Maternal Ch 14, 15, 16, 17 Changes of Pregnancy

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sdelap
ID:
133997
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Maternal Ch 14, 15, 16, 17 Changes of Pregnancy
Updated:
2012-02-09 09:04:22
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Maternal 14 15 16 17 Pregnancy
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Description:
Maternal Ch 14-17 (2A) Changes of Pregnancy
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  1. Ballottment
    Passive fetal rebound against cervix when cervix is pushed up against by examiner
  2. Chadwick's Sign
    Blue-purple discoloration of cervix
  3. Chloasma (melasma gravidarum)
    • Mask of pregnancy
    • facial darkening - irregular pigmentation of the cheeks, forehead, nose
    • Accentuated by sun eposure
    • More prominent in dark-haired women
  4. Couvade
    Observances of rituals/taboos by dad to signify transition into fatherhood

    May be intentional or unintentional

    May include sympathy pains, etc.
  5. Goodell's sign
    Softening of cervix
  6. Hegar's sign
  7. McDonald's sign
  8. Cardiovascular changes during pregnancy
    Heart pushed upward and to left/forward: Fetus exerts pressure on diaphragm

    • Systolic murmur 90% preg women
    • First/third heart sounds are louder

    Blood volume increases to 50% over non-preg

    • Vascular resistence down
    • Femoral venous pressure increases: dependent edema, veric veins

    Cardiac output up by 505

    Supine hypotensive syndrome (vena caval syndrome) or (aortocaval compression)

    Pulse increases 10 - 15 bpm

    Physiologic anemia of pregnancy
  9. Physiologic anemia of pregnancy (pseudoanemia)
    Plasma volume increases more than erythrocyte volume (50%:30%), so Hct appears to drop in blood tests.

    Increase of rbc's is only 18% in women who don't receive additional iron.
  10. Vaginal changes during pregnancy
    • Secretions thicken
    • Become acidic (pH 3.5 - 6)
    • Prevents infections during pregnancy
    • FAVORS yeast infections (moniliasis)
  11. Changes to eyes
    • Decreased intraocular pressure
    • Thickening of cornea
    • May be uncomfortable to wear normal contacts
  12. Metabolism changes
    • Increased fat demands and fat metabolism
    • Fats more completely absorbed
    • R/f ketosis during night, between meals

    Incr demand for iron
  13. Subjective Signs of Pregnancy
    Symptoms the woman reports:

    • Amenorrhea
    • N/V (elevated hCG)
    • Fatigue
    • Frequency
    • Breasts
    • Quickening (16 - 20 wks)
  14. Objective (Probable) Signs of Pregnancy
    Observed by examiner:

    • Goodells: softening
    • Chadwick's: purple
    • Hegar's: softening of isthmus
    • Ladin's: soft spot
    • McDonald's: ease in flexing uterus against cervix

    • Enlargement of abdomen
    • Braxton Hicks
    • Uterine Souffle (mom's)
    • Funic Souffle (baby's)
    • Pigmentation changes
    • Fetal outline
    • Ballottement
    • Pregnancy test
  15. Diagnostic (Positive) Changes
    Fetal heartbeat: Doppler @ 12 wks, Fetoscope @ 17-20wks

    Fetal movement: actively palpable by 20 wks

    Visualization: ultrasound (4-5 wks gestation)
  16. Antepartum
    Between conception to onset of labor (prenatal)
  17. Intrapartum
    Onset of labor until birth of infant and placenta
  18. Postpartum
    Brith till woman's body returns to prepregnant condition
  19. Gestation
    Number of wks since first day of last menstrual period (LMP)
  20. Abortion
    Birth that occurs before 20 wks gestation or birth of fetus less than 500g
  21. Term
    Normal duration of pregnancy (38 - 42 wks)
  22. Preterm or premature labor
    Labor that occurs after 20 wks, but before end of 37th wk of gestation
  23. Graqvida
    Pregnancy

    • Nulligravida: never been pregnant
    • Primigrafida: first pregnancy
    • Multigravida: second or subsequent gravida
  24. Para
    Birth after 20 wk's gestation (alive or dead)

    • Nullipara: never given birth after 20 wks
    • Primipara: 1st birth after 20 wks
    • Multipara: 2+ after 20 wks
    • Stillbirth: fetus born dead after 20wks gestation
  25. TPAL
    • T: Term
    • P: Preterm
    • A: Abortion
    • L: Living children
  26. Nagele's Rule
    Estimated date of birth (EDB):

    • First day of LMP
    • Subtract 3 months
    • Add 7 days
    • (adjust year)
  27. Leukorrhea
    Increased whitish vaginal discharge - common in pregnancy
  28. Ptyalism
    Excessive, bitter saliva is produced

    • More acidic; encourages growth of candida albicans
    • Woman more susceptible to MONILIAL VAGINITIS
  29. Pelvic Tilt
    • Pelvic rocking
    • Reduces lower back strain/pain

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