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M&J OB Final 23 Questions Antepartum and intrapartum  GTPAL  G (Gravida): the number of pregnancies  T (Term): number of infants born at ≥ 37  P (Preterm): born after 20 weeks but before the completion of 37 weeks.  A (Abortion): pregnancies ending in either spontaneous or therapeutic abortion before the end of 20 weeks.  L (Living): number of currently living children. o Due Date: from the month of their last period add nine months, then add seven days to the first day of their last period. o Nägele’s Rule: most common method of determining the EDB, which uses 280 days as the mean length of pregnancy. To use this method, begin with the first day of LMP, subtract 3 months and add 7 days. For  SIGNS OF PREGNANCY  Presumptive Changes Subjective symptoms experienced by the woman. Doesn’t confirm pregnancy. o Morning sickness o Excessive fatigue o Urinary frequency o Breast changes o Quickening  Probable Changes Objective changes that occur in pregnancy. Doesn’t confirm pregnancy since it could be due to others things o Goodell’s - Softening of the cervix o Chadwick’s - Dark violet coloration of cervix o Hegar’s - Softening of lower part of uterus o Progressive uterine enlargement o Enlargement of the abdomen with amenorrhea (no period) o Braxton-Hicks contractions o Fetal outline Ballottement: passive fetal movement elicited when the examiner inserts two fingers into the vagina and pushes against the cervix. This action pushes the fetal body up and as it falls back down, the examiner feels a rebound o Pregnancy test  Positive Changes Diagnostic test that confirm pregnancy o Fetal heartbeat: detectable by doppler ultrasound o Fetal movement: detected by echocardiography or transvaginal sonography o Fetal soufflé: blowing murmur, synchronous with the fetal heartbeat

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