Women's Health Flashcards: Key Signs and Changes

Questions and Answers

What is Chadwick's sign?

Softening and cyanosis of the cervix

Softening of the uterus

Bluish discoloration of vagina and cervix (correct)

Decrease in tidal volume

What is Goodell's sign?

Softening and cyanosis of the cervix at or after 4 weeks.

What is Ladin sign?

Softening of the uterus after 6 weeks.

How much does cardiac output increase during pregnancy?

30-50% Signup and view all the answers

Why does systemic vascular resistance (SVR) and arterial blood pressure decrease in pregnancy?

Most likely due to increase in progesterone. Signup and view all the answers

How does pregnancy affect tidal volume and total lung capacity?

Increases tidal volume by 30-40%, total lung capacity decreases by 5% due to diaphragm. Signup and view all the answers

What is nausea in pregnant patients due to?

Elevations in estrogen, progesterone, hCG. Signup and view all the answers

How does pregnancy affect glomerular filtration rate (GFR)?

Increases by 50% in early pregnancy. Signup and view all the answers

What is the change in red blood cell (RBC) volume during pregnancy?

Increases by 20-30%. Signup and view all the answers

When does hCG double during early pregnancy and when does it peak?

HCG doubles every 48 hours and reaches a peak at 10-12 weeks. Signup and view all the answers

What produces hCG which maintains the corpus luteum in early pregnancy?

Placenta. Signup and view all the answers

What does the corpus luteum produce during pregnancy?

Progesterone which maintains endometrium. Signup and view all the answers

What skin changes occur in pregnancy?

Linea nigra, perineum, and face skin changes (melasma). Signup and view all the answers

What is the increased caloric need in a pregnant patient?

300 cal/day during pregnancy and 500 during breastfeeding. Signup and view all the answers

When should pregnancy testing be done?

14 days after last intercourse. Signup and view all the answers

What is considered the most sensitive pregnancy test?

Serum test. Signup and view all the answers

What is Naegele's rule?

LMP - 3 months + 7 days. Signup and view all the answers

What does GP(TPAL) stand for?

Gravida, parity, term, preterm, abortion, live. Signup and view all the answers

When should first and following pregnancy visits be scheduled?

Between 6-10 weeks. Signup and view all the answers

What is the diagnosis of placenta previa?

US (can be over diagnosed with full bladder), transvaginal > transabdominal Signup and view all the answers

What is the treatment for placenta previa?

Strict pelvic rest and modified bed rest; blood transfusion may be necessary. Signup and view all the answers

What accounts for 20% of antepartum hemorrhage?

Placenta previa Signup and view all the answers

What are the complications of placenta previa?

Hemorrhage, preterm labor with rupture of membranes, fetal malpresentation Signup and view all the answers

What is abruptio placentae?

Premature separation of normally implanted placenta from uterine wall after the 20th week. Signup and view all the answers

What is the most common cause of third trimester bleeding?

Abruptio placentae Signup and view all the answers

What are some risk factors for abruptio placentae? (Select all that apply)

Multiparity Signup and view all the answers

What is the primary cause of abruptio placentae?

Unknown - maternal hypertension, prior hx of abruption, maternal cocaine use, external maternal trauma, rapid decompression of over distended uterus Signup and view all the answers

What are the symptoms of abruptio placentae?

Third trimester vaginal bleeding with severe abdominal pain and strong contractions Signup and view all the answers

What is the typical presentation of abruptio placentae?

Vaginal bleeding, uterine tenderness, abnormal contractions, and fetal distress Signup and view all the answers

What are the physical exam findings of abruptio placentae?

Vaginal bleeding and firm, tender uterus with small frequent contractions; 20% present with no bleeding. Signup and view all the answers

What is a couvelaire uterus?

Life-threatening condition where blood infiltrates myometrium to reach the serosa, giving it a bluish purple tone. Signup and view all the answers

How is abruptio placentae confirmed?

Inspection of placenta at delivery; presence of retroplacental clot with overlying placental destruction confirms diagnosis. Signup and view all the answers

What is the treatment for abruptio placentae?

Stabilize the patient, prepare for potential hemorrhage and preterm delivery. Signup and view all the answers

What is augmentation in the context of contractions?

Increase already present contractions via prostaglandins, oxytocin agents, mechanical dilation, artificial ROM. Signup and view all the answers

Study Notes

Signs of Pregnancy

Chadwick's Sign: Bluish discoloration of the vagina and cervix.
Goodell's Sign: Softening and cyanosis of the cervix occurs at or after 4 weeks gestation.
Ladin's Sign: Softening of the uterus noted after 6 weeks of pregnancy.

Hemodynamics and Cardiac Changes

Cardiac output (CO) increases by 30-50% during pregnancy.
Systemic vascular resistance (SVR) and arterial blood pressure (BP) decrease, mainly due to elevated progesterone levels; systolic BP drops by 5-10 mmHg and diastolic BP by 10-15 mmHg, peaking at week 24.

Respiratory Changes

Tidal volume increases by 30-40% during pregnancy.
Total lung capacity decreases by 5% due to diaphragm elevation.

Nausea and Hormonal Changes

Nausea in pregnant individuals is attributed to increased levels of estrogen, progesterone, and hCG, typically resolving by 14-16 weeks.

Renal Function

Glomerular filtration rate (GFR) increases by 50% in early pregnancy, influenced by RAAS activation increasing aldosterone levels.
Red blood cell (RBC) volume also rises by 20-30%.

hCG Levels

Human chorionic gonadotropin (hCG) doubles every 48 hours during early pregnancy, peaking between 10-12 weeks, then declining and stabilizing after week 15.
The placenta produces hCG, which helps maintain the corpus luteum during early pregnancy.

Nutritional Requirements

Caloric needs increase to 300 calories/day during pregnancy and 500 during breastfeeding, with heightened requirements for protein, iron, folate, and calcium.

Prenatal Care Guidelines

Pregnancy tests should be conducted 14 days after the last sexual intercourse in women with irregular cycles or unknown last menstrual periods.
Serum tests are the most sensitive for pregnancy detection.
Naegle's rule is utilized to estimate due dates: LMP - 3 months + 7 days.

Components of Pregnancy Visits

Initial prenatal visits occur between 6-10 weeks, with regular follow-ups scheduled every 4 weeks until 32 weeks, biweekly until 36 weeks, and weekly thereafter.
A comprehensive history taken includes current pregnancy symptoms and previous obstetric history.

Monitoring Fetal Development

Fundal height is assessed starting at 20 weeks; it corresponds roughly to gestational age.
Fetal cardiac activity can be detected as early as week 6, and by week 5, the fetal yolk sac should be visible.

Screening and Tests

Initial visit tests include complete blood count, blood type, rubella immunity, sexually transmitted infections, urine analysis, HIV screening, and early aneuploidy screening.
Second-trimester testing typically includes MSAFP/triple or quad screen and obstetric ultrasound.
Third trimester tests are often hematocrit, glucose tolerance tests, and group B strep cultures.

Complications in Multiple Gestation

Increased risks include spontaneous abortion, preterm birth, and fetal complications such as growth restriction or congenital anomalies.
Types of twins include monozygotic (identical) and dizygotic (fraternal), with specific monitoring required for conditions like twin-twin transfusion syndrome.

Abortion and Ectopic Pregnancy

Spontaneous abortion is defined as pregnancy termination before 20 weeks, with risks including smoking, infection, and systemic diseases.
Ectopic pregnancies occur outside the uterus, primarily in the Fallopian tubes, often due to tube occlusion.

Placenta Previa and Abruptio Placentae

Placenta previa involves abnormal placenta position, causing bleeding and risks for the fetus, often diagnosed via ultrasound.
Abruptio placentae is the premature separation of the placenta from the uterine wall after 20 weeks, presenting as severe abdominal pain and bleeding.

Management and Complications

Treatment for complications like ectopic pregnancy may include methotrexate and careful monitoring; surgical intervention may be necessary.
Routine monitoring for gestational trophoblastic disease includes hCG levels, with complete and partial moles exhibiting different symptoms.

Key Takeaway Points

Pregnancy entails significant physiological changes across multiple systems, emphasizing the need for careful monitoring and management.
Understanding signs, symptoms, complications, and appropriate interventions is critical for ensuring maternal and fetal health.

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Description

Test your knowledge on important signs and physiological changes in women's health during pregnancy with these flashcards. Learn about Chadwick's sign, Goodell's sign, and more. Perfect for medical students and practitioners!