Exam 1 Review PDF

Physiologic adaptations to pregnancy懷孕時的生理變化: 1. What changes does the uterus undergo? 子宮變大20倍，子宮膜變厚 2. What is the impact of hormones on smooth muscle? 因為由胎盤產生的"黃體激素（progestinine）"平滑肌會放鬆，導致許多器官工作變慢。Ex. Gi系統變慢，所以會便秘，呼吸...

Physiologic adaptations to pregnancy懷孕時的生理變化: 1. What changes does the uterus undergo? 子宮變大20倍，子宮膜變厚 2. What is the impact of hormones on smooth muscle? 因為由胎盤產生的"黃體激素（progestinine）"平滑肌會放鬆，導致許多器官工作變慢。Ex. Gi系統變慢，所以會便秘，呼吸會變慢？（why）糖代謝會變慢，是為了確定寶寶有足夠養分. Progesterone causes smooth muscle relaxation in the respiratory tract, leading to a slight decrease in airway resistance. This may result in a slight increase in breathing depth (tidal volume), but the overall respiratory rate remains stable. The diaphragm is also pushed upwards due to the growing uterus, which can cause a sensation of breathlessness. Progesterone causes vasodilation by relaxing the smooth muscle in the blood vessels, leading to lower blood pressure. However, the heart compensates by increasing the heart rate and cardiac output. 但是心跳會變快，是因為血流和氧變多，為了要滿足寶寶的慾望 3. What causes edema in the lower extremities? How can this be relieved? - - - 1. - 2. - 3. - 4. - 5. - 4. What causes nasal and sinus congestion? 1. - 2. - 3. - 5. What changes in lab values might occur as a result of adaptations of the cardiovascular system? **Lab Values Affected by Cardiovascular Changes:** 1. **Hemoglobin (Hb) and Hematocrit (Hct) Decrease**: - **Physiologic Anemia**: The increase in **plasma volume** (by about 50%) is greater than the increase in **red blood cell (RBC) mass** (which only increases by about 18-33%). This results in **hemodilution**, causing **lower hemoglobin and hematocrit** levels. - **Normal values in pregnancy**: - Hemoglobin: May drop below **11 g/dL**. - Hematocrit: Can decrease to **33%** or lower. - **中文**: 血漿量增加大於紅血球數量的增加，導致血液稀釋，從而導致**血紅素**和**血球比容**下降，稱為**生理性貧血**​​. 2. **Increased White Blood Cell Count (WBC)**: - The **WBC count** often increases during pregnancy and can reach values up to **16,000/mm³**, even in the absence of infection. This is considered a normal physiological response. - **中文**: **白血球數量**會增加，懷孕期間可達到**16,000/mm³**，即使沒有感染，也是正常現象​​. 3. **Increased Clotting Factors (Hypercoagulability)**: - Pregnancy is a **hypercoagulable state** due to the increased production of **fibrinogen** and **coagulation factors** (like factor VII, VIII, and X). This is the body\'s way of preparing for the potential blood loss during childbirth, but it also increases the risk of **venous thromboembolism (VTE)**. - **Fibrinogen**: Increases by **50%**. - **Plasma fibrin**: Increases by **40%**. - **中文**: 懷孕期間**凝血因子**增加，特別是**纖維蛋白原**上升約**50%**，這是為了應對分娩時的失血，但也增加了**靜脈血栓栓塞**的風險​​. 4. **Red Blood Cell (RBC) Increase**: - Although the red blood cell mass increases by **18-33%**, it does not fully compensate for the increase in plasma volume, leading to **physiologic anemia**. - **中文**: 雖然紅血球數量增加了**18-33%**，但仍不足以彌補血漿量的增加，因此會出現生理性貧血​. 5. **Iron Deficiency Anemia**: - Due to increased demands for iron (both for the mother and the developing fetus), some pregnant women may develop **iron deficiency anemia** if iron intake is insufficient. Hemoglobin levels below **11 g/dL** and hematocrit below **33%** may indicate iron deficiency. - **中文**: 懷孕期間對鐵的需求增加，如果鐵攝入不足，可能會導致**缺鐵性貧血**​. 6. What is supine hypotensive syndrome? **Supine Hypotensive Syndrome (仰臥低血壓綜合症)** occurs when a pregnant woman experiences a drop in blood pressure while lying flat on her back (**supine**). This condition is caused by the **compression of the inferior vena cava** by the enlarged uterus, which affects blood flow back to the heart.  **Reduced Cardiac Output**: With less blood returning to the heart, the amount of blood the heart can pump out (cardiac output) is reduced, leading to a sudden drop in **blood pressure**. - **中文**: 因為回流到心臟的血液減少，心臟的**心輸出量**降低，血壓會突然下降​.  **Symptoms**: This can cause dizziness, lightheadedness, nausea, sweating, or even fainting. The baby's blood supply can also be affected because less blood is being pumped through the placenta. - **中文**: 孕婦可能會感到頭暈、噁心、出汗，甚至昏厥。由於血液供應減少，胎兒的血液供應也會受到影響。 7. What causes heartburn and how might this be improved? **Progesterone**: The hormone **progesterone** (黃體激素) plays a significant role in relaxing smooth muscles throughout the body, including the **lower esophageal sphincter (LES)**, which is the muscle that prevents stomach acid from flowing back into the esophagus. **Relaxation of the LES**: As the LES relaxes, it becomes less effective at keeping stomach acid in the stomach. This allows acid to flow back (reflux) into the esophagus, causing the burning sensation known as **heartburn**. **Growing Uterus**: As the uterus expands, it puts pressure on the stomach, pushing its contents upward and contributing to acid reflux. **How to Improve Heartburn:** 1. **Eat Small, Frequent Meals**: Eating smaller meals more frequently helps prevent the stomach from becoming too full, which can reduce the likelihood of acid reflux. - **中文**: 吃小份量的食物且少量多餐，可以減少胃酸逆流的可能性，避免胃部過度充盈​. 2. **Avoid Lying Down After Eating**: It\'s recommended to stay upright for at least 30 minutes to an hour after eating, as lying down can increase the risk of acid reflux. - **中文**: 吃完飯後應避免立刻躺下，建議保持直立至少30分鐘到1小時，以減少胃酸逆流​. 3. **Elevate the Head When Sleeping**: Using extra pillows or sleeping in a slightly upright position can prevent acid from flowing back into the esophagus while sleeping. - **中文**: 睡覺時抬高頭部有助於防止胃酸逆流到食道​. 4. **Avoid Trigger Foods**: Spicy, fatty, or acidic foods, along with caffeine and chocolate, can aggravate heartburn. It\'s helpful to avoid these triggers during pregnancy. - **中文**: 辛辣、油膩、酸性食物以及咖啡因和巧克力會加重胃灼熱，應避免食用​. 5. **Drink Water Between Meals**: Drinking fluids between meals rather than with meals helps prevent the stomach from becoming too full. - **中文**: 在兩餐之間喝水而不是隨餐大量飲水，有助於防止胃部過度充盈​. 6. **Consult with a Healthcare Provider Before Taking Antacids**: If heartburn is severe, a healthcare provider may recommend antacids that are safe for pregnancy, but it\'s important to check before taking any medication. - **中文**: 如果胃灼熱嚴重，應在醫生建議下服用對孕婦安全的抗酸藥​. 8. Which two hormones are responsible for physiologic changes in pregnancy? **1. Progesterone (黃體激素):** - **Function**: Maintains pregnancy by relaxing smooth muscles, preventing uterine contractions, and allowing the uterus to expand. - **Effects**: Slows digestion (causing constipation), relaxes the esophageal sphincter (leading to heartburn), and maintains the uterine lining​​. **2. Estrogen (雌激素):** - **Function**: Promotes fetal growth and prepares the body for childbirth. - **Effects**: Increases blood flow to the uterus, stimulates breast development, and loosens ligaments for labor​​. 9. What causes cessation of the menstrual cycle? **1. 懷孕（激素增加）：** - **原因: 在懷孕期間，黃體激素和雌激素水平顯著升高，這些激素的作用是維持子宮內膜，讓胚胎可以植入和發育。這些高水平的激素同時抑制了排卵，因為排卵是由促性腺激素（如促黃體生成素、促卵泡生成素）控制的，而懷孕激素會抑制這些激素的分泌，從而阻止月經來潮。** - **中文: 在懷孕期間，激素增加，維持子宮內膜並抑制排卵，因此不會有月經​​。** **2. 更年期（激素減少）：** - **原因: 更年期時，卵巢功能衰退，雌激素和黃體激素的生成減少。這些激素的減少導致排卵停止，因為卵巢不再釋放卵子。此外，由於缺乏激素刺激，子宮內膜無法增厚，最終導致月經永久停止。** - **中文: 更年期時，卵巢不再產生足夠的激素，排卵和子宮內膜增厚的過程都停止，導致停經​。** - During early pregnancy, the corpus luteum secretes progesterone. In later pregnancy, the placenta takes over progesterone production to sustain the pregnancy. - **中文**: 早期懷孕由黃體分泌黃體激素。後期懷孕則由胎盤分泌黃體激素來維持懷孕。 - 表單的頂端 - 表單的底部 10. What causes low blood pressure in pregnancy? During pregnancy, **blood volume increases by 30-50%** to: 1. Support fetal development by providing more oxygen and nutrients. 2. Prepare for potential blood loss during delivery. 3. Compensate for the dilation of blood vessels caused by hormones​​. 11. What is Naegele's rule and how one calculated an estimated due date for a pregnancy? 減三個月，再加七天，再加一年。 12. What happens to the renal system in pregnancy and why are urinary tract infections more common? Progesterone relaxes the smooth muscles of the ureters and bladder, which can slow urine flow and lead to urinary stasis. This increases the risk of urinary tract infections (UTIs) during pregnancy. Urinary stasis primarily occurs in the **ureters** (which carry urine from the kidneys to the bladder) and sometimes in the **bladder**, where urine may accumulate and not be expelled efficiently. 13. What causes nausea and vomiting in pregnancy? 1. - 2. - 3. - 14. In the musculoskeletal system what are clinical signs and symptoms of softening joints? 15. What physiologic changes may lead to striae gravidarum (妊娠紋)?  **Striae gravidarum** refers to **stretch marks** that appear on the skin, particularly on the abdomen, breasts, and thighs, during pregnancy.  **Physiologic Changes**: The main cause is the **rapid stretching** of the skin as the body grows to accommodate the fetus. The **breakdown of collagen** in the skin, combined with hormonal changes, makes the skin less elastic, leading to stretch marks.  **中文**: 妊娠紋是由於孕期皮膚**快速擴張**，導致膠原蛋白結構受損，加上激素影響，皮膚變得不那麼有彈性，從而出現妊娠紋​. Genetics: 1. What is dominant inheritance and what are the dominant genes we addressed in lecture?  In **dominant inheritance**, if **one parent** carries a dominant gene, it will be expressed in the offspring. This means only one copy of the gene is needed for the trait to show up.  **Dominant Genes Discussed**: Examples of dominant genes might include conditions like **Huntington's disease** or certain **polydactyly** (extra fingers or toes).  **中文**: 顯性基因只需父母之一攜帶，子女就會表現出該基因特徵。例如，亨廷頓病和多指症可能是課堂中提到的顯性基因​​. 2. What is recessive inheritance what recessive genes did we discuss in lecture? recessive inheritance requires both parents to pass on the recessive gene for it to be expressed. If only one parent passes it on, the individual will be a carrier but will not show the trait. Recessive Genes Discussed: Recessive conditions we may have discussed include cystic fibrosis or sickle cell anemia. 中文: 隱性基因必須由父母雙方攜帶，子女才會顯示該特徵。例如，囊性纖維化和鐮刀型貧血是常見的隱性基因​. 3. What is X-linked inheritance and what example(s) did we discuss in class? **X-linked inheritance** refers to genes located on the **X chromosome**. Since males have only one X chromosome, if a recessive gene is carried on the X chromosome, they will express the trait because there is no second X chromosome to provide a normal copy of the gene. - **中文**: X連鎖遺傳是指位於**X染色體**上的基因。由於男性只有一條X染色體，如果X染色體上攜帶隱性基因，這個特徵就會表現出來，因為男性沒有第二條X染色體來提供正常的基因副本。 **例子（Examples Discussed in Class）:** Examples of X-linked inheritance include **hemophilia** and **color blindness**. These conditions are more common in males because they have only one X chromosome, so a single copy of the recessive gene will cause the condition. - **中文**: 課堂上討論的例子包括**血友病**和**色盲**。這些疾病在男性中更常見，因為他們只有一條X染色體，隱性基因只要出現一個就會表現出來。 Antenatal testing 1. What is chorionic villus sampling and when should it occur? **Chorionic Villus Sampling (CVS)** is a **diagnostic test** that involves taking a small sample of cells from the **placenta** (chorionic villi) to test for genetic conditions and chromosomal abnormalities. It is typically performed between **10-12 weeks** of pregnancy. - **What it tests for**: CVS is used to detect conditions such as: - **Chromosomal abnormalities**: Including **Down syndrome** (唐氏綜合症), **Edwards syndrome** (愛德華氏症), and **Patau syndrome**. - **Genetic disorders**: Including **Cystic Fibrosis** (囊性纖維化), **Sickle Cell Anemia** (鐮刀型貧血), and **Thalassemia** (地中海貧血). - **中文**: 絨毛膜取樣是一種診斷測試，通過從胎盤取樣來檢測**染色體異常**和**遺傳疾病**，通常在懷孕的**10-12週**進行。它用來檢測唐氏綜合症、愛德華氏症、囊性纖維化、鐮刀型貧血等疾病​​. 2. What is amniocentesis and when should it occur? **中文: 羊膜穿刺術是一種診斷測試，通常在懷孕15-20週進行，用來檢查染色體異常。在30週後，主要用來評估胎兒的肺部成熟度，通過分析羊水中的卵磷脂和神經鞘磷脂等物質來判斷。如果這些水平顯示肺部已成熟，胎兒出生後更有可能正常呼吸。** 3. What are methods of ensuring fetal well-being in pregnancy? Non-Stress Test (NST): Measures the fetal heart rate in response to fetal movements, ensuring that the baby is getting enough oxygen. 4. What is the difference between a diagnostic test and a screening test? 篩檢測試（Screening Test）**和**診斷測試（Diagnostic Test）\*\*的區別如下： **1. 篩檢測試（Screening Test）:** - **目的是**：篩檢測試是用來檢測出**是否有健康風險**，但不能確定是否真的存在疾病。這種測試通常用於確認是否需要進一步的診斷測試。 - **舉例**：血液篩檢（如**Quad Screen**）和**第一孕期篩檢（First Trimester Screening）**，主要是透過抽血或超音波來檢查胎兒是否有染色體異常的風險。 - **簡單描述**：篩檢測試是**初步篩查**，能顯示有無高風險，但不能確定疾病。 **2. 診斷測試（Diagnostic Test）:** - **目的是**：診斷測試則用來**確認胎兒是否真的有健康問題**。這類測試能確定是否有特定的遺傳疾病或染色體異常。 - **舉例**：\*\*絨毛膜取樣（Chorionic Villus Sampling, CVS）**和**羊膜穿刺（Amniocentesis）\*\*是診斷測試，通常用來確診染色體異常或遺傳性疾病。 - **簡單描述**：診斷測試是用來**確診**，能精確地判斷胎兒是否有健康問題。 **總結：** - **篩檢測試**（如血液檢測、超音波）用來判斷是否有潛在風險，是初步檢測。 - **診斷測試**（如絨毛膜取樣、羊膜穿刺）用來**確定**疾病，能夠更準確地診斷胎兒的健康狀況。 篩檢測試和診斷測試都可能包括**抽血**，但篩檢測試只提供風險評估，而診斷測試會取樣來確診胎兒的健康問題。 5. What is included in a biophysical profile? **Biophysical Profile (BPP)** is a test used to assess fetal well-being, typically performed during the **third trimester**, usually between **32 and 40 weeks** of pregnancy. It may be done earlier, starting around **28 weeks**, especially in high-risk pregnancies such as cases with advanced maternal age, fetal growth restriction, or gestational diabetes. BPP evaluates five aspects of fetal health, with each scored up to 2 points for a total of 10 points. These include: 1. **Fetal breathing movements**: At least one episode of 30 seconds of sustained breathing in 30 minutes. 2. **Fetal movements**: At least three body or limb movements in 30 minutes. 3. **Fetal tone**: At least one episode of limb extension with return to flexion. 4. **Amniotic fluid volume**: At least one pocket of amniotic fluid measuring 1 cm or more in diameter. 5. **Non-stress test (NST)**: At least two fetal heart rate accelerations of 15 beats per minute or more in 20 minutes. **Memory aid (口訣)**: **\"呼三動三伸一次，水袋一公心跳急\"** - **呼**: 30秒胎兒呼吸 - **動**: 胎兒動三次 - **伸**: 伸展一次 - **水袋**: 羊水袋至少1厘米 - **心跳急**: 20分鐘內心跳至少加速兩次 - **中文**: **生物物理評分（BPP）** 是用來評估胎兒健康的一項測試，通常在懷孕的**第三孕期**進行，特別是在**32到40週**之間。如果是高風險妊娠，如高齡產婦、胎兒生長遲滯或妊娠糖尿病等情況，可能在**28週左右**開始進行。BPP 評估胎兒健康的五個方面，每個方面最多得2分，總分為10分。這五個方面包括： 1. **胎兒呼吸動作**：30分鐘內至少一次持續30秒的呼吸動作。 2. **胎兒活動**：30分鐘內至少三次身體或肢體運動。 3. **胎兒肌肉張力**：至少一次肢體伸展並回到屈曲狀態。 4. **羊水量**：至少有一個直徑1厘米或更大的羊水囊。 5. **非壓力測試（NST）**：20分鐘內胎兒心跳至少加速兩次，每次至少15次心跳。 Diagnosing pregnancy: **1. Presumptive Signs of Pregnancy:** - These are **subjective** signs reported by the woman, which suggest pregnancy but are not definitive. - Examples: - **Amenorrhea** (missed period) - **Nausea/vomiting** (morning sickness) - **Breast tenderness** - **Fatigue** - **Frequent urination** - **中文**: 可能懷孕的症狀，通常是女性自己感覺到的，比如停經、噁心、乳房疼痛、疲勞和頻尿。 **2. Probable Signs of Pregnancy:** - These are **objective** signs observed by a healthcare provider, which are stronger indicators but still not definitive. - Examples: - **Positive pregnancy test** (urine or blood) - **Hegar\'s sign** (softening of the lower uterus) - **Chadwick\'s sign** (bluish discoloration of the cervix) - **Enlarged abdomen** - **中文**: 可能懷孕的客觀體徵，由醫護人員觀察到，如孕檢陽性、子宮頸變藍、下腹部增大等。 **3. Positive Signs of Pregnancy:** - These are **definitive** signs that confirm pregnancy without a doubt. - Examples: - **Fetal heartbeat** heard with a Doppler - **Ultrasound** showing the fetus - **Fetal movement** felt by the examiner - **中文**: 確認懷孕的明確體徵，如胎心音、超音波看到胎兒或檢查到胎動。 **4. Hormone Detected in a Urine Pregnancy Test:** - **Human Chorionic Gonadotropin (hCG)** is the hormone detected in a urine pregnancy test. hCG is produced by the placenta shortly after implantation. - **中文**: 尿液妊娠檢測檢測的是**人絨毛膜促性腺激素 (hCG)**，這是由胎盤在受精卵著床後分泌的。 Preconception and prenatal care: 1. What are components of an initial prenatal visit? The **initial prenatal visit** typically occurs around **8-12 weeks of pregnancy** and involves a comprehensive evaluation to establish a baseline of the mother\'s health and assess the development of the pregnancy. Key components include: - **Medical history**: Detailed review of the mother's personal, family, and obstetric history to identify any potential risks. - **Physical examination**: Complete physical exam including weight, blood pressure, pelvic exam, and measurement of uterine size to estimate gestational age. - **Laboratory tests**: - **Blood tests**: To check blood type, Rh factor, complete blood count (CBC), glucose levels, and to screen for STIs (e.g., HIV, syphilis), rubella immunity, and hepatitis. - **Urine tests**: To check for protein, glucose, and infection. - **Ultrasound**: May be performed to confirm the pregnancy, assess fetal heartbeat, and determine gestational age. - **Discussion and Counseling**: Information on nutrition, prenatal vitamins (e.g., folic acid), exercise, lifestyle changes (e.g., avoiding alcohol and smoking), and what to expect in the upcoming weeks. This visit lays the foundation for **ongoing prenatal care** and ensures early detection of any potential complications. **中文**: 第一次產檢通常在懷孕**8-12週**進行，包括詳細的病史詢問、體檢、化驗（血液和尿液）、確認懷孕的超音波檢查，以及有關營養、生活習慣和產前護理的討論。 2. What does teratogenesis mean? 3. Which topics in terms of prenatal education should be addressed depending on the trimester? (Examples) a. Pain relief in labor b. Postpartum care c. Early discomforts of pregnancy d. Breastfeeding e. Signs of labor f. Parenting and infant care 4. How is an obstetric history documented according to GTPAL 5. When should an individual anticipate screening for gestational diabetes? Gestational diabetes screening typically occurs between 24-28 weeks of pregnancy to check for the body's response to glucose as pregnancy progresses. 中文: 妊娠糖尿病篩查通常在懷孕的24-28週之間進行，這是因為妊娠糖尿病往往在懷孕後期發展，這時候荷爾蒙開始影響胰島素的使用。 6. When is GBS screened for in pregnancy?  **GBS** stands for **Group B Streptococcus**. Screening for GBS is typically done between **35-37 weeks** of pregnancy. This test is performed to check for the presence of **Group B Streptococcus**, a type of bacteria that can be passed to the baby during childbirth and can cause serious infections in newborns.  **Correct answer**: GBS screening is performed between **35-37 weeks** to prevent infection in the newborn during delivery.  **中文**: **GBS**（乙型鏈球菌）的篩查通常在**35-37週**進行，以防止分娩時胎兒感染乙型鏈球菌，這可能會導致新生兒嚴重感染。 1. How is infertility defined? Pregnancy and fetal development: 1. Where does fertilization occur in the reproductive tract? Fertilization typically occurs in the **fallopian tube** (not \"folie tube\"), specifically in the **ampulla**, which is the wider part of the fallopian tube. 受精通常發生在**輸卵管**的**壺腹部** 2. What structures are specific to the fetal circulatory system?  The fetal circulatory system includes specific structures like the **foramen ovale** (a hole between the right and left atria), **ductus arteriosus** (a vessel connecting the pulmonary artery to the aorta), and the **ductus venosus** (which allows blood from the umbilical vein to bypass the liver). The baby receives oxygen through the **umbilical cord**, as the lungs are not yet in use.  **中文**: 胎兒循環系統有**卵圓孔**（連接右心房和左心房的孔）、**動脈導管**（連接肺動脈和主動脈的血管），以及**靜脈導管**（讓血液繞過肝臟）。 3. What is the function of the placenta and how is it formed? The placenta provides **nutrients and oxygen** to the baby and removes waste. It forms from the **chorionic villi**, which invade the uterine wall. 4. What is the function and anatomy of the umbilical cord? The **umbilical cord** is a structure that connects the fetus to the placenta. It contains: **Two arteries**: These carry **deoxygenated blood and waste** from the fetus back to the placenta. **One vein**: This carries **oxygenated blood and nutrients** from the placenta to the fetus. The **function** of the umbilical cord is to: Deliver oxygen and nutrients from the placenta to the fetus. Remove waste products and deoxygenated blood from the fetus, sending it back to the placenta for disposal through the mother\'s body. **中文**: 臍帶連接胎兒和胎盤，包含兩條動脈和一條靜脈。動脈負責將缺氧的血液和廢物從胎兒送回胎盤，靜脈負責將含氧的血液和養分從胎盤送到胎兒。 5. What is the function of amniotic fluid? Amniotic fluid plays several important roles during pregnancy: 1. **Cushions the fetus**: It acts as a protective buffer, absorbing shocks and protecting the fetus from external pressure or trauma. 2. **Allows fetal movement**: The fluid provides space for the fetus to move, which is essential for muscle and bone development. 3. **Regulates temperature**: It helps maintain a stable temperature inside the womb, keeping the environment warm and constant for the fetus. 4. **Prevents adhesions**: It prevents the amniotic sac from sticking to the fetus, allowing normal development and movement. 5. **Assists in lung development**: The fetus breathes in the fluid, which helps in the development of the lungs. **中文**: 羊水在懷孕期間的功能包括： 1. **保護胎兒**：吸收外界衝擊，防止胎兒受傷。 2. **允許胎兒活動**：提供胎兒活動空間，有助於肌肉和骨骼的發育。 3. **調節溫度**：幫助維持子宮內的恆定溫度，給胎兒提供溫暖穩定的環境。 4. **防止黏連**：避免羊膜囊黏在胎兒皮膚上，允許胎兒正常發育和活動。 5. **促進肺部發育**：胎兒吸入羊水，有助於肺部的發育。 6. At what gestational ages is a pregnancy considered in the embryonic phase? The embryonic phase lasts until **8 weeks**. 6. When can fetal heart tones be auscultated? The heart starts developing at **3 weeks**, but **fetal heart tones** are typically heard with a Doppler around **10-12 weeks**, 第四周只是開始跳，但還聽不到 7. How is fundal height measured in pregnancy and what anatomical marker on the body usually corresponds to 20 weeks gestation? Fundal height at 20 weeks is usually at the **umbilicus**, and it may decrease after 36 weeks when the baby's head engages in the pelvis. **undal height** (子宮底高度) 是從\*\*耻骨聯合處（pubic symphysis）\*\*開始量，向上量到子宮底的最高點（fundus）。 子宮底高度的測量是從**耻骨聯合處**開始，測量到子宮的最高點，即子宮底。這種測量方法常用來評估胎兒的成長和妊娠進展。 從pubric往上樑。20週通常剛好到肚臍， 20週以上，一週加一公分，但36週到達高點後，之後，由於嬰兒的頭會倒轉到陰道附近，所以反而會下降。 8. At what gestational age is a pregnancy considered term? Pregnancy is considered **term** at 37 weeks or more.