Time from fertilization of ovum until estimated date of birth.
Lasts 280 days or 40 weeks.
First trimester - week 1-13
Second trimester - week 14-26
Third trimester - weeks 27-40
For estimating date of birth: To be accurate, woman must have regular 28 day menstral cycle.
Take 1st day of last menstral period: 9-12-2009
Add 7 days: 9-19-2009
Subtract 3 months: 6-19-2009
Add 1 yr.: 6-19-2010
Estimated date of birth: June 19, 2010
Woman who is pregnant
Number of pregnancies
A woman who has never been pregnant.
A woman who is pregnant for the first time.
Woman who has had 2 or more pregnancies.
# of births (not # of fetuses (twins) carried past 20 weeks gestation, whether or not fetus was born alive.
A woman who has not had a birth at more than 20 weeks' gestation.
A woman who has had one birth that occurred after 20 weeks' gestation.
A woman who has had two or more pregnancies that resulted in viable offspring.
Use of GTPAL
G= Gravidity; # of pregnancies, including the present one
T= Term births; # of children born at term (longer than 37 weeks)
P=Preterm births; # of children born before 37 weeks
A=Abortions or miscarriages; # of abortions/miscarriages ( included in gravida if before 20 weeks; included in parity if past 20 weeks); note that a termination of the pregnancy after 20 weeks is referred to as a therapeuetic termination.
L=Live births, # of live births or living children
1. Breast changes
3. Nausea and vomiting
4. Urinary frequency
First perception of fetal movement appearing usually in the 16th to 20th week of gestation.
Probable signs of pregnancy
1. Goodell's sign
2. Chadwick's sign
3. Hegar's sign
4. Positive result of pregnancy test (serum)
5. Positive result of pregnancy test (urine)
6. Braxton Hicks contractions
Softening of the cervix that occurs at the beginning of the second month of pregnancy.
Violet coloration of the mucous membranes of the cervix, vagina, and vulva that occurs at about week 4.
Softening of the uterus that occurs at about weeek 6.
Braxton Hicks contractions
Irregular contractions that occur intermittently throughout pregnancy and that do not increase in intensity or duration or cause cervical dilation.
The rebounding of the fetus against the examiner's fingers on palpation.
Positive signs of pregnancy
1. Visualization of the fetus via radiography or ultrasound.
2. Fetal heart rate detected by ultrasound examination at 6 weeks' gestation, by electronic devices at 10 to 12 weeks' gestation, and by nonelectronic device (fetoscope) at 20 weeks' gestation.
3. Fetal movements palpated.
4. Fetal movements visible
A woman is pregnant for the 4th time. She had one elective abortion during the first trimester, a daughter who was born at 40 weeks' gestation, and a son who was born at 36 weeks' gestation.
She is gravida, G=4; parity=2; term T=1; preterm P=1; abortion A=1; and live births L=2
G= # of pregnancies, including present one
T=# of children born at term (longer than 37 weeks)
P=# of children born before 37 weeks' gestation.
Abortions or miscariages
A=# of abortions/miscarriages (included in gravida if before 20 weeks; included in parity if past 20 weeks); note that a termination of the pregnancy after 20 weeks is referred to as a therapeutic termination.
L=# of live births or living children.
A. Measured to evaluate gestaional age of fetus.
B. During 2nd & 3rd trimesters (18 to 30 weeks), fundal height in centimeters approx. equals the fetus's age in weeks, + or - 2 cm.
C. 14-16 weeks, fundus can be found above symphysis pubis
D. 20-22 weeks, fundus rises to level of the umbilicus.
E. At term, fundus nearly reaches the xiphoid proces.
Maternal Risk Factors
1. A group of organisms capable of crossing the placenta and adversely affecting the development of the fetus; infection may also occur during delivery.
2. Toxoplasmosis; other infections, such as hepatitis and group B Streptococcus; Rubella (German measles);Cytomegalovirus; and Herpes and hepatitis A & B
Sexually transmitted infections
Chlamydia, syphilis, gonorrhea, condylomata acuminata (venereal warts), bacterial vaginosis, vaginal candidiasis, and trichomoniasis.
1. Many substances cross the placenta; no drugs, including over-the-counter drugs should be taken unless prescribe by the physician.
2. Alcohol, cocaine, crack, marijuana, amphetamines, barbiturates, heroin, and cigarettes.
3. Substance abuse threatens normal fetal growth and successful term completion of the pregnancy.
4. SA places the pregnancy and fetus/newborn at risk for bleeding, complications, miscarriage, stillbirth, prematurity, low birth weight, and sudden infant death syndrome.
5. Physical signs of drug abuse - dilated or contracted pupils, fatigue, track (needle) marks, skin abscesses, inflamed nasal mucosa, and inappropriate behavior by the mother.
6. Alcohol during pregnancy-fetal alcohol syndrome, congenital anomalies, and growth deficits, can also cause jitteriness and physical abnormalities.
7. Smoking leads to low birth weights, a higher incidence of birth defects, and stillbirth.
8. Neonatal abstinence syndrome can result as the newborn withdraws from the substance abused by the mother.
Early onset of menarche, changing sexual behaviors in this age group, problems w/family dvelopment, poverty, and a lack of knowledge regarding reproduction and birth control.
Major conerns w/adolescent preg.
Poor nutritional status, emotional and behavioral difficulties, lack of support systems, increased risk of stillbirth, low birth weight, fetal mortality, cephalopelvic disproportion, and increased risks of maternal complications, such as hypertension, anemia, prolonged labor, and infections.
Role of nurse
a. Encourage early and continued prenatal care.
b. Refer adolescent for appropriate assistance, which can help counter effects of a negative socioeconomic environment.