Anatomy & Physiology of Pregnancy

length of pregnancy

40 weeks or 280 days measured from the last menstrual period

first trimester length

0 - 13 weeks

2nd trimester length

14 - 27 weeks

3rd trimester length

28 - 40 weeks

what stimulates uterine growth in the 1st trimester?

High levels of estrogen and progesterone

by 12 weeks the uterus rises out of the ----- into the -------------

pelvis, abdominal cavity

What does 'lightening' refer to in pregnancy?

The descent of the fetus into the pelvis in preparation for birth.

What happens to fundal height as the fetus descends into the pelvis?

The fundal height decreases.

At how many weeks gestation does softening and compressibility of the lower uterine segment occur?

6 weeks

Hegar Sign

softening and compressibility of the lower uterine segment

Braxton Hicks contractions

intermittent uterine contractions that occur after the 4th month of pregnancy

Braxton Hicks contractions are ------ and ------. They usually cease with ------ or --------

irregular, painless. walking, exercise

Uterine souffle

Bruit, rushing or blowing sound of blood flowing through uterine arteries to the placenta

What is the funic souffle caused by?

fetal blood coursing through the umbilical cord

What is the uterine souffle synchronous with?

maternal pulse

What is the funic souffle synchronous with?

fetal heart rate

Nagele rule

Determine day of last menstrual period (LMP), subtract 3 months, + 7 days, + 1 year

How many days before the estimated date of birth do most women give birth?

7 days before

How many days after the estimated date of birth do most women give birth?

7 days after

What is ballottement?

passive movement of the unengaged fetus (16-18 weeks)

What is quickening?

1st recognition of fetal movements; feeling life (14-16 weeks)

Describe the characteristics of the cervix during pregnancy?

firm, nondistensible, closed structure that maintains the pregnancy/fetus within the uterus

Describe the characteristics of the cervix during labor?

soft, highly elastic tissue that dilates in preparation for birth

What is the Goodell sign?

softening of the cervical tip (6th week)

Which type of sign of pregnancy is the Goodell sign?

Probable sign

What produces estrogen and progesterone for the first 6 to 10 weeks of pregnancy until the placenta replaces its job?

corpus luteum

When does implantation bleeding often occur?

6-12 days after conception; when menstrual period might be expected to begin

What is the Chadwick sign?

Violet-blue color of vaginal mucosa and cervix

When is the Chadwick sign evident?

6-8 weeks

What is Leukorrhea?

white or grayish mucoid vaginal discharge with faint musty odor

What is the pH of pregnant vaginal secretions vs non-pregnant secretions?

3.5 - 6 pregnant, 4 - 5 non pregnant

What is Striae gravidarum?

stretch marks

How does total blood volume (TBV) change during pregnancy?

Increases rapidly during 1st half

How does cardiac output change during pregnancy?

Increases as a result of increased stroke volume, heart rate, and increased tissue demands for oxygen

How should blood pressure change during pregnancy?

Slight decrease

When does the total white blood cell count begin to increase during pregnancy?

as early as the 2nd month; (5k to 15k from 5k - 10k)

What is the effect of pregnancy on the chance of bleeding?

decreased chance of bleeding

What is the increased risk associated with blood coagulation during pregnancy?

Thrombosis

What are the hemoglobin ranges for a pregnant woman?

11-13

Fasting and non-fasting blood glucose range for pregnant woman>?

60-105 fasting, <120 post meal

What is the physiologic anemia of pregnancy?

hemodilution resulting in low hemoglobin and hematocrit

At what hemoglobin value is a pregnant woman considered anemic in the 1st or 3rd trimester?

less than 11

At what hemoglobin value is a pregnant woman considered anemic in the 2nd trimester?

less than 10.5

In what demographics may hemoglobin and hematocrit levels be higher?

high altitudes, tobacco abuse

Does respiratory rate change during pregnancy?

no; slight increase

What is pyrosis?

heartburn

What is the linea nigra?

pigmented line from the pubis region to the umbilical region

What trimesters result in difficulty sleeping for pregnant women?

2nd and 3rd

The thyroid and pituitary gland ----- during pregnancy

increase

What is the earliest biological marker of pregnancy?

hCG; quantitative serum testing