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40 Cards in this Set
- Front
- Back
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EDD
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estimated time of delivery
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Gestation
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length of time from LMP - 280 or 10 lunar months
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Gravity
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number of pregnancies
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Parity
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number of pregnanies that reach viability
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Amniocentesis
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withdrawal of amniotic fluid for chemical content - chomosomal analysis
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maternal chages during pregnancy
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- uterus fills abdo cavity
- GI tract compressed = heartburn - pressure on bladder - compression vena cava varicose veins - compression renal vessels renal hypertension |
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CV changes
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rise in cadio output 20 - 30%
HR increases 15% Blood Vol increase 30 - 50% |
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Respiratory changes
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increase in tidal volume 30%
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Repro changes
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increase in uterus from 80gm to 1200gm
hyperplasia and hypertrophy |
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urinary changes
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GF rate up 40%
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total weight gain in pregnancy
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11kg
- fetus 3.3kg - uterus 0.9kg - breasts 0.4kg - blood vol 1.3kg |
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anaemia of pregnancy
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plasma volume increases 50 - 70% by 6th wk.
RBC volume increases 35% wk 12 if not kept balanced dilution occurs iron need increase as RBC's made |
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Genital tract changes
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increased vascularity
secretion becomes copious - thin, curdy and white pH more acidic - conversion of glucogen to lactic acid - high estrogen levels |
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Genital tract changes
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uterus enlarges from 7.5 cm to 35cm
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Braxton Hicks Contractions
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spontaneous contraction of uterus
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Ovary role in gestation
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Growth of corpus luteum reaches maximim wk 8. oestrogen and progesterone secreted to maintain growing ovum before placenta takes over.
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Urinary System changes
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Calyces,renal pelvis and ureters ungergo marked dilatation.
partial obstruction can occur at pelvic brim. ureters become atonic due to high progesterione levels. GFR increases 40% by mid term. |
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Endocrine
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CHo metabolism - increased insulin secreted to transfer glucose to infant.
sensivity of insulin receptors is decreased in later months |
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Endocrine
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increased glucocorticoids - hyperactive adrenal cortex
gluconeogenisis and glucogenolyisi increased. urine output detected in 50% Px |
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metobolism
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Average 20% increase in protein intake.
placenta contains 500gm conversion of amino acid to urea supressed |
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Thyroid changes
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Estrogen stimulates > TBG
total T3 & T4 increased TSH remains normal sightly > TBG increases serum protien bound iodine |
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Adrenal Cortex
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> plasma cortisol levels form 1st trimester
levels peak again in labour with final surge of ACTH and cortisol |
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GI tract
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Changes due to elevated progesterone - smooth muscle relaxation.
< gastric empitying time displacement of intestines hemorrhoids due to vascular pressure > appendix displaced |
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Liver
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unchanged
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Gallbladder
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impaired contraction
high residual volumes Promotion of stasis due to > cholesterol saturation stones can develop |
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Skin changes
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Chloasma or melasma gravidarum - mask of pregnancy
more common in dark people fades after delivery Striae - stretch marks Linea nigra |
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Pre - eclampsia
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last tirmester
high BP 140/90 proteinuria pitting odema |
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Mild pre eclampsia
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slight hypertension 155/95
trace proteinuria oedema - slight |
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Severe Pre - eclampsia
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Diastolic .110
epigrastic pain cerebral visual disturbances oliguria .3gm protein excreted day elevated liver enzymes. |
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Patho of eclampsia
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Vasospasm affecting all vessels
- uterus - bld flow impaired , - kidney < bld flow and filtration rate - liver periportal haemorrhagic necrosis due to thrombosis of arterioles. |
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Investigations of Pre - eclampsia
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4-6 hourly blood pressure checks
24 hour urine collection - protein excretion blood tests - uric acid levels Ultrasound scan monitor baby CTG to monitor babies heart rate |
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complications of pre eclampsia
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accidental haemorrhage, ogliuria or anuria.
vision disturbances, blindness preterm labour infant interuterine death due to chronic placental insufficiency. |
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HELLP syndrome
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haemolytic anaemia, elevated liver enzymes, low platelet count
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Pre eclampsia Rx
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give birth! esp in wks 32 - 34
bed rest - reduces bld pressure protein > laxitives < emotional distress |
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Eclampsia
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Generalized siezures or coma in pregnant women
occur after wk 20. start with labour and end with delivery. |
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Risk of eclampsia
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1 out of 2000 to 3000 Px
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Risk factors eclampsia
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first pregnancy
teen pregnancy older than 35 yrs aferican american diabetes/hypertension/renal Dx |
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Patho eclampsia
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anoxia - spasm of cerebral vessels.
cerebral oedema - may contribute to irritation cerebral dysrhthmia |
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Diff diagnosis eclampsia
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Epilepsy
Hysteria Cerebral haemorrhage any SOLmenigingits |
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Eclampsia symptoms
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swelling hands and feet > 2 pounds a wk gain.Headache vision probs, stomach pain.
Fits, convulsions etc |
