Antepartum 1

• Where does fertilization occur?

  In the distal 3rd of the fallopian tube
• When does the embryonic period take place?

  Beginning of the third week until the eighth week
• When does the heart first start beating?

  4 week
• When does the fetal period take place?

  Beginning 9 weeks after conception and extending until birth
• What happens when the baby is 12 weeks?

  Sucking reflex is present

  Fetal sex can be determined

  Lanugo begins developing

  Fetus is producing urine excreting it into the amniotic fluid
• When can the baby's heart rate be heard with a doppler?

  At 10-12 weeks
• What happens during 16 weeks?

  Swallowing of the amniotic fluid

  Quickening (fetal movement) *

  Eyes face forward rather than to the side
• What happens during 20 weeks?

  Vernix caseosa (protective coating) & lanugo (fine downy hair) covers entire body

  Will react to loud noises
• When is fetal movement felt by all moms?

  Between 16 to 20 weeks
• When is heartbeat heard with a fetoscope?

  By 20 weeks
• What happens during 24 weeks?

  Eyebrows and eyelashes

  Fingernails present

  Able to hiccup

  Activity increasing

  Surfactant needed for breathing at birth is starting to be produced *
• What happens during 28 weeks?

  Eyes begin to open and close around 26 weeks

  Lungs not fully mature

  Subcutaneous fat is being deposited
• A baby's brain at 35 weeks weighs only two-thirds of what it will weigh at 39 to 40 weeks
• What happens during 38-40 weeks?

  Lungs are mature

  Vernix caseosa present in creases only

  Lanugo present on upper shoulders and back

  Ear cartilage firm

  Fingernails extend past the fingertips

  Both testes palpable in the scrotum
• What are the four functions of the placenta?

  1. Progesterone
  2. Estrogen
  3. Human chorionic gonadotropin
  4. Human placental lactogen
• When is the placenta fully functional?

  Between the 8th and 10th week of pregnancy
• Maternal side is

  Rough where it attaches to the uterus, AKA Dirty Duncan
• Fetal side is

  Smooth, AKA Shiny Schultz
• Amnion membrane is the

  Inner membrane, develops from the embryo blast
• Chorion membrane is the

  Outer membrane, develops from the trophoblast
• During the 2nd and 3rd trimester who produces the amniotic fluid?

  The fetal kidneys
• Polyhydramnios

  More than 2000 mL, increased incidence of chromosomal disorders, CNS or GI defects
• Oligohydramnios

  Less than 500 mL, increased incidence of congenital renal problems
• What are the four functions of amniotic fluid?

  1. Cushion for fetus
  2. Prevents adherence of the embryo to amniotic membrane
  3. Allows fetal movement, which aids in musculoskeletal development
  4. Provides a consistent thermal environment
• Umbilical cord

  2 arteries, carry deoxygenated blood from baby to mom

  1 vein, carry oxygenated to baby
• Antepartum

  Begins with the 1st day of LMP and ends with the onset of labor
• Intrapartum

  Begins with the onset of labor and ends with the expulsion of the placenta
• Postpartum

  Expulsion of the placenta to 6 weeks
• Preterm

  Less than 37 weeks
• Early term

  37 weeks through 38 weeks and 6 days
• Full term

  39 weeks through 40 weeks and 6 days
• Late term

  41 weeks through 41 weeks and 6 days
• Postterm

  42 weeks and beyond
• Chadwick's sign

  Blue-purple coloration
• Goodell's sign

  Softening of the cervix
• When is colostrum produced?

  By 12 weeks
• Cardio changes (6)

  1. Cardiac output increases
  2. Pulse increases
  3. Systolic murmurs can occur
  4. Blood volume increases
  5. Blood pressure decreases through 2nd trimester
  6. Supine hypotension *
• Respiratory changes (8)

  1. Diaphragm elevates and ribcage flares
  2. Tidal volume increases
  3. Oxygen consumption increases
  4. Hyperventilation
  5. Breathing changes from abdominal to thoracic
  6. Nasal stuffiness or congestion
  7. SOB in 3rd trimester when reclining
  8. Nose bleeds (epistaxis)
• GI changes (8)

  1. Nausea/vomiting
  2. Gum friability and bleeding
  3. Intestines and stomach displaced
  4. Heartburn (pyrosis)
  5. Excessive saliva secretion (ptyalism)
  6. Slowed intestinal motility/delayed gastric emptying
  7. Cravings of non foods (Pica)
  8. Gallstones/pruritus
• Skin Changes

  1. Linea nigra, cholasma, melasma, and mask of pregnancy
  2. Striae gravidarum (stretch marks)
  3. Vascular spider nevi
  4. Hyperactive sweat and sebaceous glands
  5. Edema