
First-Degree Vaginal Tear are the least severe, involving only the skin around the vaginal opening or perineal skin
Second-Degree Vaginal Tear involve the perineal muscles — the muscles between the vagina and anus that help support the uterus, bladder and rectum
Third-Degree Vaginal Tear involve the perineal muscles and the muscle that surrounds the anus (anal sphincter
Fourth-Degree Vaginal Tear are the most severe. They involve the perineal muscles and anal sphincter as well as the tissue lining the rectum
Bloody show Vaginal discharge that is a mixture of thick mucus and pink or dark brown blood Occurs as a result of the softening, dilation, and thinning (effacement) of the cervix in preparation for childbirth
Braxton Hicks contractions Mild, irregular contractions that occur throughout pregnancy
Lightening Settling of the fetal head into the pelvis Occurs a few weeks prior to the onset of labor
Contractions (False) Irregular, Not too frequent, Shorter duration, Not too intense, Discomfort, Felt in abdomen, Felt in groin area
Contractions (True) Regular, More frequent, Longer duration, More intense, Discomfort, Felt in lower back, Radiates to lower abdomen, Feels like menstrual cramps
Cesarean section Surgical procedure in which the abdomen and uterus are incised and a baby is delivered transabdominally
Induction of labor also known as inducing labor — a procedure used to artificially stimulate uterine contractions during pregnancy before labor begins on its own. Successful labor induction leads to a vaginal birth
Forceps delivery a type of assisted vaginal delivery sometimes needed in the course of vaginal childbirth
Vacuum extraction a procedure sometimes done during the course of vaginal childbirth. Clinician applies the vacuum — a soft or rigid cup with a handle and a vacuum pump — to the baby's head to help guide the baby out of the birth canal
AFP screening Serum screening test for birth defects such as spina bifida, Down syndrome, and trisomy 18 Test is offered to pregnant women between 15 and 21 weeks’ gestation
Chorionic villus sampling Prenatal diagnostic test performed in 1st trimester of pregnancy to detect chromosomal abnormalities (such as Down syndrome) in unborn child Sm amt of placental tissue is removed during 11th to 13th wk of pregnancy Contains same genetic data as fetus
Contraction stress test Stress test used to evaluate ability of fetus to tolerate stress of labor and delivery Also known as oxytocin challenge test
Fetal monitoring Use of an electronic device to monitor fetal heart rate and maternal uterine contractions
First trimester screening a blood test and ultrasound to identify risk for birth detects such as Down syndrome and trisomy 18 Only indicates level of risk Blood test measures PAPP-A and beta HCG Ultrasound measures nuchal translucency (thickness of skin on back of neck)
Nipple stimulation test Noninvasive technique that produces same results as contraction stress test Pregnant woman stimulates the nipples of her breasts by rubbing them between her fingers Causes natural release of oxytocin that causes contractions of uterus
Obstetrical ultrasound Noninvasive procedure that uses high-frequency sound waves to examine internal structures and contents of the uterus Ultrasonography
Pelvic ultrasound Noninvasive procedure that uses high-frequency sound waves to examine the abdomen and pelvis
Pelvimetry Process of measuring the female pelvis, manually or by X-ray, to determine its adequacy for childbearing
Created by: wallace263
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