Maternity PDF

Maternity Terminology Gestation Nulligravida Time from fertilization until date of delivery Woman who has never been pregnant Gravida Primig...

Maternity Terminology Gestation Nulligravida Time from fertilization until date of delivery Woman who has never been pregnant Gravida Primigravida Pregnant woman Woman who is pregnant for the first Gravidity time # of pregnancies Multigravida Parity Woman who is pregnant for at least the # of births past 20 weeks gestation 2nd time (born alive or not) GTPAL Nullipara Gravidity Woman who has not had a birth Term births (at least 37 weeks) greater than 20 weeks gestation Preterm births Primipara Abortion/miscarriages Woman who has had 1 birth that Current living children happened after 20 weeks gestation Pregnancy Length Length: 280 days, 40 weeks, 9 calendar months, 10 lunar months (28 day months) 1st Trimester: starting from the first day of last menstrual period - 13 weeks 2nd Trimester: 14 -26 weeks 3rd Trimester: 27 - 40 weeks Pregnancy Causes a hypercoagulable state that protects the mother from hemorrhage after birth → may lead to thrombus formation Nagele Rule for Estimating Date of Birth Find the first day of the last menstrual period (LMP) Add seven days Then subtract 3 months Ex: LMP is November 1, 2022 Add 7 days = November 8, 2022 Subtract 3 months = August 8, 2023 Fundal Height Measurement of the uterus to determine gestational age of fetus Fetal Heart Rate Can be heard via Doppler at 10-12 weeks gestation Prenatal Visits for Low-Risk Pregnant Women Visit MD every 4 weeks until 28 weeks, every 2 weeks from 28-36, then once a week from 36-40 weeks Defect Screenings Some states require screening for neural tube defects They will use maternal alpha-fetoprotein (AFP) levels or amniotic fluid AFP levels. Note this specific test is prone to false positives/negatives  Maternity Amniocentesis Done early in pregnancy → bladder must be full If done late in pregnancy → empty bladder (to avoid being punctured) Epidural Hydrate before C-section Increases risk for DVT (deep vein thrombosis) Placenta abruption Rigid board-like abdomen, dark red vaginal bleeding Severe pain Monitor I&O Placenta Previa Soft abdomen Painless, bright red vaginal bleeding Amniotic fluid Fluid is alkaline, which turns nitrazine paper blue. Urine and vaginal discharge are acidic and will turn it pink If the fluid is yellow with particles → meconium stained Folic Acid Give before pregnant and throughout pregnancy Vitamin; used for anemia Leafy vegetables, eggs, citrus foods NSAID’s May take in 1st and 2nd trimester only if benefits outweigh the risks Avoid in 3rd trimester due to risk of premature closure of the ductus arteriosis in the fetus Acetaminophen Pain reliever/fever reducer commonly taken during pregnancy Do not exceed 4g per day Magnesium Sulfate Used in preeclampsia Therapeutic range: 4-8 mg/dL Nonstress Test Noninvasive test in which fetal heart rate is monitored in response to fetal movement Mom pushes event marker every time she feels movement or when the FHR strip records movement Performed after 28 weeks gestation Reactive result = Normal Fetal HR increased with movement (15 BPM for 15 seconds) Indicates adequate blood flow and oxygen to fetus Nonreactive result = Further testing needed (Stress Test or BPP) Fetal HR does not increase with movement Other tests will determine if the result is due to sleep patterns, maternal medications, or fetal hypoxia If no fetal movement is shown, suspect fetus is sleeping Stimulate fetus acoustically or have mom move fetus around  Maternity Stress Test Induction of uterine contractions to show how the baby will respond during labor Contractions are induced by nipple stimulation or oxytocin infusion Performed after 34 weeks gestation and only if mother had an atypical result from a nonstress test or biophysical profile Negative result = Normal Fetus HR does not slow during contraction → fetus properly responding to stress (3 contractions in 10 min) Positive result = Abnormal Fetus HR slows during contraction → fetus is under stress Biophysical Profile Nonstress test + ultrasound to assess the health of the fetus 5 areas are assessed: Body movement, breathing movement, muscle tone, heartbeat, and amniotic fluid Each area is scored as either 0 (abnormal) or 2 (normal) Scores: 8-10 = normal, 6 = borderline,