A pregnancy with more than one fetus
MONOZYGOTIC TWINS (aka identical twins)
Twins that result when one fertilized egg divides into separate embryos
A picture analysis of the chromosomes
Three chromosomes at position 21
SPONTANEOUS ABORTION (MISCARRIAGE)
Nonelective abortion that occurs within the first 20 weeks of pregnancy
Vaginal spotting noted with a closed cervix
Abortion that occurs when the cervix dilates and part of the placenta detaches from the uterus resulting in moderate to heavy bleeding
Abortion that occurs when the fetus is passed but the placenta is retained in the uterus
Results when all the fetal tissue is passed, the cervix closes, and minimal bleeding occurs
Condition in which the fetus dies, but spontaneous abortion does not occur
THERAPEUTIC ABORTION (TAB)
The termination of the pregnancy to save the life and preserve the health of the mother, or when the fetus has a serious developmental or hereditary disorder
ELECTIVE ABORTION (EAB)
Abortion performed at the request of the mother but not for reason of maternal risk or fetal disease
Relating to the head and face
Abnormal development of an organ or structure
Chemical that can cause abnormal fetal development
Infection of the fallopian tubes
Mulberry-shaped mass of blastomeres that forms when the zygote splits; develops into the blastula
Stage of embryo formation ion which cells have formed a two-layer ball
The outermost layer of cells of the blastocyst that attaches the fertilized ovum to the uterine wall and that becomes the placenta and fetal membranes
The part of the inner cell mass of a blastocyst that will become the embryo
Embedding of the blastocyst into the endometrium
HUMAN CHORIONIC GONADOTRIPIN (hCG)
A hormone produced by the placenta that maintains the corpus luteum during pregnancy, the chemical that pregnancy kits identify in order to determine pregnancy
Outer layer of the membranes enclosing the embryo and Amnions
Inner layer of the fetal membranes, originating from inside the blastocyst, surrounding the fetus
FETAL MEMBRANES (bag of waters)
Any membrane that functions for the protection or nourishment of respiration or excretion of a developing fetus
BAG OF WATERS
The fetal membranes are referred to as what?
Fluid formed by the amnion, consisting of about 98% water, and containing glucose, proteins, urea, lanugo (fine fetal hair) and vernix caseosa
Fine fetal hair
A white, cheesy substance covering the fetus's skin to protect it from the amniotic fluid
A highly vascular organ connecting the mother and the fetus
Irregular sections of the maternal side of the placenta
HUMAN PLACENTAL LACTOGEN (hPL)
Hormone that stimulates changes in maternal metabolism during pregnancy
A hormone produced by the placenta that causes softening in the collagen connective tissue of the symphysis pubis and sacroiliac joint
A cord that connects the fetus to the placenta
White gelatinous tissue making up the umbilical cord that cushions the vessels inside the cord.
PRE-EMBRYONIC STAGE (Stage I)
From fertilization thru 14 days; the time when the fertilized ovum travels thru the fallopian tube, differentiates into trophoblast and embryonic disc, and attaches to the endometrium
EMBRYONIC STAGE (stage II)
From week 3 thru 8 of fetal development; stage in which all body systems are formed
Twins that occur from two eggs fertilized by two sperm; they generally have two separate placentas, amnions, chorians and could be different genders; dizygotic twins
FETAL STAGE (stage III)
From weeks 9 thru 38 to 40; during this stage, all body systems are refined and begin to function
Proceeding from head to toe
Two arteries in which blood flows from the internal iliac arteries in the fetus to the placenta
Vessel that brings clean, oxygenated fetal blood and nutrients back to the fetus from the placenta
A vein passing thru the liver and connecting the left umbilical vein with the inferior vena cava of the fetus
An opening in the septum between the right atrium and the left atrium
A blood vessel in a fetus that connects the pulmonary artery to the aorta
A membranous sac attached to an embryo, providing early nourishment and functioning as the circulatory system of the embryo before internal circulation begins
A substance that decreases the surface tension of fluid inside the alveoli, allowing the lungs to expand
Ability to live outside the uterus, usually 24 weeks
The first fetal stool
The hardening or calcification of soft tissue into a bonelike material, marking the transition from embryo to fetus
Absence of menses
The first fetal movements felt by the mother
A sharp upward pushing against the uterine wall with a finger inserted into the vagina; used for diagnosing pregnancy by feeling the return impact of the displaced fetus
Softening of the lower uterine segment, present by the 8th week of pregnancy
An indication of pregnancy in which the cervix and vagina soften
FETAL HEART TONES (fht)
The fetal heartbeat
Sound occurring at the same rate as the maternal pulse and caused by increased maternal blood flow to the uterus
Sound occurring at the fetal heart rate, caused by fetal blood flowing thru the umbilical cord
BRAXTON HICKS CONTRACTIONS
Irregular, painless contractions occurring throughout pregnancy, also known as false labor
A translucent yellow fluid rich in protein, antibodies and other substances to meet the needs of the newborn, produced in the breasts
SUPINE HYPOTENSIVE SYNDROME
Reduction in blood pressure that occurs when the mother lies supine; the heavy uterus presses on the inferior vena cava, resulting in reduced blood flow back to the right atrium
PHYSIOLOGIC ANEMIA OF PREGNANCY
Drop in iron that results from hemodilution, evidenced by a hematocrit of 34% to 40%; the number of white blood cells increases beginning in the second trimester.
Prolonged vomiting related to pregnancy
A dark line on the abdomen from the umbilicus to the pubis
aka "Mask of Pregnancy"; darkening of the forehead, cheeks and area around the eyes
STRIAE GRAVIDARUM (aka Stretch marks)
marks that occur when the underlying connective tissue separates during periods of rapid growth
Hormone produced by the posterior pituitary gland; stimulates uterine contractions
LET DOWN REFLEX
Release of milk after delivery
A non invasive test used to outline the shape and determine the consistency of various organs and diagnose pregnancy; it can also be used to determine the exact position, size, and gender of the fetus and to identify some developmental anomalies
The withdrawal of amniotic fluid thru a needle inserted into the abdomen and the uterus as a means of gathering data about the developing fetus
PERCUTANEOUS UMBILICAL CORD SAMPLING
A test similar to amniocentesis done in the second and third trimesters in which the physician locates the fetal parts, identifies the placenta and umbilical cord by ultrasound, and aspirates fetal blood for analysis of chemical content; the test is useful in diagnosing inherited blood disorders, detecting fetal infection and determining acid-base balance.
A serious anemia, usually resulting from maternal antibodies to Rh-positive fetal blood
CHORIONIC VILLUS SAMPLING
Test in which a sample of placental tissue is taken from a woman's abdomen and placental tissue is aspirated thru a needle; the tissue, formed from the zygote reflects the genetic makeup of the fetus
NONSTRESS TEST (NST)
A test used to assess fetal movement and fetal heart rate
A test that assess five variables; fetal breathing, fetal movement, fetal tone, amniotic fluid volume, and fetal reaction
The number of pregnancies a woman has had
The number of deliveries after 24 weeks' gestation
The termination of a pregnancy before the fetus is viable (24 weeks)
Delivery after the 24th week, but before the 38th week
Delivery between 38 & 42 weeks
Delivery after 42 weeks gestation
aka "Spontaneous abortion". Nonelective abortion that occurs within the first 20 weeks of pregnancy
A method used to determine date of birth taking the first day of the last menstrual period (LMP), subtracting 3 months, and adding 7 days
Woman who has never been pregnant
Woman who has never delivered an infant after 24 weeks gestation
First delivery after 24 weeks' gestation
Woman who has been pregnant two or more times
Woman who has delivered two or more times after 24 weeks' gestation
An abbreviation for gravida, para/term, preterm, abortion, live birth
A supportive companion who accompanies the woman thru birth, providing physical and emotional support and information, and advocating for the woman and the family
IRON, FOLIC ACID, CALCIUM & B12
What nutrients should be included in the diet for preconception?
This is the process of uniting 2 sex cells (ovum) into one
The fertilization of the ovum happens where in the fallopian tube?
The zygote (single cell) splits into 16 cells, at this time it is called a what?
When the Morula enters the uterus, it is then called a what?
EMBRYOBLAST & TROPHOBLAST
The Blastocyst has two parts, they are called what?
The Embryoblast (inner cells of the blastocyst) will eventually become the what?
The inner cells of the blastocyst are called what?
The outer cells of the blastocyst are called what?
It takes how long for the Zygote to divide into 16 cells and become the Morula?
The inner mass of embryonic cells from the blastocyst (embryoblast) become the what?
The outer layer of the blastocyst, which is involved in implantation, hormone secretion, membrane and placental formation, is called what?
CHORION & AMNION
The Throphoblast splits into two parts, what are they called?
The Chorion (from the trophoblast) will eventually become the what?
The Amnion (from the trophoblast) will eventually become the what?
INNER SAC (Amniotic cavity)
The Trophoblast splits into two parts, the Chorion and the Amnion. The Amnion is referred to as what?
The Trophoblast splits into two parts, the Chorion and the Amnion. The chorion is referred to as what?
ENDODERM, MESODERM, ECTODERM
The Embryoblast (embryonic disk) has three layers. What are they?
The inner layer of the Embryoblast is called/referred to as what?
The middle layer of the Embryoblast is called/referred to as what?
The outer layer of the Embryoblast is called/referred to as what?
ENDODERM (inner layer)
The Respiratory system, GI system, Liver, Pancreas, Bladder & Urethra are body systems which develop in which layer of the Embryoblast?
MESODERM (Middle layer)
The Muscular & skeletal system, heart, blood, blood vessels, spleen, urinary (renal system) and reproductive system are body systems which develop in which layer of the Embryoblast?
ECTODERM (Outer layer)
The Skin, Nervous system, Sense organs, mouth and anus are body systems which develop in which layer of the Embryoblast?
Tissue that lines the uterine wall during pregnancy. The endometrium is called this once the fertilized egg is implanted into it.
7 & 5 DAYS
About ___(#) days after ovulation, or ___ (#) days after fertilization, the trophoblast burrows into the endometrium. Usually in the upper part of the uterus
The fertilized blastocyst ideally implants where in the uterus?
The trophoblast puts out ____, fingerlike projections, to anchor the blastocyst.
The outer fetal membrane is the ____, formed from the trophoblast. The ____ villi degenerate, except for those attached to the uterine wall, which become the maternal side of the placenta.
AMNIOTIC SAC (bag of water)
The Chorion (outer sac) and the Amnion (inner sac) together form the what?
This sac surrounds the amnion (inner sac that houses the fetus) and attaches to the uterine wall by villi, which become (the villi) the maternal side of the placenta
This is the inner sac the houses the fetus (inside of the chorion - outer sac)
By what week, does the chorion become the placenta?
This provides protective cushion, stabilizes baby temp, hydration, equalizes pressure, allows for growth, allow limbs not to adhear to skin or other membranes.
This can be tested to check for congenital defects
The amniotic fluid develops by what week?
it takes how many days for the fertilized ovum to reach the uterus?
HCG (human chorionic gonadotropin)
This stimulates the corpus luteum to produce estrogen & progesterone
The placenta takes over production of estrogen & progesterone by what weeks?
What produces HCG
This fluid is formed by the amniotic membrane (produced by the baby urinating)
CLEAR OR STRAW
The amniotic fluid should be what color?
This is the organ for fetal respiration, nutrition and excretion
This is formed by week 3, functions by week 11-12, organ for 02 exchange between fetus & mom. Has 2 sides
PROGESTERONE, ESTROGEN, HCG, HPL & RELAXIN
What 5 hormones does the placenta produce
What hormone maintains uterine lining for implantation & reduces uterine contractions to prevent spontaneous abortion?
What hormone stimulates uterine growth, increases blood flow to uterine vessels, and stimulates breast ducts to prepare for lactation?
this causes the corpus luteum to persist and continue production of estrogen and progesterone and to sustain the pregnancy. Is detectable in maternal blood as soon as implantation occurs (usually 8-10 days after fertilization)
This hormone causes relaxation or softening of CONNECTIVE tissue?
This hormone causes changes in maternal metabolism and causes decreased insulin sensitivity and utilization of glucose by mother. Helps make more glucose available to baby & also helps mother to prepare for lactation.
maternal side of the placenta is called what? (connected to the endometrium)
Fetal side of the placenta is called what?
Acronym for prenatal blood testing
How many arteries are in the umbilical cord?
How many veins are in the umbilical cord?
What, in the umbilical cord, carries oxygenated blood and nutrients to the fetus?
What, in the umbilical cord, carries unoxygenated blood, CO2 and waste products from the fetus to Mom for excretion?
ARTERY, VEIN, ARTERY
What does the women's name AVA refer to when thinking about the umbilical cord?
What signals the transition from embryo to fetus? Week 8
What week does bone ossification take place?
By what week does fetal heart begin to beat, body flexed, C-shaped with arm & leg buds present
By what week are all organs formed, first indication of musculoskeletal ossification
By what week can the fetal heart rate be heard using a Doppler?
By what week can the sex of fetus be determined, blood forms in marrow & kidneys are able to secrete urine?
By what week does the face look human, meconium is present in bowel, heart muscle well developed, sensory organs differentiated?
By what week does Primitive respiratory movements begin, heartbeat can be heard with fetoscope, quickening occurs, brain grossly formed, vernix caseoa is formed, lanugo present?
By what week is the body lean, but well proportioned, lecithin (respiratory marker) begins to appear in amniotic fluid and ability to hear
By what week is brown fat present, eyes begin to open & close, week suck reflex present
By what week does subcutaneous fat collect, fetus has fingernails & toenails, taste present, aware of sounds outside mother's body
By what week is the skin pink, rounded body, lanugo on shoulder & upper body only, vernix caseosa scant & fetus receives antibodies from mother?
In what week are eyes large discs on side of head?
On day __ blood forms (before the heart)
In this month, there is rapid cell growth, formation of heart & brain, growth head to tail (cephalacaudal), differientated lobes in brain present, growth is general to specific and proximal to distal? Size is rice grain.
In this month fetus has large head, all major organs are formed, paddle shaped hands, heart pumps small amounts of blood, sensitive to teratogens
Teratogens are most harmful to fetal development mostly in what weeks?
Lung buds, week ___
Entire CNS formed, week __
eyelids seal to protect developing retina week __.
Fetus produces (but does not pass) urine in week __.
Fetus passes urine in week __.
Bone marrow functional, week __.
Liver makes bile, week __.
Fetal circulation by week ___.
spleen forms by week __.
All organs are formed by ___ weeks
Kidneys able to secrete urine by week ___.
Fetus has fingernails and toenails by week ____.
Vernix caseosa becomes scant by ___ weeks.
Quickening occurs between ___ & ___ weeks.
Fetal heart begins to beat on day ___.
Meconium is present in bowel by week ___.
Age of viability of fetus is ___ weeks
eyes begin to open & close by ___ weeks
Skin lacks fat until between ___ & ___ weeks
Liver will make blood cells starting week ____.
by the end of week ___, the entire central nervous system is present
Most heart anomalies occur between weeks __ & __
External male & female genitalia can be identified in week ___.
Lungs are developed but not enough alveoli to maintain gas exchange outside the uterus, what week?
Lungs producing surfactant, week ___
MATURITY OF LUNGS
L/S ration measures what?
Fetus does not have its own circulation, so these are in place
Lack of this in the diet (of the mother) can cause Neural Tube defects, spina bifida & cleft lip
What vitamin supplement should the expectant mother be sure of getting enough?
IRON & CALCIUM
What minerals should the expectant mother be sure of getting enough of?
EVERY 4 WEEKS
The prenatal office visit should be how often during first 28 weeks?
EVERY 2 WEEKS
The prenatal office visit should be how often during weeks 29-36
the prenatal office visit should be how often from 36 weeks until delivery?
Women of normal weight should only gain how many lbs?
Underweight women should gain how much during pregnancy?
Overweight women should only gain how much during pregnancy?
How many lbs should be gained during the first trimester?
How much weight should be gained each week during the 2nd & 3rd trimester?
This testing should be done each time the pregnant mother comes to the Dr. office.
HYPERTENSION & DM
Protein & Glucose in the urine will indicate_____ & _____
Glucose screening will be done at how many weeks?
The "T" in torch (blood testing) stands for what?
The "O" in torch (blood testing) stands for what?
The "R" in torch (blood testing) stands for what?
The "C" in torch (blood testing) stands for what?
The "H" in torch (blood testing) stands for what?
Subjective signs the mother experiences during pregnancy. Could mean pregnancy, could mean something else.
A bluish-purple discoloration of the cervix and vagina. Caused by increased blood supply.
This category (signs of pregnancy) means mother might be pregnant. They include: Positive pregnancy test, Ballottement, Uterine Changes: Chadwick's Sign (bluish color), Hegar's sign (softening of lower uterine segment), Goodell's sign (softening of cervix)
This category (signs of pregnancy) means the mother IS pregnant. All signs have to do with the fetus. Fetal heart tones (110-160), Visualization of fetus (Ultrasound) & Fetal movement felt by examiner.
PRESUMPTIVE, PROBABLE & POSITIVE
What are the three categories (signs) of pregnancy?
1ST DAY OF LNMP, COUNT BACK 3 MONTHS, ADD 7 DAYS
What is the formula used in Nagele's rule for determining Estimated Date of Delivery?
MCDONALD'S TECHNIQUE (aka Shirodkar)
This method of determining the estimated date of delivery only applies between weeks 18 & 30. - Measurement of the pregnant uterus by placing a centimeter tape on the abdomen and following the curvature of the abdominal surface from the pubic bone margin to the top of the uterine mass. This procedure is often performed by healthcare professionals, generally in the third trimester, to determine fetal growth retardation.
The Vaginal secretions increase in pregnancy. pH is more acidic. Higher glycogen levels, which promotes candida albicans. This causes what?
In addition to breast tenderness, some women notice small goosebump-like raised areas on the areola of your breast These are called ________ _______. During pregnancy these glands enlarge and they remain enlarged while breast-feeding.
This becomes a temporary abdominal organ during pregnancy. Capacity is 5000 ml (fetus, placenta & amniotic fluid). Grows approx 1cm per week.
The uterus will grow how much per week during pregnancy?
This is formed to prevent ascent of organisms into the uterus during pregnancy. Blocks cervical opening to seal the cervix to keep baby from undue harm (and pathogens)
Amenorrhea, Abdominal enlargement, Breast Changes, N & V, Fatigue, Urinary Frequency & Quickening. These are all _____ signs of pregnancy.
Hegar's sign, Uterine changes/enlargement, Positive pregnancy test, Ballotment, Chadwick's sign & Goodell's sign. These are all ____ signs of pregnancy.
Fetal movement felt by examiner, Visualize fetus on ultrasound, Ascultating fetal heart rate. These are all ____ signs of pregnancy.
Pulse rate in pregnant mother increased by how many beats per minute?
Increase in BP in pregnant mother is NEVER normal. If fact, it will actually ____ slightly, due to progesterone relaxing the arteries/veins. This decreases the venous return from the legs.
Blood volume increases by ____% in pregnant mother
In maternal cardiovascular system, the RBC, WBC, Clotting & Blood flow to the uterus and kidneys will ______.
Swelling in feet & ankles is NORMAL or ABNORMAL in pregnant mother?
This is caused by the blood (in pregnant mother) increasing in volume. There is an increase in plasma blood volume, but only slight increase in RBC's.
DILUTIONAL (Pseudoanemia) ANEMIA
This anemia occurs between 26-32 weeks = hematocrit 30-40%
Expectant mother should be encouraged to lie on what side? This will increase blood flow to mom's heart & OS & Blood flow to fetus.
Vena Cava is suppressed by the uterus while lying on back (in Supine Hypotensive Syndrome). This will decrease blood return to the _____ atrium. It will decrease blood pressure and client will be light headed.
Maternal Respiratory System. Oxygen consumption increased by ____%. Respiration becomes deeper, but rate does not (but can) increase.
this can occur until fetus descends into the pelvis because the baby pushes on the diaphragm.
Increased _____ causes edema, or swelling of mucous membranes of nose, pharynx, mouth and trachea (can have a voice change and bloody noses)
Maternal Renal system. Glomerular infiltration _____ and Tubular reabsorption _______, because Mom is excreting for the fetus too! This makes the mother susceptible to UTI's, due to the urinary frequency.
Digestion ____ during pregnancy due to progesterone decreasing the gastric emptying.
6 & 12
Morning sickness begins week ___ and ends week ___. Hopefully
DEHYDRATION & ELECTROLYTE IMBALANCE
You need to make sure to prevent this in Pregnant Mom due to Morning sickness
This increase in Lumbar curve will be present in Maternal Musculoskeletal system, due to increased size & weight of uterus (out front). Will cause back aches.
Linea Nigra, Hyperactive sweat glands, hair growth altered, Choalsma (mask of pregnancy) & Striae Gravidarum are all _____ condition of the Pregnant mother.
Glucose Tolerance Test abrev.
Concentrated Glucose should be what in the Maternal Endocrine system?
The mother must flunk___ out of 4 tests to be considered Gestational Diabetes.
Add ____ kcalories a day to the Maternal diet during pregnancy
Add ____ kcalories a day when breastfeeding.
1.5 - 2
Drink ____ to ____ liters of fluid per day when pregnant & breastfeeding.
Craving to eat substances that are not food. Ie: dirt, clay, chalk, glue, ice, starch or hair. Anemia may be the cause.
N & V, Increased vaginal discharge, fatigue, backache, constipation & hemorrhoids. These are all _____ signs in pregnancy.
Sudden gush of fluid from vagina, vaginal bleeding, abdominal pain, hyperemesis, epigastric pain (GH), edema with sudden weight gain, severe headache, blurred vision or dizziness, painful urination or reduced urine output, chills w/fever (over 100.4). These are all______ in pregnancy
Epigastric pain, severe persistant headache, blurred vision or dizziness, reduced urine output are all signs of what?
Abbreviation for Gestational Hypertension.
Severe persistent headache and reduced urine output can be signs of what hypertensive condition?
The fetus is most active when?
10 & 12
The fetus should move __ times in __ hours.
A perfect score for the Biophysical profile is what?
Each (of the five variables, H/R, Breathing, Body movements, Fetal Tone & Amniotic Fluid Volume) of the Biophysical profile is worth how many points?
The beat in the fetal H/R from baseline for 15-20 seconds (in a Nonstress Test) should be what? This is called Fetal Acceleration
SLEEPING, INADEQUATE OXEGENATION & BLOOD FLOW
Non reactiveness on a Fetal Nonstress Test can be due to what?
If the fetus fails the Nonstress Test, this should be done to further check it out.
1st & 28 WEEKS
A maternal hemoglobin lab test should be done at the ___ prenatal visit & at ___ weeks.
INDIRECT COOMB'S TEST
This will be done @ 28 weeks for the RH negative mother. Checks for contamination of fetal blood into mom's blood.
This will be given to the RH negative mother @ 28 weeks & 72 hours after delivery. Also given for all invasive tests.