Ob

Front 1

braxton hicks contractions

Back 1

false contractions during pregnancy

Front 2

goodell's sign

Back 2

softening of the cervix

Front 3

chadwick's sign

Back 3

blue-purple discoloration of the cervix

Front 4

vaginal pH during pregnancy...

Back 4

more acidic which protects against infections, but favors yeast organisms

Front 5

linea nigra

Back 5

dark line on abdomen from pubic area to umbilicus

Front 6

chloasma/melasma gravidarum

Back 6

mask of pregnancy

Front 7

quickening

Back 7

fetal movement felt at 16-20 weeks

Front 8

leukorrhea

Back 8

Whitish mucous discharge that is normal during pregnancy

Front 9

Montgomery tubercles

Back 9

Hypertrophy of the sebaceous glands in the areola

Front 10

physiologic anemia of pregnancy

Back 10

If Hgb <12 and Hct< 32, the pregnant woman is considered anemic

Front 11

Hct norms

Back 11

Hct levels of 32-44% are normal.

Front 12

integumentary changes caused by

Back 12

↑ levels of estrogen cause increased levels of melanocyte stimulating hormone.

Front 13

Gravida

Back 13

woman who's pregnant

Front 14

gravity

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pregnancy

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multigravida

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Woman who has had two or more pregnancies

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Multipara

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Woman who has completed 2 or more pregnancies to stage of fetal viability

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Nulligravida

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Woman who has never been pregnant

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Nullipara

Back 18

Woman who has not completed pregnancy with a fetus or fetuses who have reached the stage of fetal viability (22-25 weeks)

Front 19

Parity

Back 19

Number of pregnancies in which fetus or fetuses have reached viability, not the number of fetuses born. Ex. Twins is one birth

Front 20

Post Term

Back 20

Pregnancy that goes beyond 42 weeks of gestation

Front 21

Preterm

Back 21

Pregnancy that has reached 20 weeks of gestation but before completion of 37 weeks of gestation

Front 22

Primigravida

Back 22

Woman who is pregnant for the first time

Front 23

Primipara

Back 23

Woman who has completed one pregnancy with a fetus or fetuses who have reached stage of fetal viability

Front 24

what contributes to changes in maternal physiology during pregnancy?

Back 24

Maternal adaptations to pregnancy are attributed to the hormones of pregnancy and to the mechanical arising from the enlarging uterus.Adaptations to pregnancy protect the woman’s normal physiologic functioning, meet the metabolic demands of pregnancy imposed upon her body. These adaptations provide for a nurturing environment for fetal growth

Front 25

What stimulates uterine growth?

Back 25

high levels of estrogen and progesterone

Front 26

what changes does the uterus undergo?

Back 26

Changes in size, shape, and position from 10ml to 5L.Enlargement due to hypertrophy of myometrial cells stimulated by estrogen & the growing fetus

Front 27

at what level is the uterus at 40 weeks gestation?

Back 27

34 weeks level

Front 28

quickening

Back 28

Fetal movement usually occurs between 16 and 20 weeks of gestation

Front 29

what changes occur in the vagina and Vulva?

Back 29

Estrogen causes a thickening of the vaginal mucosa, loosening of connective tissue, and increase in vaginal secretions

Front 30

Leukorrhea

Back 30

whitish mucous discharge that is normal during pregnancy

Front 31

what role does the mucous plug play?

Back 31

Under the influence of estrogen secretes mucus that forms a plug at the opening of the endocervical canal to limit bacteria from entering the uterus.

Front 32

How is the cardiac output affected?

Back 32

Cardiac output increases from 30-50% during pregnancy because of increased tissue demand for oxygen and increased stroke volume

Front 33

how is the blood volume affected?

Back 33

Blood volume increases progressively until it is about 45% > prepregnant levels

Front 34

how is the pulse rate and blood pressure affected?

Back 34

The pulse rate increases because the enlarging uterus, developing placenta & growing fetus require additional blood flow.
Blood pressure decreases in the 1st & 2nd trimester due to decreased pulmonary and vascular resistance.

Front 35

what Hemoglobin and hematocrit indicators of physiologic anemia?

Back 35

Hct levels of 32-44% are normal. If Hgb <12 and Hct< 32, the pregnant woman is considered anemic

Front 36

why our pregnant women at an increased risk for deep vein thrombosis?

Back 36

hypercoagulability and statis

Front 37

describe respiratory system adaptations. Changes and oxygen demand and volume of air breathed.

Back 37

Oxygen demand increases by 15-20% because BMR is increased.↑
Volume of air breathed increases 30 to 40 % from decreased airway resistance that occurs in response to progesterone

Front 38

increased levels of estrogen cause increases in what hormone affecting the skin?

Back 38

melanocyte stimulating hormone

Front 39

what changes in the metabolic rate cause increased vascularity and hyperplasia and the thyroid gland?

Back 39

Basal metabolic rate goes up 25%

Front 40

how is the pancreas affected during pregnancy?

Back 40

Fetal use of glucose increases demand for insulin

Front 41

what is the main cause glucosurea?

Back 41

With the ↑ GFR the kidneys are filtering glucose faster than the renal tubules can reabsorb it so glucose is spilled into the urine

Front 42

term

Back 42

Pregnancy from the beginning of week 38 to end of week 42 of gestation

Front 43

viability

Back 43

capacity to live outside the uterus

Front 44

Alexis Page is pregnant for the 4th time. She lost her 1st pregnancy @ 12weeks gestation. She has two children at home. What is her OB history according to GTPAL?

Back 44

42012

Front 45

Yolanda Jackson is pregnant for the third time. She gave birth to a stillborn at 36 weeks gestation and has a 3 year old at home who was born at term. Record her OB history

Back 45

31101

Front 46

Mrs. Smith says that she has had two prior pregnancies. She had a miscarriage with her 1st pregnancy after eight weeks. With her second pregnancy, she delivered twin girls at 34 weeks but the babies died two days after birth

Back 46

30110

Front 47

toxoplasmosis

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A protozoan that infects the woman through undercooked meats and the handing of cat liter

Front 48

CMV( Cytomegalovirus)

Back 48

This is the most common infection that has possible serious complications for the fetus. It is viral and can not be TX. Deafness or SAB ( Spontaneous Abortion)

Front 49

list of factors related to high-risk pregnancies

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Age (< than 20 years and > 35 years or older)
Lack of prenatal care
Low educational attainment
Unmarried status
Non-Caucasian race

Front 50

abruptio placenta

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placenta detaches from uterus

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placenta previa

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placenta attaches low in the uterus

Front 52

rubella titer: immunity if

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>1.8

Front 53

two of the ways to decrease HIV transmission from the mother to the fetus?

Back 53

AZT administration reduces the risk to 8%; cesarean birth reduces the risk to 2-5%

Front 54

what is the age when it can be reliably determined that the infant is HIV-positive?

Back 54

18 months

Front 55

what are the two additional tests used in determining down syndrome in the fetus?

Back 55

HCG levels tend to be higher and unconjugated estriols levels are lower in maternal serum when the fetus has trisomy 21

Front 56

what is the Doppler ultrasound used for and when?

Back 56

Doppler ultrasound assessment of blood flow through umbilical artery
Can identify abnormalities in the diastolic flow.
Purpose:
Used with pregnancies complicated by hypertension, diabetes, or fetal growth restriction

Front 57

when can a transvaginal ultrasound be performed? what does it visualize? full bladder?

Back 57

Done @ 6 - 7 weeks
1st trimester
Done with a vaginal probe and ultrasonic gel
Visualizes the gestational sac
A full bladder is not needed

Front 58

when can an abdominal ultrasound be performed? What does it visualize? Full bladder?

Back 58

Done @ 18-20 wks
2nd trimester
A transducer to the abdomen & ultrasonic gel
Visualizes the fetus in the aminotic sac & placenta
Full bladder is needed

Front 59

Fetal Nuchal Translucency

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Ultrasound of fetal neck 10-14 wks.
Often an indication of fetal abnormalities

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Amniocentesis indications

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Genetic concerns: DX of genetic disorders, congenital anomalies( neural tube defects)
Fetal maturity: L/S ratio for fetal lung maturity
Fetal hemolytic disease: Rh-, ABO incompatibility
Meconium
Antepartal
Intrapartal

Front 61

low AFP is associated with

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Down's syndrome

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high AFP is associated with

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spina bifida

Front 63

limitations of AFP testing

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Inadequate estimation of gestational age can show abnormal results in an otherwise healthy fetus.
Because closed neural tube do not produce elevated levels of AFP, normal levels do not guarantee a perfect baby.

Front 64

what happens when Rh negative mother becomes sensitized to the Rh positive fetus?

Back 64

hemolysis occurs, the fetus responds by producing large number of immature erythrocytes (erythroblastosis)

Front 65

coombs test

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tests for Rh incompatibility

Front 66

when does the Rh negative mom receive RhoGamm?

Back 66

Rh negative mom receives RhoGAM @ 28 weeks, after an aminocentesis and 72 hrs after birth

Front 67

described nonstress test.what is the positive result?

Back 67

If the fetus has adequate oxygenation and an intact CNS, there are accelerations in the fetal heart rate with fetal movement.
Clinical significance: If NSTs remain reactive, most high risk pregnancies are allowed to continue

Front 68

high-risk women begin NST testing at

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30 to 32 wks gestation

Front 69

the five factors of the passenger that affect labor

Back 69

fetal lie, fetal attitude, field position,fetal presentation, the size of the head

Front 70

molding

Back 70

overlapping of cranial bones

Front 71

what are the three types of fetal presentation?

Back 71

1. Cephalic (Head 1st) 96% of births

2. Breech ( Buttocks or foot 1st) 3%

3. Shoulder ( Scapula 1st) 1%

Front 72

what are the four types of cephalic presentation?

Back 72

Vertex (occiput), military, brow, mentum (chin).

Front 73

and what are the two types of breech birth?

Back 73

footling and full

Front 74

What is the reference point for fetal station?

Back 74

ischial spines is 0, above is minus, below is plus

Front 75

what are the 2 types of powers involved in labor?

Back 75

primary: contractions
secondary: bearing down

Front 76

what is effacement?

Back 76

is the shortening and thinning of the cervix during the 1st stage of labor.
Cervix is normally 2-3cm in length and 1 cm thick. Effacement is expressed in %.(0-100%)

Front 77

what are the signs of impending labor?

Back 77

Lightening: Fetus settles into the pelvic inlet.
Bloody show: The mucous plug is expelled.
Increased pelvic pressure, leg cramps, lower leg edema, increased urinary frequency and increased vaginal secretions.
Ripening: The softening of the cervix.
Sudden Burst of Energy ( 24-48 hours before birth). Nesting.

Front 78

what are the signs of placental separation in the 3rd stage of labor?

Back 78

A globular-shaped uterus, a rise of the fundus in the abdomen, a gush or trickle of blood, and a lengthening of the umbilical cord.

Front 79

list 3 things involved in involution

Back 79

Contraction of the uterus
Autolysis of the Myometrial cells
Development of a new endometrium.

Front 80

how long does involution of the uterus take?

Back 80

six weeks

Front 81

what hormone suppresses ovulation in lactating women?

Back 81

Prolactin

Front 82

what happens to the heart rate post delivery?

Back 82

Bradycardia 50 to 70 beats per minute