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32 Cards in this Set
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- Back
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Pregnancy = implantation of products of conception
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1
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OTC and hospital pregnancy tests both measure ___.
When in pregnancy is this hormone at its max value? |
beta-hCG (produced by placenta)
10 weeks GA (100,000 mIU/mL) |
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At what age:
Embryo ___ Fetus ___ Infant |
embryo (8 WEEKS) fetus (DELIVERY) infant (1 year)
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Length of trimester: __-14 weeks
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12-14 weeks
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TPAL designation:
T: 37-__ weeks P: __-37 wks A: <20 wks or <___g L: _________ |
T: 37-42 wks
P: 20-37 wks A: <20 wks or 500 g L: Living children |
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30 yo with 1 pregnancy; triplets, all living; full-term delivery; not currently pregnant
G's and P's? |
G1 P1003
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Which is longer, developmental age (DA) or gestational age (GA)?
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GA = DA + 2 wks
-GA is from LMP, DA is from fertilization |
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Using Nagele rule, estimated date of delivery (EDD/EDC) is equal to:
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LMP - 3 months + 7 days
-280 days from LMP |
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During 1st trimester, US dating often differs from GA but up to ___.
2nd trimester? 3rd trimester? |
1 week in 1st trimester
2 weeks..., 3 weeks... |
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Fetal HR detectable at ___ weeks by Doppler ultrasound
Fetal movement (quickening) first experienced by mother around ___ weeks |
Doppler US: 10 weeks
Quickening: 16-20 weeks |
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At 24 wks, should maternal BP be higher or lower than non-pregnant F?
Which hormone is responsible? |
About 10 mm Hg LOWER (never higher during pregnancy)
Progesterone is a vasodilator |
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Elevation of diaphragm during pregnancy results in decreased TLC. Is tidal volume increased or decreased?
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Tidal V INCREASES by 30-40%, while RV and ERV decrease.
-may contribute to dyspnea of pregnancy |
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"Morning sickness" may occur at any time of day. What effect to hormones have on stomach and esophagus?
By week __, "morning sickness" should resolve. Pytalism = spitting during pregnancy |
Slowed gastric emptying and decreased LES tone
Weeks 14-16 |
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Cause of constipation in pregnancy?
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Hormone-mediated decrease in large bowel motility
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If serum aldosterone increases during pregnancy, why doesn't serum Na+?
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GFR also increases (by 50%)
-BUN and creatinine decrease |
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Pyelonephritis in pregnancy.
Greater or lesser risk than among non-pregnant population? Why? |
Greater risk
Progesterone relaxes SM of ureters |
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Hct, WBC count, platelet count.
Which increases during pregnancy? |
WBC (6-16 million)
-Hct and platelets decrease |
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Pregnancy is considered a hypercoagulable state.
Levels of which clotting factors are affected? Do clotting and bleeding times increase or decrease? |
Increased levels of fibrinogen and factors VII-X
-clotting and bleeding times REMAIN UNCHANGED; c/a venous stasis and endothelial damage |
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Primary site of estrogen production during pregnancy
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Placenta (from maternal adrenal precursors)
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Shares alpha subunit of LH, FSH, and TSH
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hCG
-beta subunits differ |
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Main action of hCG during pregnancy?
Peak hCG levels reached at 10-12 weeks, with steady state reached after ___ weeks. |
Maintain progesterone production by corpus luteum
-hCG steady after 15 weeks |
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How does human placental lactogen (hPL) ensure constant nutrient supply for fetus?
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Increases lipolysis and antagonizes insulin (promotes protein synthesis, diabetogenic)
-hPL = human chorionic somatotropin (hCS) |
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Free T3 and T4 levels remain stable during pregnancy.
What about total T3 and T4 levels? |
Increase along w/ estrogen-mediated INCREASE IN TBG
-prolactin levels also markedly increased |
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During pregnancy:
-estrogen is responsible for spider angiomata and palmar erythema -______ is responsible for hyperpigmentation of nipples, umbilicus, linea nigra (abdominal midline), perineum, melasma/chloasma (face) |
MSH
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Caloric intake increases by ___ during pregnancy and 500 kcal/day when breastfeeding.
Folate requirement increases from 0.4 mg/day to ___. |
300 kcal/day increase during pregnancy
0.8 mg/day of folate -patients advised to gain 20-30 lbs |
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Most common form of anemia in pregnancy?
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Fe deficiency anemia (consider supplementation)
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Initial prenatal visit ideally occurs between weeks 6 and 10
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2
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Follow-up prenatal visits should always include:
-blood pressure -weight -measurement of uterus - - Large weight gains toward end of pregnancy may be a sign of ___. |
Urine dipstick, Auscultation of fetal heart
-sign of preeclampsia |
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Prenatal urine dipstick checked for:
-protein, indicative of ___ -glucose... -leukocyte esterase... -blood |
Protein...preeclampsia
Glucose...diabetes Leukocyte esterase...UTI Blood |
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Fundal height in cm roughly correlates w/ GA in weeks
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+/- 3
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Irregular (Braxton-Hicks) contractions normal during 3rd trimester.
Regular contractions >___ per hour may be sign of preterm labor |
>5-6 per hour
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1st trimester screening includes:
-Hct, blood type, __ screen -Gonorrhea, Chlamydia, ___ -HIV -Rubella, ___ (titer) -PPD -____ -specific tests for high-risk groups |
-Rh screen
-VDRL/RPR -HIV -VZV (titer) -PPD -nuchal translucency on US (NT) -specific tests for high-risk groups |
