Mom & Baby Week 3 Key
Concept Notes
Exam #1
Exam #1:
Antepartum
High Risk
Pregnancy
Labor and Delivery
1st Initial prenatal visit:
- Last LMP
- S/S mom is having (i.e. nausea, constipation, urinary frequency)
- Any bleeding or cramping
- Obstetric history (# of pregnancies, # term & preterm, method of delivery, any complications, postpartum
hemorrhage, # of living child and their weight)
- Naegele’s Rule: LMP + 7 days – 3 months = EDD
- GTPAL:
Gravida: # of pregnancies
Term: # carried to term (37 weeks)
Preterm: # carried preterm (<37 weeks)
Abortions: # elective or spontaneous before 20 weeks
Living: # of living children
- GYN history: Pap smear, STD’s, Contraception, Any medications
- Nutrition: Obtain dietary history, Eating disorder, PICA, Hyperemesis, Folic acid (prevents neural
tube defects)
- Risk Factors: Weight > or < 200 lbs, DM, Smoking, Drugs/alcohol
- Labs: CBC, Rubella titer (cannot have Rubella vaccine during pregnancy), WBC, HIV, Syphilis, Hep B,
Chlamydia, gonorrhea
- Social & financial resources
- Stress goal of consistent prenatal care
- Assess cultural differences
Signs of Pregnancy
Presumptive (subjective) Probable (objective) Positive
Nausea + Pregnancy Test Viability (u/s @ 6 weeks)
Vomiting Ballotment (@18 weeks) Fetal heart tones (@ 12
weeks)
Amenorrhea Hegar sign (Softening of the lower Fetal Movement (@ 16-18
uterine segment) weeks)
Fatigue Braxton Hicks
Urinary frequency Uterine enlargement
Psychosocial:
Breast changes/soreness Chadwicks sign (purple/blue
1st trimester: Accepts pregnancy (consumed
vaginal with
mucosa and S/S due
cervix andtofocused on her discomfort)
2nd Trimester: very protective ofincreased perfusion
fetus, seeks to uterus) finding enjoyment and pleasure
knowledge,
Quickening
3rd
Trimester: Concern over fetus Goodell Sign (softening of cervix)
Family preparation: prepare siblings, identify ways to prepare young children, picture books, attend
antepartal visits, sibling prep class.
, Mom & Baby Week 3 Key
Concept Notes
Exam #1
Changes in Pregnancy
Cardiovascular: Gastrointestinal
- Cardiac output increased 10% by 5 weeks & up - Nausea and vomiting (should diminish by 14
to 50% by 34 weeks weeks)
- Increased blood volume - Hyperemia of gums
- HR increased 10-15 bpm Mom & Baby Week 3gallbladder
- Decreased Key and stomach emptying
Concept
- May have SOB when walking up steps during Notesgallstones
- Increased
last trimester - Constipation
Exam #1 (eat frequent meals, avoid spicy
- Heartburn
Skin Changes: Musculoskeletal:
Hormones of Pregnancy:
- Increased pigmentation - Increased production of relaxin and
- Linea nigra (line down abdomen) progesterone
-Human Chorionic (butterfly
Chloasma/Melasma Gonadotropin (hCG)
- “waddle” – pubis symphysis widens
- Main
mask function of hCG = Maintains corpus luteum until placenta starts producing progesterone
on face)
Causesgravidarum
ovum to implant - Lordosis
- Striae (stretchin uterus
Respiratory:
- Earliest marker of pregnancy
marks)
- Nasal congestion or nose bleeding due to
- Telangietasis:
Detectable 7-10 “vascular
days after conception, peaks at 8-10 weeks
elevated estrogen levels
spiders”
- hCG begins as early as the day of implantation and can be detected in maternal serum or urine as
Urinary
soon as 7System:
to 8 days before the expected menses
- Increased urinary frequency
double approximately every and nocturia
2 days for thebecause of pressure
first 4 weeks of uterus on bladder and smooth
of pregnancy
muscle relaxation, occurs early
-Estrogen
Dilation of uterus which increases risk for bacterial infection
- Causes hyperpigmentation & spider angiomas
- Causes increased perfusion of uterus and cervix for fetal oxygenation.
- Increased blood flow to breast, for milk production/lactation
Fundal Height:
- Fetal organs
- Produced by the corpus luteum until placenta can take over production (@ 12-14 weeks gestation)
Progesterone
- Relaxes smooth muscle and keeps uterus relaxed to keep baby in.
- Causes growth in mammary ducts for preparation of lactation
- Secreted by corpus luteum until placenta can take over production (@ 12-14 weeks gestation)
- Prepares endometrium for implantation
Human Placental Lactogen (hPL) -Checked at every prenatal visit to make sure
baby
- Sometimes causes insulin resistance increase risk forisGDM
growing.
- Like a growth hormone - Fundal height should be + or – 2 with week of
pregnancy
- Insulin antagonist – increases blood glucose in pregnancy
Relaxin
- Relaxes pelvic muscles and joints in preparation for childbirth
Oxytocin
- Induces uterine contraction in labor
- “milk letdown”
Prolactin
- Milk production
Concept Notes
Exam #1
Exam #1:
Antepartum
High Risk
Pregnancy
Labor and Delivery
1st Initial prenatal visit:
- Last LMP
- S/S mom is having (i.e. nausea, constipation, urinary frequency)
- Any bleeding or cramping
- Obstetric history (# of pregnancies, # term & preterm, method of delivery, any complications, postpartum
hemorrhage, # of living child and their weight)
- Naegele’s Rule: LMP + 7 days – 3 months = EDD
- GTPAL:
Gravida: # of pregnancies
Term: # carried to term (37 weeks)
Preterm: # carried preterm (<37 weeks)
Abortions: # elective or spontaneous before 20 weeks
Living: # of living children
- GYN history: Pap smear, STD’s, Contraception, Any medications
- Nutrition: Obtain dietary history, Eating disorder, PICA, Hyperemesis, Folic acid (prevents neural
tube defects)
- Risk Factors: Weight > or < 200 lbs, DM, Smoking, Drugs/alcohol
- Labs: CBC, Rubella titer (cannot have Rubella vaccine during pregnancy), WBC, HIV, Syphilis, Hep B,
Chlamydia, gonorrhea
- Social & financial resources
- Stress goal of consistent prenatal care
- Assess cultural differences
Signs of Pregnancy
Presumptive (subjective) Probable (objective) Positive
Nausea + Pregnancy Test Viability (u/s @ 6 weeks)
Vomiting Ballotment (@18 weeks) Fetal heart tones (@ 12
weeks)
Amenorrhea Hegar sign (Softening of the lower Fetal Movement (@ 16-18
uterine segment) weeks)
Fatigue Braxton Hicks
Urinary frequency Uterine enlargement
Psychosocial:
Breast changes/soreness Chadwicks sign (purple/blue
1st trimester: Accepts pregnancy (consumed
vaginal with
mucosa and S/S due
cervix andtofocused on her discomfort)
2nd Trimester: very protective ofincreased perfusion
fetus, seeks to uterus) finding enjoyment and pleasure
knowledge,
Quickening
3rd
Trimester: Concern over fetus Goodell Sign (softening of cervix)
Family preparation: prepare siblings, identify ways to prepare young children, picture books, attend
antepartal visits, sibling prep class.
, Mom & Baby Week 3 Key
Concept Notes
Exam #1
Changes in Pregnancy
Cardiovascular: Gastrointestinal
- Cardiac output increased 10% by 5 weeks & up - Nausea and vomiting (should diminish by 14
to 50% by 34 weeks weeks)
- Increased blood volume - Hyperemia of gums
- HR increased 10-15 bpm Mom & Baby Week 3gallbladder
- Decreased Key and stomach emptying
Concept
- May have SOB when walking up steps during Notesgallstones
- Increased
last trimester - Constipation
Exam #1 (eat frequent meals, avoid spicy
- Heartburn
Skin Changes: Musculoskeletal:
Hormones of Pregnancy:
- Increased pigmentation - Increased production of relaxin and
- Linea nigra (line down abdomen) progesterone
-Human Chorionic (butterfly
Chloasma/Melasma Gonadotropin (hCG)
- “waddle” – pubis symphysis widens
- Main
mask function of hCG = Maintains corpus luteum until placenta starts producing progesterone
on face)
Causesgravidarum
ovum to implant - Lordosis
- Striae (stretchin uterus
Respiratory:
- Earliest marker of pregnancy
marks)
- Nasal congestion or nose bleeding due to
- Telangietasis:
Detectable 7-10 “vascular
days after conception, peaks at 8-10 weeks
elevated estrogen levels
spiders”
- hCG begins as early as the day of implantation and can be detected in maternal serum or urine as
Urinary
soon as 7System:
to 8 days before the expected menses
- Increased urinary frequency
double approximately every and nocturia
2 days for thebecause of pressure
first 4 weeks of uterus on bladder and smooth
of pregnancy
muscle relaxation, occurs early
-Estrogen
Dilation of uterus which increases risk for bacterial infection
- Causes hyperpigmentation & spider angiomas
- Causes increased perfusion of uterus and cervix for fetal oxygenation.
- Increased blood flow to breast, for milk production/lactation
Fundal Height:
- Fetal organs
- Produced by the corpus luteum until placenta can take over production (@ 12-14 weeks gestation)
Progesterone
- Relaxes smooth muscle and keeps uterus relaxed to keep baby in.
- Causes growth in mammary ducts for preparation of lactation
- Secreted by corpus luteum until placenta can take over production (@ 12-14 weeks gestation)
- Prepares endometrium for implantation
Human Placental Lactogen (hPL) -Checked at every prenatal visit to make sure
baby
- Sometimes causes insulin resistance increase risk forisGDM
growing.
- Like a growth hormone - Fundal height should be + or – 2 with week of
pregnancy
- Insulin antagonist – increases blood glucose in pregnancy
Relaxin
- Relaxes pelvic muscles and joints in preparation for childbirth
Oxytocin
- Induces uterine contraction in labor
- “milk letdown”
Prolactin
- Milk production
