Summary Mark Klimek Lecture 10.

Mark Klimek Lecture #10 February 1, 2018 Maternal/Newborn  Calculate due date – first day of last menstrual period + 7 days – 3 months o LAST mp – june 10 – june 15 = june 17 – 3 months = march 17  Weight gain during pregnancy o Total weight gain = 28 pounds +/- 3 o First trimester = 1 lb each month = total of 3 pounds in first trimester o Second trimester = 1 lb per week o Third trimester = 1 lb per week o How do you calculate a womans ideal weight gain? Week – 9  Week 12 – 3 lb  Week 13 – 4 lb  Week 14 – 5 lb  Week of gestation – 9  EXAMPLE – 28 WEEKS – 9 = 19 lbs  31st week – 9 = 22 lbs  Fundus – top part of the uterus o Not palpable till week 12, not palpable during the first trimester o When is the fundus at the umbilicus?  20-22 weeks of gestation o Can you use fundal height to determine what trimester she’s in? YES  Signs of pregnancy o Positive – fetal skeleton on x-ray, fetal presence on ultrasound, auscultation of fetal heart rate (heard around 8-12 weeks), when examiner palpates fetal movement or outline o Maybe signs (probable and presumptive) – urine and blood tests, a positive pregnancy test is not a POSITIVE sign of pregnancy. Chadwick sign – cervical color change due to cyanosis. Goddell sign – cervical softening. Hegar sign – uterus softening.  Good prenatal care o Once a month until week 28, then once every 2 weeks until week 36, then every week until week 42. o HgB will fall and that’s normal, normal female is 12-16, first trimester it could fall to 11 and that’s normal. 2nd trimester it could fall to 10.5 and that’s normal. Third trimester could fall to 10 and be normal.  Discomforts of pregnancy o How do you treat morning sickness?  First trimester  Dry carbohydrates before you get out of bed o How do you deal with urinary incontinence?