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At what week of gestation can fetal heart sounds typically be detected through Doppler technology?
What is the normal fetal heart rate range during pregnancy?
Which sign indicates the softening of the cervix due to increased vascularity during pregnancy?
When can the embryo typically be identified using ultrasound scanning?
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What form does the mucus plug take during pregnancy, and what is its primary purpose?
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What happens to the pH level of the vaginal environment during pregnancy?
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What is the significance of palpating the entire fetus after 24 weeks of pregnancy?
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Which sign is characterized by a change in the color of vaginal walls from light pink to a deep violet due to increased circulation?
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What condition can result from the pressure of the gravid uterus on the veins and arteries during the third trimester?
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What physiological change causes supine hypotension syndrome during pregnancy?
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What is linea nigra?
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Which hormone is primarily responsible for the development of melasma during pregnancy?
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What causes dyspnea in the third trimester of pregnancy?
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What happens to residual volume in the lungs during pregnancy?
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What role does increased fibrinogen play during pregnancy?
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What change occurs to white blood cell (WBC) levels during pregnancy?
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At what stage of pregnancy is fetal movement typically first elicited?
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What causes the darkening of the areola during pregnancy?
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What is the total iron requirement for a pregnant mother to support both her and the fetus?
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Which of the following is a common systemic change during pregnancy?
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What is the primary role of Montgomery's tubercles during lactation?
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Which nutrient deficiency is linked to increased neural tube disorders in fetuses?
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What leads to pseudoanemia in pregnant women?
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What is a physiological change that occurs in the breasts during pregnancy?
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What are the effects of prolactin beginning late in pregnancy?
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What role does the renin-angiotensin-aldosterone system (RAAS) play in pregnancy?
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What triggers the release of renin during pregnancy?
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How does aldosterone function in the urinary system during pregnancy?
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What happens to the specific gravity of urine during early pregnancy?
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What is the typical blood glucose level of a fetus during early pregnancy?
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Why are parathyroid glands important during pregnancy?
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How does the thyroid gland change during pregnancy?
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What causes heartburn during pregnancy?
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Which hormone is primarily responsible for increasing glucose availability for fetal growth?
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What physiological change is associated with hyperptyalism during pregnancy?
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What is a consequence of decreased bile emptying during pregnancy?
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Which gland produces oxytocin and is involved in labor at term?
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Which hormone is secreted primarily by corpus luteum and inhibits uterine activity during pregnancy?
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What is a common digestive issue experienced during pregnancy due to hormonal changes?
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Which hormone secreted by trophoblast cells is elevated in early pregnancy?
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Study Notes
Fetal Development Assessment
- Fetal heart sounds can be detected as soon as 6 weeks via echocardiography.
- Ultrasound scanning of the fetus can identify the gestation sac as early as 4 weeks after conception.
- Palpation of the entire fetus is a positive sign after 24th week of pregnancy.
- Fetal movement can be felt by a trained examiner between the 20th and 24th week of pregnancy.
Braxton Hicks Contractions
- These are "practice contractions" that help ensure the placenta receives adequate blood flow.
Cervical Changes
- Goodell's Sign: Softening of the cervix due to vascularization and edema caused by estrogen.
- Operculum: A mucus plug that seals out bacteria and helps prevent infection.
Vaginal Changes
- Chadwick's Sign: Deep violet color of the vaginal walls due to increased circulation and estrogen.
- Leukorrhea: Increased vaginal discharge due to increased epithelial cell activity.
- Vaginal pH Change: Shift from alkaline (greater than 7) to acidic (4 or 5) due to Lactobacillus acidophilus growth and lactic acid production.
Ovarian Changes
- Ovulation ceases during pregnancy.
Breast Changes
- Feeling of tingling, fullness or tenderness in the breasts due to high estrogen.
- Increase in breast size.
- Darkening of areola and increase in diameter.
- Montgomery’s tubercles: Enlarged sebaceous glands that keep the nipple supple and prevent cracking.
Systemic Changes
Integumentary System
- Striae gravidarum: Stretch marks due to abdominal wall tension from the enlarging uterus.
- Diastasis: Separation of rectus muscles.
- Linea nigra: Brown line from umbilicus to symphysis pubis.
- Melasma: "Mask of pregnancy" due to melanocyte-stimulating hormone.
- Vascular spiders: Due to increased estrogen.
Respiratory Changes
- Nasopharynx Congestion: Due to increased estrogen levels.
- Dyspnea: Shortness of breath in the late third trimester due to upward pressure on the lungs and elevated diaphragm.
- Residual Volume: Decreases by up to 20% due to diaphragmatic pressure.
- Tidal Volume: Increases by up to 40%.
- Oxygen Consumption: Increases by 20%.
- Mild Hyperventilation: To blow off excess CO2.
- Temperature: Slightly increases due to progesterone.
- Increased Blood Volume: To provide for an adequate exchange of nutrients in the placenta.
- Pseudoanemia: Plasma volume increases faster than RBCs, causing a decline in hemoglobin and erythrocyte concentration.
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Iron, Folic Acid, Vitamin Needs:
- Fetus requires 350-400mg of iron for growth.
- Mother requires additional 400mg of iron for increased RBC mass.
- Total iron requirement = 800mg.
- Folic acid deficiency linked to neural tube disorders.
- Foods high in folic acid: spinach, asparagus, legumes.
Cardiovascular Changes
- Peripheral Blood Flow: Impaired blood flow to lower extremities in the third trimester due to pressure on veins and arteries.
- Edema and Varicosities: Can occur in the vulva, rectum, and legs due to impaired blood flow.
- Supine Hypotension Syndrome: Weight of the uterus presses on vena cava, obstructing blood flow. This can cause lightheadedness, faintness, and palpitation.
- Increased Fibrinogen: Necessary for clotting and increased due to estrogen.
- Increased WBC: Protective mechanism due to increased blood volume.
- Decreased Protein Level: Protein used by the fetus.
Gastrointestinal Changes
- Heartburn (Pyrosis): Reflux of stomach contents due to relaxed cardioesophageal sphincter caused by relaxin and progesterone.
- Flatulence and Constipation: Slow gastric emptying and intestinal peristalsis due to relaxin and progesterone.
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Nausea and Vomiting:
- Due to decreased glucose levels (glucose used by the fetus), FBS 95mg/dl or lower.
- Increased hCG, estrogen, and progesterone levels.
- Hyperptyalism: Increased saliva formation due to estrogen.
- Subclinical Jaundice: Decreased bile emptying leads to reabsorption of bilirubin, causing generalized itching.
- Hypertrophy of Gumlines and Bleeding: Increased cholesterol in bile can lead to stone formation and bleeding gums.
Urinary System
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Fluid Retention:
- Increased aldosterone production due to progesterone.
- Renin-angiotensin-aldosterone system (RAAS) regulates blood volume and vascular resistance.
- Aldosterone promotes sodium reabsorption and maintains fluid osmolarity.
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Renal Function:
- Increased urine output by 60-80%.
- Decreased specific gravity of urine.
- Increased glomerular filtration rate (GFR) and renal plasma flow.
- Glomerular Filtration Rate (GFR): Increased by 50% during pregnancy.
Endocrine Changes
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Hormonal Changes:
- hCG (Human Chorionic Gonadotropin): Secreted by trophoblast cells in early pregnancy.
- hPL (Human Placental Lactogen): Antagonist to insulin, allowing more glucose for fetal growth.
- Relaxin: Secreted by corpus luteum, inhibits uterine activity, softens cervix, and collagen in joints.
- Prostaglandins: Affect smooth muscle contractility and may trigger labor.
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Pituitary Gland:
- Produces GH and MSH.
- Oxytocin aids in labor.
- Prolactin prepares for lactation.
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Thyroid and Parathyroid:
- Thyroid enlarges, increasing basal metabolic rate.
- Parathyroid regulates calcium metabolism.
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Adrenal Glands:
- Increased corticosteroids and aldosterone levels, help suppress immune response to fetus.
- Regulate glucose metabolism.
- Aldosterone promotes sodium reabsorption.
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Pancreas:
- Increased insulin production due to higher glucocorticoid levels.
- Fetal glucose level 30mg/100ml.
- Pregnant women need high calorie diets and frequent meals.
- Early pregnancy FBS 80-85mg/100ml.
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Description
Test your knowledge on fetal development, including signs of pregnancy, fetal heart sounds, and cervical changes. This quiz covers important milestones and physiological changes that occur during pregnancy. Assess your understanding of the various stages and signs related to fetal growth.
