childbearing: exam 1

what is amenorrhea?

absence of menstrual flow

what might amenorrhea indicate?

health issues or pregnancy

what is menarche?

the first ever menstrual period

what is primary amenorrhea?

absence of menstruation by age 16

what is secondary amenorrhea?

absence of menses for 6 months or more in a woman who has previously menstruated

the absence of which two conditions must be evaluated by 13 years of age?

absence of both menarche and secondary sexual characteristics

the absence of which two conditions must be evaluated by 15 years of age?

absence of menses, regardless of normal growth and development (primary amenorrhea)

the absence of menstruation within how many years of breast development should be evaluated?

5 years of breast development

true or false-the cessation of menses for 6 months or more after a period of menstruation is secondary amenorrhea must be evaluated

true

what are 5 causes of amenorrhea?

pregnancy, anatomic abnormalities, endocrine dysfunction, chronic diseases, medications

what anatomic abnormality may result in amenorrhea?

outflow tract obstruction

which endocrine disorders may result in amenorrhea?

anterior pituitary disorders, polycystic ovarian syndrome, hypothyroidism, or hyperthyroidism

what is an example of a chronic disease that may result in amenorrhea?

type 1 diabetes

what is an example of a medication that may result in amenorrhea?

phenytoin (dilantin)

true or false-premenstrual pain and discomfort includes dysmenorrhea, premenstrual syndrome, premenstrual dysphoric disorder, and symptoms that may cluster before and after menstrual flow starts

true

what is dysmenorrhea?

pain that occurs during or shortly before menstruation

what is premenstrual syndrome?

cluster of psychological, physical and behavioral symptoms that occur in the luteal phase of the menstrual cycle and cause distress/disruption to the patient's life

what is premenstrual dysphoric disorder?

significant depressive symptoms occurring prior to menses during the majority of cycles, leading to distress or impairment (more severe than PMS)

true or false-symptoms associated with premenstrual pain and discomfort may cluster before and after menstrual flow starts

true

what cycle is primary dysmenorrhea associated with?

ovulatory cycle

what is the pathology of primary dysmenorrhea?

there is no known pathology

what age does primary dysmenorrhea manifest before?

20 years

what does primary dysmenorrhea arise from?

release of prostaglandins with menses

what substance is excessively released in primary dysmenorrhea and contributes to painful uterine contractions?

prostaglandin F2-alpha (PGF2α)

what effect does PGF2α have on the amplitude and frequency of uterine contractions?

it increases both the amplitude and frequency of uterine contractions

how does PGF2α affect uterine arterioles?

it causes vasospasm of the uterine arterioles

what condition is caused by vasospasm of uterine arterioles due to excessive PGF2α?

ischemia of the uterus

what type of pain results from ischemia caused by excessive PGF2α?

cyclic lower abdominal cramps

what are the systemic responses in response to the presence of PGF2α?

backache, weakness, GI symptoms, CNS symptoms

what GI symptoms occur in response to the presence of PGF2α?

anorexia, nausea, vomiting, and diarrhea

what CNS symptoms occur in response to the presence of PGF2α?

dizziness, syncope, headache, and poor concentration

what type of dysmenorrhea is menstrual pain that develops later than primary dysmenorrhea?

secondary menorrhea

when does secondary dysmenorrhea typically develop?

after age 25

what is secondary dysmenorrhea associated with?

a pelvic pathology, such as adenomyosis, endometriosis, pelvic inflammatory disease, and endometrial polyps

the first day of menstruation is designated as what day of the menstrual cycle?

day 1

what is the average duration of menstrual flow?

5 days

what is the average length of the menstrual cycle?

28 days

what day of the menstrual cycle does ovulation occur?

day 14

is a woman most likely to be fertile and become pregnant at the beginning, middle, or end of her menstrual cycle?

middle

what are two important hormones involved in the menstrual cycle?

estrogen and progesterone

what is conception?

union of a single egg and a single sperm

when and where does fertilization occur?

in the uterine tube within 24 hours of ovulation

what is a zygote?

fertilized egg cell

when does implantation occur?

6-10 days after conception

when does the germinal period occur?

first 2 weeks after conception

when does the embryonic period occur?

weeks 3 to 8

when does the fetal period occur?

week 9 to birth

which period is the most critical for development?

embryonic period

what is a teratogen?

substance that causes birth defects

how long does a typical pregnancy last for?

280 days (40 weeks)

which date is used to calculate the length of a pregnancy?

first day of last menstrual period

what surrounds the developing embryo/fetus?

two fetal membranes called the chorion and amnion

what two structures are connected by the umbilical cord?

baby and placenta (which is an organ in the mother's uterus)

what are two of the main components found in amniotic fluid?

fetal lung liquid and urine

what is the function of amniotic fluid?

to provide thermoregulation, a source of oral fluid/repository for waste, assist with fluid/electrolyte homeostasis, provide for fetal cushioning, musculoskeletal development, antibacterial factors, and auditory stimulation

what is oligohydramnios?

too little amniotic fluid (less than 300 mL)

what is polyhydramnios?

too much amniotic fluid (greater than 2 liters)

what blood vessels make up the umbilical cord?

2 arteries and 1 vein

what is the role of the arteries that make up the umbilical cord?

carry blood with high carbon dioxide and waste products from the fetus to the placenta

what is the role of the vein that makes up the umbilical cord?

carries freshly oxygenated and nutrient-rich blood from the placenta back to the fetus

what is wharton's jelly?

soft substance that cushions the umbilical cord vessels to prevent compression

what is a nuchal cord?

when the umbilical cord is wrapped around the baby's neck

what is a true knot?

a knot in the umbilical cord

when is the placenta fully developed?

week 12

how much of the uterine surface does the placenta cover by 20 weeks?

half of the uterine surface

which four hormones are produced by the placenta?

hCG, hCS, progesterone, and estriol

what is the role of human chorionic gonadotropin (hCG)?

human chorionic gonadotropin, the basis for pregnancy tests and is detectable in maternal serum by 8-10 weeks

what is estriol?

one of the main estrogens produced by the placenta that stimulates uterine growth and uteroplacental blood flow

how does the placenta function in respiration?

provides oxygen to the fetus and removes carbon dioxide

what nutritional role does the placenta play?

transfers nutrients from the maternal blood to the fetus

what excretory function does the placenta perform?

removes waste produces from the fetus

how does the placenta function is storage?

stores nutrients like glycogen for the fetus

what is placental function dependent on?

maternal blood pressure and adequate circulation

how does maternal blood pressure affect placental function?

low blood pressure can decrease blood flow to the placenta, impairing its ability to deliver oxygen and nutrients

true or false-the placenta has two sides: the side attached to your uterus (maternal side) and the side closest to your baby (fetal side)-the side attached to your uterine wall is a deep reddish blue color, while the side facing your baby is gray

true

which hormone is the earliest biochemical marker for pregnancy?

human chorionic gonadotropin (hCG)

how early can pregnancy tests detect hCG?

7-8 days before the expected menses

what are the types of pregnancy tests available?

serum, urine, and quantitative serum testing

by what week is the fetal heart completely developed?

by the end of week 8 (embryonic stage)

what are the special circulatory pathways in the fetus?

ductus arteriosus, ductus venosus, and foramen ovale

how does fetal hemoglobin differ from maternal hemoglobin?

fetal hemoglobin has a higher affinity for oxygen and carries 20-30% more oxygen than maternal hemoglobin

what is the normal fetal heart rate (FHR)?

110-160 bpm

when do pulmonary surfactants develop in the fetus?

by 32 weeks

what is the L/S ratio used for?

determining fetal lung maturity

when does the fetus begin swallowing amniotic fluid?

5th month

what is meconium, and when is it passed?

first stool passed by the newborn usually within 24 hours after birth

what is stored in the fetal liver?

glyocen

why can't coagulation factors be synthesized in the fetal liver?

the fetal liver lacks vitamin k

what makes up most of the amniotic fluid?

fetal urine

what does oligohydramnios indicate about the infant?

possible renal dysfunction

when is sucking present in the fetus?

week 12

at what week can the fetus taste?

week 16

when does the fetus begin responding to sound?

by week 24

when does the fetus develop the ability to see?

by week 26

when is insulin produced in the fetus?

by week 20

what happens if the mother has hyperglycemia?

the fetus can develop hyperglycemia

when can fetal sex be determined by ultrasound?

week 12

when can fetal movements (quickening) typically be felt?

20 weeks (or as early as 16 weeks)

what is vernix?

cheesy material that protects the fetus' skin

what is lanugo?

soft, fine hair covering a fetus