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Sexual intercourse OK anytime during pregnancy except for: (+) PROM, pre-term labor, incompetent cervix and (+)

vaginal spotting

HUMAN CHORIONIC GONADOTROPIN (HCG) – responsible for a positive pregnancy test

FLUID RETENTION caused by elevated estrogen and progesterone and also fatigue

OXYTOCIN – produced by posterior pituitary gland for uterine contractions

FUNDAL PRESSURE – aids in placental delivery if mother is anesthetized

GLOBULAR – uterus in 3rd stage of labor

CORD TRACTION AND FUNDAL PRESSURE DANGER – inversion of uterus and avulsion of cord

AFTERCARE post PLACENTA DELIVERY – comfort, dry clothing, perineal pads and linens

CHECK 4TH STAGE OF LABOR q15 – lochia, fundus, hematoma

AVOID SEX if cervical mucus is clear and elastic (for contraception)

INTRAFALLOPIAN TRANSFER – for low sperm count

IN-VITRO – for tubal occlusion

ANOVULATION – tx of Clomid or Parlodel

CERVICAL CAP – (-) spermicide pre-intercourse, can stay up to 24-48h, durable, contraindicated if with abnormal pap smear

IUD doesn’t protect against STDs

PROFUSE BLOOD LOSS – saturation of peripad within 15 minutes and with pain sensation

DISTENDED BLADDER inhibits uterine contraction with increased risk of blood loss

FOR IMPENDING HEMORRHAGIC SHOCK massage fundus if boggy, elevate legs from hips, IV line, oxygen at 8-10 l/min, stay with patient

PRE- LM – void

FHR – priority post rupture of membranes

FHR FREQUENCY – beginning to beginning

ENDOMETRIOSIS – growth of endometrial tissue outside the uterus; dx: lap and biopsy

DANOCRINE – menses stop, edema, weight gain, anovulation

BBT – drop 0.2 F pre ovulation, increase 0.4 F post ovulation

MOST ACCURATE BBT READING – immediately after awakening and before arising

STRIAE GRAVIDARUM – abdominal stretches

DIPPING – descending but not at ischial spine

IMPENDING DELIVERY – increase in bloody show, rectal pressure, rupture of membranes, regular and long contractions

RITGEN’S MANEUVER at crowning

FUNDAL HEIGHT AT UMBILICUS at 20 weeks or 5 months gestation

HEMORRHAGE AND INFECTION – most important to check 24 postpartum

COMPLETE CERVICAL DILATATION – termination of first stage of labor

PLACENTAL DELIVERY – end of third stage of labor

VITAMIN K – 1.0 mg for full terms, 0.5 mg for pre-terms

CLINIC VISITS 12 TO 24 MONTHS – monthly

ROOMING IN – for maternal-infant bonding

HCG PRIMARY FUNCTION – maintain corpus luteum during 1st trimester

DODERLEIN’S BACULLUS – maintains acidic vaginal pH

BTL – no lifting activities post surgery

BSE SCHED – 5-7 days post menstruation

MAMMOGRAPHY – dx of breast CA; yearly for 40s, biannual for 50y above

RADICAL MASTECTOMY – removal of breast/s, pectoral muscle, pectoral fascia, nodes

VITAL SIGNS – most important 2 h postpartum

IUD INSERTION – done during menstrual days 1-4

OVULATION PERIOD – 24-48 hours pre-ovulation to 48 hours post ovulation

OCPs – prevent ovulation

CLOMID – stimulates oogenesis

LIGHTENING - decrease in fundal height due to a change in shape of the abdomen a few weeks before onset of labor

HOME VISIT – for continuity of care

ABORTION – loss of fetus before viability (20 weeks)

INEVITABLE ABORTION – with dilated cervix

THREATENED ABORTION – closed cervix, spotting and uterine cramping

HABITUAL ABORTION – consecutive abortions

THREATENED ABORTION – complete bed rest, check vaginal bleeding and observe uterine contractions

OVULATION – 14 days before menstruation (for a 28 day cycle); increased pH of cervical secretions, (+) MITTLESCHMERZ; increase in BBT

PROLIFERATIVE – LH surge from anterior pituitary gland

AGE OF VIABILITY – at 5th month or 20-24 weeks

OSSIFICATION OF BONES – at 10th lunar month

FHT – Doppler at 3 weeks, fetoscope at 18-20 weeks

MC DONALD’S RULE – fundic ht in cm x 8/7 = aog

OOBB NNUURRSSIINNGG BBUULLLLEETTSS

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PRENATAL CHECKUPS – 1-7 mo once a month, 8th mo 2/month, 9th q wk

PREGNANCY AS A MATURATIONAL CRISIS – due to hormonal and physiological changes occurring

PROM – prone to infections

TAKING HOLD PHASE – focus is the infant

POST PARTUM BLUES – 4-5 days post partum

ZYGOTE – cell that results from the fertilization of the ovum by a sperm

MITOSIS – cell division of the fertilized ovum

OVULATION – rupture of the ovum from the graafian follicle

MORULA – mulberry-like ball of cell that results from cleavage

FUNDUS – where zygote normally implants

IMPLANTATION – 7-10 days post fertilization

EFFACEMENT – cervix becomes thinner

GDM – carbohydrate intolerance induced by pregnancy

ADVERSE EFFECTS OF GDM – morbidity common in newborn, infant may inherit a predisposing to DM, higher perinatal death

GDM NURSING INTERVENTIONS – liberal exercise, acceptable diet at 30-35 kcal/kg of IDBW/day, insulin as ordered, CBG monitoring

GLUCOSE – 18.02 mg/dl = 1 mmol

BREAST ENGORGEMENT – doesn’t last for greater than 24 hours

MEFENAMIC ACID – anti-inflammatory

PASSAGEWAY – structure of maternal pelvis

NITRAZINE PAPER TEST – urine vs. amniotic fluid; yellow vs blue

PROM – check temperature

NONPREGNANT UTERUS – lined by endometrium

VULVA – externally visible structure of the female reproductive system extending from the symphysis pubis to the perineum

AMPULLA – fertilization site

ISTHMUS – site of sterilization

VAS DEFERENS – conduit for spermatozoa

EJACULATORY DUCT – seminal fluid

LEYDIG’S CELLS – synthesize testosterone

PROGESTERONE – increased activity of endometrial glands during luteal phase; increased basal metabolism, increased placental growth, development of acinar cells in the breast

ROUND LIGAMENT – (+) hypertrophy during pregnancy

SPERM MOTILITY – best criterion for sperm quality

HYSTEROSAPINGOGRAPHY – introduction of radiopaque material into uterus and fallopian tubes to assess for tubal patency

TETANIC CONTRACTIONS – brought about by the overstimulation by oxytocin

DYSTOCIA – due to mechanical factors

POSTPARTUM HEMORRHAGE – greater than 500 ml of blood loss

CORTEX OF OVARIES – where developing follicles and the graafian follicles are found

LABIA MINORA – forms the frenulum and prepuce of the clitoris

FOURCHETTE – formed by the labia minora tapering and extending posteriorly

RUGAE – thick folds of membranous stratified epithelium on the internal vaginal wall capable of stretching during the birth process to accommodate delivery of fetus

EXTERNAL OS – location where squamocolumnar junction is, pap smear location

MYOMETRIUM – largest portion of uterus

CORPUS – upper triangular portion of uterus

LH – testosterone production

ESTROGEN – secreted by graafian follicle associated with spinnbarkeit and ferning

AUTOSOMAL RECESSIVE – cystic fibrosis, tay-sach’s disease, sickle-cell anemia

CHORIONIC VILLI SAMPLING – detects trisomy 21, cystic fibrosis and tay sach’s

MATERNAL AGE – indication for chorionic villi sampling

RHOGAM – essential post-CVS or RH (-) mom; refrain from sex 48h post-CVS

NEEDLE INSERTION SITE – most important factor affecting amniocentesis

MORNING AFTER PILL – prevent implantation of the fertilized ovum; taken within 12h post-intercourse, (+) slight nausea post-2d; not given to those with hx contraindications to OCPs

COMBINED OCPs – inhibit FSH and LH production

ESTROGEN – causes sodium retention

PARITY – indication for IUD use

HX OF PRETERM LABOR – contraindication for IUD use

HYSTEROSALPINGOGRAM – done 2-6 days after menses

COVADE’S SYNDROME – way in which an expectant father can explore his feelings

RhOGAM – should be administered within 72h; destroys fetal RBCs to prevent antibody formation

LEUPROLIDE – tx for endometriosis

AMPICILLIN – safest antibiotic for pyelonephritis

HYPOTONIC DYSTOCIA – monitor contractions

MAGNESIUM TOXICITY – first sign is disappearance of knee-jerk reflex

IUD SIDE EFFECT – excessive menstrual flow

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IUD COMMON PROBLEM – spontaneous expulsion of device

IUD – provides contraception by setting up a non-specific inflammatory cell reaction in the endometrium

OVULATION – occurs when LH is high

OCPs – causes breakthrough bleeding

POST COITAL TEST – best timed within 1-2 days of presumed ovulation

TUBAL DEFECTS – are most often related to past infections

INFERTILITY – inability to become pregnant after a year of trying

SIMS HUHNER (POST COITAL TEST) – determine the number, motility and activity of sperm

HYATIDIFORM MOLE – be alert for unusual uterine enlargement

ECTOPIC PREGNANCIES – sudden lower right or left abdominal pain radiating to the shoulders

TUBAL RUPTURE – sudden knifelike, lower quadrant pain

GERM PLASMA DEFECTS – causes most spontaneous abortions

INCOMPLETE ABORTION – fetus is expelled but part of the placenta and membranes are not

FUNIS – umbilical cord

AMNION – inner membrane that encloses the fluid medium for the embryo

FETUS – 8th week to birth

12th WEEK – uterus becomes an abdominal organ

QUICKENING – first fetal movement felt by the mother

GREATEST WEIGHT GAIN – in third trimester; 2nd trimester: height and length

PLACENTA – chief source of estrogen and progesterone after the first 3 months

DUCTUS VENOSUS – has the highest oxygen content

DIAGONAL CONJUGATE – A-P diameter of pelvic inlet

BLOOD VOLUME INCREASE – 30-50% is normal

CHADWICK’S SX – purplish discoloration of vaginal mucosa

PHYSIOLOGIC ANEMIA – result of increased plasma volume of the mother

CHORIONIC GONADOTROPIN – causes nausea and vomiting

PITUITARY GLAND – increase in melanotropin hormone causing dark nipples and linea nigra

RH DETERMINATION - routinely performed on expectant mothers to predict whether the fetus is at risk for acute hemolytic anemia

LEUKORRHEA – caused by elevated estrogen

TX FOR FLUID RETENTION - adequate fluids and elevation of lower extremities

FULL BLADDER – pre UTZ

NORMAL AMNIOTIC FLUID – clear, almost colorless, containing little white specks

RESTRICT MOVEMENT – when an external fetal monitor is being used

EARLY DECELERATION – FHT decreases just before acme due to head compression

LATE DECELERATION – FHT decreases just after acme caused by uteroplacental insufficiency; may lead to distress

VARIABLE DECELARATION – due to cord compression

LOCATION OF FUNDUS AFTER PLACENTAL DELIVERY – halfway between the symphysis pubis and the umbilicus

SLOW DEEP BREATHING – alleviates discomfort during contractions

PANTING – during crowning

OCCIPUT POSTERIOR – causes low back pain

APPLICATION OF BACK PRESSURE – during contractions to increase comfort

NPO – during second stage of labor because undigested food and fluid may cause nausea and vomiting, limiting the choice of anesthesia

TRANSITIONAL PHASE – help client retain/remain in control

POSITIONING DURING DELIVERY – legs elevated simultaneously to prevent trauma to the uterine ligaments

UTERINE TETANY – observe carefully for this during the induction of labor

PUSH WITH GLOTTIS OPEN – when fully dilated but (-) crowning

EPISIOTOMY is done to prevent lacerations

PUERPERAL INFECTIONS – 2 most important predisposing factors to its development is hemorrhage and trauma during birth

PROLACTIN - stimulates secretion of milk from the mammary glands

SITZ BATH – promotes vasodilation, relieves hemorrhoids

INFANT FEEDING – on demand; baby will soon develop a feeding schedule

CLOSURE OF FORAMEN OVALE – after birth is caused by an increase in the pulmonary blood flow

DUCTUS ARTERIOSUS – becomes the ligamentum arteriosum

HEART RATE – primary critical observation in apgar scoring

MECONIUM CHECK Q SHIFT – to keep limit development of hyperbilirubinemia

ASSYMETRICAL MORO REFLEX – associated with brachial plexus, cervical or humerus injuries

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STERILE INFANT INTESTINES – lack bacteria necessary for the synthesis of prothrombin

PKU SCREENING – measures protein metabolism

NORMAL REGURGITATION – in infants is caused by an underdeveloped cardiac sphincter

AMNIOCENTESIS – done to detect presence of neural tube defects

PREMATURITY – contraindication for oxytocin challenge test

UTEROPLACENTAL INSUFFICIENCY – (+) CST

PREGNANT ADOLESCENT – emphasize importance of consistent care

PERINATAL MORTALITY – is 2-3 times greater in multiple gestation than in single gestation

HYPOTONIC UTERINE DYSTOCIA – is oftentimes caused by multiple gestation

PYELONEPHRITIS – observe for signs of PTL; antibiotic tx should be administered until urine is sterile—2 (-) C/S

CONCEALED HEMORRHAGE – causes abdominal pain associated with abruption placenta

DIC/HYPOFIBRINOGENEMIA – causes bleeding following sever abruptio placenta

ABRUPTIO PLACENTA – is most likely to occur in women with pregnancy induced hypertension

PLACENTA PREVIA – painless vaginal bleeding

PAIN MEDS – are kept at minimum during PTL to prevent respiratory depression

ATONY OF THE UTERUS – due to overstretching is commonly caused by multiple gestation

OVERDISTENED BLADDER/HYDRAMNIOS – may cause uterine atony

POSTPARTAL HEMORRHAGE – rarely occurs as a complication of uncomplicated gestational hypertension

PIH – BP elevation of 30/15 mmHg from baseline on 2 occasions 6 hours apart

EPIGASTRIC PAIN – subjective symptom of an impending seizure

ROLLING OF EYES TO ONE SIDE WITH A FIXED STATE – objective sign of an impending seizure

DANGER OF SEIZURE – ends in 48h postpartum in a woman with eclampsia

CORD COMPRESSION - birth hazard associated with breech delivery

GRAVIDOCARDIAC PT - cardiac acceleration in the last half of pregnancy; most compromised during the first 48 hours after delivery; forceps delivery

GDM DIET – balanced, to meet the increased dietary needs with insulin adjusted as necessary

RENAL AGENESIS - funis with only two vessels

DRUG WITHDRAWAL IN INFANT - irritability and nasal congestion

NEONATAL MORBIDITY - with low apgar score at 5 minutes post delivery

HIV/AIDS INFANT – microcephalic, craniofacial features, persistent diarrhea

CHLAMYDIA INFECTIONS – purulent conjunctivitis and pneumonia in infant

RETROLENTAL FIBROPLASIA – caused by high oxygen concentration administered in premature infants

SYPHILIS – asymptomatic newborn, VDRL test

HIP DYSPLASIA – asymmetric gluteal folds

ERB’S PALSY – complication of breech delivery; flaccid arm with elbows extended; ROM exercises

PRECIPITATE DELIVERY – increased risk for intracranial hemorrhage and elevated ICP

PATHOLOGIC JAUNDICE – appearance of jaundice during the first 24 hours

DECREASED INFANT GFR – inability of the infant to concentrate urine and conserve water

RESPIRATORY DISTRESS – most common preterm complication

INFANT HYPOGLYCEMIA SX - tremors, periods of apnea, cyanosis and poor sucking

LARGER DM NEWBORNS – due to increased somatotropin and increased glucose utilization

UTERINE AND OVARIAN ARTERIES – main blood supply of the uterus

ENDOMETRIOSIS – is characterized by painful menstruation and backache

RETROCOELE – is brought about by overstretching of perineal supporting tissues as a result of childbirth

COLUMNOSQUAMOUS JUNCTION OF THE INTERNALAND EXTERNAL OS – common site of cervical CA growth

DIETHYLSTILBESTROL – management for infertility

RADIUM REACTION – pain and elevated temperature

DOXORUBICIN – inhibits RNA synthesis by binding DNA

ESTROGEN RECEPTOR PROTEIN (ERP) – evaluates potential response to hormone therapy

BILATERAL OOPHORECTOMY – surgical menopause

CESSATION OF MENSES – is due to the inability of the ovary to respond to gonadotropic hormone

BARTHOLOMEW’S RULE – via location of fundus

HAASE’S RUELE – first 5 months: month2 = aog; second half: month x 5 = aog

NAGELE’S RULE – LMP minus 3m +7d + 1y = EDC

DECIDUA BASALIS – placenta