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61 Cards in this Set
- Front
- Back
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What is Naegele's Rule?
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From first day of LMP, add 7 days and subtract 3 months to determine estimated due date (EDC)
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Phases of development completed in first 2 weeks after ovulation?
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Fertilization
Formation of free blastocyst Implantation of blastocyst |
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What do we call what's growing after the chorionic villi develop?
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EMBRYO
not zygote, fert ovum, etc |
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EMBRYONIC PERIOD
length? |
22-24 mm
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EMBRYONIC PERIOD
appearance? |
Head is BIG
Fingers and toes present arms bend at elbows upper lip complete External ears form elevations |
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EMBRYONIC PERIOD
organ development? |
Heart is completely formed
Lungs aren't finished, but most other organs are formed during this time |
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EMBRYONIC PERIOD
when does it end and what comes next? |
Ends either 8wks after fertilization or 10wks after onset of LMP
next is the fetal period |
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12 GESTATIONAL WEEKS
Crown-Rump Length? |
6-7 cm
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12 GESTATIONAL WEEKS
kickers? |
Ossification Centers
Skin, Nails, and Rudimentary Hair Spontaneous Movements Fetal Heart Tones detectable |
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16 GESTATIONAL WEEKS
kickers? |
12 cm long
Gender can be determined |
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20 GESTATIONAL WEEKS
kickers? |
Midpoint
Wt: 300gm-ish Skin less transparent Downy Lanugo covers body Some scalp hair |
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Kickers for 24 weeks of gestation?
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Wt: 630g
Skin wrinkled Head is big Eyebrows and Eyelashes show up Canalicular period of lung dev. almost done Threshold of Viability |
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Kickers for 28 weeks?
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Length: 25cm
Wt: 1100gm Skin is red w/ vernix caseosa Disappearance of Pupillary Membrane Born now = lots of complications Normal infants born now have a >90% chance of survival |
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32 week kickers?
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Length: 28cm
Wt 1800gm Skin still red and wrinkled Born now = intact but need NICU |
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36 week kickers?
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Length: 32cm
Wt: 2500gm Body more rotund and cute Still not great to be born now=>poor feeding, hypoglycemia, jaundice (inc rates) |
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Avg wt and length at 40 wks?
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36 cm
3400 gm |
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Kicker for Placental Transport?
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Molecular Weight
< 500 d diffuse readily |
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What is the uterus like in a nonpregnant woman?
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almost solid
70g cavity = 10mL or less |
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During pregnancy what changes w/ the uterus?
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cavity = 5L or more
at term wt is ~ 1100 gm |
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which arteries supply placental perfusion?
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Uterine
Ovarian |
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How does uteroplacental blood flow change during pregnancy?
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it increases from about 450mL/min to 650mL/min
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What happens to maternal blood volume during pregnancy?
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It increases approx 40-45% by term
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Fxns of Pregnancy-Induced Hypervolemia?
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Meet demands of uterus
Protect mom from impaired venous return (in supine/erect pos) Safeguard mom against blood loss at and following delivery |
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Effect of pregnancy on Hb and Hct?
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They both decrease slightly despite volume inc
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Iron and Pregnancy?
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Uterus and Fetus take most of mom's so its a good idea to supplement
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Normal pregnancy and its effects on coagulation?
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Pregnancy induces an activated state of coagulation w/ increased factors
Also changes platelets Increased Fibrinogen Increased Plasmin that breaks down the new fibrin--> inc D-Dimers |
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Which coagulation factors aren't increased in pregnancy?
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only Factors XI and XIII
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When does pregnancy affect the heart?
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first 8 weeks
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How does pregnancy affect the CV System?
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Inc CO early on in response to dec SVR and inc HR
Inc resting pulse Shifts heart left, up, and rotated |
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Changes in heart sounds during pregnancy?
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Exagerrated splitting of first heart sound w/ inc loudness
Systolic murmur in 90% Soft Diastolic Murmur in 20% |
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How does BP change w/ preg?
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Posture changes it.
So take it in the right arm while sitting. Brachial A. pressure will differ when lying down Diastolic decreases more than systolic |
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Changes in Pulmonary Fxn w/ pregnancy?
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Tidal Volume and Minute Ventilation Increase significantly
Functional Residual Capacity and Residual volume decrease (elevated diaphragm) |
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Changes in urinary system w/ preg?
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-Serum Creatinine and Urea Nitrogen Decrease
-GFR is increased -Hydroureteronephrosis |
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What should mean serum creatinine be in a pregger?
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0.5mg/dL
if > 0.9 suggest renal disease and needs work up |
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What is hydroureteronephrosis?
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Uterus compresses the ureters and causes backup
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GI changes w/ preggers?
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Things get moved around
Heartburn Constipation Hemorrhoids Gallstones |
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Extra GI issue at delivery?
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Gastric Emptying is prolonged which can lead to regurg and aspiration when under anesthesia
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How does pregnancy lead to gallstones?
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Contractility of gallbladder is reduced thanks to progesterone inhibiting cholecystokinin
This leads to stasis |
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What are you looking for in each trimester on U/S?
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First: dating
Mid: Anatomy Third: Follow Up (growth, AFI, etc) |
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For this packet, how many times should you go to the doctor while pregnant?
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6
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when are the visit?
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Initial
15-18wks 20wks 24-28wks 28wks 35-37wks |
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What do you do at all the visits?
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BP
Urine dipstick Fundal Ht FHTs |
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What do you do at initial visit?
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H&P
Prenatal labs Dating U/S |
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What do you do at 15-18wks?
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Quad Screen
inhibin A hCG unconjugated estriol AFP |
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what is the quad screen looking for?
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down's
ntd's etc |
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what do you do at 20wk check up?
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Anatomy U/S
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what about the 24-28wk checkup?
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1 hr glucose challenge
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What at 28wk checkup?
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Rho-D immunoglobulin
CBC |
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what at 35-37wk tune-up?
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Rectovaginal GBS swab
GC/Chl |
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What is Partuition?
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All phases of birthing
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phases of partuition?
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0: prelude
1: prep 2: punting 3: recovery |
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First stage of labor = ?
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When uterine contractions bring about dilation and effacement of cervix
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Second stage of labor = ?
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begins with Dilation is complete and ends with punting
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Third stage of labor = ?
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begins after punting and ends with delivery of the extra gross stuff
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How is Fetal Orientation described?
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In terms of:
Fetal Lie Presentation Position |
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Types of Fetal Lie?
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Transverse
Longitudinal (good) Oblique |
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Types of Fetal Presentation?
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Head
face Breech (butt) Foot shoulder? |
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What is up with Fetal Position?
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Relationship of arbitrarily chosen part of fetus to the right or left of birth canal
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Cardinal Movements of Labor?
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Engagement
Descent Flexion Internal Rotation Extension External Rotation Expulsion (punting) |
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What does mom need to do immediately after punting?
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Myometrium needs to stay contracted and retracted to compress blood vessels and thrombose their lumens
prevents hemorrhage |
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How long does it take to complete the gross involution of the uterus?
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4-6 weeks
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