OB Midterm Overview Fall 2022
Physiologic Changes of Pregnancy: Cardiac output, blood volume. They are protective
of the mother and fetus.
Normal lab values – H&H
● Hemoglobin: 11-13 & Hematocrit: 33-39
● 11.9 hemoglobin to a pregnant woman it would be physiological anemia
● If hemoglobin was under 11 we would worry about iron deficiency
● If we saw her RBC are really low.. We would worry about oxygen transfer to
the baby
Hormones involved in ovulation
●
Hormones of Pregnancy
● Progesterone
○ facilitates implantation
○ decreases uterine contractility (keeps it quiet)
● estrogen
○ stimulates enlargement of the breasts & uterus (gets ready for milk) (slide says
estrogen & progesterone (produced by corpus luteum then placenta change the
breasts)
● hCG
○ stimulates corpus luteum so will continue to secrete P and E until placenta
mature enough to do so
○ rapid increase when pregnant
○ Will soon disappear, first 2 months, causes nauseous
● hPL: Human Placental Lactogen
○ promotes fetal growth by regulating glucose available and stimulates breast
development in prep for lactation
○ Responsible for glucose exchange/regulation for b
● Beats When; at how many Weeks?
○ Forms third week
○ Beats fourth week
, Probable, Presumptive and Positive Signs of Pregnancy: Know examples!
Presumptive signs:
- Amenorrhea
- Breast tenderness
- Urinary frequency
- Nausea / vomitting
Probable:
- Uterine enlargement
- Hegar's sign: softening & thinning of the uterine segment that occurs at week 6
- Goodell's sign: softening of the cervix that occurs at the beginning of the 2nd
month
- Chadwick's sign: bluish discoloration of the mucous membranes of the cervix,
vag, vulva. Occurs at wk 6
- Ballottement: rebounding of the fetus against the examiner's fingers of palpation
- Braxton-hicks contractions feel like mild cramps
- Positive preg test measuring for hCG
Positive:
- Fetal heart rate detected by electronic device (Doppler) at 10-12 wks
- Fetal heart rate detected by non electronic device (fetoscope) at 20 wks
AOG
- Active fetal movement palpable by the examiners
- Outline of the fetus via radiography or ultrasound
Fetal Growth & Development – Teratogenic Effects, timing; cardiac development
● First 7-14 days ovum is known as: blastocyst
● Before 9 weeks: Embryo
● At 9 weeks: Fetus
● Fetus until baby is delivered than its a: Newborn
● Teratogenic effects most prouncounced during organogenesis up to 8
weeks
● Fetal Heart: Forms at 3wks - beats & circulates blood at 4wks
Physiologic Changes of Pregnancy: Cardiac output, blood volume. They are protective
of the mother and fetus.
Normal lab values – H&H
● Hemoglobin: 11-13 & Hematocrit: 33-39
● 11.9 hemoglobin to a pregnant woman it would be physiological anemia
● If hemoglobin was under 11 we would worry about iron deficiency
● If we saw her RBC are really low.. We would worry about oxygen transfer to
the baby
Hormones involved in ovulation
●
Hormones of Pregnancy
● Progesterone
○ facilitates implantation
○ decreases uterine contractility (keeps it quiet)
● estrogen
○ stimulates enlargement of the breasts & uterus (gets ready for milk) (slide says
estrogen & progesterone (produced by corpus luteum then placenta change the
breasts)
● hCG
○ stimulates corpus luteum so will continue to secrete P and E until placenta
mature enough to do so
○ rapid increase when pregnant
○ Will soon disappear, first 2 months, causes nauseous
● hPL: Human Placental Lactogen
○ promotes fetal growth by regulating glucose available and stimulates breast
development in prep for lactation
○ Responsible for glucose exchange/regulation for b
● Beats When; at how many Weeks?
○ Forms third week
○ Beats fourth week
, Probable, Presumptive and Positive Signs of Pregnancy: Know examples!
Presumptive signs:
- Amenorrhea
- Breast tenderness
- Urinary frequency
- Nausea / vomitting
Probable:
- Uterine enlargement
- Hegar's sign: softening & thinning of the uterine segment that occurs at week 6
- Goodell's sign: softening of the cervix that occurs at the beginning of the 2nd
month
- Chadwick's sign: bluish discoloration of the mucous membranes of the cervix,
vag, vulva. Occurs at wk 6
- Ballottement: rebounding of the fetus against the examiner's fingers of palpation
- Braxton-hicks contractions feel like mild cramps
- Positive preg test measuring for hCG
Positive:
- Fetal heart rate detected by electronic device (Doppler) at 10-12 wks
- Fetal heart rate detected by non electronic device (fetoscope) at 20 wks
AOG
- Active fetal movement palpable by the examiners
- Outline of the fetus via radiography or ultrasound
Fetal Growth & Development – Teratogenic Effects, timing; cardiac development
● First 7-14 days ovum is known as: blastocyst
● Before 9 weeks: Embryo
● At 9 weeks: Fetus
● Fetus until baby is delivered than its a: Newborn
● Teratogenic effects most prouncounced during organogenesis up to 8
weeks
● Fetal Heart: Forms at 3wks - beats & circulates blood at 4wks
