Duke PA Normal Pregnancy
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| In a normal pregnancy the hCG doubles every __ | 48 hours
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| Beta-hCG is first detectable in maternal blood __ after conception | 6-8 days
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| False positive pregnancy tests occur at hCG levels of __mIU/ml | 5-25
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| If the fetus is lost before 22 weeks it is classified as a __ | Miscarriage
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| If the fetus is lost after 22 weeks of gestation it is classified as a __ | Stillbirth
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| What is considered the gestational age of viability | 22 weeks
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| During pregnancy hemodilution is normal and produces __ | Physiologic Anemia
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| During pregnancy body water increases by __ | 6.5-8.5L (most significant adaptation in PG)
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| How is the heart affected during pregnancy | Displaced to the left and upward, increase in left ventricular end diastolic dimension, output is increased by 30-50%
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| What are some normal changes in pregnancy that may mimic heart disease | Dyspnea (most common complaint before 20 wks), decreased exercise tolerance/ fatigue/ occasional orthopnea/ chest discomfort, Edema
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| What happens to nasal mucosa during pregnancy | It becomes more edematous and erythematous, hypersecretion of mucus
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| What happens to lung volume during pregnancy | Decreases by 5%, max volume that can be inhaled increased by 5-10%
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| What happens to pulmonary function during pregnancy | Hyperventilation
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| Pregnancy causes a state of chronic respiratory __ | Alkalosis
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| The kidneys excrete more __ during pregnancy | Bicarb
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| What changes with WBC’s during pregnancy | Increased by 5,600-12,000
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| Renal plasma flow __ in pregnancy | Increases
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| Because of dilation of the renal pelvis there is an increased incidence of __ in pregnancy | Pyelonephritis
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| What happens to appetite during pregnancy | Increased by about 200 Kcal/day
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| What happens to the stomach during pregnancy | Tone and motility decreases, increased GERD
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| Morning sickness complicates __% of pregnancies | 70
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| What is the time frame of morning sickness (onset/improvement) | Onset in 4-8 weeks, improvement by 14-16 weeks
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| What is the treatment of morning sickness | Largely supportive (reassurance, avoid triggers, frequent small meals, acupressure/ginger/V B6
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| What are the skin changes in pregnancy | Hyperpigmentation, linea alba becomes linea nigra, pigmented nevi/freckles/recent scars
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| What are the hair changes in pregnancy | Mild degree of hirsutism
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| Striae (stretch marks) affect up to __% of pregnant women | 90%
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| In the fetus what is the vasculature that bypasses the liver | Ductus venosus
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| What is the bypass that allows blood to flow from the right atrium to the left atrium | Foramen ovale
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| What is the bridge that allows blood to pass from pulmonary veins to the aorta | Ductus arteriosus
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| When does the foramen ovale change to the fossa ovalis | When the baby takes its first breath, the pressure from the lungs closes the valve
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| What happens to the ductus venosus and the ductus arteriosus after a child is born | They become ligaments (ligamentum venosum, ligamentum arteriosum)
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| The hypervolemia of pregnancy compensates for maternal blood loss at delivery, which averages __ml for vaginal and __ml for c-section | 500-600, 1000
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| With uterine enlargement and diaphragmatic elevation, the heart rotates on its long axis in left upward displacement. As a result the apical beat shifts __ | Laterally
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| if hCG results uncertain, repeat test in: | 2 days
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| very high hCG levels seen in: | molar PG (gestational trophoblastic disease)
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| Not normal symptoms (re: heart) | syncope, chest pain with exertion, progressive orthopnea, and hemoptysis
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