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15 Cards in this Set
- Front
- Back
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How do you date pregnancy?
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Menstrual age (obstetricians) counts from the first day of the last period (pregnancy lasts about 280 days)
Embryologists date from ovulation (around 266 days) |
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Trimesters
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First: 1-12 6/7 weeks
Second: 13-27 6/7 weeks Third: 28-40 weeks |
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Normal Pregnancy-Changes in Breast
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Early: tenderness, hypersensitivity
6-8 weeks: less tender, still hypersensitive, enlargement due to hypertrophy of alveoli (estrogen), deep pigmentation of areoli |
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Normal Pregnancy-Changes in Urinary Tract
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Beginning of second trimester: Kidney size increases, ureteral elongation/dilation, GFR increases 30-50% by 14 weeks (estrogen), enhanced reabsorption in tubules because of higher steroid hormone level, net water and salt accumulation, urinary frequency due to increase in urine formation and widening/deepening of bladder trigone (muscle hyperplasia)
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Normal Pregnancy-Changes in Metabolism/Endocrine
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BMR increases by 20 weeks due to hormones
Weight gain Increase protein and iron requirements-->serum concentrations are lower than normal Lower serum glucose than normal HPL-->lipolysis-->high free fatty acids Pregnancy us potentially diabetogenic |
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Normal Pregnancy-Changes in Hematologic/Cardiovascular/Respiratory
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Blood volume increases 50%
Hematocrit decreases WBC normal to slightly elevated CO, HR increase TPR decreases (progesterone) Arterial bp decreases Increased tidal volume Decreased FRC, EV, pCO2, paCO2, bicarb |
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Normal Pregnancy-Changes in Reproductive Anatomy
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Stretching and hypertrophy of myometrium (progesterone)
Cervix becomes soft and cyanotic Glands of cervical mucosa multiply to produce thick mucous plug No ovulation Increased vascularity in vagina, vulva Softening of CT-->increased length of vaginal wall Acidic discharge (estrogen, increased lactobacillus) |
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Naegele's Rule
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To estimate expected date of confinement, add 7 days to the first date of last menses and subtract three months
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Most important task in prenatal care?
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Accurate assessment of gestational age
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Braxton Hicks contractions
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Painless uterine contractions occurring at irregular intervals starting early in pregnancy, become more frequent in last four weeks
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Gestational Trophoblastic Disease
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Maternal tumor arising from fetal tissue
Abnormal proliferation of trophoblastic tissue |
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Types of Gestational Trophoblastic Disease
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Hydatidiform Mole
Persistent/Invasive GTD Choriocarcinoma Placental Site Trophoblastic Tumors |
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Clinical Characteristics of Molar Pregnancy
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Irregular bleeding
Uterine size > dates No fetal heart Abnormally high hCG titers Development of pregnancy complications Exaggerated Pregnancy symptoms Snowstorm ultrasound Possible malignant transformation |
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Complete Mole
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Hydropic Placental villi only
Paternal origin 46 XX Fertilization of empty egg with sperm that duplicates No vessels, fetus, amnion 20% risk of trophoblastic neoplasia |
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Incomplete Mole
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Fetal tissue present
69 XXY One haploid maternal set, two haploid paternal sets Dispermic fertilization 5% risk of trophoblastic neoplasia |
