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Physiologic Adaptations to Pregnancy
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Physiologic Adaptations to Pregnancy

Created by
@SupportingMarigold

Questions and Answers

What is the indication for immediate delivery when assessing fetal well-being through NST scoring?

  • 2/10 score (correct)
  • 4/10 score
  • 6/10 score
  • 8/10 score

    • Which of the following is considered a presumptive sign of pregnancy?

  • Auscultation of fetal heart
  • Enlargement and tenderness of breasts (correct)
  • Skin hyperpigmentation
  • Sonographic visualization of the fetus

    • At how many weeks' gestation is quickening typically first felt by a primigravida?

  • 10 to 12 weeks
  • 14 to 16 weeks
  • 22 to 24 weeks
  • 18 to 20 weeks (correct)

    • Which hormone is primarily detected in laboratory tests for pregnancy?

    <p>hCG</p> Signup and view all the answers

    What is the term for the dark line that appears on a pregnant woman's abdomen?

    <p>Linea nigra</p> Signup and view all the answers

    What minimal score on a fetal NST requires further evaluation due to non-reassuring results?

    <p>6/10</p> Signup and view all the answers

    Which of the following is a probable sign of pregnancy?

    <p>Uterine growth</p> Signup and view all the answers

    What is the best time to perform a urine pregnancy test for the most accurate result?

    <p>First morning urine specimen</p> Signup and view all the answers

    What is the role of the mucus plug formed by cervical glands during pregnancy?

    <p>To serve as a protective barrier between the uterus and vagina.</p> Signup and view all the answers

    Which hormone is primarily responsible for muscle relaxation in the smooth muscles during pregnancy?

    <p>Progesterone</p> Signup and view all the answers

    Which of the following factors contributes to the development of edema in the lower extremities during pregnancy?

    <p>Increased venous pressure.</p> Signup and view all the answers

    What is the expected change in hemoglobin (Hgb) levels during pregnancy?

    <p>Decrease in hemoglobin concentration.</p> Signup and view all the answers

    Which of the following methods is NOT recommended for relieving lower extremity edema?

    <p>Laying on the back frequently.</p> Signup and view all the answers

    How is the perception of fetal movements typically assessed during pregnancy?

    <p>By counting distinct fetal movements over a specified period after eating.</p> Signup and view all the answers

    Which explanation accurately describes the physiological cause of nasal and sinus congestion during pregnancy?

    <p>Elevation of estrogen and progesterone hormones.</p> Signup and view all the answers

    Which of the following statements regarding Braxton-Hicks contractions is true?

    <p>They are irregular and can occur due to increased uterine contractility.</p> Signup and view all the answers

    What indicates a reactive Nonstress Test (NST)?

    <p>FHR increases by 15 bpm above baseline for 15 seconds at least 2 times in 20 minutes</p> Signup and view all the answers

    In a Contraction Stress Test, what does a negative result indicate?

    <p>There are no decelerations in FHR during contractions that are 40 seconds or less</p> Signup and view all the answers

    What is the normal range for Amniotic Fluid Index (AFI)?

    <p>8 cm to 24 cm</p> Signup and view all the answers

    What is a key characteristic of oligohydramnios in terms of AFI?

    <p>AFI less than 5 cm</p> Signup and view all the answers

    How is a Biophysical Profile conducted?

    <p>A 30 min ultrasound with NST and AFI assessment</p> Signup and view all the answers

    What does a positive result in a Contraction Stress Test signify?

    <p>Late decelerations in fetal heart rate occur with 50% of contractions</p> Signup and view all the answers

    Why is the biophysical profile considered highly predictive of perinatal outcomes?

    <p>It combines multiple assessments including NST and AFI.</p> Signup and view all the answers

    What structure connects the umbilical vein to the inferior vena cava in the fetal circulatory system?

    <p>Ductus venosus</p> Signup and view all the answers

    Which component of the placenta is developed from the trophoblast?

    <p>Chorionic villi</p> Signup and view all the answers

    What is the main function of the foramen ovale in the fetal heart?

    <p>To permit shunting of oxygenated blood from the right atrium to the left atrium</p> Signup and view all the answers

    How does the ductus arteriosus function in fetal circulation?

    <p>It allows blood to flow from the pulmonary artery to the descending aorta</p> Signup and view all the answers

    What hormone stimulates the growth of the uterus and breast during pregnancy?

    <p>Estrogen</p> Signup and view all the answers

    What role does human placental lactogen (hPL) play in fetal development?

    <p>Regulates fetal glucose and promotes growth</p> Signup and view all the answers

    What is the primary purpose of the placenta's decidua basalis layer?

    <p>Prevent maternal-fetal blood mixing</p> Signup and view all the answers

    Why does the ductus arteriosus constrict after birth?

    <p>Due to rising oxygen levels and hormonal changes</p> Signup and view all the answers

    What is the primary purpose of the initial prenatal visit?

    <p>To assess health risks and gather comprehensive information</p> Signup and view all the answers

    Which of the following best defines teratogenesis?

    <p>Production of congenital malformations due to harmful agents</p> Signup and view all the answers

    When should an individual expect to be screened for Group B Streptococcus (GBS) during pregnancy?

    <p>35-37 weeks</p> Signup and view all the answers

    Which statement correctly identifies components typically included in a blood screening during the initial prenatal visit?

    <p>Antibody screen and blood type</p> Signup and view all the answers

    What does the acronym GTPAL stand for in obstetric history documentation?

    <p>Gravida, Term, Preterm, Abortions, Living</p> Signup and view all the answers

    Which trimester is the ideal time to discuss early discomforts of pregnancy?

    <p>First trimester</p> Signup and view all the answers

    What is considered infertility in terms of conception?

    <p>Inability to conceive after one year when under 35 years old</p> Signup and view all the answers

    Where does fertilization typically take place within the female reproductive system?

    <p>Outer third of the fallopian tube</p> Signup and view all the answers

    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.

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