Term
|
Definition
Presumptive
Probable
Positive |
|
|
Term
| Presumptive signs of pregnancy |
|
Definition
-amenorrhoea
-n/v; changes in taste
-Tingling and sensitive breasts
-Frequency of micturition(discharge of urine) 1st and 3rd trimesters
-increased appetite and thirst/cravings
-bleeding gums
-fatigue/tiredness |
|
|
Term
| Probable signs of pregnancy |
|
Definition
-Presence of HCG (Human Chorionic Gonadotropin) in blood and urine
- Goodell's sign - softening of the vaginal portion of the cervix
- Chadwick's/Jacquemiers sign - a bluish discolouration of the cervix, vagina and labia
-increased pigmentation of skin |
|
|
Term
| Postivie signs of pregnancy |
|
Definition
-Foetal parts felt
-Foetal heart heard
-Foetus visualised on ultrasound |
|
|
Term
| What is hCG's (Human Chorionic Gonadotrophin) function in pregnancy? |
|
Definition
-it is secreted from from the trophoblast
-prevents degeneration of the corpus luteum and stiumlates it to secrete oestrogen and progesterone until placenta takes over around 12 wks
-linked to changes in smell, taste and saliva
-may be responsible for nausea in 1st trimester
-has an immonosuppressant effect thereby preventing the woman from rejecting her foetus and placenta
-present in the bloodstream 7-10 days after conception, and in the urine 26-28 days |
|
|
Term
|
Definition
| the flattened outer cells of the blastocyst that eventually forms the placenta |
|
|
Term
|
Definition
| A hormone-secreting structure that develops in an ovary after an ovum has been discharged but degenerates after a few days unless pregnancy has begun |
|
|
Term
|
Definition
-hCG (Human Chorionic Gonadotrophin)
-hPL - Human Placental Lactogen
-Oestrogen
-Progesterone |
|
|
Term
| Human Placental Lactogen (hPL) |
|
Definition
-reduces maternal usage of glucose by reducing the response of maternal cells to insulin, thereby making more available to the foetus
-mobilises maternal lipid stores leaving the glucose for foetal uptake
-accelerates maternal transfer of amino acids to the foetus |
|
|
Term
|
Definition
-stimulates growth of tissues - uterus, breasts
-causes swelling and softening of connective tissue
-increases sensitivity of the uterus to progesterone
-increases sensitivity of maternal resp system to Co2
-effects lead to some water retention, oedema, pelvic relaxation of ligaments and joints |
|
|
Term
|
Definition
-lowers smooth muscle excitability
-has a role in implantation and helps to suppress maternal immunological response
-responsible for oesophageal reflux, N/V, UTI, Varicose veins, Haemorrhoids, Postural Hypotension and Body temp increase by 0.5-1 degree |
|
|
Term
| Respiratory adaptation during pregnancy |
|
Definition
-increased basal metabolic rate
-progesterone and oestrogen work to increase sensitivity of the resp centre to CO2 resulting in mild hyperventilation
-increases oxygen consumption - 20%
-Flared ribs and raised the position of the diaphragm caused by relaxing of the muscles and cartilage of the thorax
-change from abdominal to thoracic breathing
-sleep disordered, snoring |
|
|
Term
| Skeletal adaptation during pregnancy |
|
Definition
-progesterone relaxes ligaments and muscles thereby increasing pelvic capacity, pelvis is widened and the coccyx is able to be pushed out of the way during labour
-Lordosis of the spinal column (causes back pain) |
|
|
Term
|
Definition
| exaggerated forward curvature of the lumbar and cervical regions of the spinal column |
|
|
Term
| Renal adaptation during pregnancy |
|
Definition
-increased metabolic wastes from the maternal and foetal metabolism
-glomerular filtration rate increased by 40-50% in 1st Trimester due to increase in renal blood flow
-mild glycosuria, proteinuria and increased creatinine clearance - resulting from normal changes in renal function
-relaxation of smooth muscle by progesterone affecting the bladder and ureters increases the risk of urine stasis and UTI's
-sodium retention
-increased extracellular volume
-decreased bladder tone
-bladder capacity doubles |
|
|
Term
|
Definition
-filtration of fluid through the kidneys
-it allows water, solutes and small protein molecules to pass through, but blood cells and larger protein molecules are prevented from passing through.
-in pregnancy the glomerular size increases the the number of cells stay the same...therefore, larger molecules can pass through, thus the incidence of proteinuria |
|
|
Term
|
Definition
-filtration of fluid through the kidneys
-it allows water, solutes and small protein molecules to pass through, but blood cells and larger protein molecules are prevented from passing through.
-in pregnancy the glomerular size increases the the number of cells stay the same...therefore, larger molecules can pass through, thus the incidence of proteinuria |
|
|
Term
| Cardiovascular adaptation during pregnancy |
|
Definition
-increase in blood volume 30-50%
-Haemo dilution causes a drop in Hb (Haemoglobin/Iron)115-160d/l (non pregnant) to 100-150g/l (pregnant)
-WCC increases and iron stores can also fall
-BP same or drops slightly
-relaxation of walls of the veins increases their capacity by as much as a litre
-Skin and mucous membranes receive up to 70% increase in blood flow by the 36th week
-Supine posi causes uterus to compress vena cava and decrease venous return
-effects: heat intolerance, sweating, nasal congestion |
|
|
Term
| Integumentary adaptation in pregnancy |
|
Definition
| -melanocyte-stimulating hormone increases which causes deeper skin pigmentation that can lead to: chloasma (irregular brownish or blackish spots especially on the face), Linea nigra (pigmented line on abdomen from navel to pubis) and areola darkening and toughening |
|
|
Term
| Reproductive adaptation in pregnancy |
|
Definition
-enlargement of the uterus (12 wks felt outside pelvis, 20 wks reaches the umbilicus, 30 wks formation of lower uterine segment, 26 wks uterus reaches xiphisternum {lowest part of the sternum})
-softening of the cervix
-engorgement of the vulva
-growth and development of the breasts |
|
|
Term
|
Definition
-information sharing
-choices for maternity care
-information on community groups and agencies
-interviewing the woman
-options for antenatal education, place of birth, who is to be involved in the birth |
|
|
Term
| Assessment & Screening (early pregnancy) |
|
Definition
-review history
-identify and discuss alerting risk factors
-current health
-establish EDB (Estimated Date of Birth)
-discuss routine tests offered in pregnancy: bloods, urine, scans, PAP smears
-refer if warranted-dietician, physio
-discuss frequency of visits |
|
|
Term
|
Definition
-blood group and Rh factor
-Rhesus antibodies
-full blood count
-Hepatitis B
-rubella antibodies |
|
|
Term
| Maternal respiratory adaptions in pregnancy - Upper Resp tract changes |
|
Definition
| - Mucosa of nasopharrynx becomes more hyperaemic & oedematous due to increase in circulating oestrogen - marked nasal stuffiness, nose bleed (epistaxis) more common, polyposis of nose and nasal sinuses may develop |
|
|
Term
| Maternal respiratory adaptions in pregnancy - Anatomical changes |
|
Definition
- Muscles and cartilage of the thorax relax - shape of chest changes
- Diaphragm becomes raised by a max of 4cm
- Change from abdominal to thoracic breathing |
|
|
Term
| Maternal respiratory adaptions in pregnancy - Biochemical changes |
|
Definition
- Pulmonary ventilation increases by 40% during preg
- Tendency to overbreath - CO2 washed out of lungs - concentration is lower (progesterone causes an increased sensitivity to CO2)
-Progesterone may also contribute to decrease in airway resistance - reduces the work of breathing making a greater airway flow
- O2 consumption is increased |
|
|
Term
| Skeletal changes in pregnancy - Calcium & phosphorus metabolism |
|
Definition
- Absorption and urinary excretion of calcium is increased
- Phosphate and magnesium levels fall due to haemodilution |
|
|
Term
| Basic Purpose of Booking Visit |
|
Definition
-Info Sharing
-Choices for Maternity care
-Info on community groups & agencies
-Interview the woman
-Options for antenatal edu
-Establish place of birth
-who is to be involved in the birth |
|
|
Term
| Basic Antenatal Assessment & Screening |
|
Definition
-R/v history
-Id & discuss alerting or risk factors
-Current health
-Establish EDB
-Discuss routine tests offered during pregnancy: bloods, urine, scans, PAP smears
-refer if warranted - dietician, physio, wellbeing
-Discuss frequency of visits |
|
|
Term
| Basic Antenatal routine screening |
|
Definition
-Blood group & Rh factor
-Rhesus antibodies
-FBC
-Hep B
-Rubella antibodies |
|
|
Term
| Universal versus Risk Based Screening |
|
Definition
-HIV
-Hep C
-Triple/quadruple testing for Neural tube defects and Downs Syndrome
-Nuchal fold screening
-GDM
-TB
-Haemoglobinopathies - sickle cell, thalassaemia |
|
|
Term
| Basic Health Education in booking visit |
|
Definition
-Lifestyle changes (smoking, drinking, drugs, work, diet, exercise & self care)
-Safety - Physical & emotional
-Avoiding infections - listeria, toxoplasmosis, STIs |
|
|
Term
| Basic How of Booking Visit |
|
Definition
- Have a holisitc focus
-Two way process of info sharing and decision making
-R/v past, identify the present & plan for the future
-ID health & risk markers for potential ill health for the woman or her baby
-Include practical arrangements of care in terms of frequency, time and place |
|
|
Term
| Common discomforts of pregnancy |
|
Definition
Morning Sickness
Urinary frequency
Stretch marks (striae)
Increased perspiration
Uncomfortable warmth
Dizziness & syncope
Oedema
Varicose veins
Lower back ache
Abdominal pain
Leg cramps
Leucorrhea
Headaches
Fatigue
Sleep Difficulties
Dental Problems
Heartburn/Reflux |
|
|
Term
| Cause & Treatment for Morning Sickness |
|
Definition
Changes is taste and smell can contribute & more severe in women with higher hCG levels. Also, iron supplements can increase nausea.
Help: Eat small meals often, avoid greasy & spicy foods, drink small amounts of fluids often, mandarin oil, VitB6, accupressure/puncture, ginger tea & glace fruit, eat watermelon, carb snacks at bedtime & before rising. |
|
|
Term
| Cause & treatment for Urinary frequency |
|
Definition
Increased circulating volume, increased GFR, increased pressure on the bladder from the uterus in 1st & 3rd trimester
Help: Burning or pain needs to be ruled out for UTI & vaginal infections, maintain fluid intake |
|
|
Term
| Cause & treatment for Increased Perspiration |
|
Definition
Increases in endocrine glands on skin, possible because of increased thyroid activity, increased dilation of the blood vessels in the skin.
Help: reassure the this is normal, bathing, loose fitting clothing of absorbent material, control room temperature |
|
|
Term
| Cause & Tx for Dizziness & Syncope |
|
Definition
Growing uterus causes compression of lower extremities & pelvic veins causing venous pooling, warm weather makes it worse, hypoglycaemia secondary to n&v.
Help: calf exercises & long support stockings to combat venous pooling; use left lateral tilt position for correcting hypotension |
|
|
Term
|
Definition
Slowed venous return caused by uterine pressure on Vena Cava in 3rd tri, increased circulating blood volume.
Help: avoid sitting & standing for long periods of time, daily leg exercises, support stockings, loose fitting waistbands, leg elevation & rest |
|
|
Term
| Cause & Tx Varicose Veins |
|
Definition
Relaxation of smooth muscle, increased venous pressure in pelvis & lower extremities, found in legs & vulva, leads to leg fatigue & painful night leg cramps.
Help: rest & elevation, elastic stockings |
|
|
Term
| Cause & Tx Lower back ache |
|
Definition
Altered center of gravity, stretched abdo muscles, lumbar lordosis, 3rd tri joints & ligaments become more lax.
Help: avoid excessive weight gain, improve posture, proper bending with straight back, sleeping on firm mattress, local heat, massage |
|
|
Term
|
Definition
1+ slight pitting, disappears rapidly (2 mm)
2+ deeper pit, disappears in 10-15 secs (4mm)
3+ Pit is noticeably deep and may last more than a minute. The extremity looks fuller & swollen (6mm)
4+ the pit is very deep, lasts 2-5mins, and the extremity is grossly distorted (8mm) |
|
|
Term
| Cause & Tx Abdominal Pain |
|
Definition
Sharp pain caused by spasm of round ligaments...enlarged uterus make them more susceptible, pain associated with abrupt movements, other causes: contractions, gastroenteritis, appendicitis & renal or billary colic
Help: physical exercise within tolerance, rise & sit gradually, avoid sudden movements, rest with local heat appplication |
|
|
Term
|
Definition
caused by a build up of acids that cause involuntary contractions of the affected muscles, usually at night, more common in 2nd & 3rd trimesters
Help: walk around, stretch & massage the affected muscles to disperse the build up of acids |
|
|
Term
|
Definition
Vaginal flow is increased - whitish in colour & variable consistency, non-problematic unless accompanied with itching, burning, foul odour or labial swelling; change in quantity or quality should be differentiated from leaking or ruptured membranes
Help: regular hygiene & wear cotton underwear |
|
|
Term
|
Definition
Can be related to sinus congestion, increased vascular blood flow, nasal oedema, fatigue, tension eyestrain & migraines
Help: relaxation & warm compresses, be alert for headaches that are accompanied by dizziness, blurred vision(possible sign of preeclampsia) |
|
|
Term
|
Definition
can be related to basal metabolic rate, increased demand on CV & renal systems, loss of sleep due to urinary frequency, emotional factors, stress anxienty, depression
Help: proper nutrition & exercise & treat possible anaemia with diet & exercise |
|
|
Term
| Cause & Tx sleep difficulties |
|
Definition
early in pregnancy (psychological stressors & frequency of urination), later in pregnancy (difficulty finding position of comfort, fetal movements, feeling short of breath)
Help: plan quiet time before going to bed, limit fluid intake prior to sleeping, pillows to support back, abdomen & legs, warm bath or shower and massage, meditation & visualisation, warm milk |
|
|
Term
| Cause & Tx dental problems |
|
Definition
gum hypertrophy, gum bleeding (gingivitis) & tooth decay (more rapid in pregnancy)
Help: soft toothbrush, mild toothpaste, daily flossing, dental work can be done with anaesthesia |
|
|
Term
| Cause & Tx Heartburn/reflux |
|
Definition
Caused by reflux of acid gastric contents into oesophagus, most problematic after 30wks, main cause: relaxing effect of progesterone on muscle of cardiac sphincter
Help: avoid bending over doing work, sleep more upright, balanced not spicy small reg meals, antacids can be prescribed |
|
|
Term
| Regions/presentations of the foetal skull |
|
Definition
|
|
Term
| Bones of the foetal skull |
|
Definition
Parietal, Temporal, Occipital & Frontal
Named for the part of the brain lying beneath it |
|
|
Term
| Sutures of the foetal skull |
|
Definition
| Frontal, sagittal, lambdoidal & coronal |
|
|
Term
|
Definition
| Lies between the two frontal bones |
|
|
Term
|
Definition
| runs from the anterior to the posterior fontanelle, uniting the two parietal bones |
|
|
Term
|
Definition
| lies between the posterior edges of the parietal bones and the occipital bone |
|
|
Term
|
Definition
| Separates the posterior edges of the two frontal bones from the anterior edges of the two parietal bones |
|
|
Term
| Fontanelles of the foetal skull |
|
Definition
Anterior(bregma)
Posterior (lambda) |
|
|
Term
|
Definition
| the area of the two frontal bones, extending from the orbital ridges to the anterior fontanelle |
|
|
Term
|
Definition
| bounded by the anterior fontanelle, the posterior fontanelle and the two parietal eminences |
|
|
Term
|
Definition
| extends from the chin to the orbital ridges |
|
|
Term
|
Definition
| the area over the occipital bone, extending from the posterior fontanelle to the nape of the neck. |
|
|
Term
|
Definition
| iamond-shaped and formed at the junction of four sutures: the frontal parietal and two halves of the coronal sutures. It measures 2.5 cm across by 3 cm long |
|
|
Term
|
Definition
| triangular in shape and formed at the junction of three sutures: the sagittal suture and the two halves of the lambdoidal suture |
|
|
Term
|
Definition
Diameter of the foetal skull in normal birth. Measured from the nape of the neck to the centre of the anterior fontanelle. It is 9.5cm and presents when the head is fully flexed.
Circumference is 33cm |
|
|
Term
|
Definition
| Bleeding between the bone of the pericranium forming a swelling |
|
|
Term
|
Definition
| Oedema formed in the loose tissue of the foetal head. Results from venous return being impeded as the head is pressed against the ring of the dilating cervix |
|
|
Term
| Measurements of the gynaecoid pelvis |
|
Definition
Brim (Anterioposterior:11cm, Oblique:12cm, Transverse:13cm)
Cavity (AP:12cm, Ob:12cm, Trans:12cm)
Outlet (AP:13cm, Ob:12cm, Trans:11cm) |
|
|
