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79 Cards in this Set
- Front
- Back
Fundus
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upper body of the uterus
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if the uterus is firm and the mom is still bleeding what do you do?
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look for bleeding somewhere else~ lacerations etc
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FB or F
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Fingerbreadth (assuming that each finger is a centimeter)
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U
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Umbilicus
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BF
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Breastfeeding
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Boggy
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Soft and “squishy” (use in describing uterus tone) [not good]
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Lochia
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Drainage from the uterus and vagina after delivery of a baby
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Lochia Rubra
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First 3 days after child birth, blood
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Lochia Serosa
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Fourth day lochia changes to pink or brown-tinged
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Lochia Alba
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white or cream colored by the 11th day may persist to the 6th week after childbirth
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Lochia Amount
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-Scant: les than 1 inch stain on pad
-Light: 1 - 4 inch stain -Moderate: 4 - 6 inch stain -Large: Saturated peripad in 1 hour -Excessive: saturated pad in 15 minutes -A constant trickle of lochia indicates excessive bleeding and requires immediate attention -Foul odor can suggest endometrial infection |
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Perineal Assessment
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-REEDA
-R: redness -E: edema -E: ecchymosis (bruising) -D: discharge -A: approximation (should be closed as if they were stuck or glued together) |
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Fundal Height
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-Immediately following delivery the fundus can be found midway between the symphysis pubis and the umbilicus
-Then the fundus rises to the level of the umbilicus and remains at this level for 24 hours -After 24 hours the fundus begins to desend by approximately 1cm, or 1 fingerbreadth per day -By 10th day it is back in the pelvic cavity |
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Postpartum Vital Signs
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-HR: 50-60 is normal as large amounts of blood return to the maternal circulation after the placenta is born
-B/P: hypotension may indicate a hemorrhage -Resp: 16-20 -Temp: 100.4 is common during the first 24 hours after birth |
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Newborn Vital Signs
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-Temp:
*Axillary: 97.7 - 99.5 *Rectal: 97.7 - 99.7 -HR: 120-160 -Resp: 30-60 -BG: 40-45 |
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Newborn Measurments
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-Weight: 2500-4000g
-Length: 48-53cm -Head Cir: 33-35.5cm -Chest Cir: 30.5-33cm |
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Signs of Delayed Bonding
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-Using negative terms to describe infant
-Discussing infant in impersonal or technical ways -Failing to give the infant a name or to use name -Visiting or calling infrequently or not at all -Decreasing number & length of visits -Showing interest in other infants -Refusing offers to hold and learn to care for infant -Showing decrease in or lack of eye contact |
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Mastitis
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-A painful infection of the breast usually caused by the entry of germs, often from the baby's mouth, into a milk duct through a crack or fissure in the nipple.
-Symptoms include fever, soreness, and swelling. It occurs in about one in 20 breastfeeding mothers at some time during lactation, most commonly between the tenth and 28th days postnatally. |
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Breast Feeding Health teaching tool
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-Latch within the first 2hrs of birth
-Offer breast every 2-3hrs -Feed 20min or longer ea side -Position: football, cross, cradle, side lying -Stimulate baby's lower lip -Support baby's head -Listen for swallows -Avoid artificial nipples -Avoid formula or glucose H2O -Offer encouragement -Est. care plan if problems *begin pumping as soon as problem arises -Not wanting to breast feed: *do not take hot showers *No stimulation of breasts -Tight fitting bras |
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S/S Mastitis
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-Temp up to 40c
-Hard irregular warm red spot on breasts -Pain in breasts -Feel like flu-like symptoms |
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Avoiding Mastitis Health teaching
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-Alternating breasts
-Allow breasts to air dry -Avoid soap or alcohol -Proper positioning of baby -Avoid stasis with warm soaks, freq feedings |
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SVD
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spontaneous vaginal delivery
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C/S
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Cesarean section – C-section~ opening into the uterus to take the baby out
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FP
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Family planning
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SBE
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self breast exam
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EBL
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estimated blood loss
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HNV
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has not voided
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DTV
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due to void
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Episiotomy
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incision on perineum to assist delivery of infant
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Mediolateral
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a placement of episiotomy
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Cervix
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Structure between uterus and vagina
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Striae
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Stretch marks
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Cholasma
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mask of pregnancy – darkened area on woman’s face~ around the eyes especially, may darken with sun exposure
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Linea nigra
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dark line on Mom’s abdomen due to pregnancy~ due to hormones, may also be on the baby
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Tubal ligation
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cutting of the Fallopian tubes for sterilization
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Lochia Health teaching
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-Amount should decrease each day.
-Color should progress from bright red to pinky red to brownish-red/white -Should not go back in color or amount -Fleshy odor – not foul smelling Lochia –changes in amount -when getting OOB and standing up -with breastfeeding- uterus clamps down better and that is cause -with massage –dark = pooled. Red=fresh -with exertion – esp. when goes home -with C/S and Pitocin use the flow is little to none |
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Perineum – Health teaching
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a. Wash hands before and after BR
b. Peri bottle q void c. Change pad q void d. Apply pad front to back e. Report any foul drainage f. Kegals exercises |
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Newborn Tests
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-heel stick for
*B/G *PKU (Phenal Ketone Uria) *bilirubin test *Coomb's test -Auditory test |
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Bilirubin
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-With breakdown of RBCs, bilirubin is an usable product that needs to be excreted
-it can be toxic at high levels -it is fat soluble so it can be absorbed by the SQ fat Causes yellowish discoloration of skin and scolera (white) of eye |
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Teratogenic
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-Any substance that is capable of interfering with normalembryonic development and can produce non-heritable birth defects
-teratogenic substances are most often radiation or chemicals -drugs given to the mother that can cross the placental barrier to the unborn child. they are capable of interfering with the development of the fetus, thus causing birth defects |
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Acrocyanosis
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Bluish discoloration of the hands and feet due to reduced peripheral circulation
-normal in the newly born infant should go away after the first couple of hours of life to 1-2 days after birth |
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Umbilical cord care
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-cord should be check for bleeding and oozing
-cord clamp should be securely fastened -parents should clean the cord with alcohol at least TID -fold diaper below the cord -clamp can be removed 24 hours after birth if the cord is dry |
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Involution
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Retrogressive changes that returns the reproductive organs, particularly the uterus, to their prepregnancy size and condition
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Signs of respiratory distress
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-tachypnea: >60
-retractions: sternal, substernal, suprasternal, intercostal -flaring of the nares -cyanosis: generalized -grunting: end expiratory pressure against a closed glottis -seesaw respiration -decreased breath sounds -crackles |
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Nursing postpartum care for a C-Section
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*VS q5 min then q15 min when stable
*o2 status, pulse ox, and tdbc, I&O, NPO, IV and foley *the IV will be 10-20U of pitocin used to help cause involution of the uterus *incision and dressing: if bleeding, circle, date and time *fundus and lochia checks *assess post anesthesia state, epidural and general |
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Subinvolution
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-This is the failure of the uterus to shrink according to normal progression
-caused by retained fragments or infection -S&S *fundus that does not shrink one cm/day *lochia that deviates from rubia-serosa-alba, varies in amt *uterine tenderness, heaviness, bachache |
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Physiologic Jaundice
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-occurs when bilirubin reaches 5-7
-never present during he first 24 hours of life -appears on day 2 or 3 -normal in newborns -levels begin to fall about a week after birth -phototherapy may be used |
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pathologic jaundice
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-occurs during the first 24 hours of life
-a bilirubin level above 1 or a total bilirubin concentration that increases by more than 5 per day or is higher than 12 or persists after the second week -due to abmormalities causing excessive destruction of RBCs -can be due to incompatable blood (mothers/infants), infection, metabolic disorders |
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cephalhematoma
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-does not cross the suture line
-check for jaundice -does not appear until 24-48 hours after birth -gone within a few weeks |
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meconium aspiration
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may be caused by:
-hypoxia- creating a relaxation of the anal sphincter -vagal stimulation possible from cord compression -GI motility, norm for term or post-term infant ->38 weeks, less amniotic fluid, increased cord compression -can cause pnemonia, asphyxia, pneumothorax, distress |
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Newborn Reflexes
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-Moro: allow the head and trunk of newborn to fall backward (arms and legs should extend and abduct)
-Palmer grasp: when infant's hand is touched at the base of the fingers the hand should close into a tight fist -Plantar grasp: same as above except on the feet -Babinski: stroking the sole of the infant's foot causing the toes to flare -Rooting: when infant's check is touched near the mouth the head turns toward that side -Sucking: when the mouth or palate is touched the infant should begin to suck -Tonic neck: arm and leg should extend on the side of the body in which the head is turned (fencing reflex) -Stepping: when infant is held upright w/their feet touching a hard surface they should lift one foot then the other as if they were walking |
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Moro Reflex
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allow the head and trunk of newborn to fall backward (arms and legs should extend and abduct)
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Palmar grasp
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when infant's hand is touched at the base of the fingers the hand should close into a tight fist
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Plantar grasp
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same as palmar except on the feet
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Babinski reflex
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stroking the sole of the infant's foot causing the toes to flare
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Rooting reflex
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when infant's check is touched near the mouth the head turns toward that side
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Sucking reflex
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when the mouth or palate is touched the infant should begin to suck
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Tonic neck reflex
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arm and leg should extend on the side of the body in which the head is turned (fencing reflex)
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Stepping reflex
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when infant is held upright w/their feet touching a hard surface they should lift one foot then the other as if they were walking
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Signs of neonatal hypoglycemia
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-Jitteriness
-Poor muscle tone -Diaphoresis -Poor suck -Tachypnea -Dyspnea -Cyanosis -Apnea -Low temp -High-pitched cry -Irritability -Lethargy -Seizures, coma -Some infants may be asymptomatic |
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Respiratory Distress Syndrome
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-Increases w/decreased gestational age, multiple gestation and uncontrolled DM
-A deficiency of surfactant production -Surfactant keeps the aveoli surface tension down to prevent aveoli from collapsing at the end of expiration |
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gravid
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pregnant, the state of being pregnant
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gravida (g)
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a pregnant woman
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Primigravida
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a woman who is pregnant for the first time
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multigravida
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a woman who has been pregnant more than once
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nulligravida
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a woman who has never been pregnant
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para (p)
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a woman who has delivered a viable infant (over the age of 20 weeks gestation), whether alive or stillborn~ refers to the number of deliveries not infants
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parity
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the number of times a woman has delivered a viable infant or infants
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nullipara
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one who has never borne a viable child
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Primipara
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a woman who has had one delivery of a viable infant or infants
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multipara
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a woman who has had two or more deliveries of viable infants
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puerperium
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the 6 week postpartal period. It nds with the resumption of ovulatory menses. It is broken down into three phases:
*immediate~ first 24 hours *early~ second to seventh day *late~ seventh day through the sixth week |
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rate of involution
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Faster in primip than in multip due to better muscle tone in the primip. this is also faster in breast feeding mothers than non-breast feeding due to stimulation of oxytocin. slower when the uterus is overdistended (ex~ polyhydraminos, twins, large baby)
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gestation
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period of fetal development from conception to birth
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trimester
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refers to a period of 3 months. pregnancy is divided into a 1st, 2nd and 3rd trimesters
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term
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beginning of the 38th week to the end of the 42nd week
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pre-term
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20th week to the end of the 37th week
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abortion
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Spontaneous or therapeutic cessation of pregnancy before 20 weeks (ab or ETP)
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Ectopic pregnancy
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development of an embryo outside the uterine cavity. Not viable. Removed surgically approximately 6-8 weeks of pregnancy (usually in fallopian tubes could also present in the abdominal cavity)
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