MCN 2.2

What refers to the number of pregnancies that reached viability, regardless of whether the infants were born alive or not?

**Para**

What refers to a woman who is or has been pregnant?

Gravida

What refers to a woman who is pregnant for the first time?

Primigravida

What refers to a woman who has given birth to one child past age of viability?

Primipara

What refers to a woman who has been pregnant previously?

Multigravida

What refers to a woman who has carried two or more pregnancies to viability?

Multipara

What refers to a woman who has never been and is not currently pregnant?

Nulligravida

What is the OBSTETRIC SCORE?

G P (T P A L M)

In OBSTETRIC SCORE, which refers to a number of pregnancies and it includes current and previous pregnancies, whether or not successfully delivered

Gravida

In OBSTETRIC SCORE, which refers to a Number of deliveries, alive or stillborn, that reached viability at 20 week?

Paragravida

In OBSTETRIC SCORE, which refers to a number of deliveries, alive or stillborn, that reached 37 to 42 weeks and also referred as full term?

> Twins, triplets, and so on, counted as 1

Term

In OBSTETRIC SCORE, which refers to a number of deliveries, alive or stillborn, from viability at 20 weeks to less than 37 weeks?

> Twins, triplets, and so on, counted as 1.

Pre-Term

In OBSTETRIC SCORE, which refers to a number of deliveries less than 20 weeks, including spontaneous or induced abortions

Abortion

In OBSTETRIC SCORE, which refers to a number of currently living children?

Living

In OBSTETRIC SCORE, which refers to a number of multiple pregnancies?

> Twins, triplets, and so on, counted as 1

Multiple Pregnancy

T/F: TPALM is for deliveries. The baby must be delivered.

TRUE

In GP TPAM, multiple pregnancies count as?

1

T/F: In (T P A L M), L must be counted individually to see who is alive.

TRUE

t/f: (T P A L M): The L part is also the reason why the mother’s OB Score to change every second of the day because one child can die which will change the whole OB score.

TRUE

What are the PSYCHOLOGIC CHANGES OF PREGNANCY?

* Reproductive Changes
* Integumentary Changes
* Systemic Changes

Which changes in REPRODUCTIVE CHANGES is the Increase in length, depth, width, and weight and this growth is due to muscle fibers which aids in the stretching

**Uterine Changes**

What refers to the settling of the fetal head to prepare for birth?

Lightening

Fundus of the uterus usually remains midline during pregnancy, but may be pushed slightly to the right due to?

larger bulk of sigmoid colon on the left

Which refers to an extreme softening of the lower uterine segment revealed bimanual examination by week 6 of pregnancy?

**Hegar’s sign**

Which Uterine contractions begin as early as week 12, and is present throughout the rest of the pregnancy.

> May be mistaken for true labor contractions and is often called false labor

**Braxton-Hick’s Contractions**

T/F Labor Contractions: When it begin and remain irregular (no right time)

FALSE, Begin irregularly but become regular and predictable

T/F Labor Contractions: Begin irregularly but become regular and predictable

TRUE

T/F Labor Contractions: Felt first in the lower back and sweep around to the abdomen in a wave

TRUE

T/F Labor Contractions: Felt first abdominally and remain confined to the abdomen and groin

FALSE, Felt first in the lower back and sweep around to the abdomen in a wave

T/F Labor Contractions: Continue no matter what the woman’s level of activity.

TRUE

T/F Labor Contractions: Often disappear with ambulation and sleep Ask the patient to try walking or rest. If the contractions disappear with either activity or rest, then it is false labor.

FALSE, Continue no matter what the woman’s level of activity.

T/F Labor Contractions: Increase in duration, frequency, and intensity

TRUE

T/F Labor Contractions: Do not increase in duration, frequency, or intensity.

FALSE, Increase in duration, frequency, and intensity

T/F Labor Contractions: Achieve cervical dilation If IE is applied, the cervix dilates which may be dangerous the baby is not in term.

TRUE

T/F Labor Contractions: Do not achieve cervical dilation. The cervix does not dilate.

FALSE, Achieve cervical dilation If IE is applied, the cervix dilates which may be dangerous the baby is not in term.

Which Amenorrhea is due to suppression of FSH Impregnation has occurred

> The hormones of the woman remains high, therefore no feedback

During pregnancy

Which Amenorrhea is Heralds onset of menopause

> Uterine infection, climate change, chronic illness, or stress

Without pregnancy

Which becomes more vascular and edematous in pregnancy?

cervix

What is called to a tenacious coating of mucus that fills the cervical canal which seal out bacteria during pregnancy and help prevent infection in the fetus and membrane?

**operculum**

T/F: The tenacious coating of mucus increases which hardens and seals the cervical opening.

TRUE

What is called to the softening of the cervix during pregnancy?

**Goodell’s sign**

T/F: In Vaginal Changes, Vagina during pregnancy become hypertrophic and is enriched with glycogen, which results in white discharges.

TRUE

What is the pH level of vaginal secretions during pregnancy that favors the growth of candida albicans?

**pH of over 7 to 4 or 5**

What does it favors when the Vaginal secretions during pregnancy fall from a pH of over 7 to 4 or 5?

**growth of candida albicans**

What is called when vaginal walls during pregnancy changes from light pink to deep blue?

Chadwick’s sign

T/F: In Ovarian Changes, Ovulation stops due to active feedback mechanism of estrogen and progesterone.

TRUE

T/F: In Ovarian Changes:


1. Corpus luteum later in pregnancy
2. Placenta early in pregnancy

FALSE


1. early
2. later

Which refer to a rule of measuring the symphysis fundal height measurement, though not documented to be thoroughly reliable?

**MCDONALD’S RULE**

Which refer to the easy method of determining fetal growth in uterus and indicates typical milestones?

**MCDONALD’S RULE**

Where does the non-pregnant woman’s uterus hides?

**Symphysis pubis**

What week is the fundic height measurement begins?

12 weeks

What it means if the fundic height is in the umbilicus?

it is approximately 20 weeks

What it means if the fundic height is in the typhoid process which involves feelings of shortness of breath?

it is already 36 weeks

What week when it has lower fundic height because there is already lightening or engagement?

40th week

What refers to the pink or reddish streaks on sides of abdominal walls?

**Striae gravidarum (stretch marks)**

What refers to due to rupture and atrophy of connective layer of skin as the abdominal wall stretches

**Striae gravidarum (stretch marks)**

What do you call when the Striae gravidarum (stretch marks) lightens to a silvery-white color weeks after birth

striae albicantes

What does the Gravidarum mean?

pregnant

Which may appear to be protruding as a round bump at the center due to stretching of the abdomen?

Umbilicus

T/F: In Extra Pigmentation, Once the baby has been delivered, the high hormones will decrease, therefore, it will fade

TRUE

Which extra pigmentation is a brown line from the umbilicus to the symphysis pubis?

Linea

Which extra pigmentation are darkened areas on face, particularly cheeks and nose?

Melasma

T/F: Changes in breasts, may experience feeling of fullness, tingling, or tenderness due to __increased stimulation of breast tissue by high estrogen level__

TRUE

Why does Breast size increases?

hyperplasia of mammary alveoli and fat deposits

What happens to the areola in changes in breasts?

Areola darkens in color, and diameter increases from 3.5 to 5 or 7.5 cm

Which can be expelled from the nipples as early as 16th week in changes in breasts?

Colostrum

T/F: Colostrum is the precursor for breastmilk

> The colostrum is like water and should not be taken by the newborn

TRUE

T/F: It is normal to have feelings of shortness of breath during the third trimester especially if the **fundus has reached the xiphoid process** because it *compresses the diaphragm and the enlargement of the uterus*.

TRUE

In early pregnancy, what causes the body temperature when slightly increases?

progesterone from the CL (corpus luteum)

From 16 weeks onward, what causes the temperature decreases to normal?

placental take-over

What is the amount of blood loss after birth?

**300 to 1000 ml**

T/F: The Blood volume increases from 30% - 50 %

TRUE

The fetus requires iron to grow coming from the mother wherein it would normally require ____ mg to grow.

350 to 400

There is an increase in the mothers RBC, therefore needing another ____

400mg

Less absorption of iron because a pregnant woman has less ___

less gastric acidity

T/F: Cardiac output also increases by 25% to 50%, therefore, the heart rate also increases by about 10 beats per minute

TRUE

What is common during pregnancy and is due to increased SNS stimulation (diaphragm is caught in between) and increased thoracic pressure

Palpitations

Which refers to Pregnancy-induced hypertension?

Pre-eclampsia

Is it normal to have high BP during pregnancy even though there is a normal blood volume increase?

FALSE

What happens when the placenta is fully functioning around 20 weeks AOG?

BP will be lessened by 5-10 mmHg

What refers to the weight of the growing uterus presses the vena cava against the vertebrae, obstructing blood flow from the lower extremities?

Supine hypotension syndrome

What safeguards the mother from major bleeding especially during delivery?

Fibrinogen

Which are the supply energy to the fetus?

Lipids and cholesterol

Which is mainly used by the fetus for growth and development and decreases?

Protein

Which causes a fluid-shift from in to out of the cell (fluid comes out of cell).

> It’s a normal occurrence which causes the common ankle & foot edema (pagmanas) among pregnant women

Low protein

In Gastrointestinal System what causes morning sickness, nausea and vomiting?

increasing levels of HCG, estrogen, and progesterone and decreasing glucose

What leads to heartburn, constipation, and flatulence?

Slow intestinal peristalsis and emptying time

Which hormone is responsible when due to the increase of uterus, it pushes the GI tract organs to the back and into the sides of the abdomen?

relaxin hormone

What is produced from inside from the ovary, creating the relaxation of the normal peristaltic movement or the GI movement of the body?

Relaxin hormone

What causes subclinical jaundice or symptom of generalized itching?

reabsorption of bilirubin into the maternal bloodstream

What is the amount of urine output during pregnancy?

increases 60% to 80%

What is the total body water during pregnancy?

increases 7.5 L

Why is there an increase in urination and body water?

* High estrogen & progesterone
* Compressed bladder and ureter due to the enlargement of uterus size
* Increase in blood volume (30- 50%)
* Postural influences (changing center of gravity due to enlarging uterine size)

What requires when building the fetal skeleton and causes women to develop leg cramps?

Increased calcium and phosphorus

What hormone causes the gradual softening of pelvic ligaments and joints?

relaxin and progesterone

What causes back pain to pregnant women?

Lordotic gait

What is the most striking change in Endocrine System?

addition of the placenta

What increases during pregnancy?

activity of mother’s adrenal glands

Which is believed to suppress an inflammatory reaction against the foreign protein of the fetus?

Adrenal Glands

Which E gland changes in Early in pregnancy is decreased insulin production because of heavy fetal demand for glucose and after 1st trimester, increased insulin production because of insulin antagonist properties of estrogen, progesterone, and human placental lactogen?

Pancreas