Terminology & math calculations: length for a normal pregnancy :
10 Inar mths
- Gestation: how many weeks pregnant; HOW pregnant are you a calendar mths
- Trimester: 90 WKS
- 0 - 12 wks 200 days
- 13 - 27 wks
- 28 wks - delivery
- Term: when it’s time for the baby to be born; 38 - 48 wks
- Preterm: 20 wks - end of 37th wk
- Postterm: delivery after 42 wks
- Antepartum: conception ▶ labor
- Intrapartum: true labor begins ▶ delivery of baby
- Postpartum: delivery ▶ 6 wks after
- gravidity/gravida: amt of times you’ve been pregnant; regardless of # of wks
- Parity: any delivery 20 wks or more (dead or alive)
- Due date: 40 wks primipara mom who completed
:
- Viable baby: 20 wks I Pregnancy o a fetrs who
- Nulligravida: never been pregnant reached 20wks of gestation
- Primigravida: 1st pregnancy
-&Multigravida: 2nd or more pregnancies
may feel
- Nulliparity: noo delivery that doesn't make it to 20 wks
movement
- Abortion: deliver before 20 wks
as early as
lauks
- Stillbirth: baby born dead
- Advanced gestational age: after 35 yrs
- Lightning: when the baby drops
- Quickening: when mom feels baby kicking & moving
- Ectopic pregnancy: baby didn’t make it down to the uterus; have to take it out
Hormones:
estrogen - Stimulates uterine development to provide environment for fetal growth
- Helps prepare breast for lactation
HCG (human - Secreted by trophoblast
chorionic - Stimulates progesterone & estrogen to maintain the pregnancy until the placenta
gonadotropin) takes over that function
- What makes the pregnancy test show positive ; biomarker for pregnancy test
- Causes: nausea, vomiting, & morning sickness
- When you get pregnant, it ⬆
HPL (human placental - Antagonist of insulin
lactogen) - ⬇ the maternal metabolism of glucose to allow fetal growth
- Ensures that more protein, glucose, & minerals are available for fetus
- Makes you nauseous & vomit
it
Progesterone - Most important hormone for the maintenance of the pregnancy relaxes
smot
- Maintains the endometrium & inhibits uterine contractions; prevents abortion
- Aids in preparation for lactation
Prostaglandins - Lipid substance produced by body tissue
- Exact purpose = unknown
, - High concentrations found in pregnancy
- Associated w onset of labor
- ⬇ levels contribute to pregnancy induced hypertension (PIH)
Relaxin - Works w progesterone
- Found in maternal serum from time of 1st missed period
- Inhibits uterine activity, aids in softening the cervix for cervical dilation & relaxation of
symphysis pubis
Changes the body goes through in pregnancy and how to help alleviate it
Cardiovascular system - Physiological anemia aka false anemia: plasma blood volume ⬆ more than the RBC
volume. HCT ⬇ resulting in physiologic anemia
- HGB (hemoglobin) < 11 = ABNORMAL (due to iron deficiency)
- Supine hypotension: pressure from enlarged uterus ⬇ venous return from lower
extremities
- s&s:
- Hypotension
- Dizziness
- Diaphoresis
- pallor
- mom laying down in bed, teach her to NOT jump out of bed suddenly
- Teaching: sit ⬆ 1st & dangle legs, THEN get up slowly
- Orthostatic hypotension: Stagnation of blood in lower extremities
- Teaching: encourage to rise slowly (dangle feet before getting up); keep feet
moving while standing
- Vena caval syndrome -
- Vena cava supplies baby w oxygenated blood
- occurs when you are laying on your back, you NOW have the baby pressing ⬇
on vena cava. Also happens during doctor appt
- s&s: SOB (after a lil)
- Teaching: DON’T lay flat on your back, put pillow/wedge/cushion under hip
when lying down (so baby is tilted away from vena cava)
- Left side is the best side to go on
- Doctor appt, breaks might be needed to help mom
- ⬆ cardiac load - may cause palpitation
- Why?: bc of ⬆ blood volume, ♥ has to work harder pumping blood all over
body
- BP ⬇ in 2nd trimester due to lowered peripheral resistance
- BP ⬆ in 2nd trimester? SOMETHING IS WRONG
- ⬇ regional blood flow causes edema & varicosities
- Blood pulls down to ankles
- Teaching: if sitting for MANY hrs, put box under desk to rest feet to help
circulation
- Stick legs ⬆ to help w circulation
- ♥:
- Position: pushed upward, laterally to left
- Working double time
- Cardiac hypertrophy: due to ⬆ blood volume & cardiac output
, - Heart sounds: exaggerated 1st & 3rd; systolic murmurs
- Nosebleeds are NORMAL
- Capillaries in nose pop bc of extra volume of blood
- Extra blood = extra pressure
- Teaching: treat like a normal nosebleed
Respiratory system - Hyperventilation
- Why? Lungs have a smaller capacity to expand
- Baby pushing on diaphragm; can't take deep breath
- Smaller oxygen supply
- Shortness of breath = NORMAL
- Teaching: breathe slower; SLOW DOWN
- Nasal stuffiness: due to ⬆ estrogen
- ⬆ tidal volume
- ⬆ oxygen consumption
- Diaphragm elevates
- ⬆ chest circumference - dyspnea
- Bc you’re breathing MORE
- Educate regarding normal changes & symptoms
Renal system - Glomerular filtration rate ⬆ sometimes resulting in glycosuria (greater than a trace of
1+ is suspicious)
- Why you find glucose in the urine
- Pressure of the uterus on the ureter causes urinary stasis & pyelonephritis
- Pressure on the urethra results in poor emptying which can cause infection leading to
kidney problems or preterm labor
- IF infection: “uterus gets pissed off & you’ll have a premature baby”
- Kidney problems: bc it travels back ⬆ the kidneys
- Get a lot of UTIs sometimes
- Every visit mom pees it a cup & check w dipstick for:
- Glucose = diabetes
- Blood
- Protein = preeclampsia
- Ketones = dehydration
- Uterus gets upset & causes contractions
- Teaching: get them hydrated quickly
Neurological system - ⬇ attention span
- Poor concentration
- Memory lapses
- Carpal tunnel syndrome
- Bc of extra weight presses on the nerves
- Teaching: exercise or brace & lose weight after pregnancy
- Syncope: fainting spells
- Teaching: get up slowly (so they don’t pass out)
- Anticipatory guidance regarding changes
Gastrointestinal - Displacement of the stomach & slowed intestinal peristalsis causes:
system - Heartburn
- Teaching: eat smaller more frequent meals
10 Inar mths
- Gestation: how many weeks pregnant; HOW pregnant are you a calendar mths
- Trimester: 90 WKS
- 0 - 12 wks 200 days
- 13 - 27 wks
- 28 wks - delivery
- Term: when it’s time for the baby to be born; 38 - 48 wks
- Preterm: 20 wks - end of 37th wk
- Postterm: delivery after 42 wks
- Antepartum: conception ▶ labor
- Intrapartum: true labor begins ▶ delivery of baby
- Postpartum: delivery ▶ 6 wks after
- gravidity/gravida: amt of times you’ve been pregnant; regardless of # of wks
- Parity: any delivery 20 wks or more (dead or alive)
- Due date: 40 wks primipara mom who completed
:
- Viable baby: 20 wks I Pregnancy o a fetrs who
- Nulligravida: never been pregnant reached 20wks of gestation
- Primigravida: 1st pregnancy
-&Multigravida: 2nd or more pregnancies
may feel
- Nulliparity: noo delivery that doesn't make it to 20 wks
movement
- Abortion: deliver before 20 wks
as early as
lauks
- Stillbirth: baby born dead
- Advanced gestational age: after 35 yrs
- Lightning: when the baby drops
- Quickening: when mom feels baby kicking & moving
- Ectopic pregnancy: baby didn’t make it down to the uterus; have to take it out
Hormones:
estrogen - Stimulates uterine development to provide environment for fetal growth
- Helps prepare breast for lactation
HCG (human - Secreted by trophoblast
chorionic - Stimulates progesterone & estrogen to maintain the pregnancy until the placenta
gonadotropin) takes over that function
- What makes the pregnancy test show positive ; biomarker for pregnancy test
- Causes: nausea, vomiting, & morning sickness
- When you get pregnant, it ⬆
HPL (human placental - Antagonist of insulin
lactogen) - ⬇ the maternal metabolism of glucose to allow fetal growth
- Ensures that more protein, glucose, & minerals are available for fetus
- Makes you nauseous & vomit
it
Progesterone - Most important hormone for the maintenance of the pregnancy relaxes
smot
- Maintains the endometrium & inhibits uterine contractions; prevents abortion
- Aids in preparation for lactation
Prostaglandins - Lipid substance produced by body tissue
- Exact purpose = unknown
, - High concentrations found in pregnancy
- Associated w onset of labor
- ⬇ levels contribute to pregnancy induced hypertension (PIH)
Relaxin - Works w progesterone
- Found in maternal serum from time of 1st missed period
- Inhibits uterine activity, aids in softening the cervix for cervical dilation & relaxation of
symphysis pubis
Changes the body goes through in pregnancy and how to help alleviate it
Cardiovascular system - Physiological anemia aka false anemia: plasma blood volume ⬆ more than the RBC
volume. HCT ⬇ resulting in physiologic anemia
- HGB (hemoglobin) < 11 = ABNORMAL (due to iron deficiency)
- Supine hypotension: pressure from enlarged uterus ⬇ venous return from lower
extremities
- s&s:
- Hypotension
- Dizziness
- Diaphoresis
- pallor
- mom laying down in bed, teach her to NOT jump out of bed suddenly
- Teaching: sit ⬆ 1st & dangle legs, THEN get up slowly
- Orthostatic hypotension: Stagnation of blood in lower extremities
- Teaching: encourage to rise slowly (dangle feet before getting up); keep feet
moving while standing
- Vena caval syndrome -
- Vena cava supplies baby w oxygenated blood
- occurs when you are laying on your back, you NOW have the baby pressing ⬇
on vena cava. Also happens during doctor appt
- s&s: SOB (after a lil)
- Teaching: DON’T lay flat on your back, put pillow/wedge/cushion under hip
when lying down (so baby is tilted away from vena cava)
- Left side is the best side to go on
- Doctor appt, breaks might be needed to help mom
- ⬆ cardiac load - may cause palpitation
- Why?: bc of ⬆ blood volume, ♥ has to work harder pumping blood all over
body
- BP ⬇ in 2nd trimester due to lowered peripheral resistance
- BP ⬆ in 2nd trimester? SOMETHING IS WRONG
- ⬇ regional blood flow causes edema & varicosities
- Blood pulls down to ankles
- Teaching: if sitting for MANY hrs, put box under desk to rest feet to help
circulation
- Stick legs ⬆ to help w circulation
- ♥:
- Position: pushed upward, laterally to left
- Working double time
- Cardiac hypertrophy: due to ⬆ blood volume & cardiac output
, - Heart sounds: exaggerated 1st & 3rd; systolic murmurs
- Nosebleeds are NORMAL
- Capillaries in nose pop bc of extra volume of blood
- Extra blood = extra pressure
- Teaching: treat like a normal nosebleed
Respiratory system - Hyperventilation
- Why? Lungs have a smaller capacity to expand
- Baby pushing on diaphragm; can't take deep breath
- Smaller oxygen supply
- Shortness of breath = NORMAL
- Teaching: breathe slower; SLOW DOWN
- Nasal stuffiness: due to ⬆ estrogen
- ⬆ tidal volume
- ⬆ oxygen consumption
- Diaphragm elevates
- ⬆ chest circumference - dyspnea
- Bc you’re breathing MORE
- Educate regarding normal changes & symptoms
Renal system - Glomerular filtration rate ⬆ sometimes resulting in glycosuria (greater than a trace of
1+ is suspicious)
- Why you find glucose in the urine
- Pressure of the uterus on the ureter causes urinary stasis & pyelonephritis
- Pressure on the urethra results in poor emptying which can cause infection leading to
kidney problems or preterm labor
- IF infection: “uterus gets pissed off & you’ll have a premature baby”
- Kidney problems: bc it travels back ⬆ the kidneys
- Get a lot of UTIs sometimes
- Every visit mom pees it a cup & check w dipstick for:
- Glucose = diabetes
- Blood
- Protein = preeclampsia
- Ketones = dehydration
- Uterus gets upset & causes contractions
- Teaching: get them hydrated quickly
Neurological system - ⬇ attention span
- Poor concentration
- Memory lapses
- Carpal tunnel syndrome
- Bc of extra weight presses on the nerves
- Teaching: exercise or brace & lose weight after pregnancy
- Syncope: fainting spells
- Teaching: get up slowly (so they don’t pass out)
- Anticipatory guidance regarding changes
Gastrointestinal - Displacement of the stomach & slowed intestinal peristalsis causes:
system - Heartburn
- Teaching: eat smaller more frequent meals
