Maternity Module 5

Front 1

Intrapartum

Back 1

time women is in labor

Front 2

postpartum

Back 2

after baby and placenta has been delivered

Front 3

Naegele's rule

Back 3

day of last menstraual period, add one year, subtracts three months and adds seven days

estimated date of confinement

Front 4

number of days in gestational period

Back 4

280 days

Front 5

how many trimesters

Back 5

three thirteen week trimesters

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gravida

Back 6

pregnancy terms - number of times she has ever been pregnant

Front 7

para

Back 7

number of births after 20 weeks- includes still borns

Front 8

GTPAL

Back 8

G is number of pregnancies including current pregnancy

T- Term-number of pregnancies delivered at 37 weeks or later

P-Preterm-number of pregnancies delivered between 20 and 37 weeks

A-Abortion-number of pregnancies ending in spontaneous or therapeutic abortion

L- living-number of currently living children

Front 9

changes that occur in pregnancy that are subjective- can be caused by other conditions beside pregnancy

Back 9

amenorrhea, nausea and vomiting, excessive fatigue, urinary frequency, breast changes, quickening- from 16-20 weeks after last menstrual period- baby movement

Front 10

objective changes during pregnancy

Back 10

changes in pelvic organs (chadwicks sign making it bluish/ purpleish)(hagers sign-softening of cervix), enlargement of abdomen, braxton hicks, abdominal striae, uterine souffle (auscultation of maternal pulse through uterine arteries), changes in skin pigmentation (darkening of melanin in face) (darkening of line from abdomen to pubis), ballottement, positive pregnancy test (just confirms HCG produced from placenta) (can be false positive)

Front 11

hemagglutination-inhibition test

Back 11

pregnancy test- use urine which is added to HCG sensitivezed RBC and if HCG is in urine, then clumping of cells is inhibited

can be done 4-10 days after missed period

Front 12

latex agglutination test

Back 12

pregnancy test- same thing as hemagglutination -inhibition test, but done with latex instead of HCG

Front 13

radioimmunoassay

Back 13

pregnancy test- have increased accuracy of pregnancy tests- detect pregnancy 8 days after ovulation

expensive

radioactive medical waste

Front 14

home pregnancy tests use...

Back 14

enzyme-linked immunosorbent assay (ELISA)

false negative results are more common than false positive

marijuana, methodone, aspirin can all cause false positive

hormonal changes in menopause and tumors can cause false positive

false negative are due to low levels of HCG

- should repeat it one week after first test

Front 15

how do pregnancy tests work

Back 15

antigen-antibody response

hcg is antigen in urine- hcg binds to the implanted antibodies

test region contains anti hcg antibodies- bind on stick and changes color of stick

control area changes stick color to show antibodies are doing what they should and test is behaving appropriately

Front 16

positive signs of pregnancy

Back 16

auscultation of fetal heart beat (10-12 weeks), fetal movement (20 weeks), visualization of fetus (ultrasound, 4-5 weeks, vaginal is 10 days after implantation)

Front 17

uterus changes

Back 17

pre pregnancy is 2 ounces, at the end is 2 pounds.

enlargement from hypertrophy

braxton hicks is irregular or intermittent tightening to fill blood in spaces

Front 18

cervical changes

Back 18

mucous plug develops, hegar's sign- softening of isthmus

goodell's- softening of cervix

chadwick's sign- bluish/ purple discoloration

Front 19

vaginal changes

Back 19

estrogen induced changes, hypertrophy, hyperplasia, acidic pH helps with bacterial infections, loosening of supportive tissue.

Front 20

basal metabolism in pregnancy

Back 20

oxygen increases and therefore respiratory alkalosis occurs to compensate for this

Front 21

cardiovascular changes

Back 21

blood volume increases 40-50%, decrease of impact of blood loss after delivery, blood composition changes to more red blood cells (vitamin supplements helps this), plasma volume increases more than red blood cells though (technically this is physiologic anemia)

hemoglobin is 12

37-44for hematocrit (amount of space red blood cells take up)

blood pressure adapts so there is not an increase in blood pressure even though there is a larger volume of blood

Front 22

postural hypotension

Back 22

more prone during pregnancy. can also lead to lower extremity edema

Front 23

kidney changes

Back 23

glomerulo filtration rate increases a lot

increased flow and volume, decreased buin and creatine levels, increased volume of blood

some drugs might be at a subtherapeutic level

sugar in urine is common

increased susceptibility to urinary infection

Front 24

skin changes

Back 24

hyperpigmentation

lineanegra- darkening of line from umbilicus to pubis

chloasma- darkening patches on face and extremities

vascular spider nevi- from increased blood flow

stretch marks

hair changes- hair feels thicker- rate of hair growth decreases and resting phase prolongs

excellerated sweat and sebaceous glands- more acne

Front 25

relaxin

Back 25

causes ligaments and joints to relax in order to facilitate delivery of baby

Front 26

center of gravity changes

Back 26

lumbar spine changes causing sway back and shoulder, neck, and upper extremity discomfort

Front 27

rubin's tasks of pregnancy

Back 27

ensuring safe passage through pregnancy, labor, and birth

seeking of acceptance of this child by others

seeking of commitment and acceptance of self as mother to the infant

learning to give of oneself on behalf of one's child

Front 28

couvade

Back 28

physical changes of father during pregnancy

Front 29

ultrasound

Back 29

establish gestational age, fetal life, fetal number, fetal presentation and anatomy, amniotic fluid index, placental position, evaluate cervix and uterus

can see cervix and uterus to see if there are any problems.

can determine crown rump measurement

fetal activity (fetal cardiac movement)

Front 30

Maternal Serum Alpha Fetoprotein

Back 30

secreted by fetal liver and secreted into mother's blood

elevated in neural tube defects

Front 31

nuchal translucency on transvaginal ultrasonography

Back 31

can show down's syndrome if abnormalities in neck region (fluid filled sack)

15-20 weeks of pregnancy

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amniocentesis

Back 32

metabolic disorders, genetic testing, embryonic cells, chromosomes, blood typing

invasive- risk for infection- slight risk of spontaneous abortion

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chorionic villus sampling

Back 33

piece of chorionic villus

10-12 weeks.

if done earlier, short limb syndrome can happen

genetic abnormality testing

alpha fetal protein is not obtainable so can't test neural tube defects

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nonstress test

Back 34

accelerations of heart beat imply intact CNS

without stress being placed- if there are two or more fetal heart rate accelerations is normal

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contraction stress test

Back 35

evaluates uteral placental function

placenta is lungs of baby in utero

identifies hypoxia of baby

if fetus is compromised, FHR decreases with contraction

Front 36

negative contraction stress test

Back 36

good. late or variable decelerations

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biophysical profile

Back 37

nonstress test and an ultra sound

nonstress is looking at CNS fetal heart rate accelerations

ultrasound has four sections- fetal breathing, movements, tone, amniotic fluid volume (tells us if kidneys are working)