Fetal Lifespan and Development

The Yolk sac provides initial nutrition and gas exchange for the developing embryo.

Exposure to teratogens, certain medications, chemicals, radiation, cannabis, illicit drugs, alcohol, and infections such as rubella can increase the risk of birth defects.

Breathing movements become noticeable between weeks 11-14, surfactant production starts between weeks 23-26, and lungs are fully developed by 38-40 weeks.

The heart is fully developed and starts pumping blood by week 6.

The fetal kidneys are fully formed by weeks 31-34, and the testes descend into the scrotum by week 6.

Amenorrhea (missed period), breast tenderness, fatigue, nausea, and frequent urination are all possible signs of pregnancy

Hemorrhoids, swollen feet, insomnia, and belly tightening are typical physical changes during the third trimester. Bleeding during this period is a concern and could be a sign of preterm labor

Leopold Maneuvers are a series of steps used to assess the fetal position inside the uterus.

Kick counts are important to monitor fetal well-being. Expect more than 10 movements within 2-3 hours.

The mother's heart rate increases by about 20% above her baseline during pregnancy.

Lightening, which occurs near the end of pregnancy, reduces pressure on the diaphragm, making breathing easier for the mother.

hCG (Human Chorionic Gonadotropin), Progesterone, Estrogen, and Prolactin.

The normal fetal heart rate ranges from 110 to 160 beats per minute.

A positive pregnancy test, ballottement (a bouncing sensation when the uterus is pressed), softening of the uterus and cervix, and a bluish discoloration of the vagina are all probable signs of pregnancy.

Naegele's Rule is a way to estimate the due date by subtracting three months from the first day of the last menstrual period and adding seven days.

Urinalysis during the first trimester may show a small amount of protein, which is normal during pregnancy.

Contractions that increase in intensity and frequency, leakage of amniotic fluid from the vagina, and blood-tinged vaginal mucus are signs of true labor.

The glucose challenge screening involves drinking a sugary drink and having blood drawn after one hour. A normal result is below 140.

Age over 35 is a significant risk factor for developing high blood pressure during pregnancy.

A nonstress test (NST) is a non-invasive method of assessing fetal well-being using external monitoring of fetal heart rate. The expected outcome is an increase in fetal heart rate of at least 15 beats per minute for 15 seconds.

The alpha-fetoprotein (AFP) test is a blood test done during pregnancy to assess the fetus' risk of birth defects, especially neural tube defects.

Amniotic fluid infection, polyhydramnios (excess amniotic fluid), and an overdistended uterus (as in multiple pregnancies) can increase the risk of preterm premature rupture of membranes (PPROM).

Age, genetics, race, and chronic illnesses are nonmodifiable risk factors for pregnancy complications. They cannot be changed.

Complete abortion involves the expulsion of all pregnancy products, incomplete involves some retained products, inevitable means expulsion is inevitable, threatened involves bleeding and cramping with a closed cervix, and missed means the fetus has died but not been expelled yet.

Conditions that affect the fallopian tubes are a high risk, especially those that cause scarring. Women over 35, those with endometriosis, PID, or a history of smoking also have increased risk.

If the placenta doesn't migrate up by the third trimester and remains close to or covers the cervix, this is called marginal placenta previa.

A history of thrombophilia in a first-degree family member increases the risk of inherited thrombophilia. Autoimmune diseases like SLE can cause acquired thrombophilia.

The increased blood volume during pregnancy can increase the risk of blood clots because the blood is thicker and more prone to clotting.

Age less than 15 or over 35, a previous molar pregnancy, infertility, and spontaneous abortions are all risk factors for a molar pregnancy.

Monitor for tachycardia and hypotension, as a ruptured ectopic pregnancy can cause rapid heart rate and low blood pressure.

Placental abruption can be caused by factors like high blood pressure, smoking, drug use, trauma, and a history of prior abruption.

The most common cause of spontaneous abortion is fetal chromosomal abnormalities, although the exact cause is often unknown. Modifiable risk factors, such as lifestyle choices, can increase the risk.

A molar pregnancy initially presents as a viable pregnancy, so early symptoms often mimic a normal pregnancy. However, hCG levels will be abnormally high, usually above 100,000.

An ultrasound is used to check gestational viability and fetal heartbeat. In a spontaneous abortion, fetal length exceeding 7mm with no fetal heart tones is a diagnostic finding.

Light, chronic, and intermittent vaginal bleeding is a common manifestation of placenta previa.

Diagnostic tests for placenta previa include a CBC, coagulation studies, and an ultrasound. A digital exam is avoided to prevent further bleeding.

Start an IV, monitor vital signs, monitor fetal heart rate, and place the client on their side. These interventions help manage the situation and support the client and fetus.

Misoprostol is commonly used for uterine evacuation of products of conception in a spontaneous abortion.

After surgery for a molar pregnancy, teach the client about potential complications, the need for contraception during treatment, and the importance of contacting the doctor for heavy vaginal bleeding.

Progesterone is used medically to help prevent premature delivery in women with cervical insufficiency. This medication is typically used until 36 weeks of gestation.

Anticoagulation therapy using low molecular weight heparin is a key component of care for clients with thrombophilia. Regular NST visits are required at 36 weeks gestation.

Provide emotional support, prepare for potential cerclage placement, and educate the client on the importance of prenatal care.

Eclampsia can cause unexpected placental implantation, inadequate blood flow to the placenta, and changes in the mother's blood pressure, leading to cerebral vascular dysfunction.

Preeclampsia with severe features is primarily caused by inadequate blood flow to the placenta and subsequent placental dysfunction. This can lead to a cascade of issues.

HELLP syndrome is a severe form of preeclampsia and its primary clinical manifestation is the destruction of red blood cells, leading to anemia, low platelet count, and elevated liver enzymes.

Magnesium Sulfate is given to treat HELLP syndrome to help prevent seizures by relaxing muscles and reducing nerve activity.

Clients with gestational hypertension should refrain from smoking, alcohol, and high-sugar foods, maintain a healthy diet, exercise regularly, limit caffeine, avoid supplements without consulting the doctor, and attend all prenatal appointments.

A primary cause of oligohydramnios is chronic uteroplacental ischemia, which is a reduction in blood flow to the placenta, ultimately affecting the amniotic fluid.

Graves' disease, thyroiditis, and goiter are all potential causes of hyperthyroidism.

Pregestational type 1 diabetes is generally associated with genetic factors and family history, whereas gestational diabetes is more likely linked to factors like BMI over 25, a prior history of GDM, family history of diabetes, history of A1C 5.7%-6.4%, or a previous large for gestational age (LGA) infant.

Elevated hCG due to a molar pregnancy or multiple gestation, estradiol increase due to elevated hCG, and nausea due to motion can all contribute to hyperemesis gravidarum.

Clients with gestational diabetes often require increased antenatal testing (nonstress tests), more frequent provider visits, additional lab testing, and potentially increased financial stress due to the need for special care.

Hemoglobin A1C should be monitored every 2 months during pregnancy for clients with gestational diabetes to manage blood sugar levels.

Signs of dehydration include a furrowed tongue, dry skin, dizziness, dark or strong-smelling urine, headaches, rapid heart rate, and confusion.