Fetal Development and Maternal Adaptation (Antepartum Period)

This set covers fetal stages, genetic terms, maternal physiological adaptations, signs of pregnancy, obstetric history (GTPAL), common complications (previa, ectopic, HG), and prenatal care interventions based on the lecture notes.

What is the definition of an Allele?

A different version of a gene, such as one allele from mom and one from dad.

During which weeks of pregnancy does the Embryonic stage occur?

Weeks $3 – 8$ of pregnancy.

What characterizes the Morula stage of development?

A solid ball of cells formed after the zygote divides several times.

What is the definition of Mosaicism?

When a person has two or more genetically different cell lines in the body.

What are the specific functions of the Placenta?

It provides oxygen and nutrients, removes waste, and produces hormones during pregnancy.

What is a Teratogen?

Anything that can harm fetal development, such as alcohol, certain medications, infections, or radiation.

Which embryonic layer forms the central nervous system and skin?

The Ectoderm.

Which embryonic layer is responsible for forming the skeletal, urinary, circulatory, and reproductive organs?

The Mesoderm.

Which embryonic layer forms the respiratory system, liver, pancreas, and digestive system?

The Endoderm.

What is the function of the Ductus venosus in fetal circulation?

It bypasses the liver and connects the umbilical vein to the inferior vena cava.

What is the function of the Ductus arteriosus in fetal circulation?

It bypasses the lungs and connects the main pulmonary artery to the descending aorta.

What is the anatomic opening between the right and left atrium in a fetus called?

The Foramen ovale.

What is Chadwick sign?

A bluish-purple color of the cervix or vagina resulting from increased blood flow during pregnancy.

What is Hegar sign?

Softening of the lower uterine segment during pregnancy.

Which assessment involves tapping the cervix and feeling the fetus rebound?

Ballottement.

Define Physiologic Anemia of Pregnancy.

A normal dilutional anemia caused by plasma volume increasing more than red blood cells.

What is Pica?

Craving or eating non-food items, such as dirt, clay, starch, or ice.

What is the clinical definition of Quickening?

The first fetal movements felt by the pregnant person, typically occurring around $16 – 20$ weeks.

What are the only signs that can determine a pregnancy with $100\%$ accuracy?

Positive signs (e.g., ultrasound, fetal heart tones, clinician-felt movement).

In terms of hCG levels, what value is considered positive for pregnancy?

Anything higher than $25\,mIU/mL$.

Which hormone is responsible for maintaining the corpus luteum and is the basis for pregnancy tests?

Human chorionic gonadotropin (hCG).

What is the primary role of Progesterone during pregnancy?

It supports the endometrium, inhibits uterine contractility, and assists in breast development for lactation.

Which hormone increases the flexibility of the pubic symphysis to permit pelvic expansion?

Relaxin.

What is the recommended total weight gain for a woman with a normal BMI ($18.5 – 24.9$)?

$25 – 35\,lb$.

What is the recommended total weight gain for an Obese patient (BMI of $30$ or higher)?

$11 – 20\,lb$.

What instructions should be given to a pregnant patient to manage Nausea and Vomiting?

Avoid an empty stomach, eat dry crackers in bed before arising, eat small frequent meals, and drink fluids between meals.

Which medication is a teratogen known to cause severe birth defects and carries a miscarriage risk?

Isotretinoin (Accutane).

What are the common fetal risks associated with Maternal Tobacco or Nicotine use?

Low birth weight, placental problems, and preterm birth.

Define the term Multigravida.

A person who has been pregnant more than once.

How is 'Para' defined in obstetric history?

The number of pregnancies that reached viability, usually around $20$ weeks or more, regardless of birth outcome.

What does each letter in the GTPAL acronym stand for?

G: Gravida, T: Term births, P: Preterm births, A: Abortions, L: Living children.

What are the major signs of Hyperemesis Gravidarum?

Inability to keep fluids down, weight loss, dehydration, electrolyte imbalance, ketonuria, tachycardia, and hypotension.

What is the most common cause of Spontaneous Abortion in the first trimester?

Chromosomal or genetic abnormality of the fetus.

What is the Hallmark NCLEX finding for an Ectopic Pregnancy?

Abdominal pain with spotting $6 – 8$ weeks after a missed period.

Where is the most common location for an Ectopic Pregnancy?

The fallopian tube.

What is the classic sign of Placenta Previa?

Painless, bright red vaginal bleeding after $20$ weeks gestation.

What is a major nursing precaution when Placenta Previa is suspected?

Do NOT perform a vaginal exam, as it can disrupt the placenta and cause massive hemorrhage.

When is an Amniocentesis typically performed?

At $14 – 16$ weeks gestation.

What is the purpose of Chorionic Villus Sampling (CVS)?

To detect chromosomal/genetic disorders (e.g., Down syndrome, Cystic Fibrosis) between $9 – 14$ weeks gestation.

When is RhoGAM routinely administered to an Rh-negative client?

Around $28$ weeks gestation and within $72$ hours after birth if the newborn is Rh-positive.

What do high levels of Alpha-Fetoprotein (AFP) suggest?

Neural tube defects (e.g., spina bifida), abdominal wall defects, wrong gestational age, or multiple gestation.

What determines a diagnosis of Gestational Diabetes in a $3$-hour Glucose Tolerance Test?

If two or more blood glucose values are elevated.

What is Cervical Insufficiency (Incompetent Cervix)?

A weak cervix that painlessly dilates too early, often treated with a cervical cerclage.

What is the preferred treatment for a pregnant client who tests positive for Group B Streptococcus (GBS)?

Prophylactic antibiotics, specifically Penicillin G, during labor.

Which drug is used to promote fetal lung maturity in cases of preterm labor before $34$ weeks?

Betamethasone (Celestone).

Define Couvade syndrome.

A sympathetic response of the partner to the female's pregnancy, where they may experience similar symptoms or emotions.

What is the primary psychological focus of a woman during her second trimester?

Developing attachment to the fetus, acknowledging the fetus as a separate entity (facilitated by quickening).

Describe the Lamaze method of childbirth.

A preparation method focused on breathing techniques, relaxation, concentration, and support person coaching.

How much water is a pregnant woman encouraged to consume daily?

At least $3\,qt$ of water daily.

What are the common tests included in a Maternal Biophysical Profile (BPP)?

Fetal heart rate monitoring, fundal height, and movement checks (specific to monitoring fetal well-being).