509 Exam 1 Preparation
What does amniotic fluid do?
- Maintains body temperature - Permits symmetric growth and development - Cushions fetus from trauma - Prevents compression of umbilical cord - promotes fetal development - lung formation (if the fetus can't make the kidneys, it can't make the lungs) - repository for waste
What are the hormones that are excreted by the placenta?
-hCG -Human Placental lactogen (hPL) -estrogen (estriol) -progesterone (progestin) -relaxin
What is the rate of pregnancy loss before 8w?
1/5 or 1/4
when can you auscultate the fetal heart tones on doppler?
10-12 weeks
Average start of menses in the US
11-12 years old
How long is the window period that you can get pregnant every cycle?
12-24 hour window every cycle to get pregnant
How long does the preembryonic stage last?
14 days
When does quickening occur?
16-20 weeks
What indicates the start of menses?
1st day of bleeding also known as your LMP
Explain the breakdown for trimesters
1st: conception to 13w 2nd: 14-27 weeks 3rd: 28-delivery
How long is the embryonic stage?
2 weeks (day 15) to 8 weeks. This includes the completion of major body organs
How long does the embryonic stage last?
2-8 weeks
When can you feel fetal movement?
20 weeks
How long is the average menstrual cycle?
28 days
How many days does a typical pregnancy last?
280 days (40 weeks/9 months) from last menstrual period.
When are you able to pick up and embryo/fetus on ultrasound?
4-6w
HCG levels double every
48/72 hours
How many eggs is a female born with? (on avrg)
50,000 eggs
What is Hegar's sign and when does it occur
6-12 weeks softening of the lower uterus/cervical isthmus
at what month gestation is your first prenatal visit?
8 mo
At what week do people typically start prenatal care?
8 weeks
How long does the fetal stage last?
8 weeks to birth
How long is the fetal stage
8 weeks to delivery
What is included in the fetal stage of development?
8th week until birth - Growth and refinement of organ systems - fetal circulation
The prenatal period spans ____ calendar days and _____ lunar months.
9,10
What is the ductus venosus?
A shunt at the end of the umbilical cord which allows blood coming from the placenta to bypass the liver and empty directly into the IVC
What is a probable symptom of pregnancy?
Braxton Hicks contractions (16-28 wks) Positive pregnancy test (4- 12 wks) Abdominal enlargement (14 wks ) Ballottement (16-28 wks) Goodell's sign (5 wks) Chadwicks sign (6-8 wks) Hegar's sign (6-12 wks)
What happens to the muskuloskeletal system in pregnancy?
Changes in posture and gait Relaxin and progesterone Softening and increased mobility of pelvic joints ◦ Increased size of pelvic cavity Lordosis due to increased lumbosacral curve Alteration of center of gravity Pregnancy waddle
What is the role of the endocrine system in pregnancy?
Control supply of maternal nutrients to fetus
What day in the menstrual cycle do you ovulate?
Day 14
What are presumptive signs of pregnancy?
Fatigue (12 wks) Breast tenderness (3-4 wks) Nausea and vomiting (4-14 ws) Amenorrhea (4 wks) Urinary frequency (6-12wks) Hyperpigmentation of skin (16 wks) Fetal movements (quickening: 16-20 wks) Uterine enlargement (7-12 wks ) Breast enlargement (6 wks)
What is GTPAL
G: Gravidity- includes all pregnancies, including present T: Term pregnancies (37+weeks) P: Preterm pregnancies (20 weeks and zero days-36 weeks and 6 days) A: Abortions/miscarried pregnancies by 19 weeks and 6 days L: Living children to date
Pregnancy causes an increase in ___, ___, and ___ in relation to the cardiovascular system.
Heart rate (25%), cardiac output (30-50%), and blood volume (50%) increase in plasma volume causes physiologic anemia.
(Cardiovascular system) Pregnancy is a ________ state.
Hyper coagulable increase in clotting factors and venous stasis
What happens to the integumentary system in pregnancy?
Hyperpigmentation of pregnancy ◦ Estrogen, progesterone, MSH Striae gravidarum Varicosities of legs, perineum; vascular spiders Decline in hair growth
What happens to the renal/urinary system in pregnancy?
Increased blood flow to kidneys Dilation of renal pelvis and ureters Increase glomerular filtration rate ◦ Increased clearance of medications Hypertrophy of kidneys
What is the role of the adrenal glands in pregnancy?
Increased cortisol and aldosterone secretion
What happens to the respiratory system in pregnancy?
Increased maternal metabolism Uterine compression Increased tidal volume ◦ Maternal hyperventilation and hypocapnia More vulnerable to respiratory conditions Increased vascularity results in congestion, epistaxis, rhinitis
What is involved in the proliferative phase of the uterine cycle?
Influenced by estrogen. The thickness of the endometrium increases to get ready for possible implementation. Making a comfy atmosphere.
What is the role of the anterior pituitary in pregnancy?
Inhibition of FSH and LH TSH Growth hormone replaced by human placental lactogen (hPL) Increase in prolactin; suppressed by progesterone ◦ Milk production Melanocyte stimulating hormone and estrogen responsible for skin changes of pregnancy ◦ Darkening areola, melasma of pregnancy, linea nigra
From the mature follicle to the ruptured follicle, there is a surge in...
Luteinizing hormone
What does an ovulation test look for?
Luteinizing hormone
What does progesterone do?
Maintains lining of uterus & maintains pregnancy
What are the stages of gametogenesis?
Meiosis results in haploid gametes (sperm and ova) Genetic rearrangement - diversity 2n (46 chromosomes) to n (23 chromosomes) results in a haploid cell.
What are the positive symptoms of pregnancy?
Nothing else but pregnancy is cause. Ultrasound verification of embryo or fetus (4-6 wks) Fetal movement felt by experienced clinician (20 wks) Auscultation of fetal heart tones via Doppler (10-12 wks )
What is the role of the posterior pituitary in pregnancy?
Oxytocin ◦ Uterine contractions ◦ Milk let down ADH
What are the extra embryonic structures?
Placenta & Umbilical cord
What does relaxin do?
Softens ligament letting joints widen which reduces the risk of broken bones during labor and delivery
Parity is
TPAL
The pituitary gland releases what hormone that stimulates what reproductive process.
The pituitary gland releases follicle stimulating hormone that starts the maturation of the follicle.
What is the corpus luteum?
The portion of follicle left behind after ovulation.
What is involved in the secretory phase of the uterine cycle?
This is influenced by progesterone. The endometrial lining becomes highly vascular and edematous.
What reproductive system adaptations during pregnancy?
Uterus increases in size and shape, softening of lower uterine segment (Hegar's) Cessation of ovulation and menstruation Increased vascularity of vagina Cervix and vagina become congested and purple (Chadwick's) cervix softens (Goodell's) Leukorrhea Ovaries enlarge in first trimester Primary source of estrogen and progesterone in first trimester Breasts increase in size under influence of estrogen and progesterone Darkening of nipples/areola Production of colostrum
Naegele's Rule
add 7 days to LMP, subtract 3 months, add 1 year
What are the stages of embryonic development
blastocyst development zygote development morula development cleavage cell division implantation fetal stage (after 8w)
What is Chadwick's sign and when does it occur?
bluish color of vaginal mucosa and cervix 6-8 weeks
How long is the pre-embryonic stage
conception- two weeks
What does the ductus arteriosus do?
connects the pulmonary artery and descending aorta during development. It allows the blood to bypass the lungs, since the fetus is not receiving any oxygen from them in utero.
As you age, the quality of the egg...
decreases
What is involved in the formation of the placenta, and what does it do? When does it develop?
derived from trophoblastic cells. It is an interface between mom and fetus, and maintains 2 separate system. It develops by 12 weeks gestation.
What are the names (in order) of the different cells as they mature
egg->zygote->2 cell stage->4 cell stage->Morula->blastocyst
What hormone is excreted by the follicular fluid in the mature follicle?
estrogen
What are the main hormones of pregnancy?
estrogen and progesterone
The carrying capacity of fetal hemoglobin is ____ adult hemoglobin.
greater than
What is the role of the pancreas in pregnancy?
hPL promotes insulin resistance Low blood glucose levels first half of pregnancy and risk of GDM second half of pregnancy
advance maternal age is considered..
high risk. Because females are born with all of the eggs that they'll have, the older the women are, the higher the risk of the pregnancy.
What organs are involved in the endocrine hormones of the female reproductive system
hypothalamus, pituitary, and ovaries
During the fetal period, fetal hemoglobin levels are ___ to promote oxygenation.
increased
Pregnancy causes the enhancement of what immune system?
innate. ◦ Inflammatory response and phagocytosis ◦ Suppression of adaptive immune system ◦ Cell mediated immunity
What are the sections of the blastocyst?
inner cell mass blastocele trophoblast
What does human placental lactogen (hPL) do?
makes the maternal system a little insulin resistant. This is what causes gestational diabetes.
When does fertilization occur?
occurs around 14 days after LMP
How many arteries and veins are in the umbilical cord?
one vein (oxygenated blood) Two arteries (deoxygenated blood)
What is the chorion?
outer membrane in extraembryonic membranes that eventually becomes the placenta.
what does ectopic mean?
outside of the uterus
The surge in LH causes..
ovulation aka the rupture of the follicle and release of the egg.
The inner cell mass is filled with __ and becomes the __.
pluripotent cells baby
What does fetal hemoglobin look like?
polycythemic Babies have an increased HCT and increased RBC The fetus lives in a hypoxic environment. Fetal hemoglobin has a high affinity to O2
What are the stages of fetal development?
pre-embryonic, embryonic, fetal
The risk of exposure to teratogens is lowest in the _____ stage of development.
preembryonic
How do you determine EDC
pregnancy dial/measurement of embryo
What does estrogen do in ovulation?
preparing the uterus and formation of the endometrial lining.
What does hCG do?
prevents the degeneration of the corpus luteum, which maintains the secretion of estrogen and progesterone. This hormone causes a hypermetabolic state that makes moms nauseous.
After ovulation, the corpus luteum secretes what hormone?
progesterone
What does the placenta do?
protects fetus from immune attack (IS NOT A BARRIER FROM INFECTION) Prevents mixing of maternal/fetal blood Exchange of nutrients and waste Hormonal function
What is Wharton's jelly?
protects the cord from compression
What is the medical term for excessive salivation?
ptyalism
What is the medical term for heartburn
pyrosis
is a urine dip stick qualitative or quantitative
qualitative
What does the foramen ovale do?
shunts blood from the right atrium to the left atrium to bypass the lungs
What causes constipation in pregnancy?
smooth muscle relaxation and decreased peristalsis. also- there's a baby in there.
What is goodells sign? When does it occur?
softening of the cervix (5 weeks)
What stage is the embryo most susceptible to damage from external sources (teratogens)/infections/radiation/nutritional deficiencies
the embryonic stage
Where does fertilization occur?
the impalla of the fallopian tube
What is the fundus?
top of uterus
When does implementation begin?
within 10 days of conception
What is a fertilized egg called?
zygote
How long does the corpus luteum last when you are not pregnant?
~14 days. as it disintegrates, menstruation happens.
How long can sperm survive in female reproductive system?
~3days (you can get pregnant 3-5 days prior to ovulation)
What is the role of the thyroid in pregnancy?
◦ Increase in size and activity ◦ Increased TFTs (thyroid function tests) ◦ Maternal TH (thyroid hormone) transferred to fetus - critical for fetal brain development
