Pregnancy Care and Assessment

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Questions and Answers

What is the normal range for fetal heart rate during intermittent auscultation?

130-190 beats per minute

110-160 beats per minute (correct)

120-180 beats per minute

100-140 beats per minute

What is the purpose of assessing cervical dilation and effacement during vaginal examination?

To determine fetal position and station

To diagnose placenta previa

To evaluate maternal blood pressure

To assess labour progress and plan appropriate care (correct)

What is a contraindication for vaginal examination?

Premature rupture of membranes without labour

Maternal hypertension

Placenta previa (correct)

Active vaginal bleeding with a known source

What is the duration of intermittent auscultation during labour?

At least one full minute Signup and view all the answers

What is the definition of a strong contraction during labour?

Contractions are very intense, and speaking during them is difficult Signup and view all the answers

What is the normal range for maternal pulse rate?

60-100 beats per minute Signup and view all the answers

What is an indication for vaginal examination during labour?

To determine cervical dilation and effacement Signup and view all the answers

What is the role of the fetal adrenal glands in the onset of labour?

They produce hormones that stimulate placental production of estrogens and prostaglandins Signup and view all the answers

What is the primary reason for administering Anti-D immunoglobulin to Rh-negative women during pregnancy?

To prevent sensitization Signup and view all the answers

What is the primary purpose of urine screening tests during pregnancy?

To screen for protein, glucose, ketones, and signs of infection Signup and view all the answers

What is the normal fetal heart rate range during pregnancy?

110-160 beats per minute Signup and view all the answers

What is the primary aim of abdominal assessment during pregnancy?

To assess fetal growth and well-being Signup and view all the answers

What is the best place to auscultate the fetal heart during pregnancy?

Over the fetal back Signup and view all the answers

What is the term for the relation of the long axis of the fetus to the long axis of the mother?

Lie Signup and view all the answers

What is a contraindication for palpation during pregnancy?

Preterm labour Signup and view all the answers

What is the purpose of documenting abdominal assessment during pregnancy?

To record fetal position, presentation, engagement, estimated fetal size, fetal heart rate, and any abnormalities Signup and view all the answers

What is the primary purpose of examining the placenta during delivery?

To inspect for completeness and check for any abnormalities Signup and view all the answers

What is the normal range of blood loss for a cesarean section?

Up to 1000 mL Signup and view all the answers

What is the primary benefit of skin-to-skin contact between the mother and the baby?

Regulation of the baby's temperature Signup and view all the answers

What is the acronym APGAR an abbreviation for?

Appearance, Pulse, Grimace, Activity, Respiratory effort Signup and view all the answers

What is the scoring range for the heart rate in the APGAR scoring system?

0 (absent) to 1 (100 bpm) Signup and view all the answers

What is the location of the cord insertion in a battledore placenta?

At the placental edge Signup and view all the answers

What is the typical number of cotyledons on the maternal surface of the placenta?

15-20 Signup and view all the answers

What is the covering of the fetal surface of the placenta?

Amnion Signup and view all the answers

Study Notes

Prophylactic Anti-D

Women who are Rh-negative should receive Anti-D immunoglobulin at 28 and 34 weeks gestation and within 72 hours after birth if the baby is Rh-positive to prevent sensitization.

Urine Assessment

Urine screening tests include checking for protein, glucose, ketones, and signs of infection.
Urinalysis helps detect conditions like gestational diabetes, preeclampsia, and urinary tract infections.
Urine tests screen for proteinuria (preeclampsia), glucosuria (gestational diabetes), and bacteriuria (UTIs).

Abdominal Assessment

Aims of abdominal assessment: to assess fetal growth and well-being, and to determine the position and presentation of the fetus.
Indications for palpation: routine antenatal check-ups, assessing fetal position, and estimating fetal size.
Contraindications for palpation: preterm labor, placental abruption, or conditions where abdominal manipulation may cause harm.
Inspecting the abdomen: look for size, shape, fetal movements, and any abnormalities such as scars or skin changes.
Palpating the abdomen: feel for fetal position, presentation, and engagement, as well as uterine tone and tenderness.
Auscultating the fetal heart: the best place is usually over the fetal back, often in the lower quadrant of the maternal abdomen.
Normal fetal heart rate range: 110-160 beats per minute.
Documenting abdominal assessment: record fetal position, presentation, engagement, estimated fetal size, fetal heart rate, and any abnormalities.

Terms Explained

Lie: the relation of the long axis of the fetus to the long axis of the mother (e.g., longitudinal, transverse).

Placenta Examination

Steps involved: inspect for completeness, check the umbilical cord, and examine maternal and fetal surfaces.
Cord insertion types: central, eccentric, battledore, and velamentous.
Normal mean diameter: approximately 22 cm.
Fetal surface covering: covered by the amnion.
Umbilical cord blood vessels: two arteries and one vein.
Amniotic sac membranes: two membranes: the amnion and the chorion.
Cotyledons: 15-20 cotyledons on the maternal surface.

Incomplete Placenta Implications

Implications: postpartum hemorrhage, infection, and retained placenta necessitating surgical intervention.

Normal Blood Loss Post-Birth

Normal range: up to 500 mL for vaginal delivery and 1000 mL for cesarean section.
Timing for calculation: blood loss is calculated immediately after delivery and documented in the maternal records.

Benefits of Skin-to-Skin Contact

Benefits: regulates baby's temperature, promotes bonding and breastfeeding, and stabilizes baby's heart rate and breathing.

APGAR Scoring

APGAR acronym: appearance, pulse, grimace, activity, and respiratory effort.
APGAR scoring: heart rate, respiratory effort, muscle tone, grimace, and color.

Water Birth APGAR Assessment

Fetal contribution: the maturing fetal adrenal glands produce hormones that stimulate placental production of estrogens and prostaglandins, contributing to labor onset.

Assessment of Contractions

Contraction aspects: duration, intensity, and frequency.
Definitions of contraction strength: mild, moderate, and strong.

Vaginal Examination

Indications: assess labor progress, determine cervical dilation and effacement, and evaluate fetal position and station.
Contraindications: placenta previa, active vaginal bleeding with an unknown source, and premature rupture of membranes without labor.
Information obtained: cervical dilation, effacement, fetal position, station, and membrane status.

Intermittent Auscultation and Fetal Heart Rate

Intermittent auscultation: periodic listening to the fetal heart rate during labor to assess fetal well-being.
Auscultation duration and normal range: listen for at least one full minute, ideally during and after a contraction, with a normal range of 110-160 beats per minute.

Questions for Assessing Hospital Admission

Questions to ask: are you experiencing regular contractions? How far apart are they? Have your waters broken? Are you experiencing any vaginal bleeding? How is your baby's movement pattern?

Normal Maternal Observations

Normal range for maternal observations: blood pressure (90/60 to 120/80 mmHg), pulse (60-100 beats per minute).

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Description

Assessing the health of pregnant women and their babies through various tests and screenings, including Urine Assessment and Prophylactic Anti-D.