NC chapters 23 & 42

Follicle stimulating hormone

Stimulates follicle and leads to the maturation and release of the oocyte

Anterior pituitary gland

Releases FSH (following stimulation from gonadotropin releasing factor) and and LH

Luteinizing hormone

Stimulates the release of the egg

Corpus luteum

Remaining structure after the egg has been released. Secretes estrogen, progesterone, and inhibin, preventing further development of follicles.

Prostaglandins

Produced by the placenta. Have hormone like effects, and stimulate contraction along with oxytocin during delivery

Homan chorionic gonadotropin hormone (hCG)

Hormone transmitted to the corpus luteum that pregnancy has begun. Corpus produces hormones to support pregnancy until placenta can assume this function

Gestational period

Time for the fetus to develop into in utero. Can be calculated by taking the first day of the last menstrual cycle, adding 1 year, subtracting 3 months, and adding 7 days.

Changes in mother during pregnancy

Uterus increases in weight and size

• Puts pressure on GI tract. This along with progesterone decreasing GI motility leads to constipation/heartburn

Kidney volume increases by 30%

Skin/hair darkening

30-50% increase in blood volume

• Increases iron demand: Prenatal vitamins

• RBC and WBC increase

30-50% increase in cardiac output

Primigravida

Women who is pregnant for the first time

Primipara

A women who has had only one delivery

Multigravida

A women who has had more than one pregnancy, regardless of outcome

Multipara

Women who has had more than one delivery

Grand multipara

More than five deliveries

Nullipara

A women who has never delivered

Supine hypotensive syndrome

Highest risk in the third trimester, uterus compresses the inferior vena cava

Peripartum cardiomyopathy

Form of heart failure that occurs in the last month of pregnancy, or up to five months after giving birth

• Similar to preeclampsia, differentiated by history of hypertension as opposed to acute onset, proteinuria absence, BP fluctuations

gestational hypertension

BP of 140/90 and greater that presents after the 20th week, or persists postpartum

Preeclampsia

Hypertension with any of the following

• proteinuria

• Low platelet count

• Renal insufficiency

• Impaired liver function

• Pulmonary edema

• Headache/dizziness/syncope

• Visual disturbances

May last up to 10 days post delivery

Preeclampsia with severe features

BP greater than 160 mmhg systolic or 110 mmhg diastolic

Hyperemesis gravidarum

Nausea/vomiting more severe/persistent than morning sickness. Most common between 4-16 weeks of pregnancy

Rh sensitization

When a Rh - woman is impregnated by an Rh + man and the fetus is Rh +, the mother can develop antibodies that can attack the fetus. More common after the first pregnancy.

Group B strep test

Those without adequate prenatal care are screen between 35 and 37 weeks

Cholestasis

Blockage of bile flow from the liver to gallbladder, leading to a buildup of bile acids in the bloodstream

TORCH Syndrome

Refers to infections that occur in neonates as a result of organisms passing through the placenta from the women to the fetus

Toxoplasmosis, other agents, rubella, cytomegalovirus, and herpes simplex

Cytomegalovirus

Herpes family, can remain dormant for years

• High fever, chills, headache, malaise, extreme fatigue, enlarged spleen

• Newborns are susceptible to lung, blood, liver problems, swollen glands, rash, and poor weight gain

Abortion

Expulsion of the fetus at any point before the 20th week of gestation

Recurrent pregnancy loss

Three or more consecutive pregnancies that end in miscarriage

Threatened abortion

Abortion that is attempting to take place

Missed abortion

Fetus dies during the first 20 weeks of gestation but remains in utero

Abruptio placentae

Premature partial or incomplete separation of the normally implanted placenta from the walls of the uterus, most commonly during the last trimester of pregnancy

• Sudden onset of severe abdominal pain, often radiating into the back

• decreased fetal movement/heart tones

• Signs of shock, out of proportion to the apparent volume of blood loss

Placenta previa

Placenta is implanted low in the uterus and can partially or fully obscure the cervical canal

-leading cause of painless vaginal bleeding in the second or third trimesters

First stage of labor

Begins with the onset of labor pains, ends with the cervix being fully dilated

Second stage of labor

Full cervical dilation to delivery of the fetus

Third stage of labor

Involves the separation of the placenta from the uterine wall and expulsion of the placenta from the uterus

Lochia

Vaginal discharge following delivery, normally blood and mucus

Preterm labor

Contractions and effacement between the 20th week and 37th week of gestation

Uterine rupture

Typically presents as women in active labor with weakness, dizziness, and thirst. Strong and painful contractions followed by slackening contractions and sharp, tearing pain

Post term pregnancy

delivery later than 42 weeks

Fetal macrosomia

Large fetus, generally more than 4500 G (9 lbs)

Amniotic fluid embolism

Amniotic fluid and fetal cells enters the mothers circulatory system, leading to an allergic response

• Hypotension, respiratory distress, seizures, cyanosis

Polyhydramnios

Condition of too much amniotic fluid, typically greater than 1 pint (500 mL)

Oligohydramnios

Condition in which the volume of amniotic fluid is smaller than expected

Frank presentation

Hips flexed and knees extended, with the buttocks as the presenting part

Incomplete breech presentation

One of both hips and knees extended, with one or both feet as the presenting part

Complete breech presentation

Hips and knees both flexed, with buttocks as the presenting part

Transverse presentation

Fetus lies crosswise in the uterus, cannot be delivered in the field

Footlong breech

One or both feet dangle down through the vaginal opening. C section

Deflex presentation

Face or brow presents instead of head. C section

McRoberts maneuver

Hyperflex the women’s legs slightly to her abdomen, apply suprapubic pressure, and gently pull of the fetuses head

Postpartum hemorrhage

blood loss exceeding 1 pint (500 mL) during the first 24 hours post deliver.

Uterine atony

Inability of the uterus to contract after childbirth

Maternal physiologic changes during pregnancy

40% increase in blood volume

15-20 BPM increase in pulse rate

In trauma, RR less than 20 in insufficient

Bartholin abscess

Develops from a cyst in the bartholin glands, which run on either side of the vagina and secrete mucus

Candida albicans

Common fungal cause of vaginal yeast infections

cystitis

Infection of the bladder

Endometriosis

Presence of tissue outside the uterus that resembles the endometrium in both structure and function

Dysfunctional uterine bleeding

Bleeding, abnormal in amount or frequency, that is due to hormonal interruptions during the menstrual cycle