OB 1

! What hormone stimulates growth of breasts?

estrogen

! What hormone causes mammary gland maturation?

Progesterone

! What 2 things does estrogen do to the breasts?

Stimulates growth
Increases vascularity

! Lobules of the breast are clusters of \______

acini

What hormone is responsible for hyperpigmentation and striae?

Estrogen

! \_____ is the pre milk

Colostrum

! Colostrum is high in what?

antibodies and nutrients

! Physiologic alterations in breast size reach
minimal level \__ to \___ days after menstruation stops

5-7

! BSE is best carried out during which phase of menstrual cycle?

5-7 days after menstruation stops

! What is menarche?

the first menstrual period

! How is the first year of having a period?

Irregular

! Typical \# of days in menstrual cycle

28 days

! What are the 4 phases of the endometrial (menstrual) cycle and what is happening at each?

1. menstrual phase (shedding or bleeding)

2. proliferative phase (endometrial surface is restored. Body preparing for implantation)

3. secretory phase (producing projesterone, endometrium lining is fully mature, velvety soft and ready for egg)

4. ischemic phase (if there is not a feterilized egg and attached then the uterus becomes ischemic and dies off, following week begins bleeding)

! Prostaglandins are what?

Oxygenated fatty acids classified as hormones.

! Prostaglandins play what role?

Smooth muscle contractility

Modulation of hormonal activity

ovulation

! Is there much difference between male and female sexual responses?

No

! What are the 4 phases of sexual response?

excitement, plateau, orgasm, resolution

What is ovulation?

The release of an egg from the ovary

What are the 4 Cs of cultural competence?

Call, Cause, Cope, Concerns

Normal feedback regulation of the menstrual
cycle depends on an intact \_______

hypothalamic-
pituitary-gonadal mechanism.

The \______ of the uterus is uniquely
designed to expel the fetus and promote
hemostasis after birth

myometrium

! Definition of conception

Union of a single egg
and a single sperm

! Is conception an isolated event?

No, part of sequence

What is fertilization?

Sperm penetrates membrane surrounding ovum

! Where does fertilization take place?

outer third of the fallopian tube

What is implantation?

Attachment of the blastocyst to the endometrium

! Implantation occurs how many days after conception?

6-10

! Considered fertile for how many hours after ovulation?

24

! def capacitation

Removal of sperm's protective coating

How many days does pregnancy last and how is it calculated?

280 days. From first day of last menstrual period

What are the 2 fetal membranes that surround the developing embryo?

Chorion - fetal side
Amnion - umbilical cord

What is vernix?

cheese-like white substance found coating the skin of newborn human babies

Relationship to vernix to due date

Closer to due date less vernix, early more vernix

Umbilical cord has how many arteries and veins?

2 arteries and 1 vein

! Placenta definition

Metabolic exchange, ensuring 02 goes to baby and removes co2

! When is the placenta complete?

12 weeks

! What are the 4 hormones the placenta produces?

HcG

Human placental lactogen (hPL), also called human chorionic somatomammotropin (hCS)

Progesterone
Estriol

Estrogen and progesterone is produced by

placenta

! What is the name of one of the main estrogens produced by the placenta\>

Estriol

! One of the early functions of the placenta is what?

endocrine gland function

! During early pregnancy, progesterone is produced by \___, then gradually, this becomes the primary source

corpus luteum, placenta

! Progesterone does what?

maintains endometrium, inhibits contractions, stimulates maternal metabolism, and development of breast alveoli

! How can maternal positioning effect fetal circulation, what is worst and best position?

Worst - Lying on back

Best - lying on side

Lying on back the uterus compresses the vena cava

! Definition of viability

the capability of the fetus to survive outside
the uterus

What is the week range for viability?

22-25 weeks

! What is the ductus arteriosus?

The ductus arteriosus is a blood vessel that allows blood to bypass the pathway to the lungs and flow from the pulmonary artery to the aorta.

! What is the ductus venosus

connects the umbilical vein to the inferior vena cava

! What is the foramen ovale?

An opening between the right and left atria in the embryo and fetus.

! What is used to determine fetal lung maturity?

L/S ratio of surfactant

What test checks the L/S ratio

Amniocentesis

! What ratio do you want to L/S to be?

2:1

! When does the fetus reach lung maturity?

Middle of 3rd trimester

What period does teratogens have the greatest effect?

day 15-60

The organ systems and external features
develop during the \______ period, that is,
the third to the eighth week after fertilization.

embryonic

Define lightening

The head of the fetus descends into the woman's pelvis as it positions for delivery

When does lightening occur in pregnancy?

38-40 weeks or 2 weeks before birth

Define quickening

First movements of the fetus, occurs between 16 to 20 weeks gestation

What causes physiologic anemia of pregnancy?

Physiologic anemia of pregnancy is caused when plasma volume expands more than red blood cell volume, diluting the red blood cells and causing a fall in hemoglobin and hematocrit levels. It is not a true anemia.

What trimester is physiologic anemia of pregnancy most notable?

2nd trimester

A pregnant woman is considered anemic if the hemoglobin is less than \___ or the hematocrit is less than \____- during the 1st or 3rd trimester or if the hemoglobin is less than \_____ or the hematocrit is less than \____ in the 2nd trimester

11g/dl
33%

10.5g/dl
32%

Constipation in pregnancy is caused by smooth muscle relaxation and reduced peristalsis caused by what hormone?

increased progesterone

What causes urinary frequency in early pregnancy?

increased bladder sensitivity

Hyperpigmentation is stimulated by the \_______ which is increased during pregnancy

Anterior pituitary hormone melanotropin

What is melasma?

Also called chloasma. The "mask of pregnancy," a patchy tan-to-dark brown discoloration of the face.

Melasma begins at what week?

16th week and increased gradually until term

What is line nigra?

dark line of pigmentation from the umbilicus extending to the pubic area

What is striae gravidarum?

stretch marks

Where does striae gravidarum tend to appear?

abdomen, thighs, and breast

What is palmar erythema?

a normal symptom of pregnancy ;
red hands

What is pruritus gravidarum and where does it usually occur?

Itching, abdomen

What is the most common dermatologic symptom during pregnancy?

Itching

What are angiomatas?

Vascular spiders

What phase of pregnancy does stria gravidarum occur?

2nd half

What hormone is responsible for duct development for lactation?

Progesterone

What hormone is responsible for decreased smooth muscle tone causing constipation, heart burn, and varicose veins

progesterone

Role of hCG

maintains corpus luteum production of estrogen and progesterone until placenta takes over

What hormone maintains pregnancy?

progesterone

What hormone stimulates labor?

oxytocin and prostaglandins

role of oxytocin

Causes contraction
Inhibited by progesterone during pregnancy
Aids in milk ejection during breast feeding

What hormone stimulates milk production and ejection?

Production: Prolactin

Ejection: Oxytocin

Prostaglandins do what in labor?

dilate cervix and cause uterine contractions

What integumentary change persists after birth?

Striae gravidarum

Rhogam is given 72 hours after brith to a Rh \_____ mom with a Rh \___ baby

negative, postive

What trimester to screen for gestational diabetes?

2nd

Antipate quickening during what trimester?

2nd

What does GTPAL stand for?

1. Gravidity (number of pregnancies including present one)

2. Term births (longer than 37 weeks)

3. Preterm births (before 37 weeks)

4. Abortions or miscarriages

5. Living children

late preterm

34-36 weeks

early term

37-38 weeks

late term

40-40.6 weeks gestation

post term

reached 42 weeks gestation and beyond

Define gravita

Woman who is pregnant

What is the week range of term and preterm?

Term: 39 wks
Preterm: less than 39

In a twin pregnancy what is the gravita and para?

1

What does para mean?

number of deliveries

Define multigravida and multipara

Had 2 or more pregnancy

Completed 2 or more pregnancies

Define nulligravida

a woman who has never been pregnant

Define nullipara

woman who has not completed pregnancy with a fetus or fetuses who have reached 20 weeks gestation

What are causes of oligohydramnios?

premature rupture of membranes

fetal kidney abnormalities

Complications of oligohydramnios?

Pulmonary hypoplasia

Umbilical cord compression

When is a CVS performed?

10-12 weeks (1st trimester)