Your text here
OB Final Exam Study Guide
Signs of Pregnancy: Presumptive, Probable, & Positive
Presumptive
o Things that could be due to pregnancy but could also be explained by something else
Fatigue, breast tenderness, N/V, Amenorrhea, Urinary Frequency,
hyperpigmentation of the skin, quickening, uterine enlargement, and breast
enlargement.
Probable
o You’re probably pregnant, but we don’t know for sure
Braxton hicks contractions, Positive pregnancy test, abdominal enlargement,
ballottement (examiner pushes on cervix and feels rebound from fetus),
Goodell’s sign, Chadwick’s sign, Hegar’s sign
Positive
o You are definitely pregnant!
Seeing a fetus or embryo on an ultrasound
Fetal movement felt by a clinician
Auscultating fetal heart tones w/ doppler
GTPAL classification
G – How many pregnancies
T – How many pregnancies to term >38 weeks
P – How many pregnancies were preterm <38 weeks
A – How many abortions <20 weeks
L – How many living children
Naegle’s Rule
First Day of LMP – 3 months + 7 Days = Due date
Nutrition in Pregnancy
INCREASE
o Calories – 2,500 calories/day
o Protein – 80g/day
o Iron – 27g/day
o Folic acid – 800mcg/day
Weight gain in pregnancy
Underweight women should gain 28-40 pounds
, o 5 lbs in the 1st trimester
o Then 1.2 lbs per week
Normal weight women should gain 25-35 pounds
o 3.5-5 lbs in the first trimester
o Then ~1lb per week
Overweight women should gain 15-25 pounds
o 2 lbs in first trimester
o Then 2/3 lb per week
Obese women should gain no more than 15 pounds
Exercise in pregnancy
Exercise during pregnancy is encouraged but the intensity and duration should be modified
Contraindicated in preterm labor, poor weight gain, anemia, face and hand edema, pain,
hypertension, threatened abortion, dizziness, SOB, multiple gestation, decreased fetal activity,
cardiac disease and palpitations
150 minutes of moderate intensity exercise per week
Helps return the woman’s body to normal after pregnancy
Low-impact aerobic exercises with stretching before and after
Never exercise to the point of exhaustion
Danger/warning signs of pregnancy
First trimester
o Spotting or bleeding, painful urination, severe persistent vomiting, lower abdominal pain
with dizziness and shoulder pain.
Second Trimester
o Regular uterine contractions, pain in calf, often increased with foot flexion, sudden gush
or leakage of fluid from the vagina, and absence of fetal movement for more than 12
hours
Third Trimester
o Sudden weight gain, periorbital or facial edema, severe abdominal pain, headache w/
visual changes, decrease in fetal daily movement for more than 24 hours.
Common discomforts of pregnancy
First Trimester
o Urinary frequency or incontinence
Decrease fluids 2-3 hrs before bed, limit intake of caffeine, Kegel exercises,
empty bladder with first full sensation
o Fatigue
Get a full night’s sleep, healthy well-balanced diet, nap in the early afternoon,
rest when you feel tired.
, o N/V
Avoid an empty stomach, eat dry crackers before getting out of bed, eat several
small meals throughout the day, avoid brushing teeth immediately after eating,
Acupressure wristbands, drink fluids between meals, avoid greasy, fried foods,
or foods with a strong odor.
o Breast tenderness
Wear a larger bra with good support even while she’s sleeping
o Constipation
Eat fresh or dried fruit with the skins on, whole grain cereal and breads, increase
physical activity, pelvic floor exercises, stretching exercises, and yoga daily, meals
at regular intervals, defecate at a certain time each day, use a Squatty Potty,
increase water intake, decrease refined carbs, warm fluids in the morning, avoid
large amounts of cheese.
o Nasal stuffiness, bleeding gums, and epistaxis
Increase fluids, use a humidifier in room at night, advise her to blow her nose
gently, one nostril at a time, avoid nasal decongestants and sprays. If her
nosebleed advise her to loosen clothing around her neck, tilt her head forward,
pinch nostrils for 10-15 minutes, and apply an ice pack to her nose. Advise her to
practice good oral hygiene, soft toothbrush and flossing daily, warm saline
mouth washes.
o Cravings
Watch out for Pica
o Leukorrhea
Keep perineal area clean and dry, wash with mild soap during shower, avoid
pantyhose or tight nylon clothes, encourage cotton underwear and the use of a
nightgown, avoid douching and tampon use.
Second Trimester
o Backache
Avoid standing or sitting for long periods, apply heating pad, put pillows behind
back when sitting, use proper body mechanics when lifting, avoid excessive
bending, lifting or walking without rest, wear supportive shoes, avoid heels,
maintain good posture.
o Leg Cramps
Elevate the legs above heart level, straighten both legs and flex feet toward your
body, taking additional calcium supplements
o Varicosities of the leg and vulva
Walking daily, elevate legs, avoid standing in one positions too long, avoid
constrictive knee-high stocking and socks, don’t cross legs when sitting, wear
support stockings for better circulation.
o Hemorrhoids
OB Final Exam Study Guide
Signs of Pregnancy: Presumptive, Probable, & Positive
Presumptive
o Things that could be due to pregnancy but could also be explained by something else
Fatigue, breast tenderness, N/V, Amenorrhea, Urinary Frequency,
hyperpigmentation of the skin, quickening, uterine enlargement, and breast
enlargement.
Probable
o You’re probably pregnant, but we don’t know for sure
Braxton hicks contractions, Positive pregnancy test, abdominal enlargement,
ballottement (examiner pushes on cervix and feels rebound from fetus),
Goodell’s sign, Chadwick’s sign, Hegar’s sign
Positive
o You are definitely pregnant!
Seeing a fetus or embryo on an ultrasound
Fetal movement felt by a clinician
Auscultating fetal heart tones w/ doppler
GTPAL classification
G – How many pregnancies
T – How many pregnancies to term >38 weeks
P – How many pregnancies were preterm <38 weeks
A – How many abortions <20 weeks
L – How many living children
Naegle’s Rule
First Day of LMP – 3 months + 7 Days = Due date
Nutrition in Pregnancy
INCREASE
o Calories – 2,500 calories/day
o Protein – 80g/day
o Iron – 27g/day
o Folic acid – 800mcg/day
Weight gain in pregnancy
Underweight women should gain 28-40 pounds
, o 5 lbs in the 1st trimester
o Then 1.2 lbs per week
Normal weight women should gain 25-35 pounds
o 3.5-5 lbs in the first trimester
o Then ~1lb per week
Overweight women should gain 15-25 pounds
o 2 lbs in first trimester
o Then 2/3 lb per week
Obese women should gain no more than 15 pounds
Exercise in pregnancy
Exercise during pregnancy is encouraged but the intensity and duration should be modified
Contraindicated in preterm labor, poor weight gain, anemia, face and hand edema, pain,
hypertension, threatened abortion, dizziness, SOB, multiple gestation, decreased fetal activity,
cardiac disease and palpitations
150 minutes of moderate intensity exercise per week
Helps return the woman’s body to normal after pregnancy
Low-impact aerobic exercises with stretching before and after
Never exercise to the point of exhaustion
Danger/warning signs of pregnancy
First trimester
o Spotting or bleeding, painful urination, severe persistent vomiting, lower abdominal pain
with dizziness and shoulder pain.
Second Trimester
o Regular uterine contractions, pain in calf, often increased with foot flexion, sudden gush
or leakage of fluid from the vagina, and absence of fetal movement for more than 12
hours
Third Trimester
o Sudden weight gain, periorbital or facial edema, severe abdominal pain, headache w/
visual changes, decrease in fetal daily movement for more than 24 hours.
Common discomforts of pregnancy
First Trimester
o Urinary frequency or incontinence
Decrease fluids 2-3 hrs before bed, limit intake of caffeine, Kegel exercises,
empty bladder with first full sensation
o Fatigue
Get a full night’s sleep, healthy well-balanced diet, nap in the early afternoon,
rest when you feel tired.
, o N/V
Avoid an empty stomach, eat dry crackers before getting out of bed, eat several
small meals throughout the day, avoid brushing teeth immediately after eating,
Acupressure wristbands, drink fluids between meals, avoid greasy, fried foods,
or foods with a strong odor.
o Breast tenderness
Wear a larger bra with good support even while she’s sleeping
o Constipation
Eat fresh or dried fruit with the skins on, whole grain cereal and breads, increase
physical activity, pelvic floor exercises, stretching exercises, and yoga daily, meals
at regular intervals, defecate at a certain time each day, use a Squatty Potty,
increase water intake, decrease refined carbs, warm fluids in the morning, avoid
large amounts of cheese.
o Nasal stuffiness, bleeding gums, and epistaxis
Increase fluids, use a humidifier in room at night, advise her to blow her nose
gently, one nostril at a time, avoid nasal decongestants and sprays. If her
nosebleed advise her to loosen clothing around her neck, tilt her head forward,
pinch nostrils for 10-15 minutes, and apply an ice pack to her nose. Advise her to
practice good oral hygiene, soft toothbrush and flossing daily, warm saline
mouth washes.
o Cravings
Watch out for Pica
o Leukorrhea
Keep perineal area clean and dry, wash with mild soap during shower, avoid
pantyhose or tight nylon clothes, encourage cotton underwear and the use of a
nightgown, avoid douching and tampon use.
Second Trimester
o Backache
Avoid standing or sitting for long periods, apply heating pad, put pillows behind
back when sitting, use proper body mechanics when lifting, avoid excessive
bending, lifting or walking without rest, wear supportive shoes, avoid heels,
maintain good posture.
o Leg Cramps
Elevate the legs above heart level, straighten both legs and flex feet toward your
body, taking additional calcium supplements
o Varicosities of the leg and vulva
Walking daily, elevate legs, avoid standing in one positions too long, avoid
constrictive knee-high stocking and socks, don’t cross legs when sitting, wear
support stockings for better circulation.
o Hemorrhoids
