Physiology of Pregnancy and Diagnosis

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Questions and Answers

Which of the following is NOT a physiological characteristic of a pregnant woman?

Increased ventilation

Increase in functional residual capacity of the lungs (correct)

Increased cardiac output

Increased oxygen consumption

What is the most important method for diagnosing early pregnancy?

Vaginal examination data

Ultrasound data (correct)

Assessment of doubtful signs of pregnancy

Immunological pregnancy tests

What is the most significant sign of pregnancy during a vaginal examination?

Increase in uterine size in relation to menstrual delay (correct)

Increase in uterine size

Hardening of the uterus upon palpation

Softening in the isthmus area

Which factors are used to determine gestational age?

All listed data Signup and view all the answers

What can be determined from an ultrasound during pregnancy?

All of the above Signup and view all the answers

The Leopold-Levitsky techniques can determine which of the following?

All of the above Signup and view all the answers

What does the second Leopold–Levitsky technique primarily determine?

Position and appearance of the fetus Signup and view all the answers

At 40 weeks of pregnancy, what is the expected measurement of the height of the uterine fundus?

100 and 32 cm Signup and view all the answers

What are the signs of eclampsia?

convulsions and coma Signup and view all the answers

What is the most common cause of maternal mortality in eclampsia?

brain hemorrhage Signup and view all the answers

Which of the following is not classified as a hypertensive condition?

renal hypertension Signup and view all the answers

What characterizes severe preeclampsia?

gestation period is less than 20 weeks Signup and view all the answers

How is a loading dose of magnesium sulfate administrated for severe preeclampsia?

iv 16 ml for 5 minutes, 20 ml intramuscularly Signup and view all the answers

When can an attack of eclampsia develop?

during pregnancy, childbirth, and the postpartum period Signup and view all the answers

Which drug is considered a hormonal method of contraception?

regividon Signup and view all the answers

How are synthetic progestins prescribed during the menstrual cycle?

from the 5th to the 26th day Signup and view all the answers

Which of the following is not a progestin-only contraceptive?

Depo-Provera Signup and view all the answers

What is the most common side effect of progestin-only contraceptives?

Menstrual irregularities Signup and view all the answers

Depo-Provera injections should be administered every:

3 months Signup and view all the answers

Which condition is a contraindication to breastfeeding?

Maternal HIV infection Signup and view all the answers

What is the most acceptable method of contraception for an HIV-infected couple?

Condom Signup and view all the answers

What does HAART therapy stand for?

Highly active antiretroviral therapy Signup and view all the answers

How long can the carriage of HIV infection continue?

All life Signup and view all the answers

What is the first step in processing used surgical tools?

Disinfection in 0.5% chlorine solution for 10 minutes Signup and view all the answers

Which of the following is an absolute contraindication for IUD insertion?

Acute and subacute inflammation of the genitals Signup and view all the answers

What is primarily responsible for the contraceptive effect of oral contraception?

Inhibition of ovulation Signup and view all the answers

Which contraceptive method is considered less effective?

Barrier and chemical methods Signup and view all the answers

What should be advised if pregnancy occurs while a woman is taking oral contraceptives?

Stop taking medications Signup and view all the answers

Which of the following is NOT a role of estrogenic hormones during the follicular phase?

Increased uterine tone Signup and view all the answers

Which statement is incorrect regarding the effect of progesterone on a woman's body?

Increased uterine tone Signup and view all the answers

The mechanism of action of copper-containing IUDs includes:

Prevents implantation of the fertilized egg Signup and view all the answers

Which method of contraception is typically contraindicated for an actively smoking woman over 35 years of age?

Oral contraceptives Signup and view all the answers

What is the main criterion for assessing fetal maturity?

fetal length Signup and view all the answers

What is the recommended duration of labor for first-time mothers?

10-14 hours Signup and view all the answers

Which heart rate range is normal for a newborn?

120–160 beats/min Signup and view all the answers

What is the rate of opening of the uterine pharynx in primigravidas?

1 cm per hour Signup and view all the answers

What is the increase in diastolic blood pressure at 20 weeks of gestation indicating?

chronic hypertension Signup and view all the answers

Timely release of amniotic fluid should occur when?

when the cervix is dilated by more than 6 cm Signup and view all the answers

What is the Apgar score not used to assess?

weight and body length of the newborn Signup and view all the answers

Which antibiotic is contraindicated for use in pregnant women?

tetracyclines Signup and view all the answers

In which cases should antihypertensive drugs be administered during severe preeclampsia?

if diastolic blood pressure is 90 mmHg and above Signup and view all the answers

What is considered the most common kidney disease in pregnant women?

pyelonephritis Signup and view all the answers

What indicates the beginning of the second stage of labor?

from the moment of complete dilation of the uterine cervix Signup and view all the answers

The best method of prevention for ophthalmoblenorrhea is?

1% tetracycline ointment Signup and view all the answers

What should be administered if there is an overdose of magnesium sulfate?

administration of calcium supplements Signup and view all the answers

Which condition is indicated by increased blood pressure in combination with proteinuria during pregnancy?

preeclampsia Signup and view all the answers

Study Notes

Physiological Characteristics of Pregnancy

Pregnant women experience an increase in cardiac output, ventilation, and oxygen consumption. However, their functional residual capacity of the lungs decreases.
Lung capacity during inspiration increases, but the functional residual capacity decreases.

Diagnosing Early Pregnancy

Immunological pregnancy tests are the most reliable method for diagnosing early pregnancy.

Signs of Pregnancy During Vaginal Examination

The most significant sign of pregnancy is an increase in the size of the uterus that corresponds to the period of missed menstruation, along with a soft consistency.

Determining Gestational Age

Gestational age is determined using a combination of factors, including the date of last menstruation, ultrasound data, and vaginal examination data.

Ultrasound During Pregnancy

Ultrasound can determine gestational age, fetal position, placenta localization, presence of placental pathologies, undeveloped pregnancy, and fetal malformations.

Leopold-Levitsky Techniques

These techniques determine fetal position and appearance, the relationship of the presenting part to the pelvic inlet, the nature of the presenting part, and the fundal height of the uterus.

Second Leopold-Levitsky Technique

The second Leopold-Levitsky technique specifically determines the nature of the presenting part.

Uterine Fundal Height and Abdominal Circumference

At 40 weeks of pregnancy, the uterine fundal height should be around 35 cm.
It should be 32 cm at 36 weeks.
The abdominal circumference should be around 95 cm at 40 weeks of pregnancy.
Average abdominal circumference at 36 weeks should be 85 cm.

Fetal Head Positioning

In a primigravida at 40 weeks, the fetal head should be fixed by a large segment at the entrance to the pelvis.

Assessing Fetal Condition

Assessing the condition of the intrauterine fetus includes methods like fetal auscultation, counting fetal movements, amnioscopy, and determining hormone levels.

Fetal Maturity

Gestational age is the primary criterion for assessing fetal maturity.

Term of the Fetus

Fetal term is determined based on the gestational age.

Cardiovascular Changes During Pregnancy

These changes include physiological hypertrophy of the left ventricle, increased cardiac output, increased heart rate, and a horizontal position of the heart.

Cervical Dilation Rate

In primigravidas, the rate of cervical dilation is approximately 1 cm per hour.
In multiparous women, the rate can be around 2 cm per hour.

Water Breaking

Amniotic fluid should be released when the cervix is dilated more than 6 cm.

Beginning of Labor

The beginning of labor is marked by contractions and the appearance of regular contractions leading to shortening and smoothing of the cervix.

Stages of Labor

The second stage of labor begins with complete dilation of the uterine cervix.
The latent phase of the first stage of labor involves contractions, but with cervical dilation up to 4 cm.
The active phase of the first stage of labor involves regular contractions and cervical dilatation exceeding 4 cm.

Active Management of Third Stage of Labor

Active management of the third stage of labor occurs immediately after the birth of the fetus.

Newborn Heart Rate

The normal heart rate for a newborn is 120-160 beats/min.

Ophthalmoblenorrhea Prevention

Ompthalmoblenorrhea is prevented using 1% tetracycline ointment.

Duration of Labor

Labor for first-time mothers can last 10-14 hours.
Labor in multiparous women lasts 6-8 hours.

Apgar Scale

The Apgar score does not include assessment of the newborn's weight and body length.
A normal Apgar score is 8-10.
This scale evaluates the severity of hypoxia and respiratory failure.

Pregnancy Complications with Pyelonephritis

Complications of pyelonephritis during pregnancy include premature birth, fetal growth restriction syndrome, development of preeclampsia, and fetal infection.

Kidney Disease in Pregnancy

Pyelonephritis is the most common kidney disease in pregnant women.

Antibacterial Drugs for Pyelonephritis

Penicillin antibiotics are the preferred choice for treating pyelonephritis in the first trimester of pregnanc
Tetracyclines, aminoglycosides, streptomycin, and sulfonamides should be avoided during pregnancy.

Pregnancy Management for Kidney Diseases

Hospitalization is recommended for early pregnancy to assess the severity of the disease and weigh the possibility of prolonging pregnancy.
Hospitalization is also recommended in case of disease exacerbation or pregnancy complications.

Causative Agents of Gestational Pyelonephritis

Escherichia coli, Proteus, Klebsiella, Enterococci, staphylococci, and microbial associations can cause gestational pyelonephritis.

Infection Route for Gestational Pyelonephritis

The infectious agent usually reaches the kidney through the ascending urinogenic and hematogenous route.

Factors Contributing to Pyelonephritis in Pregnancy

Increased levels of progesterone and corticosteroids, decreased tone of the urinary tract, presence of reflux, and compression of the ureters by the pregnant uterus contribute to pyelonephritis in pregnancy.

Contraindications to Prolonging Pregnancy with Pyelonephritis

Contraindications include kidney failure, pyelonephritis of a single kidney, and arterial hypertension.

Anemia in Pregnancy

Iron deficiency hypochromic anemia is the most common type of anemia in pregnant women.

Factors Contributing to Anemia in Pregnancy

Occupational hazards, a birth interval less than 2 years, diseases of the gastrointestinal tract, and multiple births can contribute to anemia in pregnancy.

Pathogenesis of Hypochromic Anemia

Impaired iron absorption, poor nutrition, increased iron consumption during fetal development, and increased tissue turnover during pregnancy contribute to hypochromic anemia.

Hemoglobin Levels and IDA

In mild IDA, hemoglobin levels range from 110-90 g/l.
In moderate IDA, hemoglobin levels are 90-70 g/l.
In severe IDA, hemoglobin levels are 70 g/l and below.
A decrease in hemoglobin below 110 g/l is considered the criterion for IDA in pregnant women.

Preeclampsia

Increased blood pressure in combination with proteinuria during pregnancy indicates preeclampsia.

Symptoms of Chronic Hypertension

An increase in diastolic blood pressure of 90 mm Hg and above at a gestation period of up to 20 weeks is a symptom of chronic hypertension.

Symptoms of Severe Preeclampsia

An increase in diastolic blood pressure above 100 mmHg with an interval of 4 hours.
Proteinuria up to 3g/l.
Other signs include severe headache, blurred vision, epigastric pain, and decreased urine output.

First-Choice Drug for Seizures in Preeclampsia

Magnesium sulfate is the first-choice drug for preventing or treating seizures in severe preeclampsia or eclampsia.

Overdose of Magnesium Sulfate

An overdose of magnesium sulfate can be stopped by administering calcium supplements.

Anticonvulsant Therapy for Preeclampsia or Eclampsia

Anticonvulsant therapy should be carried out within 24 hours after delivery or the last spasm, whichever occurs last. It should continue as long as the hypertensive syndrome persists.

Antihypertensive Therapy for Severe Preeclampsia

Antihypertensive drugs are administered to lower blood pressure if diastolic blood pressure is 110 mmHg and above. The goal is to maintain diastolic BP between 90 mmHg and 100 mmHg.

Signs of Eclampsia

Eclampsia is characterized by convulsions and coma.

Maternal Mortality in Eclampsia

The most common cause of maternal mortality in eclampsia is brain hemorrhage.

Hypertension Classification

Renal hypertension, gestational hypertension, chronic hypertension, severe preeclampsia, and eclampsia are included in the classification of hypertensive conditions.

Severe Preeclampsia

Severe preeclampsia is characterized by an increase in diastolic blood pressure of 90 mm Hg or more every 4 hours, proteinuria up to 3 g/l, and other signs of severe preeclampsia.

Express Diagnostic Method for Consumption Coagulopathy

Bedside tests can be used to diagnose consumption coagulopathy in late pregnancy.

Loading Dose of Magnesium Sulfate

A loading dose of magnesium sulfate for severe preeclampsia is administered intravenously at 16 ml. for 5 minutes or 20 ml intramuscularly into each buttock.

Eclampsia Development

Attacks of eclampsia can develop during pregnancy, childbirth, and the postpartum period.

Hormonal Methods of Contraception

Examples include Regividon, Triziston, and Microgynon.

Complications of Synthetic Progestins

Headaches, dizziness, nausea, irritability, menstrual irregularities, and thromboembolic complications are common side effects.

IUD Insertion

IUDs are typically inserted between days 1-7 of the menstrual cycle.

Absolute Contraindications for IUD Insertion

Absolute contraindications include acute and subacute inflammation of the genitals, cervical cancer, and uterine malformations.

Mechanism of Action of Oral Contraceptives

Oral contraceptives inhibit ovulation and impact the hypothalamic-pituitary system.

Less Effective Contraceptives

Barrier and chemical methods are less effective than IUDs, oral contraceptives, surgical methods, and injectable contraceptives.

Pregnancy While Taking Oral Contraceptives

If pregnancy occurs while taking oral contraceptives, it is recommended to stop taking the medication.

Role of Estrogenic Hormones in the Follicular Phase

Estrogenic hormones contribute to proliferation of the endometrium, increased formation of contractile muscle protein in the uterus, increased phosphorus compounds, glycogen, increased uterine tone, and proliferation of the excretory ducts of the mammary gland.

Effects of Progesterone

Progesterone causes secretory transformation of the endometrium, inhibits myometrial contractility, stimulates mammary gland parenchyma growth, and affects fat metabolism. It does not, however, increase uterine tone.

Mechanism of Action of Copper-Containing IUDs

Copper-containing IUDs prevent implantation of the fertilized egg.

Contraception Counseling

Primary contraception counseling covers information about all existing methods of contraception.
Secondary contraception counseling focuses on the patient's chosen method of contraception.

Contraindications to COC

Combined oral contraceptives (COCs) are contraindicated for actively smoking women over 35 years of age.

Progestin-Only Contraceptives (PPCs)

Examples include Mini-pili, Depo-Provera, Norplant, and Noristerate.

Side Effects of Progestin-Only Contraceptives

The most common side effect is menstrual irregularities.

Depo-Provera Injection

Depo-Provera is administered every 3 months.

Contraindications to Breastfeeding

Contraindications include maternal HIV infection, diphtheria, hepatitis, and anemia.

Contraception for HIV-Infected Partners

Condoms are the most acceptable method of contraception for couples where one partner is HIV-infected.

HAART Therapy

HAART stands for highly active antiretroviral therapy.

HIV Transmission from Mother to Fetus

HIV can be transmitted through hematogenous, transplacental, iatrogenic, and vertical routes.

HIV Infection Carriage

HIV infection persists for a lifetime.

Most Common HIV Infection in Fetuses and Children

Infection typically occurs during childbirth.

Childbirth in HIV-Infected Women

Childbirth requires the same prevention of all complications as in the general population.

Genital Herpes

The causative agent of genital herpes is herpes simplex virus (HSV).

Standard Precautions for Infection Prevention

Standard Precautions apply to all patients and healthcare workers.
These precautions include hand hygiene, use of personal protective equipment, proper cleaning and disinfection of surfaces, and safe injection practices.

Processing Used Tools

The first step in processing used tools is rinsing them under running water followed by soaking in a cleaning solution for 10 minutes.

Disposal of Needles and Syringes

Used needles and syringes must be placed in a puncture-resistant container after rinsing in a 0.5% chlorine solution.
Bending or breaking the needle is detrimental.

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Description

Explore the physiological changes during pregnancy, including cardiac output and lung capacity. This quiz also covers early diagnosis methods, signs of pregnancy during a vaginal examination, and ultrasound applications for determining gestational age.