making babies exam 2

what is the leading cause of maternal and infant illness/death?

preeclampsia and eclampsia

what is the difference between preeclampsia and eclampsia?

eclampsia includes seizures

if a mother is Rh-, what may she be given at 28 weeks and within 72 hours after delivery to prevent Rh+ antigens from attacking any future pregnancies?

RhoGam (shot)

placental previa

when the placenta is covering a part of or the entire cervical opening

symptoms of placental previa

painless, heavy bleeding around 28 weeks

macrosomia

large baby due to excess glucose as a result of a mother who has gestational diabetes

placental abruption

when the placenta is prematurely separated from the uterine wall

symptoms of placental abruption

sudden onset of abdominal pain and uterine contractions, anytime after 20 weeks gestation

gravid

pregnant

primigravida

first pregnancy

linea nigra

line down the umbilicus

Braxton hicks contractions

practice for real contractions, mild, and irregular

goodells sign

softening of the cervix

Chadwicks sign

discoloration of the cervix

what is hyperemesis graviduram?

morning sickness throughout the entire pregnancy, including extreme nausea and vomiting, which can lead to severe weight loss

what is quickening and when can both first time and second time mothers usually experience it?

when the mother can feel fetal movement
first time=around 18-20 weeks
second=16 weeks(know what to expect)

what is the role of progesterone?

progesterone thickens the endometrium and suppresses the development of any more follicles

when is the second trimester?

14-28 weeks

when is the third trimester?

28-40 weeks

when is the first trimester?

LMP-14 weeks

when does pregnancy begin?

after implantation

what has an affect on whether a mother will have a multifetal pregnancy?

her family history

are monozygotic twins identical or fraternal?

identical

how many sperm are there in monozygotic twins? eggs?

one sperm
one egg

are dizygotic twins identical or fraternal?

fraternal

how many sperm are in dizygotic twins?eggs?

-two sperm
-two eggs

which can include one boy and one girl, monozygotic or dizygotic?

dizygotic

how much does the mothers oxygen consumption increase during pregnancy?

15-20%

what is vanishing twin syndrome?

when one twin is reabsorbed into the placenta early in the pregnancy

what is twin-to-twin transfusion syndrome?

when there is a huge difference in the fluid being shared by twins, one becomes a donor and the other a recipient

what type of twins do twin-to-twin transfusions take place in?

monozygotic

what is a donor fetus?

the fetus that receives less fluid during twin-to-twin transfusion syndrome, they typically have a higher prenatal death rate

what is a recipient fetus?

the fetus that gets more fluid during twin-to-twin transfusion syndrome, typically have excessive blood flow

what is the treatment for twin-to-twin transfusion syndrome?

terminate one of the pregnancies via layer surgery

what causes 75% of triplet pregnancies to occur?

ARTs

what is open adoption?

direct, ongoing contact between baby, adoptive parents and birth parents

what is semi-open adoption?

may have some contact or photos but not a completely open adoption

what is a closed adoption?

birth parents will have no contact with child or adoptive parents

up to how many weeks in abortion allowed?

12 weeks

how many weeks are medicine abortion options allowed for?

10 weeks

are abortions allowed after 27 weeks?

yes, if it is being done to save the mothers life

who used the name Jane Roe?

Norma McCorvey

when was Roe v. Wade overturned?

June 24, 2022

what are trigger bans?

laws that were put into place to become active once Roe v. Wade was overturned to make abortion illegal

what non-surgical method is used for abortions and how does it work?

RU486 (mifepristone), medicine that blocks progesterone, leading to the break down of the endometrium
-97% effective
-works within 2-24 hours

what is methotrexate?

an oral medication that can be used up until 7 weeks for aborting a pregnancy, teratogenic to embryo (interrupts development)

what is taken with methotrexate (MTX) and RU486 (mifepristone)?

misoprostol

up to how many weeks can surgical abortions be performed?

12 weeks

what is a manual vacuum aspiration (MVA)?

surgical form of abortion method that can only be done if it is not your first pregnancy since the cervix will become too tight

what two types of surgical abortions can be done in the first trimester?

manual vacuum aspiration (MVA) and Dilation and curettage (D&C)

dilation curettage

scraps pregnancy away, sucks it out

what is used to remove a first trimester miscarriage?

dilation and curettage (D&E)

what does misoprostol do?

causes cramping and bleeding to empty the uterus during an abortion

second trimester abortion options

dilation and evacuation (D&E)

dilation and evacuation (D&E)

larger tool, vacuum
-can be done during 12-24 weeks of pregnancy

why are fetal assessments done?

to assess fetal well-being during pregnancy

what are the 4 types of fetal assessments?

-fetal kick count
-non-stress test
-biophysical profile
-contraction stress test

what is being assessed in fetal assessments?

heart rate, movement and contractions

what should the fetal heart rate be?

110-160 BPM

what does good fetal movement indicate?

sufficient fetal oxygenation

what is a fetal doppler?

tool used with gel in ultrasounds to detect heart rate

what does a tocodynamometer measure?

frequency and duration of contractions

how many kicks should you feel in a fetal kick count in 2 hours?

10

what will be done next if a fetal kick count is failed?

non-stress test

what does a non-stress test do?

measures heart rate in response to fetal movement, placed on an electronic fetal monitor (EFM) to measure contractions and heart rate for 20-30 minutes

what may make the non-stress test inaccurate?

sleeping baby, baby being less than 32 weeks, or mother had some sort of sedation that got to the baby

what is the next step if the non-stress test in non-reactive?

biophysical profile

what warrants a reactive non-stress test?

2 accelerations of heart rate in 20 minutes

what is a biophysical profile?

ultrasound that measures heart rate, movement, muscle tone, amniotic fluid and breathing

how is a biophysical profile scores?

point system out of either 8 or 10
-each factor is worth two points

what is something that can be seen on a biophysical profile that may result in a necessary delivery?

lack of amniotic fluid

what is a contraction stress test?

used to check for fetus's ability to withstand labor by inducing contractions

what does a positive contraction stress test mean? what is the next step?

there was a decrease in fetal heart rate during the contractions
-next step would be a c-section

what does a negative contraction stress test mean?

the baby is normal and is able to withstand labor contractions

what are the goals of prenatal testing?

maximize maternal and fetal health

when are prenatal visits supposed to take place?

-first one at 8-10 weeks
-monthly for 1st and 2nd trimester
-every two weeks until 36 weeks
-weekly 36 weeks-EDD

what do maternal health test screen for?

diabetes, sickle cell anemia, Tay-Sachs, cystic fibrosis

what does routine blood work determine? (around 8-10 weeks)

blood type, Rh factor, anemia, thyroid function and rubella immunity

what does a routine blood test determine? (at 24-28 weeks)

gestational diabetes screening

what is look for in maternal urine screening that takes place at every prenatal visit?

glucose for diabetes
protein for pre-eclampsia
ketones for dehydration
white blood cells for infections

what is looked for at 36 weeks at during the routine maternal vaginal rectal test?

Group B streptococcus (GBS)
-if found, mother will be given antibiotics during labor

what are the two types of optional prenatal tests?

screening and diagnostic

what do neural tube defects affect?

spine or brain

what is folic acid?

supplement taken to prevent neural defects like spina bifida and anencephaly

when can sex being determine through ultrasound?

16-18 weeks

alpha fetoprotein test

-blood test
-chromosomal and neural tube defects
-15-20 weeks

1st trimester combined test

-chromosomal abnormalities
-10-13 weeks

quad screen test

-blood test
-chromosomal and neural tube defects
-15-20 weeks

sequential integrated test

-chromosomal and neural tube defects
-results from 1st trimester combines and quad tests

cell-free DNA test

-chromosomal abnormalities
-10-22 weeks

chorionic villus sampling (CVS)

-chromosomal abnormalities
-invasive
-diagnostic

amniocentesis

-chromosomal and neural tube defects
-invasive
-diagnostic

fetal blood sampling

-chromosomal abnormalities
-also checks for blood disorders and infections
-diagnostic

what optional tests look for neural tube defects?

amniocentesis, alpha fetoprotein, quad, sequential integrated

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why measure fetal heart rate?

reduce neonatal death and avoid neurologic/brain injury

external monitoring examples

ultrasound or tocodynomometer

internal monitoring examples

fetal scalp electrodes
intrauterine pressure catheter

fetal scalp electrode

attaches to the baby scalp to record the electrical conduction of fetal heart

intrauterine pressure catheter

thin tube inserted into the uterus to measure duration, frequency and strength of uterine contractions

what is used to measure the strength of contractions?

intrauterine pressure catheter