| Term 
 | Definition 
 
        | Mucus plug in the cervical os |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Mother feels the fetus move (16-20 weeks) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Fetus decends into the pelvis (39-40 weeks) |  | 
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        | Term 
 | Definition 
 
        | The state of a woman being pregnant |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | The state of a woman haven given birth to a viable fetus. |  | 
        |  | 
        
        | Term 
 
        | A)Gravida 1, Para 0 B)Gravida 1, Para 1
 C)Gradida 2, Para 0
 D)Gravida 2, Para 1
 C)Gravida 2, Para 2
 |  | Definition 
 
        | A)currently pregnant for 1st time or was pregnant once and lost the pregnancy B) Delivered a viable fetus from her 1st pregnancy or delivered viable twins (or more) from her 1st pregnancy
 C) Currently pregnant for the 2nd time after losing 1st pregnancy or lost 2 pregnancies
 D) Pregnant for the 2nd time, 1st pregnancy was viable
 E) Pregnant twice, both delivered
 |  | 
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        | Term 
 | Definition 
 
        | blood test screening for birth defects (15-18 weeks) |  | 
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        | Term 
 
        | Women who are overweight are __% less likely to conceive. |  | Definition 
 
        | 40% less likely to conceive. |  | 
        |  | 
        
        | Term 
 
        | "A lone factor, be it insult, irritant, hormone, gene, with whatever the potential it may possess for altering the body, must still rely on the response of that body to dertermine its impact." |  | Definition 
 
        | ?...a system that is properly functioning to its potential, may resist destructive forces more successfully with less damage. |  | 
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        | Term 
 
        | When should you make healthy changes before conception? |  | Definition 
 
        | at least 3 months to a year. |  | 
        |  | 
        
        | Term 
 
        | According to research, the most effective care is given by: midwive, family physicians, or obstetricians? |  | Definition 
 
        | All equally effective, women were slightly more satisfied with care from midwives and family physicians. |  | 
        |  | 
        
        | Term 
 
        | Why are the first 12 weeks of pregnancy important? |  | Definition 
 
        | Time of organogenesis and heightened fetal vulnerability to teratogens. |  | 
        |  | 
        
        | Term 
 
        | Air travel for pregnant women is safe until ___. |  | Definition 
 
        | 4 weeks before the EDD. Lenghy trips increase the risk of venous thrombosis.
 |  | 
        |  | 
        
        | Term 
 
        | What are some contraindications for breastfeeding? |  | Definition 
 
        | maternal HIV, chemical dependency, certain medications. |  | 
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        | Term 
 
        | Caloric requirements for pregnant women increase by |  | Definition 
 
        | 340-450 kcal/day in 2nd and 3rd tri's. |  | 
        |  | 
        
        | Term 
 
        | Pregnant women should gain approxiamtely |  | Definition 
 
        | 25-35 lb. during pregnancy. |  | 
        |  | 
        
        | Term 
 
        | Of aspartame, sucralose, saccharin, and acesulfame-k, which would you most want to limit or avoid? |  | Definition 
 
        | saccharin: it can cross the placenta and may remain in fetal tissue. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | May act as a uterine stimilant or lead to abortion |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | May alter hormone levels, and lead to possible premature labor. May result in high prolactin/estrogen levels.
 May elevate blood pressure
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | May worsen heartburn and GURD May promote flow of bile from gall bladder and aggravate gallstone symptoms.
 |  | 
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        | Term 
 
        | Pregnant patients history should include: |  | Definition 
 
        | Current pregnancy Past pregnancies
 Medical Hx
 Contraceptive Hx
 Family Hx
 Psychological Hx
 Plans for childbirth
 Risk factors
 |  | 
        |  | 
        
        | Term 
 
        | Pregnant patients "cheif complaint" should include: |  | Definition 
 
        | Patient's age Marital status
 Gravidity and parity
 Last Menstrual period
 Previous usual menstrual period
 Expected date of delivery
 Occupation
 Father of baby and his occupation
 |  | 
        |  | 
        
        | Term 
 
        | Pregnant patients "present Problem" should include |  | Definition 
 
        | Description of current pregnancy previous medical/health care
 Attention given to specific problems:
 nausea, vomiting, fatigue, edema
 |  | 
        |  | 
        
        | Term 
 
        | Review of symptoms special attention is given to:
 |  | Definition 
 
        | Reproductive system Cardiovascular system
 Endocrine system
 Urinary tract
 Respiratory function
 |  | 
        |  | 
        
        | Term 
 
        | The growing fetus accounts for __lbs. of the total weight gain. |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Most of the weight gain associated with pregnancy is due to |  | Definition 
 
        | Placenta Amniotic fluid
 Uterus
 Blood and fluid volumes
 Breasts
 Fat reserves
 |  | 
        |  | 
        
        | Term 
 
        | What is accountable for most of the weight gain during: 2nd tri
 3rd tri
 |  | Definition 
 
        | 2nd: Maternal tissue growth 3rd: Baby growht
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | "stretch marks" 2nd tri
 May be influenced by cortisol levels (stress).  Hydration and nutrition are the best prevention.
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | "vascular spiders" May be found on face, neck, chest, and arms
 usually resolve after delivery.
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | old ones may increase in size, new ones may develop. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | result from epithelial hyperplasia |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Found to some extent in all pregnant women. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | pigmentation of linea alba |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | "mask of pregnancy" 70% of pregnant women
 Hyperpigmentation
 Usually fades, sun exposure worsens, makes it more likely to be permanent.
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Diffuse redness covers the entire palmar surface or the thenar and hypothenar eminences. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Fine: breasts and abdomen due to stretching Ru Roh: Generalized itching, begins in palms and soles starting in 3rd tri.  Sign of more serious condition. (liver being strained, skin taking some of detox role)
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Some degree of goiter may develop if iodine defficient. A thyroid bruit may be heard due to increased vascularity
 |  | 
        |  | 
        
        | Term 
 
        | Corneal changes associated with pregnancy |  | Definition 
 
        | Corneal edema and thickening (3rd tri) Causes hypersensitivity
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | increase in corneal epithelial pigmentation. |  | 
        |  | 
        
        | Term 
 
        | Why might contact lense wearers have a greasy sensation associated with their eyes during pregnancy? |  | Definition 
 
        | Tears contain an increased level of lysosome. |  | 
        |  | 
        
        | Term 
 
        | Costal angle change during pregnancy |  | Definition 
 
        | 68 degrees pre pregnancy 103 degrees post pregnancy
 |  | 
        |  | 
        
        | Term 
 
        | Blood volume during pregnancy |  | Definition 
 
        | 40% increase, mainly due to increase in plasma volume. |  | 
        |  | 
        
        | Term 
 
        | Cardiac output during pregnancy |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Heart position during pregnancyq |  | Definition 
 
        | shifted to a horizontal position with slight axis rotation. |  | 
        |  | 
        
        | Term 
 
        | Blood pressure ___ during the 2nd trimester and ____ during the 3rd |  | Definition 
 
        | decreases returns to pre pregnancy levels
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | add 7 days to the first day of the last normal mestrual period and count back 3 months. |  | 
        |  | 
        
        | Term 
 
        | Measure the Fundal Height |  | Definition 
 
        | Have the patient empty bladder Patient supine
 Measure from upper pubic symphysis to superior fundus
 Recorded in cm.
 Most accurate between 20-30 weeks
 fundal height=gestational age.
 |  | 
        |  | 
        
        | Term 
 
        | Hormonal influences on muskuloskeletal system during pregnancy |  | Definition 
 
        | Progesterone: alterss the vascular supply to the motor unit (decreases smooth muscle tone) as well as the surrounding structures Estrogen: relaxes the joint capsule, allows more "play" in the joints
 Relaxin: Contributes to the relaxation effect allowing pelvis to open.
 |  | 
        |  | 
        
        | Term 
 
        | Women with uncomplicated "morning sickness" have been noted to have better/worse pregnancy outcomes? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | When should morning sickness begin? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | Complete:no identifiable fetal tissue Partial: Some recognizable fetal tissue
 Signs: vaginal bleeding, Hyperemesis
 Absense of fetal heart tones
 Treatment:Evacuation and curettage or hysterectomy
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Any pregnancy outside the uterine cavity. 97% Tubal
 Abdominal pain, vaginal bleeding, normal/slightly enlarged uterus, palpable adnexal mass, pelvic pain with manipulation of the cervix.
 Diagnosis: Ultrasound
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Pregnancy loss at less than 20 weeks 50% of pregnancies complicated by bleeding.
 20% of pregnancies (30% may be more accurate)
 Diagnose: ultrasound, dilated cervix?
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | pregnancy complicated by bleeding before 20 weeks |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | The cervix has dilated, but the products of conception have not been expelled. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Implantation of the placento over or near the internal os of the cervix. Vaginal bleeding in the 2nd or 3rd trimester.
 Diagnose:ultrasound
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Separation of the normally located placenta after the 20th week of gestation (prior to birth) Compromises blood supply to the fetus
 1% of all pregnancies
 Can be caused by maternal hypertension
 Presentation: vaginal bleeding, abdominal, back, or uterine tenderness, fetal distress, abnormal uterine contractions, 15% Fetal death
 Difficult to identify on ultra sound
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Abnormally high levels of amniotic fluid (>2000mL) Exam: rapidly enlarging uterus, difficulty palpating fetus
 Manage diabetes, steroid therapy
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Inadequate levels of amniotic fluid Causes: fetal uninary tract anomalies, placental insufficiency, premature rupture of membrane, leakage of amniotic fluid
 Complications: infection, fetal distress
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Pregnancy-specific multisystem disorder of unkown etiology. New onset of elevated blood pressure and proteinuria after 20 weeks' gestation.
 3rd leading cause of pregnancy related deaths
 |  | 
        |  | 
        
        | Term 
 
        | Preeclampsia history and examination
 |  | Definition 
 
        | visual disturbance, persistant headache, epigastric or R upper quadrant pain, increased edema. |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Elevated blood pressure >140 systolic or >90 diastolic
 Proteinuria
 >.3g in 24 hour urine collection
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Magnesium sulfate (during labor to prevent seizures) Antihuertensive drug therapy.
 exercise, lifestyle, chiropractic
 |  | 
        |  | 
        
        | Term 
 
        | Preeclampsia-HELLP Syndrome |  | Definition 
 
        | Hemolysis, Elevated Liver enzymes
 Low Platelet count
 4-14% preeclamptic women
 25% mortality or serious morbidity
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | severe complication of preeclampsia new onset of seizures in a woman with preeclampsia
 Deliver baby ASAP
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | 8-10% of US births Management:
 Tocolytic Therapy- slow down contractions, can buy up to 3 days
 Corticosteriods- stimulate lung developement
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Pregnancy 42+ weeks mortality rate doubles at 42 weeks, 4-6x greater 44 weeks
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Glucose intolerance that begins or is first recognized, during pregnancy. Increases preeclampsia, c section, future diabetes.
 |  | 
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