10/22/24, 12:54 Maternal-child
PM review
Maternal-child review
1. Prenatal information
a. Pregnancy signs
i. Presumptive changes
ii. Amenorrhea
iii. Nausea/Vomiting
iv. Fatigue
v. Urinary frequency
vi. Breast/skin changes
vii. Fetal movement- Quickening 16-20 weeks
b. Probable
i. Abdominal enlargement
ii. Ballottement
iii. Uterine souffle
iv. Chadwick's-violet coloration of the cervix & vagina
v. Goodell’s- softening of the cervix
vi. Hegar's- softening of a lower uterine segment at week 6
c. Positive
i. Sonogram, fetal heart per Doppler, palpation of movement
d. Nagele’s Rule
i. First day of last menses
1. October 5
ii. Subtract 3 months
1. July 5
iii. Add 7 days
1. July 12 is EDD
2. Based on a 28-day cycle
e. Weight gain
i. Normal weight 25-35 lb
ii. 1-4 lbs first trimester
iii. ~1 lb./wk 2nd & 3rd trimester
f. Folic Acid (B9)
i. Decreases neural tube defects. Take 3 months before getting pregnant.
g. Umbilical Cord
i. 2 arteries & 1 vein in the umbilical cord
ii. Arteries carry deoxygenated blood
iii. The vein carries oxygenated blood
h. GTPAL
i. G-gravida (#of pregnancies)
ii. T-Term (#of infants >37 wks.)
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, 10/22/24, 12:54 Maternal-child
PM review
iii. P-Preterm (#of births <37 wks.)
iv. A-Abortion (#of births <20 wks.)
v. L- (#of living children)
i. *Action taken if fundal height is excessive
2. Adaptations to Pregnancy
a. Endocrine
i. Increased BMR
b. Respiratory
i. Slight increase in the rate
ii. Bigger chest, displaced diaphragm
iii. Abdominal breathing
c. Musculoskeletal
i. Spinal curvature increased
ii. Diastasis recti
d. GU
i. Increased urination
ii. Increased vaginal secretions
e. Metabolic
i. Increased water retention
f. Heart
i. Displaced
ii. Supine hypotension
iii. Increased HR
g. GI
i. Constipation
ii. Heartburn
iii. Indigestion 3rd trimester
iv. Gallstones
v. Amniotic fluid 500-1200 ml
h. Integumentary
i. Hyperpigmentation-melasma
ii. Breast changes (colostrum, late pregnancy, and after delivery)
3. Prenatal Testing/Prenatal Labs
a. Know these labs!
i. NST
1. Non-Stress tests are done for high-risk pregnancies, i.e.
diabetics, or for those who might have decreased fetal
movement.
2. We want to see an increase in heart rate, or accelerations
with movement; at least 3 accels in 20 minutes.
3. NST should be reactive.
about:bl 2
PM review
Maternal-child review
1. Prenatal information
a. Pregnancy signs
i. Presumptive changes
ii. Amenorrhea
iii. Nausea/Vomiting
iv. Fatigue
v. Urinary frequency
vi. Breast/skin changes
vii. Fetal movement- Quickening 16-20 weeks
b. Probable
i. Abdominal enlargement
ii. Ballottement
iii. Uterine souffle
iv. Chadwick's-violet coloration of the cervix & vagina
v. Goodell’s- softening of the cervix
vi. Hegar's- softening of a lower uterine segment at week 6
c. Positive
i. Sonogram, fetal heart per Doppler, palpation of movement
d. Nagele’s Rule
i. First day of last menses
1. October 5
ii. Subtract 3 months
1. July 5
iii. Add 7 days
1. July 12 is EDD
2. Based on a 28-day cycle
e. Weight gain
i. Normal weight 25-35 lb
ii. 1-4 lbs first trimester
iii. ~1 lb./wk 2nd & 3rd trimester
f. Folic Acid (B9)
i. Decreases neural tube defects. Take 3 months before getting pregnant.
g. Umbilical Cord
i. 2 arteries & 1 vein in the umbilical cord
ii. Arteries carry deoxygenated blood
iii. The vein carries oxygenated blood
h. GTPAL
i. G-gravida (#of pregnancies)
ii. T-Term (#of infants >37 wks.)
about:bl 1
, 10/22/24, 12:54 Maternal-child
PM review
iii. P-Preterm (#of births <37 wks.)
iv. A-Abortion (#of births <20 wks.)
v. L- (#of living children)
i. *Action taken if fundal height is excessive
2. Adaptations to Pregnancy
a. Endocrine
i. Increased BMR
b. Respiratory
i. Slight increase in the rate
ii. Bigger chest, displaced diaphragm
iii. Abdominal breathing
c. Musculoskeletal
i. Spinal curvature increased
ii. Diastasis recti
d. GU
i. Increased urination
ii. Increased vaginal secretions
e. Metabolic
i. Increased water retention
f. Heart
i. Displaced
ii. Supine hypotension
iii. Increased HR
g. GI
i. Constipation
ii. Heartburn
iii. Indigestion 3rd trimester
iv. Gallstones
v. Amniotic fluid 500-1200 ml
h. Integumentary
i. Hyperpigmentation-melasma
ii. Breast changes (colostrum, late pregnancy, and after delivery)
3. Prenatal Testing/Prenatal Labs
a. Know these labs!
i. NST
1. Non-Stress tests are done for high-risk pregnancies, i.e.
diabetics, or for those who might have decreased fetal
movement.
2. We want to see an increase in heart rate, or accelerations
with movement; at least 3 accels in 20 minutes.
3. NST should be reactive.
about:bl 2
