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45 Cards in this Set

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Describe the serum levels of b-HCG through out pregnancy
produced by the placenta

-1st trimester = 100,000 mIU/ml peak @ 10 wks
-2nd tri = decrease
-3rd = levels off @ 20-30,000
A viable pregnancy can be confirmed by US which may show a __1__ as early as 5 wks (bHCG = 1500-2000) & the __2__ as soon as 6 wks (HCG = 5000-6000)
1. Gestational sac

2. Fetal Heart
Define an Embryo
conceptus from time of fertilization until 8 wks (10 wks GA)
Define a Fetus
Conceptus after 8 wks until time of birth
Define Infant
period b/w delivery & 1 year of age
When does the 1st tri last until?
12 wks or 14 wks GA
When does the 2nd tri occur?
12-14 wks until 24-28 wks GA
When does the 3rd tri occur?
24-28 wks until delivery
What does the term Previable mean?
infant delivered prior to 24 wks
What does the term Preterm mean?
infant delivered 24-37 wks
What does the term "Term" mean?
infant delivered from 37-42 wks
What does the term "postdate or postterm" mean?
pregnancy carried beyond 42 wks (10.5 months)
This refers to the # of times a woman has been pregnant
Gravidity
This refers to the number of pregnancies that led to a birth beyond 20 wks GA or of an infant weighing more than 500 g
Parity
Define "Gestational Age"
age in wks & days measured from the last menstrual period (LMP)
Define "Developmental Age"
number of wks & days since fertilization
Why is the GA usually 2 wks more than the DA?
b/c fertilization usually occurs about 14 days after the first day of the prior menstrual period
Explain Nagele's rule for calculating the "estimated date of confinement" (EDC) / "estimated date of delivery" EDD
subtract 3 months from the LMP & add 7 days
How would one calculate the Estimated Date of Confinement using Exact Dating?
280 days after a certain LMP
If the Ovulation date is known, how can EDC be calculated?
add 266 days
What is the rule of thumb when using Ultrasound to date?
should not differ from LMP dating by more than 1 wk in the 1st tri, 2 wks in the 2nd tri, 3 wks in 3rd tri
What happens to Cardiac Output & Systemic Vascular Resistance during pregnancy? What is teh change in SVR probably due to?
CO = increases

SVR = decreases
- progesterone
-Systolic = decreases 5-10
-Diastolic = decreases 10-15
When should BP during pregnancy slowly return to prepregnancy levels?
b/w 24 wks gestation & term
-BP should never exceed prepregnancy levels
What 3 pulmonary changes occur during pregnancy?
1. Tidal Volume = 30-40% increase
2. TLC = decrease by 5% due to elevation of diaphragm
3. Increase in Minute Ventilation of 30-40%
This pulmonary symptom occurs in about 60-70% of pregnant patients
Dyspnea of pregnancy
-possible secondary to decreased PaCO2 levels, increased Tidal Volume, or decreased TLC
When should "morning sickness" routinely resolve by? What can morning sickness be attributed to?
14-16 wks gestation

Elevated estrogen, progesterone, & hCG
What changes during pregnancy can lead to GI reflux?
1. prolonged gastric emptying times
2. Gastroesophageal sphincter has decreased tone
What pregnancy change can lead to increased water absorption & constipation?
decreased bowel motility
Describe Renal Physiological changes during pregnancy
1. Kidneys increase in size & ureters dilate

2. GFR increases by 50%
-BUN & creatinine decrease by 25%

3. Increase in Renin-Angiotensin system -> increased Aldosterone
-Plasma Sodium stays the same due to increased GFR
What happens to Plasma Volume, RBC volume & Hematocrit during pregnancy?
Plasma Volume = increase by 50%

RBC volume = increase by 20-30%

Hematocrit = decreases
Define "Developmental Age"
number of wks & days since fertilization
Why is the GA usually 2 wks more than the DA?
b/c fertilization usually occurs about 14 days after the first day of the prior menstrual period
Explain Nagele's rule for calculating the "estimated date of confinement" (EDC) / "estimated date of delivery" EDD
subtract 3 months from the LMP & add 7 days
How would one calculate the Estimated Date of Confinement using Exact Dating?
280 days after a certain LMP
If the Ovulation date is known, how can EDC be calculated?
add 266 days
What is the rule of thumb when using Ultrasound to date?
should not differ from LMP dating by more than 1 wk in the 1st tri, 2 wks in the 2nd tri, 3 wks in 3rd tri
What happens to Cardiac Output & Systemic Vascular Resistance during pregnancy? What is teh change in SVR probably due to?
CO = increases

SVR = decreases
- progesterone
-Systolic = decreases 5-10
-Diastolic = decreases 10-15
When should BP during pregnancy slowly return to prepregnancy levels?
b/w 24 wks gestation & term
-BP should never exceed prepregnancy levels
What 3 pulmonary changes occur during pregnancy?
1. Tidal Volume = 30-40% increase
2. TLC = decrease by 5% due to elevation of diaphragm
3. Increase in Minute Ventilation of 30-40%
This pulmonary symptom occurs in about 60-70% of pregnant patients
Dyspnea of pregnancy
-possible secondary to decreased PaCO2 levels, increased Tidal Volume, or decreased TLC
When should "morning sickness" routinely resolve by? What can morning sickness be attributed to?
14-16 wks gestation

Elevated estrogen, progesterone, & hCG
What changes during pregnancy can lead to GI reflux?
1. prolonged gastric emptying times
2. Gastroesophageal sphincter has decreased tone
What pregnancy change can lead to increased water absorption & constipation?
decreased bowel motility
Describe Renal Physiological changes during pregnancy
1. Kidneys increase in size & ureters dilate

2. GFR increases by 50%
-BUN & creatinine decrease by 25%

3. Increase in Renin-Angiotensin system -> increased Aldosterone
-Plasma Sodium stays the same due to increased GFR
What happens to Plasma Volume, RBC volume & Hematocrit during pregnancy?
Plasma Volume = increase by 50%

RBC volume = increase by 20-30%

Hematocrit = decreases