pregnancy

What abdominal skin changes are common during pregnancy?

Striae gravidarum = stretch marks; linea nigra = dark vertical abdominal line; diastasis recti = separation of the rectus abdominis muscles. EXAM: Diastasis recti = separation at the midline.

How does the uterus change during pregnancy?

It increases dramatically in size, from about 70 g at conception to nearly 1,100 g at delivery.

Around what gestational age does the uterus become externally palpable?

Around 12-14 weeks as it rises above the pelvic brim.

Why does urinary frequency occur during pregnancy?

The enlarging uterus and pregnancy-related urinary changes increase pressure on the bladder.

What is uterine dextrorotation?

A slight rotation of the enlarging uterus toward the right.

What causes round ligament pain?

Stretching of the uterine supporting ligaments as the uterus enlarges, typically causing lower-quadrant discomfort.

Where is the uterine fundus at approximately 12 weeks?

Near the symphysis pubis.

Where is the fundus at approximately 20 weeks?

Around the level of the umbilicus. HIGH YIELD.

How does fundal height relate to gestational age?

During mid-pregnancy, fundal height in centimeters roughly corresponds to gestational age in weeks. Example: 28 cm is approximately 28 weeks.

What happens to the cervix during pregnancy?

It softens and may develop a bluish/cyanotic coloration because of increased vascularity.

What happens to the vagina during pregnancy?

Increased vascularity can cause bluish coloration, and vaginal secretions increase.

What is leukorrhea in pregnancy?

A normally increased white vaginal discharge. Foul-smelling or pruritic discharge should be investigated.

Why can pregnancy increase susceptibility to vaginal candidiasis?

Pregnancy-related vaginal changes can create conditions favorable for Candida growth.

What breast changes normally occur during pregnancy?

Enlargement, tenderness, prominent veins, darker/larger nipples and areolae, and increased glandular tissue in preparation for lactation.

What are major effects of estrogen during pregnancy?

Promotes endometrial growth, enlarges the pituitary gland, increases prolactin, and contributes to a hypercoagulable state. EXAM: Pregnancy has increased thromboembolic risk.

What are major effects of progesterone during pregnancy?

Supports pregnancy, increases tidal volume/minute ventilation, relaxes smooth muscle, decreases GI motility, and relaxes the uterus and bladder. MEMORY: Progesterone = relaxation.

Why can progesterone contribute to GI symptoms?

Smooth-muscle relaxation and decreased GI motility contribute to constipation and reflux.

What is the major role of hCG?

Supports early pregnancy, including early progesterone support. Pregnancy tests detect hCG.

When does hCG typically peak?

During the first trimester.

What is an important metabolic effect of placental growth hormone?

It contributes to insulin resistance, helping explain increased gestational-diabetes risk.

What happens to thyroid physiology during pregnancy?

Thyroid-binding globulin and thyroid physiology change to support increased metabolic demands.

What does relaxin do during pregnancy?

Remodels reproductive connective tissue and increases joint/pelvic mobility. MEMORY: Relaxin = relax/remodel connective tissue.

What happens to erythropoietin during pregnancy?

Erythrocyte production increases, but plasma volume expands even more, contributing to physiologic anemia of pregnancy.

From what point is gestational age traditionally calculated?

The first day of the last menstrual period (LMP), NOT the actual conception date.

What is the expected duration of pregnancy based on LMP?

Approximately 40 weeks.

How can EDD be calculated from LMP?

LMP + 7 days - 3 months + 1 year. HIGH YIELD.

Why is ultrasound useful for dating pregnancy?

It helps establish or confirm gestational age, especially when LMP is uncertain or menstrual cycles are irregular.

What commonly causes nausea and vomiting early in pregnancy?

Hormonal changes, especially during the first trimester.

What causes breast tenderness and tingling early in pregnancy?

Pregnancy hormones stimulate breast growth and increased vascularity.

What causes round ligament abdominal pain?

Rapid uterine growth stretches the round ligaments.

What causes striae gravidarum?

Stretching and thinning of dermal connective tissue as the abdomen enlarges.

Why is constipation common during pregnancy?

Hormonal slowing of GI transit, pressure from the enlarging uterus, and sometimes iron supplementation.

What are Braxton Hicks contractions?

Intermittent, generally irregular contractions that do not represent progressive labor. EXAM: True labor becomes regular/progressive and produces cervical change.

Why can edema occur during pregnancy?

The enlarging uterus can reduce venous and lymphatic return from the lower extremities.

Why does heartburn occur during pregnancy?

Progesterone relaxes the lower esophageal sphincter, promoting reflux.

Why are hemorrhoids common during pregnancy?

Increased pelvic pressure, constipation, decreased venous return, and vascular changes.

What happens to respiratory rate during normal pregnancy?

Respiratory rate generally stays relatively stable while tidal volume/minute ventilation increases.

What should be established during an initial prenatal history?

Current pregnancy details, previous pregnancy outcomes, medical/surgical history, medications, family/genetic risks, social/environmental factors, substance exposure, mental health, safety, and infectious-disease risks.

What does GTPAL mean?

G = Gravida; T = Term births; P = Preterm births; A = Abortions/pregnancy losses; L = Living children. VERY HIGH YIELD.

What does gravida mean?

Total number of pregnancies, including the current pregnancy.

What does para describe?

Pregnancy outcomes reaching the defined gestational threshold rather than simply the number of babies delivered.

How are twins counted in parity?

Twins from one pregnancy represent one delivery event for parity, but each living child is counted under living children.

What should be assessed during the physical examination of a pregnant patient?

General appearance, height/weight, vital signs, head/neck, thorax/lungs, heart, breasts, abdomen, external genitalia, internal genitalia when indicated, and anorectal examination when appropriate.

Why should weight be monitored during pregnancy?

Inadequate or excessive weight changes may be associated with pregnancy complications or poor outcomes.

What position helps avoid supine hypotension later in pregnancy?

Avoid prolonged flat supine positioning; use left lateral tilt/side positioning to improve venous return.

What is supine hypotensive syndrome?

The gravid uterus compresses major vessels, especially the inferior vena cava, reducing venous return and causing hypotension, dizziness, weakness, or lightheadedness.

What should you do if a pregnant patient becomes dizzy while lying supine?

Reposition toward the LEFT side. MEMORY: Pregnant + dizzy while flat = LEFT.

Which infectious diseases are emphasized for pregnancy screening?

HIV, syphilis, hepatitis B, and other infections based on guidelines and individual risk.

Why is syphilis screening important during pregnancy?

Untreated maternal infection can cause severe fetal/neonatal complications; appropriate treatment greatly reduces risk.

Why is hepatitis B screening important during pregnancy?

Identifying maternal infection allows interventions that reduce perinatal transmission.