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Questions and Answers
What is the indication for immediate delivery when assessing fetal well-being through NST scoring?
What is the indication for immediate delivery when assessing fetal well-being through NST scoring?
Which of the following is considered a presumptive sign of pregnancy?
Which of the following is considered a presumptive sign of pregnancy?
At how many weeks' gestation is quickening typically first felt by a primigravida?
At how many weeks' gestation is quickening typically first felt by a primigravida?
Which hormone is primarily detected in laboratory tests for pregnancy?
Which hormone is primarily detected in laboratory tests for pregnancy?
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What is the term for the dark line that appears on a pregnant woman's abdomen?
What is the term for the dark line that appears on a pregnant woman's abdomen?
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What minimal score on a fetal NST requires further evaluation due to non-reassuring results?
What minimal score on a fetal NST requires further evaluation due to non-reassuring results?
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Which of the following is a probable sign of pregnancy?
Which of the following is a probable sign of pregnancy?
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What is the best time to perform a urine pregnancy test for the most accurate result?
What is the best time to perform a urine pregnancy test for the most accurate result?
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What is the role of the mucus plug formed by cervical glands during pregnancy?
What is the role of the mucus plug formed by cervical glands during pregnancy?
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Which hormone is primarily responsible for muscle relaxation in the smooth muscles during pregnancy?
Which hormone is primarily responsible for muscle relaxation in the smooth muscles during pregnancy?
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Which of the following factors contributes to the development of edema in the lower extremities during pregnancy?
Which of the following factors contributes to the development of edema in the lower extremities during pregnancy?
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What is the expected change in hemoglobin (Hgb) levels during pregnancy?
What is the expected change in hemoglobin (Hgb) levels during pregnancy?
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Which of the following methods is NOT recommended for relieving lower extremity edema?
Which of the following methods is NOT recommended for relieving lower extremity edema?
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How is the perception of fetal movements typically assessed during pregnancy?
How is the perception of fetal movements typically assessed during pregnancy?
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Which explanation accurately describes the physiological cause of nasal and sinus congestion during pregnancy?
Which explanation accurately describes the physiological cause of nasal and sinus congestion during pregnancy?
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Which of the following statements regarding Braxton-Hicks contractions is true?
Which of the following statements regarding Braxton-Hicks contractions is true?
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What indicates a reactive Nonstress Test (NST)?
What indicates a reactive Nonstress Test (NST)?
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In a Contraction Stress Test, what does a negative result indicate?
In a Contraction Stress Test, what does a negative result indicate?
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What is the normal range for Amniotic Fluid Index (AFI)?
What is the normal range for Amniotic Fluid Index (AFI)?
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What is a key characteristic of oligohydramnios in terms of AFI?
What is a key characteristic of oligohydramnios in terms of AFI?
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How is a Biophysical Profile conducted?
How is a Biophysical Profile conducted?
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What does a positive result in a Contraction Stress Test signify?
What does a positive result in a Contraction Stress Test signify?
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Why is the biophysical profile considered highly predictive of perinatal outcomes?
Why is the biophysical profile considered highly predictive of perinatal outcomes?
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What structure connects the umbilical vein to the inferior vena cava in the fetal circulatory system?
What structure connects the umbilical vein to the inferior vena cava in the fetal circulatory system?
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Which component of the placenta is developed from the trophoblast?
Which component of the placenta is developed from the trophoblast?
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What is the main function of the foramen ovale in the fetal heart?
What is the main function of the foramen ovale in the fetal heart?
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How does the ductus arteriosus function in fetal circulation?
How does the ductus arteriosus function in fetal circulation?
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What hormone stimulates the growth of the uterus and breast during pregnancy?
What hormone stimulates the growth of the uterus and breast during pregnancy?
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What role does human placental lactogen (hPL) play in fetal development?
What role does human placental lactogen (hPL) play in fetal development?
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What is the primary purpose of the placenta's decidua basalis layer?
What is the primary purpose of the placenta's decidua basalis layer?
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Why does the ductus arteriosus constrict after birth?
Why does the ductus arteriosus constrict after birth?
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What is the primary purpose of the initial prenatal visit?
What is the primary purpose of the initial prenatal visit?
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Which of the following best defines teratogenesis?
Which of the following best defines teratogenesis?
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When should an individual expect to be screened for Group B Streptococcus (GBS) during pregnancy?
When should an individual expect to be screened for Group B Streptococcus (GBS) during pregnancy?
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Which statement correctly identifies components typically included in a blood screening during the initial prenatal visit?
Which statement correctly identifies components typically included in a blood screening during the initial prenatal visit?
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What does the acronym GTPAL stand for in obstetric history documentation?
What does the acronym GTPAL stand for in obstetric history documentation?
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Which trimester is the ideal time to discuss early discomforts of pregnancy?
Which trimester is the ideal time to discuss early discomforts of pregnancy?
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What is considered infertility in terms of conception?
What is considered infertility in terms of conception?
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Where does fertilization typically take place within the female reproductive system?
Where does fertilization typically take place within the female reproductive system?
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Study Notes
Physiologic Adaptations to Pregnancy
- Uterine changes include hypertrophy of the wall, increased contractibility, and formation of a mucus plug for protection.
- Softening of vaginal muscles and connective tissue prepares for birth; cervical glands also hypertrophy.
- Increased vascular congestion and abdominal muscle stretching (diastasis recti) occur due to uterine enlargement.
- Hormonal impact leads to smooth muscle relaxation, resulting in dyspnea, nasal congestion, and incontinence.
- Edema in lower extremities is due to increased venous pressure and blood flow compression, relieved by side sleeping, hydration, and compression socks.
- Nasal and sinus congestion arises from elevated hormone levels (estrogen, progesterone).
- Cardiovascular adaptations result in increased RBC count and plasma volume, with lowered hemoglobin levels.
Fetal Monitoring Techniques
- Daily fetal movement counts (FMC) start around 28 weeks, requiring 10 movements in 2 hours or 4 movements in 1 hour.
- Vibroacoustic stimulation (VAS) is used if the non-stress test (NST) is non-reactive, stimulating fetal response through sound.
- Contraction stress test assesses the fetal heart rate (FHR) response to simulated contractions; negative indicates no fetal distress, while positive shows late decelerations and potential oxygen reserves issues.
- Amniotic Fluid Index (AFI) measures amniotic fluid levels; normal is 8-24cm, while oligohydramnios is less than 5cm and polyhydramnios is over 24cm.
- Biophysical profile comprises NST with ultrasound, assessing fetal heart rate activity, breathing, movement, tone, and AFI, scoring 8-10 as reassuring.
Pregnancy Diagnosis and Signs
- Presumptive signs: amenorrhea, nausea, breast changes, fatigue, frequent urination, and quickening occur at various gestational weeks.
- Probable signs include uterine and abdominal growth, skin hyperpigmentation (melasma, linea nigra), and ballottement.
- Positive signs confirmed by fetal heart auscultation (10-12 weeks), palpation (after 20 weeks), and sonographic visualization (4-8 weeks).
- Urine pregnancy tests detect hCG, with first morning samples preferred; maternal blood tests can detect hCG earlier.
Initial Prenatal Visit Components
- Initial visit includes a health assessment, pregnancy history, physical exam, EDD, nutrition recall, psychosocial evaluation, and assessment for intimate partner violence.
- Blood tests should check blood type, Rh factor, antibody screen, and CBC (hemoglobin, RBC, WBC, platelets).
- Additional screenings for syphilis, HIV, hepatitis B, rubella titer, tuberculosis, urinalysis, and cultures for gonorrhea and chlamydia are performed.
- Chorionic villus sampling is available at 10-12 weeks for genetic evaluation.
Teratogenesis and Prenatal Education
- Teratogenesis refers to the induction of congenital malformations due to teratogens.
- Prenatal education topics should include pain relief in labor, postpartum care, early pregnancy discomforts, signs of labor, and infant care.
Documenting Obstetric History (GTPAL)
- G: Total times pregnant
- T: Full-term births (>37 weeks)
- P: Preterm births (twins count as one)
- A: Abortions (spontaneous or induced)
- L: Living children
Screening and Infertility
- Gestational diabetes screening is scheduled between 24-28 weeks of pregnancy.
- Group B Streptococcus (GBS) screening occurs at 35-37 weeks.
- Infertility is defined as the inability to conceive after 6 months of trying.
Fertilization and Fetal Circulation
- Fertilization typically occurs in the outer third of the fallopian tube, forming a zygote that develops into a blastocyst which later implants in the uterine wall.
- Fetal circulatory structures include ductus venosus (umbilical vein to inferior vena cava), foramen ovale (right to left atrium), and ductus arteriosus (pulmonary artery to aorta), which close postnatally in response to oxygen levels.
Placenta Formation and Function
- The placenta consists of fetal (chorionic villi from trophoblast) and maternal (decidua basalis) tissues, preventing blood mixing.
- Functions include metabolic exchanges (nutrients and waste), hormone production (estrogen, progesterone, hCG, hPL), and supporting fetal development.
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Description
This quiz explores the various physiological changes that occur in the uterus during pregnancy. It highlights adaptations such as hypertrophy of the uterine wall, changes in muscle and connective tissue, and increased contractility. Improve your understanding of these crucial developments that support fetal health.
