Term
| Additional energy demands = extra ____ kcal/day |
|
Definition
|
|
Term
| Weight increase due to: (5) |
|
Definition
uterus
uterine contents (fetus & placenta account for ~ 9 lbs)
increase in blood volume
extracellular fluid
(cellular water, deposition of fat, and protein) |
|
|
Term
Water increase ≈ ___L
___ in uterus
___ in blood volume and breasts |
|
Definition
|
|
Term
Average weight gain = ___ lbs
recommended weight gain = ___-___ lbs |
|
Definition
|
|
Term
| brown patches on skin during pregnancy - increased pigmentation = “mask of pregnancy”- pituitary produces melanocyte stimulating hormone |
|
Definition
|
|
Term
| herniation – where abdominal muscles meet – due from increased abdominal pressure during pregnancy |
|
Definition
|
|
Term
| Umbilicus ____ or ____ during pregnancy |
|
Definition
|
|
Term
| cutaneous condition characterized by stretch marks on the abdomen during and following pregnancy |
|
Definition
|
|
Term
| black line down center – due to increased melanin – sometimes it doesn’t go away even after pregnancy |
|
Definition
| Linea nigra (linea alba in nonpregnant state) |
|
|
Term
| Tumor, usually benign, or swelling composed of lymph and blood vessels that can appear during pregnancy |
|
Definition
|
|
Term
| reddening of the palms at the thenar and hypothenar eminences during pregnancy. Occurs 2/3 white women; 1/3 black women. Due to increased estrogen |
|
Definition
|
|
Term
| the Cervix _____ during pregnancy |
|
Definition
|
|
Term
| ligaments have relaxed so don’t have as much tension resulting in inward curvature of a portion of the vertebral column |
|
Definition
|
|
Term
FYI
Increased joint mobility -> "waddle" gait; back pain
Sacroiliac
Sacrococcygeal
Pubic symphysis
Under direction but not directly correlated with levels of maternal estradiol, progesterone, or relaxin levels |
|
Definition
|
|
Term
| breast Overall _____ to ____ in size during pregnancy |
|
Definition
|
|
Term
breast Tenderness and tingling in ____ weeks or pregnancy
Also Softening and loosening of tissue |
|
Definition
|
|
Term
|
Definition
|
|
Term
Colostrum
Accumulates in ____
May crust onto ____
_____ – first few days after deliveries – has a _____ effect for the baby and have a lot of nutrients / calories for babies |
|
Definition
alveoli
nipple
First milk
laxative |
|
|
Term
| Areolae increases/decreases in diameter, gets darker/lighter, and more flat/erectile during pregnancy |
|
Definition
|
|
Term
| _____ glands become prominent during pregnancy. Create ___ to keep the skin of breasts lubricated to keep protected |
|
Definition
|
|
Term
Heart Changes during pegnancy:
increased/decreased cardiac output by 20-24 weeks gestation (__-__% on average but can double in some women)
increased/decreased systemic vascular resistance
increase/decrease in heart rate by __ bpm – pumping more often in a min & thus helps increase CO
later in pregnancy, when supine, large uterus can impede cardiac venous return. As uterus gets larger & baby is pushing on it and compressing blood vessels – less coming back to the heart so increased CO helps alleviate that. |
|
Definition
increased
40-45
decreased
increase
10 |
|
|
Term
Heart Changes during pregnancy:
____ murmur in ___% of pregnant women -> b/c they have all this extra blood and flow is more turbulent
Increase ____ ventricular size
Similar to changes reported for moderate to strenuous exercise (however, pregnancy is not considered to be a continuous high output state) |
|
Definition
|
|
Term
Heart changes during pregnancy
Blood Pressure:
increase/decrease BP by ___-___ mmHg during pregnancy
increase/decrease BP at end of pregnancy
increase/decrease blood volume
increase/decrease blood flow to uterus/skin/kidneys
increase/decrease in conc. of all clotting factors -> due to an increase in _____. |
|
Definition
decrease
6-10
increase
increase
increase
increase
estrogen |
|
|
Term
Heart Changes During Pregnancy:
Occlusion of pelvic veins causing a stagnation of blood in lower extremities leads to: (4) |
|
Definition
Dependent pedal edema
Varicose veins in legs and vulva
Hemorrhoids
↑ risk of thrombosis in lower extremities |
|
|
Term
| ↑ in venous pressure below level of uterus often results ____ late in pregnancy |
|
Definition
|
|
Term
| Gums may become ____, slightly ____ and prone to ____ easily during pregnancy |
|
Definition
|
|
Term
Stomach gets displaced downward/upward
Lower esophageal sphincter relaxes/constricts
increased/decreased GERD & heartburn |
|
Definition
upward
constricts
increased |
|
|
Term
| Liver should _____ in size as nonpregnant state |
|
Definition
|
|
Term
Gallbladder
contractility is increased/decreased
results in increased/decreased residual volume and stasis
along with cholesterol increase/decrease during pregnancy, this leads to increased/decreased prevalence of cholesterol stones |
|
Definition
decreased
increased
increase
increased |
|
|
Term
Colon
displaced ____ & ____
hypoperistalsis = _____
appendix displaced ____ & ____ |
|
Definition
laterally and superiorly
constipation
upward and laterally |
|
|
Term
Lower quadrant pain
Need to Differentiate ____ (holds the uterus in place) from pain with UTI, constipation, appendicitis, etc. |
|
Definition
|
|
Term
| Hemorrhoids are very common due to ____ and Elevated ____ pressure in LE’s |
|
Definition
|
|
Term
Kidneys
increase/decrease ~ 1-2cm in length
GFR increases/decreases by 40-50%
Renal plasma flow increases/decreases
Renal pelvis dilates/constricts
BUN and Cr levels increase/decrease
Creatinine clearance increases/decreases by 30%
Proteinuria and hematuria are abnornal/normal -> (except at ___)
Mild glucosuria can be normal but suspicion of ___ should not be ignored |
|
Definition
increase
increases
increases
dilates
decrease
increases
abnormal
delivery
GDM - gestational diabetes mellitus |
|
|
Term
Ureters
constrict/dilate
Possibly due to smooth muscle relaxation due to ↑ ____ |
|
Definition
|
|
Term
Bladder
increased/decreased bladder pressure
increased/decreased bladder capacity
increased/decreased urethral length
Incontinence still often results in __/__ of women
Urine is checked for ___ & ___ at every OB visit |
|
Definition
increased
increased
increased
1/5
glucose and protein |
|
|
Term
Uterus:
Nonpregnant uterus: ___g (capacity of 10mL)
Uterus at end of pregnancy: ____g (capacity of 5L to 20L) |
|
Definition
|
|
Term
Cervix:
At ___ month, cervix undergoes softening and cyanosis due to increased vascularity and edema-Chadwick’s sign
A major component of the cervix is _____
Cervical glands undergo ___ and ____ -> As a result, cervical secretions increase/decrease considerably |
|
Definition
1
connective tissue
hypertrophy
hyperplasia
increase |
|
|
Term
The vagina undergoes changes, too:
Considerable increase/decrease in thickness of the mucosa
____ of connective tissue
____ of smooth muscle |
|
Definition
increase
Loosening
Hypertrophy |
|
|
Term
Respiratory Tract:
Essentially unchanged other than ___ displaced diaphragm |
|
Definition
|
|
Term
| Pituitary gland enlarges with ensuing hormone fluctuations: (2) |
|
Definition
Prolactin (lactation)
Growth hormone (impt for developing baby) |
|
|
Term
Thyroid enlarges/shrinks
icreased/decreased TBG
Stimulated by ____
increased/decreased iodine availability
______thyroidism common in pregnancy -> Can cause ___ in babies
Investigate ____!!! =(swelling in the thyroid gland, which can lead to a swelling of the neck) |
|
Definition
englarges
increased
placenta
increased
hypo
mental retardation
goiters |
|
|
Term
| Parathyroid hormone increases/decreases in response to increase/decrease in serum calcium |
|
Definition
|
|
Term
| Adrenal glands undergo ___ change; hormones slightly increased/decreased if anything |
|
Definition
|
|
Term
Neuro:
Memory increase/decrease often reported
Difficulty going to sleep
Frequent awakenings
Fewer hours of sleep
Reduced sleep efficiency
sleep issues are due to increased ____ |
|
Definition
|
|
Term
| _____ is the term for fallopian tubes & ovaries -> examined during PE |
|
Definition
|
|
Term
| during ___ OB visit, take Hx, full PE, & labs |
|
Definition
|
|
Term
During ____ OB visit, check:
Weight
Blood pressure
Check urine for protein and glucose
Calculate weeks gestation
Listen for fetal heart rate (FHR)
Measure fundal height
Check for pedal edema
Check cervix (if 38-40wks or if problem)
Examine problems |
|
Definition
|
|
Term
| Average duration of gestation = ___ days (__weeks) = __ lunar months |
|
Definition
|
|
Term
Weeks of gestation calculated using:
___ wheel
Naegele’s rule: EDC (expected delivery date) = [(LMP + __ days) – __ mo] + _ year |
|
Definition
|
|
Term
| Uterus palpable @ __ weeks |
|
Definition
|
|
Term
| Fundal height measurement: ___ to _____ |
|
Definition
Symphysis pubis
superior fundus (top of uterus) |
|
|
Term
| Fundus is at level of umbilicus at __ weeks |
|
Definition
|
|
Term
height of fundus: __ cm/week gestation is expected
if Larger = ____ or _____
Smaller = ____ |
|
Definition
1
multiple birth (gestations)
GDM
IUGR (Intrauterine growth retardation) |
|
|
Term
What to Watch for when measuring fundal Height: (FYI)
obesity
amniotic fluid amount
myoma (uterine fibroid)-> Makes uterus larger than normal
multiple gestations
fetal size
uterine position -> Some curve forward or backward |
|
Definition
|
|
Term
McDonald Rule:
Length in cm of the pubic symphysis to the fundus of the uterus, divided by ___, gives the duration of pregnancy in ____.
applicable only after the ___ month of pregnancy
same examiner at each visit if possible |
|
Definition
|
|
Term
Doppler or fetoscope, 1 minute
Heart sounds first heard with doppler at __ wks
Heart sounds first heard with fetoscope at __-__ wks
Compare with mothers’s pulse
Normal = ___-___ bpm |
|
Definition
|
|
Term
Fetal well-being: kick counts
Pattern of movement over a given time
Done early/later in pregnancy
done a lot in women who have previously had a ___ pregnancy |
|
Definition
|
|
Term
Leopold Maneuvers:
1. While facing the woman, palpate the woman's ___ with both hands.
2. Attempt to locate the fetal back by palpating each ___ of the uterus one at a time.
3. The presenting part (head or butt) is palpated above the ___ and degree of engagement determined
4. The fetal occipital prominence and brow is determined. |
|
Definition
upper abdomen
lateral side
symphysis |
|
|
Term
Pelvic types:
____: suited for delivery (50%)
____: male-like, poor prognosis
33% Caucasian
15% African American
least suited – complicated delivery
____: (1/3)
20% Caucasian
85% African American
usually no problem
verticle diameter > transverse diameter
____: <3-5% |
|
Definition
Gynecoid
Android
Anthropoid
Flat/Platypelloid |
|
|
Term
order of pelvic types
most suited -> least suited for delivery |
|
Definition
| gyenecoid -> anthropoid -> flat/platypelloid -> android |
|
|
Term
Early “signs” of pregnancy:
____: softening of cervix, __-__ wks (compare nose tip firmness to lips softness)
____: softening of uterine isthmus, __-__ wks -> Connects the body of the uterus to the cervix
____: vascular congestion and bluish color of vagina/cervix, early signs after conception at about __-__ wks
____: uterine body flexes easily on the cervix, __-__ wks
____: fullness & softening of fundus at implantation site, ___ wks |
|
Definition
Goodell
4-6
Hegar
6-8
Chadwick
8-12
McDonald
7-8
Von Fernwald
7-8 |
|
|
Term
Intranatal - Presentation
Information to record from abdominal palpation:
___- relation of long axis of fetus to that of mother
-> ____: Baby’s body runs in same direction as
mothers’ - Either head toward mothers’ head or
butt towards head
-> ____: (left acromiodorsoposterior, LADP) Baby’s
body is perpendicular to mother’s body
-> ____: (45 degree angle)
____ of fetal head and neck
-> flexed or extended
Fetal ____ |
|
Definition
Lie
Longitudinal
Transverse
Oblique
Attitude/Posture
position |
|
|
Term
Intranatal - Presentation
Information to record from abdominal palpation
_____ – part of fetal body foremost w/in birth canal
-> _____ = head below umbilicus
-> ____ (fetal neck is flexed)
Sagittal suture, anterior and posterior
fontanel present first. Relation of fetal
occiput to mother’s L /R and anterior
(symphysis) / posterior (sacrum)
-> ____ (fetal neck is sharply extended)
Chin identifying landmark presenting
first (mentum)
-> ____ (anterior fontanel presenting)
-> ____ (brow presents first)
->____ = head above umbilicus
-> ___ – hips & knees are flexed
-> ____ hips are flexed, but knees are straight
- like fold baby in half
-> ____ either one or both feet - will come out first |
|
Definition
Presentation
->Cephalic
->Vertex
->Face
->Sinciput
->Brow
->Breech
-> Frank
-> Complete
-> footling |
|
|
Term
Cervical dilation measured in cm by palpation
Closed os = __ cm
Complete, full dilatation = ___ cm |
|
Definition
|
|
Term
___of the cervix = process of thinning out (0% - 100%)
Normal length of cervix ~1.5-3cm = __%
If ___% effacement = cervix is paper thin |
|
Definition
|
|
Term
___ - level of head or breech in pelvis compare to mother’s ischial spine
If above the spines (-1cm,-2cm,-3cm,”____”)
Presenting part at spines = zero station "_____"
If below the spines (+1cm, +2cm, +3cm, “____”) |
|
Definition
Station
floating
engaged
on the perineum |
|
|
Term
Uterus involutes rapidly/slowly postpartum
Uterus ___g at delivery and 100-200g 3 wks postpartum
Uterine level at umbilicus end of __ day & at level of symphysis by the ___ day
Breastfeeding inhibits/accelerates uterus involution |
|
Definition
rapidly
1000
first
10th
accelerates |
|
|
Term
~__-__ weeks to regain pelvic tone postpartum
Kegel exercises |
|
Definition
|
|
Term
| ___ causes contractions to dispell the milk – consequently causes contraction of the uterus - helping to return it to its original size prior to pregnancy |
|
Definition
|
|
Term
Postpartum Menstruation/ovulation:
Hormones fall to non-pregnant range within __ wk
Nursing mothers rarely menstruate < __ wks postpartum
Non-lactating mother, __%, resume menstruation by the 6th week |
|
Definition
|
|
Term
| Breast involution, __ mo after termination of lactation |
|
Definition
|
|
Term
| Postpartum: Areolae/nipples retain darker/lighter color, breasts more/less firm |
|
Definition
|
|
Term
Colostrum:
↑ Estrogen & progesterone inhibit/increase milk production
Post delivery, Estrogen and progesterone increase/decrease
____ is no longer inhibited by estrogen & progesterone so it stimulates milk production
___, ____ & ___ hormone play a secondary role in lactation |
|
Definition
inhibit
decrease
Prolactin
Insulin, thyroid, adrenal hormone |
|
|
Term
| Lactation Begins about __-__ hrs after delivery with sudden breast engorgement -> hard, warm, shiny, painful |
|
Definition
|
|
Term
Colostrum available immediately after birth
Primarily ___ & ____
Also contains ___ & ___ |
|
Definition
protein and minerals
fat and antibodies (IgA) |
|
|
Term
Milk replaces colostrum in __-__ days
Unique proteins, minerals, antibodies and other host resistance factors
Source of omega-__ fatty acid |
|
Definition
|
|
Term
| Nursing accelerates ____ of uterus (oxytocin) |
|
Definition
|
|
Term
| Nursing contraindicated in women with HIV, TB, drug/EtOH abuse, and with an infant with _____ |
|
Definition
|
|
Term
Clogged milk ducts: common (FYI)
inadequate emptying
ill-fitting support
tender, lumpy, hot spot
frequent nursing, heat |
|
Definition
|
|
Term
| Nipple irritation as a result of ___ nipples |
|
Definition
|
|
Term
____ - inflammation of breast tissue
Often due to ____
Abscesses can develop |
|
Definition
|
|
