Pregnancy

Pregnancy

State of fertilization and developmental for one or more offspring within a woman's uterus 

Embryo

Term for developing humans up to 8 weeks after fertilization to 10 weeks of gestation

Fetus

Term used after 10 weeks of gestation 

First trimester

carries the highest risk of miscarriage (natural death of the embryo or fetus

Second trimester

development of the fetus is easily monitored

Third trimester

often approximates the point of viability (ability of fetus to survive without medical help and uterus)

Viability

ability of fetus to survive without medical help and uterus

Gravida

a pregnant female

Gravidity

scientific term for state of pregnancy 

Nulligravida

woman who has never been pregnant

Multigravida

woman in subsequent pregnancies

Parity

number of female has given birth

Para

Parity is abbreviated as?

Nulliparous

woman who has never given birth

Multiparous

woman who has had more than one live birth

2

1

If a woman is in her 2nd pregnancy, she is described as gravida __ and para _

Implantation

Placenta formation

Umbilical cord formation

Common pregnancy symptoms

What are the 4 anatomical changes

endometrial lining

Pregnancy begins when the developing embryo implants into the _______ of a woman's uterus

Bleeding

Most women don’t feel any different at this stage, but some may notice a small amount of ____—this is normal.

Decidua

After implantation or the embryo stick into the lining; the uterine endometrium is called the ______

Placenta

The _____ begins to form from both the decidua and parts of the embryo.

Decidua

Parts of embryo

Placenta forms from?

Embryo

Uterine wall

Placenta connects what parts?

Nutrient uptake

Waste elimination

Gas exchange via the mother's blood supply

What is the purpose of placenta aside from connecting the embryo to uterine wall

Umbilical cord

It connects the embryo or fetus to the placenta

Fetal development

The developing embryo undergoes tremendous growth and changes during the process of _________

Nausea and vomiting 

Excessive tiredness and fatigue

Craving unusual foods

Frequent urination, particularly during the night

Common pregnancy symptoms

1. Presence of hCG (human chorionic gonadotropin) in the blood and urine

2. Missed menstrual period

3. Implantation bleeding (implantation of embryo in uterus during 3rd to 4th week after last menstrual period)

4. Hegar’s sign (softening of the uterus)

5. Increased basal body temperature sustained over 2 weeks after ovulation

6. Chadwick sign (darkening of the cervix, vagina, and vulva) 

7. Godell’s sign (softening of the vaginal portion of the cervix)

8. Pigmentation of linea alba (linea nigra), darkening of the midline and abdomen skin. Discoloration by hormonal changes during middle of pregnancy

Early Medical Signs Pregnancy

1-12 weeks

How many weeks 1st trimester is

13-28 weeks

How many weeks 2nd trimester is

29-40 weeks

How many weeks 3rd trimester is

Highest

The first 12 weeks of pregnancy is considered the _____ chance for miscarriage, but drops significantly after this trimester.

brain

head

hands

feet

other organs

All major organs including __________ begin forming during fetal stage

Second trimester

What trimester is when the mother is more energized and put more weight since the symptoms subside

Second trimester

What trimester is when there is visible baby bump

Second trimester

What trimester is when the mother have more breast development

Second trimester

What trimester is when the movement of the baby can be felt

Quickening

it is also known as the movement of the baby that is felt

Third trimester

What trimester is the final weight gain of the mother since the baby is growing more rapidly

28 grams

How many grams do the baby add up in 3rd trimester

Third trimester

What trimester is when the women’s navel became more convex and body posture changes

Protein

Carbohydrates

In pregnancy, _____and _____ metabolism is affected 

Fetus and Placenta

Uterine contractile, Breast glandular tissue, Plasma protein, an Hemoglobin

1kg of extra protein is deposited into:

Fetal growth and deposition

Increased in nutrients is required for:

Steroid hormone

Lactogen

Cortisol

In nutrient metabolism, changes are caused by?

Liver metabolism

There is a increase in what metabolism that causes more gluconeogenesis that increase maternal glucose level

Gestational diabetes

Maternal insulin resistance might cause?

Gestational diabetes

It happens when women without previously diagnoses diabetes exhibit high blood glucose level during pregnancy esp. in 3rd trimester

Insulin receptors not working properly

What is the main cause of gestational diabestes

There is a presence of human parental lactogen that interferes with the insulin receptors

Why is insulin receptors not working properly?

3-10%

Gestational diabetes affect ____% of pregnancies depending on the population studies.

Screening

Blood samples

Gestational diabetes can be diagnoses through _______ during pregnancy; diagnostic tests detect inappropriately high level of glucose in ____

Large babies (leading to delivery issues)

Low blood sugar and jaundice in newborns

Seizures or stillbirth in severe cases

Possible effects of gestational diabetes

• Insulin binds to receptors on the cell membrane.

• This activates proteins inside the cell.

• GLUT-4 transporters move to the cell surface, bringing glucose inside.

• This leads to:

  • Glycogen formation (stored energy)

  • Glycolysis (breaking down glucose for energy)

  • Fatty acid production

Effect of insulin on glucose uptake and metabolism (Process)

Yes

Is gestational treatable or no?

Endocrine system

One of the hormonal changes is adjustment in what system?

HcG

Parathyroid

Adrenal

There is an increase in hormones including:

Progesterone

A hormone for relaxing smooth muscles

Human placental lactogen

What hormone is produced by placenta?

Enlarging uterus

Growing fetus

Placenta and amniotic fluid

Acquisition of fat and water retention

Weight gain happen due to:

5lbs (2.3 kg) to over 100lbs (45kg)

Weight gain varies from anywhere from ________

40% to 50%

In circulatory changes, plasma and blood volume slowly increase by ______

Systemic vascular system

In circulatory changes, what drops?

Common

Edema (swelling) of the feet is common or not common?

Hypercoagulable

Pregnant woman will also become _________, leading to increased risk for developing blood clots and embolisms

Aerobic exercise

Regular ________ during pregnancy appears to improve (or maintain) physical fitness

30

In absence of either medical or obstetric complications, the doctors advice an accumulation of _____ mins a day on most if not all days of the week 

1. vaginal bleeding

2. dyspnea before exertion

3. dizziness

4. headache,

5. chest pain,

6. muscle weakness 

7. preterm labor

8. decreased fetal movement

9. amniotic fluid leakage

10. calf pain or swelling (to rule out thrombophlebitis)

Contraindications for exercise include 

Increase

 Dietary intake should be _______for optional pregnancy outcome

Pre conception

During conception

Trimester

Diet for pregnant women varies according to

Changes in maternal body composition

Maternal support tissue

Product of conception

3 components of weight gain

Changes in maternal body composition

A component in weight gain where there is increased blood and fluid volume.

Maternal support tissue

A component in weight gain where there is growth of the uterus and breasts.

Product of conception

A component in weight gain where there are the fetus, placenta, and amniotic fluid

Intrauterine growth retardation

This happens when there is poor weight gain in the infant

28 to 40

25 to 35

11 to 25

11 to 20

Recommendations for Total and Rate of Weight Gain during Pregnancy
Pre-Pregnancy	BMI (WHO)	Total Weight Gain Range (lbs)	Rate of weight gain (mean range in lbs/wk)
Underweight	<18.5		1 (1 - 1.3)
Normal	18.5- to 24.9		1 (0.8 to 1)
Overweight	25.09 to 29.9		0.6 (0.5 to 0.7)
Obese (all class)	≥30		0.5 (0.4 to 0.)

Complete the table

1 (1 - 1.3)

1 (0.8 to 1)

0.6 (0.5 to 0.7)

0.5 (0.4 to 0.6)

Recommendations for Total and Rate of Weight Gain during Pregnancy
Pre-Pregnancy	BMI (WHO)	Total Weight Gain Range (lbs)	Rate of weight gain (mean range in lbs/wk)
Underweight	<18.5	28 to 40
Normal	18.5- to 24.9	25 to 35
Overweight	25.09 to 29.9	11 to 25
Obese (all class)	≥30	11 to 20

Complete the following

300

Calories:
Increase by ~____kcal/day to support healthy weight gain.

8

Protein:
Additional ___g/day (above normal needs) for:

5

Zinc:
Extra __ mg/day is recommended during pregnancy.

27

34

38

Iron (RNI):

• 1st trimester: __ mg/day

• 2nd trimester: __ mg/day

• 3rd trimester: __ mg/day

Blood volume

Fetal tissue development

Why is iron needed more during pregnancy

Ferrous sulfate

Iron is not met only on diet so ________ is given

30 to 60 mg

How many mg of ferrous sulfate should be given?

400

Folic acid is also inadequate, thus daily supplementation is needed with ____mcg

27g

300g

How many grams (RNI) of protein and water added?

maternal

paternal

Even before conception, nutritional and other factors, both from ______ and ________sides, may be playing a role in the determination of the eventual aging in an individual

spermatogenesis

oogenesis

Both ___________, in the father, and _________, in the mother, may be subject to mutations or disorders

Maternal nutrition

It is particularly essential during the pre-, peri-, and postnatal years to ensure the proper development and growth of the offspring

smoking

Evidence is now available that ______, through oxidant effects, can alter the genetic material in sperm

oxidant effects

Evidence is now available that smoking, through ______, can alter the genetic material in sperm

Hematological malignancy

The alteration in smoking effects may cause?

Vitamin C

Vitamin E

What vitamins are potent antioxidants

Oxidation

vitamins C & E are potent antioxidants that can protect the male germ against?

Male germ

vitamins C & E are potent antioxidants that can protect the ????

Childhood disease

Longer-term

Genes

A paternal diet depleted in antioxidant-containing fruits and vegetables may increase the risk of _______. This may also have _______ effects when the offspring is adult, depending on the ____affected

Mitochondria

It show a maternal mode of inheritance

Mitochondria

The mutation rate is higher than nuclei or mitochondria?

Mitochondrion

The potential effects of diet to protect or to enhance mutation are also greater in the ______

Mitochondrial disease

It is characterized by defects in the mitochondria and have been linked to disease  such as: