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Signs of pregnancy include? (3)
Presumptive: are s/s that lead the client to believe she is pregnant but are not conclusive
Probable: more conclusive than presumptive signs but are still not definitive
Positive: there are only three definite signs
What are the Presumptive Signs?
- breast sensitivity
- Chadwick's sign
- fingernail changes
- urinary frequency
- wt gain
What are the Probable Signs?
- ballotment:fetus rebounds
- Chadwick's sign:bluish vagina
- Goodell's sign: softening of the cervical lip
- Hegar's sign: softening of the uterus
What are the Positive Signs?
- fetal heart tones
- Leopold's maneuver
- Ultrasound of the fetal outline
What is an Alpha-Fetoprotein Screening?
*is obtained by a blood sample from the mother
*alpha-fetoprotein is a glucoprotein produced by fetal yolk sac, GI tract, and liver
*it can be done on mother's blood b/t 16-20weeks gestation
*this protein passes through the placenta to the maternal circulation and is excreted through fetal circulation and into the mother's circulation
*if abnormal levels, amniocentesis should be done
What is an amniocentesis?
*it can be done as early as 16 weeks gestation
*ultrasound exam of uterus is performed prior to the amnio centesis to locate the placenta and the pockets of amniotic fluid
*full bladder is recommended
*large bore needle is used
*report any crampling or bleeding and avoid lifting objects heavier than 5lbs for several days
When can you hear fetal tones using a fetoscope and ultrasound?
- fetoscope:18-20 weeks
- ultrasound:~12 weeks
What is the benefit of ultrasonography?
*it is done to determine fetal age and can be useful tool in determining fetal abnormalities
Signs of Complications of Pregnancy include: (8)
- persisrent vomiting: hyperemesis gravidarum (N&V after the fisrt trimester) can lead to fluid and electrolyte imbalances
- vaginal bleeding:indication of placenta previa, abruptio placenta, or threatened abortion
- abd pain:threatened abortion, an ectopic pregnancy, or abruptio placenta
- incompetent cervix:causes spontaneous abortion (corrected by McDonalds', cerclage=procedure to close the cervix)
- vertigo, h/a, or edema of the hands and face:preeclampsia
- chills and fever:UTI or infection
- excessively rapid uterine enlargement:hydatidiform mole
What is TORCHS syndrome?
*it includes toxoplasmosis, rubella, cytomegalovirus, herpes, syphillis
What is a hyatidiform mole?
- *is a rapid proliferation of the cells within the uterus d/t trophoblastic disease
- *rapid cell growth can be associated with chorionic carcinoma
- *tx:dilation and curettage(scraping) or d&c
- *not be pregnant for at least a year b/c a rising HCG level will stimulate CA cell growth
What are the types of abortions?
- *elective:evacuation of fetus
- *threatened:produces spotting (tx is bedrest)
- *inevitable: no fetal heart tones and part of the fetus are passed (tx:d&c)
- *incomplete:fetal demise exists but part of the conception is not passed (tx:d&c)
- *septic:presence of infection
- *missed:there is fetal demise but there is no expulsion of the fetus (tx:induction of labor or a surgical removal of the fetus)