Amniotic fluid is a pale, straw-coloured fluid in which the fetus
floats.
Ballottement is the rebounding of the fetus against the examiner's
finger on palpation.
Chadwick’s sign is the violet coloration of the mucous membranes of the
cervix, vagina, and vulva that occurs at about 4 weeks of pregnancy caused by
increased vascularity. This is considered a probable sign of pregnancy.
Embryo is the stage of fetal development that lasts from day 15 until
approximately 8 weeks after conception or until the embryo measures 3 cm from
crown to rump.
Goodell's sign is the softening of the cervix that occurs at the
beginning of the second month of gestation. This is considered a probable sign
of pregnancy.
Hegar's sign is the compressibility and softening of the lower uterine
segment that occurs at about week 6 of gestation. This is considered a probable
sign of pregnancy.
Implantation is the embedding of the fertilized ovum in the uterine
mucosa 6 to 10 days after conception.
Lecithin-to-sphingomyelin (L/S) ratio is a ratio of two components of
amniotic fluid, used for predicting fetal lung maturity; normal L/S ratio in
amniotic fluid is 2:1 or greater when the fetal lungs are mature.
Parity is the number of pregnancies that have reached viability
regardless of whether the fetus was born alive or stillborn.
Quickening is the maternal perception of fetal movement for the first
time, occurring usually in the sixteenth to twentieth week of pregnancy.
Surfactant is the phospholipid that is necessary to keep the fetal lung
alveoli from collapsing; amount is usually sufficient after 32 weeks gestation.
Uterus has four parts fundus, corpus (body), isthmus, and cervix.
Viability is the capability of the fetus to survive outside the uterus;
about 22 to 24 weeks of gestation or fetal weight more than 500 g.
The gynecoid pelvis is most favorable for successful labour and birth.
Posterior sagittal diameter is the distance from the point where the
anteroposterior and transverse diameters cross each other to the middle of the
sacral promontory.
Fertilization occurs in the ampulla of the fallopian tube.
In 8 weeks fetus every organ system is present.
Kidney begin to form urine at 12 weeks of fetus.
Lanugo hair begins to develop in 16 weeks of fetus.
At 20-week heartbeat is detected by regular fetoscope.
A 24-week fetus has ability to hear.
A 28-week fetus if born, neonate can breathe at this time.
The placenta begins to form at implantation; the structure is complete
by week 12.
The normal fetal heart rate is 120 to 160 beats/min at term.
FHR is about twice the maternal heart rate.
The fetal heart rate is 160 to 170 beats/min in the first trimester.
Normally the human gestation period is about 280 days.
Nulligravida is a woman who has never been pregnant.
Primigravida is a woman who is pregnant for the first time.
Parity is the number of births (not the number of fetuses, E.g., twins)
carried past 20 weeks gestation, whether or not the fetus was born alive.
Nullipara is a woman who has not had a birth at more than 20 weeks of
gestation.
Primipara is a woman who has had one birth that occurred after the
twentieth week of gestation.
Amenorrhea, nausea and vomiting, increased size and increased feeling
of fullness in breasts, pronounced nipples, urinary frequency, quickening,
fatigue and discoloration of the vaginal mucosa are the presumptive signs of
pregnancy.
Uterine enlargement, Hegar's sign, Goodell's sign, Chadwick sign,
ballottement, Braxton hicks concentration, and positive hcg test are the probable
sign of pregnancy.
Fetal heart rate, active fetal movements palpable by examiner and
outline of fetus via radiography or ultrasound are the positive signs of
pregnancy.
At 20 to 22 weeks, the fundus is approximately at the location of the
umbilicus.
Fundal height is measured to evaluate the gestational age of the fetus.
At 36 weeks, the fundus is at the xiphoid process.
When assessing fundal height, monitor the client closely for supine
hypotension when placed in the supine position.
Women younger than 20 years and older than 35 years are at risk for
adverse perinatal outcomes.
Women of childbearing age should take folic acid supplements to prevent
neural tube defects and orofacial clefts in the fetus.
During pregnancy nausea and vomiting may occur as a result of the
secretion of human chorionic gonadotropin; it subsides by the third month.
Alpha-fetoprotein level is determined by a maternal blood sample drawn
between 16 to 18 weeks gestation.
Chorionic villus sampling is performed at 10 to 13 weeks gestation.
Amniocentesis is performed between 15 to 20 weeks of pregnancy.
The fern test is a microscopic slide test to determine the presence of
amniotic fluid leakage.
A Nitrazine test strip is used to detect the presence of amniotic fluid
in vaginal secretions
In presence of amniotic fluid nitrazine strip convert in blue color.
Reactive nonstress test (normal, negative) indicates a healthy fetus.
Negative contraction stress test is normal.
Positive contraction stress test is abnormal.
An increase of about 300 calorie/day is needed during pregnancy.
An increase of about 500 calorie/day is needed during lactation.
Abortion means a pregnancy that ends before 20 weeks gestation,
spontaneously or electively.
Gestational diabetes mainly occurs during second and third trimester.
Pregnant women should be screened for gestational diabetes between 24
and 28 weeks of pregnancy.
A 3-hour oral glucose tolerance test is performed to confirm
gestational diabetes mellitus.
Oral hypoglycemic agents are never prescribed for use during pregnancy
(gestational diabetes).
Gestational diabetes frequently can be treated by diet alone; however,
some clients may need insulin.
Most common location of ectopic pregnancy is the ampulla of the
fallopian tube.
Methotrexate is given in ectopic pregnancy. It is a folic acid antagonist,
may be prescribed to inhibit cell division in the developing embryo.
Hydatidiform mole is a form of gestational trophoblastic disease.
Absence of fetal heart rate, vaginal bleeding, symptoms of gestational
hypertension, fundal height greater than expected for gestational date, elevated
human chorionic gonadotropin levels and characteristic snowstorm pattern shown
on ultrasound are the features of hydatidiform mole.
After evacuation of hydatidiform mole instruct the client to avoid the
pregnancy for 1 year.
To prevent hyperemesis gravidarum encourage the client for intake of
small portions of food like low-fat, easily digestible carbohydrates, such as
cereals, rice, and pasta.
Hypertension, generalized edema, and proteinuria are the signs of
preeclampsia.
Abruptio placenta, disseminated intravascular coagulation, thrombocytopenia,
placental insufficiency, intrauterine growth restriction, and intrauterine
fetal death are the complications of gestational hypertension.
Nurse monitor for HELLP syndrome, a laboratory diagnosis for severe
preeclampsia characterized by hemolysis, elevated liver enzyme levels, and low
platelet count.
To treat preeclampsia magnesium sulfate is prescribed and it is
preventing the client from seizures.
Flushing, sweating, hypotension, depressed deep tendon reflexes, and
central nervous system depression including respiratory depression are the
signs of magnesium toxicity.
Calcium gluconate is the antidote for magnesium toxicity.
Incompetent cervix refers to premature dilation of the cervix, which occurs
most often in the fourth or fifth month of pregnancy and is associated with
structural or functional defects of the cervix.
Toxoplasmosis is an infection with the intracellular protozoan parasite
toxoplasma gondii.
Condyloma acuminatum is caused by human papilloma virus.
Trichomonas vaginalis is a protozoal STD disorder and it is detected by
normal saline wet smear of vaginal secretions indicates the presence of
protozoa.
Metronidazole is used to treat trichomonas vaginalis.
Bacterial vaginosis is caused by haemophilus vaginalis (Gardnerella
vaginalis) and transmitted via sexual contact.
In bacterial vaginosis the client complains of “fishy odour” to vaginal
secretions and increased odour after intercourse.
Labour is a coordinated sequence of involuntary, intermittent uterine
contractions.
Delivery is an actual event of birth.
Four P's of labour are power, passageway, passenger, and psyche.
Attitude is the relationship of the fetal body parts to one another.
The normal intrauterine attitude is flexion.
Lie is a relationship of the spine of the fetus to the spine of the
mother.
Presentation is a portion of the fetus that enters the pelvic inlet
first.
Cephalic is the most common presentation. It has four variations- Vertex,
military, brow, and face.
The mother has a burst of energy, also known as “nesting”, often 24 to
48 hours before onset of labour.
False labour is also known as prodromal labour.
In true labour, contractions increase in duration and intensity. In false
labour, contractions are irregular and do not produce dilation, effacement, or
descent.
Fetal bradycardia: FHR is less than 120 beats/min for 10 minutes or
longer.
Fetal tachycardia: FHR is more than 160 beats/min for 10 minutes or longer.
If the fetal bradycardia and tachycardia occurs, change the position of
the mother, administer oxygen, and assess the mother's vital signs. Notify the
health care provider as soon as possible.
Uterine contraction intensity is about 50 to 75 mm Hg during labor and may
reach 110 mm Hg with pushing during the second stage.
The average resting tone is 5 to 15 mm Hg.
A labor curve, often called a Friedman curve.
Schultze mechanism: Centre portion of the placenta separates first, and
its shiny fetal surface emerges from the vagina.
Duncan mechanism: Margin of the placenta separates, and the dull, red,
rough, maternal surface emerges from the vagina first.
The bishop score is used to determine maternal readiness for labor and
evaluates cervical status and fetal position.
The bishop score is indicated before the induction of labor.
The bishop score of 6 or more indicates a readiness for labor
induction.
Supine hypotension occurs when the venous return
to the heart is impaired by the weight of the uterus on the vena cava.
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