Maternal Nursing: The Normal Antepartal and Intrapartal Period

Comprehensive vocabulary flashcards covering the normal antepartal and intrapartal periods, including maternal physiologic adaptations, diagnostic signs, pelvic assessment, and labor mechanisms.

Antepartal Period

The period of pregnancy extending from conception until the onset of labor, also called the prenatal period, during which the woman is referred to as a gravida.

Organogenesis

The rapid developmental process during the first trimester (specifically weeks 3 through 8) where the three primary germ layers differentiate to form the foundational structures of all major internal organs and organ systems.

Fundal Height

The distance measured in centimeters from the pubic bone to the top of the uterus (fundus) to assess fetal growth and amniotic fluid volume.

Hegar's Sign

A probable sign of pregnancy characterized by the softening and easy compressibility of the lower uterine segment (the isthmus), typically identified between weeks 6 and 12 of gestation.

Goodell's Sign

A probable sign of pregnancy characterized by significant softening of the cervix caused by increased pelvic vascularity, shifting from the consistency of the tip of the nose to that of an earlobe.

Chadwick's Sign

A probable sign of pregnancy characterized by a bluish, purplish, or violet discoloration of the vaginal mucosa, cervix, and labia due to venous congestion and increased vascularity.

Braxton-Hicks Contractions

Intermittent, irregular, and painless abdominal contractions felt as tightening around month 4 and more pronounced at 8 months; they serve as false or practice labor contractions that do not dilate the cervix.

Ballottement

A physical exam technique and probable sign of pregnancy detected at 4 to 5 months where tapping the cervix or lower abdomen causes the fetus to rebound against the examining fingers.

Leukorrhea

An increased whitish, mucoid, non-foul, and non-pruritic vaginal discharge prompted by elevated estrogen levels that increases vaginal acidity to protect against bacterial invasion.

Human Chorionic Gonadotropin (hCG)

A hormone secreted by the trophoblast/chorion of the placenta whose primary function is maintaining the corpus luteum in early pregnancy; it is detectable in serum by 8 to 10 days and urine by 10 to 14 days after missed menses.

Human Placental Lactogen (hPL / hCS)

A placental hormone that acts as a major insulin antagonist and diabetogenic agent in pregnancy, altering maternal metabolism to supply glucose to the fetus and predisposing to gestational diabetes mellitus.

Supine Hypotensive Syndrome

A drop in blood pressure and cardiac output occurring when a pregnant woman lies flat on her back, caused by the gravid uterus compressing the inferior vena cava and decreasing venous return; relieved by the left lateral recumbent position.

Physiologic Anemia of Pregnancy

A pseudoanemic state resulting from hemodilution, where maternal plasma volume increases by up to $50\%$ while red blood cell volume increases by only $30\%$, causing a modest decline in measured hemoglobin and hematocrit concentrations.

Homans' Sign

A screening maneuver for deep vein thrombosis indicated by calf pain upon forced dorsiflexion of the foot with the leg extended or flexed; historically used but considered unreliable in modern practice.

Ptyalism

An excessive secretion of saliva associated with nausea and increased estrogen levels during pregnancy, appearing at 2 to 3 weeks and resolving after delivery.

Pyrosis

Heartburn or a burning retrosternal sensation caused by progesterone-mediated relaxation of the cardiac sphincter, delayed gastric emptying, and esophageal reflux from upward displacement of the stomach.

Chloasma

Irregular brownish hyperpigmented patches appearing across the cheeks, nose, and forehead, commonly referred to as the 'mask of pregnancy,' caused by elevated melanocyte-stimulating hormone.

Linea Nigra

A pigmented dark line extending along the midline of the abdomen from the symphysis pubis up to the xiphoid process, induced by hormonal increases in estrogen and melanocyte-stimulating hormone.

Striae Gravidarum

Silvery or pinkish stretch marks that develop on the abdomen, thighs, and breasts due to mechanical stretching and adrenal hypertrophy in pregnancy.

Lordosis

An exaggerated inward curvature of the lumbar spine (swayback) that develops as the center of gravity shifts forward over the lower back, resulting in characteristic pregnancy-related backache and altered balance.

Couvade Syndrome

A condition in which an expectant partner develops sympathetic pregnancy-related physical and emotional symptoms, such as weight gain, nausea, fatigue, and food cravings, without being biologically pregnant.

Presumptive Signs of Pregnancy

Subjective symptoms experienced and reported directly by the woman (e.g., amenorrhea, nausea and vomiting, fatigue, breast tingling, quickening) that suggest but do not diagnose pregnancy.

Probable Signs of Pregnancy

Objective findings noted by an examiner on physical or laboratory examination (e.g., Hegar's sign, Goodell's sign, Chadwick's sign, ballottement, positive pregnancy test) that strongly indicate pregnancy but are not absolute proof.

Positive Signs of Pregnancy

Definitive clinical evidence directly originating from the fetus that confirms pregnancy beyond doubt, including fetal heart tones, ultrasound visualization of the fetus, and fetal movement palpated by a clinician.

Roll-Over Test

A predictive clinical screening test performed between 28 and 32 weeks where maternal blood pressure is compared in the left lateral recumbent position versus the supine position; a rise in diastolic pressure greater than $20\,\text{mm Hg}$ indicates a high risk for pregnancy-induced hypertension.

TPALM System

A standardized clinical system for documenting obstetric history, representing Term births ($\ge 37$ weeks), Preterm births ($20$ to $36\,\frac{6}{7}$ weeks), Abortions ($< 20$ weeks), Living children, and Multiple gestations.

Gravida

A woman who is currently pregnant or has been pregnant in the past, reflecting the total number of pregnancies regardless of duration or outcome.

Parity

The number of pregnancies carried to the point of fetal viability ($20$ to $24$ weeks of gestation or greater), regardless of whether the infants were born alive or stillborn.

Naegele's Rule

A standard calculation used to estimate the date of delivery: add 7 days to the first day of the last menstrual period (LMP), subtract 3 calendar months, and add 1 year.

McDonald's Rule

A clinical formula for estimating gestational age based on fundal height (FH) in centimeters: $\text{AOG in weeks} = \frac{\text{FH} \times 8}{7}$ and $\text{AOG in months} = \frac{\text{FH} \times 2}{7}$.

Leopold Maneuvers

A systematic four-step abdominal palpation sequence (Fundal Grip, Lateral Grip, Pawlik's Grip, and Pelvic Grip) used to assess fetal lie, presentation, position, attitude, and engagement.

True Pelvis

The lower, bony canal bounded superiorly by the linea terminalis and pelvic inlet, consisting of the inlet, cavity, and outlet, through which the fetus must navigate during birth.

Diagonal Conjugate

The anteroposterior diameter extending from the inferior border of the symphysis pubis to the sacral promontory, measured clinically during pelvic examination (adequate size: $\ge 12.5\,\text{cm}$).

Obstetric Conjugate

The smallest anteroposterior diameter of the pelvic inlet, measured from the inner posterior surface of the symphysis pubis to the sacral promontory; estimated by subtracting $1.5\text{ to }2.0\,\text{cm}$ from the diagonal conjugate (adequate size: $\ge 10.5\,\text{cm}$).

Pelvis Classification

The structural categorization of the female pelvis into four types: Gynecoid (round, ideal for birth), Android (heart-shaped, male-like), Anthropoid (oval with deep AP diameter), and Platypelloid (flat with wide transverse diameter).

Lightening

The premonitory dropping or descent of the fetal presenting part into the true pelvis prior to labor onset, occurring around 2 weeks before labor in primigravidas and often immediately before or during labor in multigravidas.

Cervical Effacement

The shortening, thinning, and eventual obliteration of the cervical canal from its baseline length down to paper-thin margins, quantified clinically as a percentage from $0\%$ to $100\%$.

Cervical Dilatation

The progressive enlargement and widening of the external cervical os, measured in centimeters from $0\,\text{cm}$ (closed) to $10\,\text{cm}$ (fully open).

Bandl's Ring

A pathologic retraction ring visible as an abdominal groove between the actively contracting upper uterine segment and distended lower segment, indicating obstructed labor and impending uterine rupture if uncorrected.

Phases of Uterine Contraction

The three components of a contraction waveform: the increment (longest phase of increasing tension), the acme (the peak or apex of highest intensity), and the decrement (the period of relaxation).

Duration of Contraction

The elapsed time measured in seconds from the beginning of the increment to the completion of the decrement of the same contraction wave, typically reaching up to $90\,\text{seconds}$ in transition.

Frequency of Contraction

The timing interval measured from the beginning of one contraction to the beginning of the subsequent contraction, typically expressed in minutes.

Ferguson Reflex

The maternal involuntary urge to bear down stimulated by mechanical stretch receptors in the pelvic floor when the presenting part reaches station $+1$ or lower with complete cervical dilation.

Engagement

The cardinal mechanism of labor whereby the biparietal diameter (the greatest transverse diameter of the fetal head) successfully traverses the pelvic inlet, fixing the head at station 0.

Ritgen's Maneuver

An obstetric technique to control the delivery of the fetal head and protect the perineum by exerting upward forward pressure on the fetal chin through the perineum with one hand while the other hand controls the occiput.