Mark Klimek
Lecture #10
February 1, 2018
Maternal/Newborn
• Calculate due date – first day of last menstrual period + 7 days – 3 months
o LAST mp – june 10 – june 15 = june 17 – 3 months = march 17
• Weight gain during pregnancy
o Total weight gain = 28 pounds +/- 3
o First trimester = 1 lb each month = total of 3 pounds in first trimester
o Second trimester = 1 lb per week
o Third trimester = 1 lb per week
o How do you calculate a womans ideal weight gain? Week – 9
▪ Week 12 – 3 lb
▪ Week 13 – 4 lb
▪ Week 14 – 5 lb
▪ Week of gestation – 9
• EXAMPLE – 28 WEEKS – 9 = 19 lbs
st
• 31 week – 9 = 22 lbs
• Fundus – top part of the uterus
o Not palpable till week 12, not palpable during the first trimester
o When is the fundus at the umbilicus?
▪ 20-22 weeks of gestation
o Can you use fundal height to determine what trimester she’s in? YES
• Signs of pregnancy
o Positive – fetal skeleton on x-ray, fetal presence on ultrasound, auscultation
of fetal heart rate (heard around 8-12 weeks), when examiner palpates fetal
movement or outline
o Maybe signs (probable and presumptive) – urine and blood tests, a positive
pregnancy test is not a
POSITIVE sign of pregnancy. Chadwick sign – cervical color change due to
cyanosis. Goddell sign – cervical softening. Hegar sign – uterus softening.
• Good prenatal care
o Once a month until week 28, then once every 2 weeks until week 36, then every
week until week 42.
o HgB will fall and that’s normal, normal female is 12-16, first trimester it could fall
to 11 and that’s
normal. 2nd trimester it could fall to 10.5 and that’s normal. Third trimester could
fall to 10 and be normal.
• Discomforts of pregnancy
o How do you treat morning sickness?
▪ First trimester
▪ Dry carbohydrates before you get out of bed
o How do you deal with urinary incontinence?
▪ First and third trimester problem
▪ Void every 2 hours
o Difficulty breathing
▪ Second and third trimester problem
, ▪
Teach them tripod position
o Back pain
▪ Second and third trimester
▪ Pelvic tilt exercises, tilt pelvis forward
Labor and Birth
Lecture #10
February 1, 2018
Maternal/Newborn
• Calculate due date – first day of last menstrual period + 7 days – 3 months
o LAST mp – june 10 – june 15 = june 17 – 3 months = march 17
• Weight gain during pregnancy
o Total weight gain = 28 pounds +/- 3
o First trimester = 1 lb each month = total of 3 pounds in first trimester
o Second trimester = 1 lb per week
o Third trimester = 1 lb per week
o How do you calculate a womans ideal weight gain? Week – 9
▪ Week 12 – 3 lb
▪ Week 13 – 4 lb
▪ Week 14 – 5 lb
▪ Week of gestation – 9
• EXAMPLE – 28 WEEKS – 9 = 19 lbs
st
• 31 week – 9 = 22 lbs
• Fundus – top part of the uterus
o Not palpable till week 12, not palpable during the first trimester
o When is the fundus at the umbilicus?
▪ 20-22 weeks of gestation
o Can you use fundal height to determine what trimester she’s in? YES
• Signs of pregnancy
o Positive – fetal skeleton on x-ray, fetal presence on ultrasound, auscultation
of fetal heart rate (heard around 8-12 weeks), when examiner palpates fetal
movement or outline
o Maybe signs (probable and presumptive) – urine and blood tests, a positive
pregnancy test is not a
POSITIVE sign of pregnancy. Chadwick sign – cervical color change due to
cyanosis. Goddell sign – cervical softening. Hegar sign – uterus softening.
• Good prenatal care
o Once a month until week 28, then once every 2 weeks until week 36, then every
week until week 42.
o HgB will fall and that’s normal, normal female is 12-16, first trimester it could fall
to 11 and that’s
normal. 2nd trimester it could fall to 10.5 and that’s normal. Third trimester could
fall to 10 and be normal.
• Discomforts of pregnancy
o How do you treat morning sickness?
▪ First trimester
▪ Dry carbohydrates before you get out of bed
o How do you deal with urinary incontinence?
▪ First and third trimester problem
▪ Void every 2 hours
o Difficulty breathing
▪ Second and third trimester problem
, ▪
Teach them tripod position
o Back pain
▪ Second and third trimester
▪ Pelvic tilt exercises, tilt pelvis forward
Labor and Birth
