Pregnancy

Fundal height: Pt supine, measure from symphysis pubis to top of fundus, if patients is 18+ wks pregnant the height in cm will be same as weeks pregnant give or take 2 cm Biophysical Profile (BPP) identification of a compromised fetus and consists of 5 components: -fetal breathing movement -fetal movement of the body or limbs -fetal tone (extension or flexion of the limbs) -amniotic fluid volume index (AFI) visualized as of fluid around the fetus -reactive non-stress test each component 0-2, 8-10-desirable. Estrogen stimulates uterine development to provide a environment for the fetus, and stimulates the breasts to prepare for lactation. If the baby is a posterior presentation, the sounds are heard at the sides. If the baby is anterior, the sounds are heard closer to midline, between the umbilicus and where you would listen to a posterior presentation. If the baby is breech, the sounds are high up in the fundus near the umbilicus. If the baby is vertex, they are a little bit above the symphysis pubis Menstrual period -- woman loses about 40 mL of blood. Montgomerys tubercles are sebaceous glands in the areola.

Epidural: injected in the area between the dura matter and the ligamentum flavum
Nagele's Rule: First date of last menstrual period + 7 days - 3 months + 1 year. Anemia of pregnancy: is common in the 2nd trimester due to rapid expanding blood volume and is not a cause for concern

Aminocentesis: Early as 14 weeks. direct analysis of fetal chromosomes,

development, viability and lung maturity (last trimester).

Chorionic Villi: Early as 10 weeks. for early diagnosis of genetic, metabolic

problem.

AFP: Quad Marker Screening.

VBAC Contraindication = vertical scar.

C-Section increases risk for respiratory secretions altering breathing.

Prenatal Visits Q4 weeks - 28-32 weeks Q2 weeks - 32-36 weeks Q1 week - 36-40 weeks Sonagraph in 1st trimester = determining gestational age. Fetus L/S Ratio: < 2= immature lungs - may give dexamethasone or betamethasone to speed up lung maturity 2-3=borderline. >3=good lung maturity Recommended weight gain for pregnancy 1.5-16 kg or 25-35 lbs Self breast exams: do monthly, 7-10 days after menses Prenatal Vitamins: Take at night if nausea present. Spicy foods does not affect breast milk. Lactation = +500 cal/day. Add 300 Calories to diet when pregnant, 500 when breastfeeding. Dehydration = most common cause of increased temperature postpartum. Minieres Disease: Sx: Tinnitus, hearing loss, sense of fullness in the ear. TORCH: Toxoplasmosis, Other (syphilis, hep.), Rubella, Cytometalovirus, Herpes Simplex

1st Trimester (Chorionic villis sampling, US scan) 2nd Trimester (AFP screening or Quad Screening,Amniocentesis)

3rd Trimester (kick counts,Nonstress Test,Biophysical Profile, Percutaneous Umbilical Blood sampling, Contraction Stress Test )

Pregnant woman with "Charley horse" pain (pain in the "gastrocnemius muscle" =>the muscle in the back part of the leg that forms the greater part of the calf; responsible for the plantar flexion of the foot) is relieved by dorsiflexing the foot, which reduces the muscle spasm Posterior presentation, the sounds are heard at the sides. Anterior: the sounds are heard closer to midline, between teh umbilicus and where you would listen to a posterior pr esentation. Breech: the sounds are high up in the fundus near the umbilicus. If the baby is vertex, they are a little bit above the symphysis pubis. Stop pitocin if contractions longer than 90 seconds and closer than 2 minutes. Android Pelvis is wedge shaped, narrow and unfavorable for birth hemophilia is x-linked. Mother passes disease to son.