Fetal Development and Cardiovascular Changes

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Questions and Answers

What is the management strategy for relieving pressure on the kidneys during pregnancy?

Rest at right side-lying position

Engage in high-impact exercises

Raise legs above hip level (correct)

Raise legs below hip level

What is a recommended treatment for pain associated with hemorrhoids during pregnancy?

Non-steroidal anti-inflammatory drugs

Hot compress application

Witch hazel application (correct)

Mild massage therapy

Why are pregnant women at an increased risk of blood clot formation?

Lower blood volume

Increased levels of circulating fibrinogen (correct)

Decreased levels of circulating red blood cells

Increased physical activity levels

What should be avoided to prevent the risk of thromboembolism during pregnancy?

Massaging the legs Signup and view all the answers

What effect does the weight of the uterus have on the veins in pregnant women?

Increases pressure on veins returning blood Signup and view all the answers

Which of the following is a noted symptom associated with Deep Vein Thrombosis (DVT)?

Pain in the calf upon dorsiflexion Signup and view all the answers

What is the recommended position for a patient to reduce pressure on the inferior vena cava?

Side-lying, preferably on the left side Signup and view all the answers

Which anticoagulant should never be given to a patient with DVT?

Coumadin Signup and view all the answers

What is a crucial supportive measure for a patient when experiencing symptoms of DVT?

Use of support hose or elastic stockings Signup and view all the answers

What condition might a patient experience when lying on their back during the second trimester?

Supine hypotension syndrome Signup and view all the answers

Which is a common misconception about managing DVT symptoms?

Massaging the affected area is beneficial. Signup and view all the answers

What might a patient exhibit with 'Milk Leg' or 'Phlegmasia Alba Dolens'?

A shiny, white appearance of the leg Signup and view all the answers

Which of the following should be avoided to prevent aggravating bleeding in DVT patients?

Administration of Aspirin Signup and view all the answers

What is defined as the stage from fertilization to implantation?

Zygote Signup and view all the answers

At what point is the age of viability generally accepted for a fetus?

24 weeks Signup and view all the answers

Which of the following methods can provide a precise measurement of heart rate?

Electrocardiogram (ECG) Signup and view all the answers

What does a gradual increase of 30-50% in total cardiac volume indicate during pregnancy?

Physiologic anemia of pregnancy Signup and view all the answers

What is the recommended method to measure stroke volume non-invasively?

Echocardiography (Ultrasound) Signup and view all the answers

Which characteristic is associated with the cardiovascular system toward the end of the 3rd trimester?

Drop in hemoglobin and hematocrit values Signup and view all the answers

Which of the following describes the embryo stage of development?

From implantation to 5-8 weeks Signup and view all the answers

What symptom might indicate cardiovascular changes during pregnancy?

Easy Fatigability Signup and view all the answers

What is the ideal INR range for patients taking Warfarin?

2 to 3 Signup and view all the answers

Which antidote is used for Warfarin toxicity?

Vitamin K Signup and view all the answers

What is the maximum PTT range for patients on Heparin?

40 to 70 seconds Signup and view all the answers

What dietary recommendation is made for managing morning sickness?

Carbohydrates like toast or crackers Signup and view all the answers

What physiological change contributes to physiological anemia during pregnancy?

Plasma volume expansion Signup and view all the answers

What are common symptoms of hyperemesis gravidarum?

Excessive nausea and vomiting Signup and view all the answers

What mechanism is most often attributed to morning sickness during the first trimester of pregnancy?

Increased acidity Signup and view all the answers

Which condition denotes significant dehydration and starvation beyond the first trimester in pregnant individuals?

Hyperemesis gravidarum Signup and view all the answers

What cervical change occurs in the first and third trimester of pregnancy?

Cervix softens and darkens in color Signup and view all the answers

What is the significance of lactic acid in the vaginal environment during pregnancy?

It enhances resistance to bacterial invasion Signup and view all the answers

Which of the following describes the Chadwick sign?

Increased vascularity leading to color changes in the vaginal wall Signup and view all the answers

What is the expected pH level of the vagina during pregnancy?

Around 4 to 5 (Acidic) Signup and view all the answers

Which of the following is a common preliminary sign of pregnancy?

Feeling of fullness and tenderness in the breasts Signup and view all the answers

What happens to the cervix just before labor?

It becomes very soft, akin to butter Signup and view all the answers

What symptom indicates a potential metabolic alkalosis condition during pregnancy?

Decreased hemoglobin and hematocrit levels Signup and view all the answers

What is the expected management for a pregnant woman showing symptoms of metabolic alkalosis?

Administer D10NSS 3000ML over 24 hours and ensure complete bedrest Signup and view all the answers

Study Notes

Fetal Growth Terminology

Ovum: From ovulation to fertilization.
Zygote: From fertilization to implantation.
Embryo: From implantation to 5-8 weeks.
Fetus: From 5-8 weeks until term.
Conceptus: Developing embryo and placental structures throughout pregnancy.
Age of Viability: Generally accepted as 24 weeks or when the fetus weighs over 500-600g.

Cardiovascular System Changes During Pregnancy

Gradual 30-50% increase in total cardiac volume, peaking at 6 months.
Drop in hemoglobin and hematocrit due to increased plasma volume (physiologic anemia of pregnancy).
Manifestations: Easy fatigability and shortness of breath.
Management: Raise legs above hip level, rest in left side-lying position (improves kidney glomerular filtration rate and venous return).
Supine hypotension syndrome: Blood pressure may drop slightly in the second trimester when lying supine due to uterine pressure on the inferior vena cava. Management: Turn to side-lying position (left side preferred).

Varicosities

Development of tortuous leg veins due to uterine weight pressure on veins.
Management: Avoid massaging, rest with legs elevated, use support hose, avoid prolonged sitting or constrictive clothing.

Thrombus Formation

Increased circulating fibrinogen predisposes to blood clot formation.
Management: Avoid massaging to prevent thromboembolism. At-risk individuals include those with family history, obesity, large fetus, or multiple pregnancies.

Thrombophlebitis/Deep Vein Thrombosis (DVT)

Venous inflammation with thrombus formation.
Positive Homan's sign (calf pain on dorsiflexion).
Milk leg (phlegmasia alba dolens): Shiny white leg due to skin stretching and inflammation.
Management: Complete bed rest, avoid massaging, administer heparin (not coumadin), avoid aspirin.

Heparin vs. Warfarin

Heparin: Fast onset, antidote is protamine sulfate, PTT monitoring (40-70).
Warfarin: Slow onset, antidote is Vitamin K, INR monitoring (2-3).

Physiologic Anemia

Hemodilution of blood due to 45-50% increase in blood volume (75% plasma, 25% RBC).
Normal values: Hematocrit 32-42%, Hemoglobin 10.5-14 g/dL. Hematocrit and hemoglobin shouldn't fall significantly in the 1st and 3rd trimesters.

Gastrointestinal System Changes

Morning sickness (nausea and vomiting) common in the first trimester due to increased HCG and progesterone, increased acidity, or emotional factors.
Management: Eat small, frequent meals, avoid trigger foods.
Hyperemesis gravidarum: Excessive nausea and vomiting persisting beyond 3 months, leading to dehydration, starvation, and acidosis; may result in metabolic alkalosis. Management: IV fluids, complete bed rest.

Cervical Changes

Softening and increased vascularity, causing the cervix to darken from pale pink to violet (Chadwick's sign).
Consistency changes from firm (like a nose) to soft (like an earlobe) to buttery soft just before labor.

Vaginal Changes

Increased vascularity causes a color change from light pink to deep violet.
pH changes from alkaline (>7) to acidic (4-5) due to Lactobacillus acidophilus, increasing resistance to bacterial invasion.

Breast Changes

Fullness, tingling, and tenderness starting around 6 weeks.

Weight Gain Distribution During Pregnancy

Note: The provided text does not specify details regarding the distribution of weight gain during pregnancy.

Signs of Pregnancy

Presumptive signs: Symptoms suggesting pregnancy but not definitive. The provided text does not list specific presumptive signs.

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Description

Explore the key terminology related to fetal growth, from ovum to fetus, and understand the cardiovascular adaptations that occur during pregnancy. This quiz covers critical aspects of maternal physiology, including changes in blood volume and the management of common pregnancy-related issues.