Pregnancy and Fetal Development Quiz

Obstetric Nursing

• Topic: Anatomy and Physiology
• Subtopic: Male Reproductive System: External
  • Scrotum
  • Testes
  • Seminiferous tubules
  • Leydig's cells
  • Penis
• Subtopic: Male Reproductive System: Internal
  • Epididymis (20 ft)
  • 5% semen production
  • Vas Deferens
  • Final maturation of sperm occurs
  • Seminal Vesicles (30% semen production)
  • Ejaculatory Ducts
  • Prostate Gland (60% semen production)
  • Bulbourethral (Cowper's) Glands
  • Urethra
• Subtopic: Female Reproductive System: External
  • Mons Veneris
  • Labia Minora
  • Labia Majora
  • Other External Organs
  • Hymen
  • Vestibule
  • Two Skene's glands
  • Front of vaginal opening
  • Bartholin's Glands
  • Back part of vaginal opening
• Subtopic: Female Reproductive System: Ovaries
  • Female gonad
  • Produce, mature, and discharge ova (egg cells)
  • Produce estrogen and progesterone
  • Initiate and regulate menstrual cycles
• Subtopic: Female Reproductive System: Fallopian Tube
  • Approximately 10 cm long
  • Interstitial portion
  • Isthmus
  • Ampulla (fertilization usually occurs)
  • Infundibulum (funnel shaped)
• Subtopic: Female Reproductive System: Uterus
  • Receive ovum from fallopian tube
  • Implantation and nourishment of fetus
  • Expands during pregnancy
  • Portion cut during C-section
  • Cervix (lowest portion)
• Subtopic: Female Reproductive System: Vagina
  • Lined with stratified squamous epithelium
  • Similar to cervix covering
  • Contains folds (rugae)
  • Bulbocavernosus (at external opening)
  • Acts as voluntary sphincter
  • Mucus with rich glycogen content
  • Lactobacillus (Döderlein's bacillus)
  • Forms lactic acid
• Subtopic: Question
  • On physical examination, Suzanne Matthews is found to have a cystocele
  • A cystocele is the herniation of the bladder into the vaginal wall

Sexual Response Cycle

• Excitement (physical and psychological stimulation)
  • Women: clitoris increases in size, vaginal walls lubricate, vagina widens in diameter and length, nipples become erect
  • Men: penile erection, scrotal thickening and elevation of the testes
• Plateau (just before orgasm)
  • Women: clitoris drawn forward and retracts, lower part of vagina congested (formation of orgasmic platform), increased nipple elevation
  • Men: vasocongestion leads to penis distention, heart rate increases to 100-175 beats/minute, respiratory rate to approximately 40 respirations/minute
• Orgasm (discharge accumulated sexual tension)
  • Women: vigorous contraction of pelvic area muscles, expulsion or dissipation of blood and fluid
  • Men: muscle contractions surrounding seminal vessels, prostate project semen into the proximal urethra, propulsive ejaculatory contractions

Resolution

• 30-minute period for external and internal genital organs to return to an unaroused state
• Women: possible for additional orgasms immediately after
• Men: refractory period (further orgasm impossible)

Infertility/Subfertility

• Subfertility investigation usually limited to three assessments: semen analysis, ovulation monitoring, and tubal patency tests, and ultrasound

Management

• Therapeutic insemination (sperm deposition)
• In-vitro fertilization (IVF)
• Gamete intrafallopian transfer (GIFT)

Stages of Fetal Development

• Preembryonic (0-2 weeks, beginning w/ fertilization)
• Embryonic (3-8 weeks)
• Fetal (8 weeks-birth)

Fetal growth and development

• Three periods: preembryonic, embryonic, fetal

Fertilization

• Aka: conception
• Ovum
• Sperm
• Zygote
• Embroyo
• Fetus
• Conceptus
• Age of viability

Implantation

• Zygote moves towards the uterus body
• Mitotic cell division (cleavage) begins
• zygote consists of 16-50 cells
• Morula

Embryonic Structures: The Decision

• Corpus luteum continues to function
• Decidua is thickened endometrial lining
• Has three parts: basalis, capsularis, vera

Embryonic Structures: Chorionic Villi

• Develop by the 11th or 12th day
• Reach out from cells into uterine endometrium
• Begin formation of placenta

Embryonic Structures: The Placenta

• Blastocyst splits into embryo and placenta around 4 weeks
• Takes place of the corpus luteum around weeks 10-12

Embryonic Structures: Amniotic Membranes

• Smooth chorion develops into the chorionic membrane
• Forms sac with amniotic fluid
• Hydramnios: increased amniotic fluid
• Oligohydramnios: reduced amniotic fluid
• Slightly alkaline

Embryonic Structures: The Umbilical Cord

• Transports oxygen/nutrients to fetus and wastes to placenta
• Gelatinous mucopolysaccharide (Wharton's jelly)
• Consists of one vein and two arteries

Cardiovascular System

• First systems to become functional in intrauterine life
• Formation starts as early as the 16th day
• Heart beats by the 24th day
• Doppler audible by 10th-12th week
• Stethoscope audible by 16th week

Fetal Circulation

• Fetal heart beats 120-160 bpm

Respiratory System

• Alveoli and capillaries develop between weeks 24-28
• Surfactant (phospholipid substance) is produced in the alveolar cells around week 24

Nervous System

• Develops around weeks 3-4
• Neural plate (thickened ectoderm) becomes apparent in the third week

Neural Tube Defects

• Category of neurological disorders
• Includes: spina bifida, anencephaly, meningocele, myelomeningocele
• Caused by lack of folic acid and genetic factors

Determination of Estimated Birth Date

• EDD or EDC ranges from 38-42 weeks
• Naegel's Rule (LMP)

Fetal Movement

• Quickening (felt by mother) between weeks 18-20
• At least 10 times per day during weeks 28-38

Fetal Heart Rate/Tone

• Beats 120-160 bpm
• Rhythm strip testing assesses fetal heart rate

Nonstress Testing

• Measures fetal heart rate response to movement
• Monitor both fetal heart rate and uterine contractions

Contraction Stress Test

• Analyzes fetal heart rate during contractions
• Initiated with oxytocin or nipple stimulation

Ultrasonography

• Diagnosis of pregnancy, placenta, amniotic fluid, fetal sex, and position
• Maturity prediction
• Complication discovery

Amniocentesis

• Aspiration of amniotic fluid (scheduled between weeks 14-16)
• To reduce bladder size, and prevent inadvertent punctures
• Alpha-Fetoprotein = potential indication of anencephaly or myelomeningocele
• Rho(D) immune globulin administered if woman has Rh-negative blood

Pregnancy: Presumptive Signs

• Nausea, vomiting
• Amenorrhea
• Quickening
• Linea nigra
• Melasma
• Striae gravidarum
• Breast changes

Pregnancy: Probable Signs

• Chadwick's sign (violet vagina)
• Goodell's sign (softened cervix)
• Hegar's sign (softened lower uterine segment)
• Ballottement
• Braxton Hicks contractions

Pregnancy: Positive Signs

• Fetal heart tones (FHTs)
• Fetal movements felt by examiner
• Fetal visualization by ultrasound

Obstetric History

• Gravida (number of pregnancies)
• Para (number of pregnancies reaching viability)
• Term (full-term births)
• Preterm (preterm births)
• Abortion
• Living
• Multiple (multiple pregnancies)

Signs Indicating Complications of Pregnancy

• Vaginal bleeding
• Persistent vomiting
• Chills and fever
• Sudden escape of clear fluid from the vagina
• Pregnancy-Induced Hypertension (PIH)
• Increase or decrease in fetal movement

Health Promotion During Pregnancy

• Self-care needs
• Bathing (tub baths restricted)
• Dental care (routine oral hygiene)
• Perineal hygiene
• Clothing (comfortable and loose-fitting)
• Sexual activity
• Exercise
• Swimming

Discomforts of Early Pregnancy (First Trimester)

• Breast tenderness
• Palmar erythema
• Constipation
• Nausea, vomiting, pyrosis
• Muscle cramps

Discomforts of Early Pregnancy (First Trimester)

• Hypotension
• Varicosities
• Hemorrhoids
• Frequent urination (Kegel exercises)
• Pubococcygeal muscles

Discomforts of Middle to Late Pregnancy

• Backache (lumbar lordosis)
• Pelvic rocking/tilting
• Dyspnea (uterus pressure on diaphragm)
• Ankle edema
• Braxton Hicks contractions

Teratogenic Maternal Infections

• Toxoplasmosis, Rubella, Cytomegalovirus, Herpes Simplex Virus

Toxoplasmosis

• Protozoan infection acquired often through uncooked meat or handling cat feces
• Can damage CNS if transmitted through placenta

Rubella

• Viral infection potentially causing severe birth defects if contracted during pregnancy
• Immunization recommended before pregnancy

Cytomegalovirus

• Herpes virus family, leading to severe damage if mother infected
• Can cause neurologic problems, eye damage

Herpes Simplex Virus (Genital Herpes)

• Viral infection crossing the placenta causing first trimester complications like miscarriage or severe congenital abnormalities
• Treatment: Intravenous or oral antiviral medications

Syphilis

• Bacteria causing possible fetal complications if left untreated

Nutritional Health During Pregnancy

• Weight gain 11.2-15.9 kg (25-35 lb) recommended
• Adequate caloric intake, including 300 additional calories per day.

Protein Needs

• DRI increase to 71 g/day during pregnancy

Vitamin and Mineral Needs

• Increased fat-soluble and water-soluble vitamins and minerals crucial during pregnancy
• Important vitamins/minerals: Calcium, Phosphorus, Iodine, Iron, Zinc

Preparing a Family for Childbirth

• Tailor sitting
• Perineal abd abdominal exercises
• Squatting
• Kegel exercises
• Pelvic Rocking
• Swimming

Preparing for Labor

• Preliminary signs of labor (lightening, show, Braxton Hicks)
• True labor contractions

Signs of True Labor

• Show (Release of cervical plug)
• Contractions (30-70 secs, 5-10 mins apart)
• Rupture of membranes (sudden gush of amniotic fluid)

Components of Labor

• Passage
• Passenger
• Powers (uteral contractions)
• Psyche (psychological states)

Phases of the Puerperium

• Taking-In (2-3 days, reflection, passivity)
• Taking-Hold (Initiating action, interest for child)
• Letting-Go (Redefining new roles)

Pregnancy Complications

• Diabetes Mellitus
• Bleeding during Pregnancy, including threatened miscarriage, imminent/inevitable miscarriage, missed miscarriage, incomplete miscarriage, complete miscarriage, ectopic pregnancy, hydatidiform mole, premature cervical dilatation

Placenta Previa

• Condition of pregnancy in which the placenta implants abnormally in uterus
• Painless bleeding in 3rd trimester

Abruptio Placentae

• Premature separation of placenta from uterine wall during pregnancy
• Sharp, stabbing pain, heavy bleeding, DIC can occur

PIH (Pregnancy-Induced Hypertension)

• Vasospasm in small and large arteries during pregnancy
• Classic signs: hypertension, proteinuria, and edema.
• Classifications: gestational hypertension, preeclampsia, eclampsia
• Management: low-dose aspirin, bed rest, monitoring, nutritional support, and medications

Test your knowledge on key aspects of pregnancy and fetal development with this informative quiz. Questions cover topics such as fetal heart tones, surfactant components, and recommended weight gain during pregnancy. Perfect for students in obstetrics or individuals interested in maternal health.