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Questions and Answers
What causes fatigue during the first trimester of pregnancy?
Which of the following are probable signs of pregnancy observed by a physician?
What is a common breast change during early pregnancy?
How does the position of the uterus change as pregnancy progresses?
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What change occurs to the Montgomery glands during pregnancy?
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What is the typical weight increase of the uterus by the end of pregnancy?
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What symptom may also lead to fatigue during pregnancy aside from the expanding uterus?
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What is colostrum, and when does it typically appear?
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What physical changes contribute to heartburn during pregnancy?
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Which hormone is primarily responsible for inhibiting uterine activity during pregnancy?
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What is the effect of hPL on glucose during pregnancy?
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What causes the increased production of saliva during pregnancy?
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Which change in the gastrointestinal system is associated with slower intestinal peristalsis during pregnancy?
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What physiological change can lead to an increased risk of jaundice in pregnant women?
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What is the role of progesterone in the gastrointestinal changes experienced during pregnancy?
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Which factor contributes to increased O2 consumption during pregnancy?
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What is the primary effect of prolactin during pregnancy?
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Which hormonal system plays a key role in regulating blood volume during pregnancy?
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How does aldosterone contribute to fluid balance during pregnancy?
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What is the effect of the thyroid gland during early pregnancy?
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What happens to urine specific gravity during pregnancy?
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What is the target glucose level for the fetus during pregnancy?
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Which statement about the kidneys during pregnancy is accurate?
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What dietary recommendation is suggested for pregnant women regarding meal timing?
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What is a sign of softening of the cervix during early pregnancy?
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At what week can fetal heart sounds first be detected with Doppler?
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What color change occurs in the vaginal walls due to increased circulation during pregnancy?
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How does the vaginal pH change during pregnancy?
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What is the normal fetal heart rate range during pregnancy?
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Which method can help visualize the gestation sac during early pregnancy?
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What is the purpose of the operculum during pregnancy?
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What is identified as a positive sign during the palpation of the fetus after 24 weeks of pregnancy?
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What is the primary purpose of the mucous plug in relation to pregnancy?
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What is the significance of Braxton-Hicks contractions during pregnancy?
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What potential abnormalities can give a positive pregnancy test result?
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How does the volume of the uterus change during pregnancy?
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At what stage does uterine wall thickening occur during early pregnancy?
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What is Hegar's sign indicative of?
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The weight of the uterus can increase to what amount by the end of pregnancy?
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What describes the process of ballotement during pregnancy?
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Study Notes
Pregnancy Changes
- Fatigue is a common complaint in the first trimester due to the uterus pressing on the bladder, however, it subsides with the rise of the uterus.
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Breast Changes
- Darkening of the areola (the brown area around the nipple)
- Enlargement of Montgomery glands (tiny nodules surrounded by the areola)
- Increased firmness and tenderness of the breasts
- More prominent veins due to increased blood flow
- Presence of colostrum (precursor to breast milk)
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Braxton Hick's Contractions
- These painless contractions occur throughout pregnancy
- They start around the 12th week and become progressively stronger
- They usually stop with walking
- These contractions do not cause dilation of the cervix
Probable Signs Of Pregnancy
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Uterine Changes
- The uterus rises above the symphysis pubis by the 12th week
- The uterus reaches the xiphoid process by the 36th week
- The uterus increases in width and length about 5 times its normal size.
- The uterus increases in weight from 50 grams to 1000 grams.
- The uterine wall thickens from 1 cm to 2 cm in early pregnancy and thins to become supple and only about 0.5 cm thick by the end of pregnancy.
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Cervical Changes
- Goodell's sign (softening of the cervix)
- Operculum (a mucus plug forms to protect from bacteria)
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Vaginal Changes
- Chadwick's sign (change in vaginal wall color due to increased circulation)
- Leukorrhea (increase of epithelial cell activity)
- Change in vaginal pH (from alkaline to acidic)
Positive Signs Of Pregnancy
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Fetal Heart Sounds
- Can be demonstrated by echocardiography by 6-7 weeks
- Can be heard through an ultrasound by the 10th to 12th week
- Can be heard through a stethoscope by the 18th to 20th week
- Normal fetal heart rate is 120-160 beats per minute
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Ultrasound Scanning of the Fetus
- The gestation sac is visible and can be photographed
- The embryo is visible by the 4th week
- Fetal parts begin to appear by 10th week
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Palpation of the Entire Fetus
- Must include fetal head, back, and upper and lower body parts
- This is a positive sign by the 24th week if the woman is not obese
Other Pregnancy Changes
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Gastrointestinal System Changes
- Heartburn (pyrosis) due to a relaxed cardioesophageal sphincter caused by relaxin and progesterone
- Flatulence and constipation due to slow emptying of the stomach and slow intestinal peristalsis
- Nausea and vomiting due to decreased glucose levels and increased hCG, estrogen and progesterone
- Hyperptyalism (increase in saliva formation) due to increased estrogen levels
- Subclinical jaundice due to decreased bile emptying, leading to reabsorption of bilirubin
- Enlarged gum lines and bleeding gums
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Urinary System Changes
- Fluid Retention due to aldosterone production
- Increased urine output by 60-80%
- Decreased urine specific gravity
- Increased Glomerular Filtration Rate (GFR) and renal plasma flow
Hormones During Pregnancy
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Human Chorionic Gonadotropin (hCG)
- Secreted by trophoblast cells of the placenta
- Plays a role in early pregnancy
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Human Placental Lactogen (hPL)
- Antagonist to insulin, allowing more glucose for fetal growth
- Increased hPL, estrogen, and progesterone levels
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Relaxin
- Secreted by the corpus luteum
- Inhibits uterine activity
- Soften the cervix and collagen in joints
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Prostaglandins
- Affect smooth muscle contractility
- May trigger labor at term
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Pituitary Gland
- Production of growth hormone (GH) and melanocyte-stimulating hormone (MSH)
- Oxytocin produced in the posterior pituitary gland late in pregnancy to aid labor
- Prolactin produced late in pregnancy to prepare for lactation
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Thyroid & Parathyroid Gland
- Thyroid gland enlarges in early pregnancy to increase basal metabolic rate by 20%
- Parathyroid glands are necessary for calcium metabolism
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Adrenal Glands
- Levels of corticosteroids and aldosterone are increased
- Aldosterone increases sodium reabsorption and maintains osmolarity of fluid retention
- Reduces the possibility of rejection of the fetus
- Regulates glucose metabolism
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Pancreas
- Production of insulin to respond to higher levels of glucocorticoids
- Fetal glucose level is 30mg/100ml
- Pregnant women should eat a high-calorie diet and shouldn't go more than 12 hours between meals
- In early pregnancy, blood glucose is between 80-85 mg/100ml.
Key Terms
- Hegar's Sign: Softening of the lower uterine segment.
- Ballotement: "To toss about" - the fetus can be felt to bounce and rise in the amniotic fluid.
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Braxton Hicks Contractions: "Practice contractions"
- These contractions ensure the placenta receives adequate blood
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Goodell's Sign: Softening of the cervix
- The cervix becomes more vascular and edematous due to estrogen.
- Operculum: A mucus plug that seals out bacteria and protects the fetus and membranes from infection.
- Chadwick's Sign: Change in vaginal wall color from light pink to deep violet due to increased circulation from estrogen.
- Leukorrhea: Increase in the activity of epithelial cells.
- Hyperptyalism: Increase in saliva formation.
- Subclinical Jaundice: Increased bilirubin reabsorbed due to decreased bile emptying.
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Description
Test your knowledge on the various physical changes during pregnancy and the probable signs that indicate a successful conception. This quiz covers topics such as fatigue, breast changes, Braxton Hicks contractions, and uterine transformations throughout pregnancy. Understand what to expect in different trimesters and learn the significance of these changes.
