Studied by 2 peoplewhat 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
A A Q S
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
Note
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