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Questions and Answers
What is the maximum capacity increase of the uterus during pregnancy?
What physiological condition is characterized by a decrease in peripheral vascular resistance leading to low blood pressure in pregnancy?
Which of the following hormones are primarily responsible for smooth muscle relaxation during pregnancy?
How does Naegele's rule help determine an estimated due date for a pregnancy?
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What causes edema in the lower extremities during pregnancy?
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Which change in lab values might indicate cardiovascular adaptation in pregnancy?
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What is primarily responsible for the cessation of the menstrual cycle during pregnancy?
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What causes nasal and sinus congestion during pregnancy?
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What distinguishes a diagnostic test from a screening test?
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Which of the following is NOT considered a probable sign of pregnancy?
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Which physiological change contributes to the development of striae gravidarum during pregnancy?
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What is included in a biophysical profile?
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Which hormone is primarily detected in a urine pregnancy test?
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What is the primary characteristic of dominant inheritance?
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Which method of antenatal testing is performed between 10-12 weeks and cannot detect neural tube defects?
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Which of the following factors is NOT considered in the assessment for an initial prenatal visit?
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What does teratogenesis refer to?
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What is a common clinical sign or symptom of softening joints in the musculoskeletal system during pregnancy?
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In the GTPAL system, what does the 'T' stand for?
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In recessive inheritance, how many alleles must be present to express the trait?
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Which topic would NOT typically be addressed during prenatal education based on the trimester?
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What is the purpose of an amniocentesis during pregnancy?
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Which of the following is an example of an X-linked disease?
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What is indicated by increased levels of hCG during early pregnancy?
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At what gestational age is a pregnancy considered in the embryonic phase?
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What is the primary function of human chorionic gonadotropin (hCG) during pregnancy?
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How is infertility defined for women older than 35 years of age?
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What structure connects the umbilical vein to the inferior vena cava in the fetal circulatory system?
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Which of the following statements about fundal height measurement is correct?
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What is the typical gestational age when fetal heart tones can first be heard?
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Which component of the umbilical cord carries oxygenated blood?
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When is Group B Streptococcus (GBS) typically screened for in pregnancy?
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Study Notes
Physiologic adaptations to pregnancy
- Uterine size increases 20x its original size
- Weight of the uterus increases from 70g to 1,100g
- Capacity of uterus increases from 10mL to 5,000mL
- Increased blood flow to uterus at term is 500-600mL/min
- Estrogen, progesterone, and prostaglandins cause smooth muscle relaxation
- Edema in lower extremities is caused by increased venous pressure and decreased blood flow
- Nasal and sinus congestion is caused by vascular engorgement due to hormones
- Increase in RBC count by 30%, RBC volume by 18-33%, plasma volume by 50% and WBC count
- Supine hypotensive syndrome occurs when a pregnant woman sits up and becomes hypotensive
- Heartburn is caused by increased progesterone levels slowing stomach emptying and relaxing the esophageal sphincter
- Increased levels of estrogen and progesterone cause cessation of the menstrual cycle
- Low blood pressure in pregnancy is caused by a decrease in peripheral vascular resistance
- Naegele's rule estimates the due date: Start with the first day of the last menstrual cycle, subtract 3 months, add 7 days and add 1 year.
- Increased renal blood flow in the first trimester, followed by a decrease in the second and third
- Progesterone causes relaxation of smooth muscles, leading to the elongation of ureters with decreased motility, leading to decreased bladder tone and increased capacity
- Nausea and vomiting in pregnancy is driven by increased hCG levels and altered carbohydrate metabolism.
- Clinical signs and symptoms of softening joints include altered gait, low back pain, pelvic discomfort and changes in posture and walking style
- Increased action of adrenocorticosteroids makes cutaneous elastic tissues fragile leading to striae gravidarum.
Genetics
- Dominant inheritance requires only one copy of the dominant allele to express a trait.
- Dominant genes include Huntington’s Disease and Chromosome 4
- Recessive inheritance requires both copies of the recessive allele to express the trait.
- Recessive genes include Sickle Cell Anemia and Chromosome 11
- X-linked inheritance occurs when genes are located on the X-chromosome.
- X-linked diseases include Hemophilia and Duchenne’s Muscular Dystrophy
Antenatal Testing
- Chorionic villus sampling occurs between 10-12 weeks, and involves aspirating placental tissue for testing
- Amniocentesis occurs between 15-20 weeks and involves inserting a needle through the maternal abdominal wall to obtain a sample of amniotic fluid
- Nonstress test (NST), daily fetal movement counts (FMC), vibroacoustic stimulation (VAS), contraction stress test, amniotic fluid index (AFI), biophysical profile, and modified biophysical profile are used to ensure fetal well-being.
- Screening tests identify individuals who are not affected by a disease or abnormality
- Diagnostic tests identify a disease or provide information that aids in diagnosis.
- Biophysical profile is an ultrasound assessment of fetal status along with an NST
Diagnosing Pregnancy
- Presumptive signs of pregnancy include absence of menstruation, nausea and vomiting, breast changes, fatigue, urinary frequency and quickening
- Probable signs of pregnancy include uterine and abdominal growth, skin changes and a positive pregnancy test
- Positive signs of pregnancy include: auscultation of fetal heart sounds, observation of fetal movements, and sonographic visualization of the fetus
- Urine pregnancy tests detect hCG (human chorionic gonadotropin)
Preconception and Prenatal Care
- Initial prenatal visit involves a comprehensive health and risk assessment, current pregnancy history, physical examination, EDD determination, nutrition assessment, psychosocial assessment, and assessment for intimate partner violence.
- Teratogenesis is developmental defects caused by exposure to toxic substances while in utero
- Prenatal education should address pain relief in labor, postpartum care, early discomforts of pregnancy, breastfeeding, signs of labor, parenting and infant care
- Obstetric history is documented according to GTPAL: G (Number of times pregnant), T (Number of term infants), P (Number of preterm infants), A (Number of abortions) and L (Number of currently living children)
- Screening for gestational diabetes is recommended in the second trimester
- GBS screening is recommended during the third trimester
- Infertility is defined as the inability to conceive and maintain a pregnancy after 12 months of unprotected intercourse. For women over 35, it is defined as 6 months.
Pregnancy & Fetal Development
- Fertilization occurs within one of the two fallopian tubes
- The fetal circulatory system includes the ductus venosus, foramen ovale, and ductus arteriosus
- The placenta is formed from both fetal and maternal tissue, with a fetal side (chorionic membrane) and a maternal side (decidua basalis)
- The placenta prevents maternal and fetal blood from mixing.
- The function of the placenta is metabolic gas exchange, hormone production, hCG production, and hPL production
- The umbilical cord connects the fetus to the placenta
- The umbilical cord is composed of two arteries (deoxygenated blood) and one vein (oxygenated blood).
- Amniotic fluid cushions the fetus, prevents the fetus from adhering to amniotic membranes, allows freedom of movement, and provides a consistent thermal environment
- The embryonic phase of pregnancy lasts from implantation to 8 weeks.
- Fetal heart tones can be auscultated at 10 to 12 weeks
- Fundal height is measured in pregnancy, reaching the umbilicus at 20 weeks of gestation.
- A pregnancy is considered term at 37 weeks of gestation.
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Description
Explore the remarkable physiologic changes that occur during pregnancy. From uterine expansion to hormonal influences, this quiz covers key adaptations that prepare the body for childbirth. Understand how these changes impact maternal health and fetal development.
