Terms related to pregnancy
o Para: number of babies born after 22 weeks
o Gravida: a woman who is or has been pregnant
o Primigravida: a woman who
... [Show More] is pregnant for the 1st time
o Primipara: a woman who has delivered one child after 22 weeks
o Multigravida: a woman who has been pregnant previously
o Multipara: a woman how has carried two more pregnancies after 22 weeks
o Nulligravida: a woman who is not pregnant and not currently pregnant (never been pregnant)
Maternal Hormones
o Placental Hormones:
Progesterone: maintains endometrium; inhibits uterine contractibility; lactation
Estrogen: breast/uterine enlargement
hCG: stimulates corpus luteum to produce estrogen and progesterone until placenta takes over
hPL: antagonist to insulins
relaxin: inhibits uterine activity; softens cervix and collagen in joints
prostaglandins: may trigger labor
o Pituitary gland:
Prolactin: responsible for milk production after birth
Oxytocin: stimulates uterine contractions, loosens joints and ligaments starting at 4 months
o Adrenal glands:
Aldosterone
o Pancreas
Insulin; additional glucose for fetus
Nagele’s Rule
o Take the first day of the womans LMP, subtract 3 months and then add 7 days and 1 year, adjusting for the year as
necessary
GTPAL
o Gravidity
o Term births (38 wks or more)
o Preterm births (up to 37 weeks)
o Abortion/miscarriages
o Living children
Betamethasone
o Used for Preterm delivery
Signs of Pregnancy
o Presumptive S/S
Amenorrhea
N/V
Enlargement & breast tenderness
Frequent urination
Feeling tired
Montgomery’s tubercules
Stretch marks
Spider veins
Quickening (fetal movements)
Colostrum from breast
Chadwick’s Sign
o Probable Signs:
Enlarged abdomen Positive pregnancy test
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Changes in uterine shape
Softening of the cervix (Goodell’s
sign)
Enlarging uterus
Braxton hick’s contraction
Hegar’s sign
Palpation of the baby
Ballottement
o Positive Signs
Fetal heart sounds
X-ray
Actual delivery of infants
Reproduction (ovulation)
Emotional Response/ Psychological tasks of Pregnancy
o Emotional Response
Ambivalence
Grief
Self-centered; feels needs to
protect body
Introversion or extroversion
Body image changes
Stress
Mood changes
Sexual desire changes
Couvade syndrome
o Psychological tasks of pregnancy
1st trimester: accept pregnancy
2nd trimester: accept baby
3rd trimester: preparing for baby, nesting, attachment with baby
Prenatal Care/ Appointments, Prenatal Tests
o Prenatal Care
Ultrasound and hcG confirms pregnancy
Complete H&H
Genetic disorders, chronic illness, meds, obstetrical hx, personal habits
Complete physical exam
VS, wt/ht, pelvic exam, assess size/shape of boney pelvis
Subsequent visits
Physical assessment
Measure fundal ht
o Fundal ht=wks of gestation
Ht larger than wks means too much amniotic fluid or multiple babies
Ht smaller than weeks means intrauterine growth restriction
Urinalysis
Teaching
Fetal heart tones
Fetoscope: 16 wks, and always by 19-20 wks
Routine Lab Test:
Blood type, Rh factor, and presence of irregular antibodies
CBC w/ differential, hgb, and Hct
Hgb electrolytes
GBS
Vaginal/cervical culture
Maternal Nutrition
o Maternal wt gain depends on BMI and pre pregnant nutrition state
Underwt. Woman: 28-40 lbs.
Normal: 25-35
Overweight: 15-27 lbs.
Obese: at least 15 lbs.
Gain of 3.5 lbs. during 1st trimester
Gain about 1lb weekly rest of pregnancy
o Heart burn: take tums and small frequent meals
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