1
Q
Ideal Age of Pregnancy
A
20-30 y.o.
2
Q
Age of Pregnancy that have High Risk
A
<18 and >35 y.o.
3
Q
Age of Pregnancy that have With Risk
A
18-20 and between 30-35 y.o.
4
Q
Once a month, a woman’s ova will reach maturity, once released, fertilization must occur quickly because an ovum is capable of fertilization for only _______ hours at the maximum. After that time, it _______ and become _______.
A
- only 24-48 hours
- it Atrophies and become Malfunction
5
Q
Similarly, functional life of spermatozoa is also about _____ hours. Sexual relations must happen within _____ hours; _____ hours before ovulation plus ____ hours afterward for fertilization to occur.
A
- 48-72 hours
- 72 hours
- 48 hours
- 24 hours
6
Q
The union of the sperm and the mature ovum in the ___ or ___ of the fallopian tube
A
- outer 3rd
- half
7
Q
Normal amount of semen per ejaculation
A
3-5cc of 1 teaspoon
8
Q
Number of sperm in an ejaculation is ___ or average ___ pero ejaculation
A
- 20-200M per ml
- 400M
9
Q
Mature ovum is capable of being fertilized within ___ after ovulation
A
24-48 hours
10
Q
Sperms are capable of fertilizing ovum for ___ after ejaculation
A
3-5 days
11
Q
Sperm is viable within ___ or ___
A
- 48-72 hours
- 2-3 days
12
Q
- transport the egg from the ovary to the uterus.
- It is an important passageway for an egg and sperm to meet and for fertilized egg (embryo) to make its way to the uterus
- The health of the fallopian tube impacts the fertility.
A
Fallopian Tube
13
Q
During ovulation, ovum is extruded from the ___ of an ovary, ovum is surrounded by a ___ and ___.
A
- graafian follicle
- ring of mucopolysaccharide fluid (zona pellucida)
- circle of cells
14
Q
- transparent but thick, composed of glycoprotein that surround the cell plasma membrane.
A
Zona Pellucida
15
Q
- it increases the bulk of the ovum and serves as protective buffer against injury.
- outer layer, granulosa or follicular cells that formed around developing oocyte in the ovary and remain until ovulation.
A
Corona Radiata
16
Q
Sperm cell are like ___ and has a ___, ___, ___.
A
- tadpoles
- head
- neck
- tail
17
Q
Life span of sperm cells
A
48-72 hours
18
Q
How many sperm cells does an average male produce?
A
525B sperm cells over a lifetime
19
Q
How many sperm cells does an healthy adult men produce?
A
20M-150M with the max of 1.2B in a single ejaculation
20
Q
How many sperm cells typically, volume of climax?
A
3-5ml ejaculate (3 quarters of the teaspoon)
21
Q
Large Head; X chromosome: ph-acidic
A
Gymnosperm
22
Q
Small head; Y chromosome: ph-alkaline
A
Andosperm
23
Q
A combination of peristalsis action of the tube and movement of the tube
A
Fimbriae
24
Q
Helps the ovum along the length of the tube
A
Cilia
25
- Ability of the sperm to release proteolytic enzymes capable of dissolving Zona Pellucida and Corona Radiata to penetrate the ovum.
Capacitation
26
One reason that an ejaculation contains such many sperms is to provide ___ to dissolve the ___
- enzymes
- corona
27
How many spermatozoa can penetrate the ovum?
1 spermatozoa
28
What does body of sperm release?
Acrosin
29
Immediately after penetration of the ovum, the chromosome material of the ovum and spermatozoon join to form a?
Zygote
30
- Equal maturation of both sperm and ovum
- Ability of sperm to reach the ovum
- Ability of the sperm to penetrate the Zona Pellucida and cell membrane and achieve fertilization.
Fertilization
31
First 2 weeks after the conception, beginning with fertilization. What stage is this?
Pre Embryonic/Germinal Stage
32
3rd to 8th week of pregnancy. What stage is this?
Embryonic Stage
33
Time from the 9th week until birth. What is this?
Fetal Stage
34
Meaning of:
O -
Z -
E -
F -
C -
- Ovum
- Zygote
- Embryo
- Fetus
- Conceptus
35
- The ___ undergoes rapid cell division as it travels to the uterus for 3-4 days and undergoes mitotic division.
Zygote
36
- cluster of cells
- formed through cell division, it consist of 16-50 cells
Morula
37
- preliminary stage wherein the embryo becoming to form, about 10-12 days after fertilization.
Blastocyst
38
It gives rise to the three primary germ layers
Inner Cell Mass (Embryoblast)
39
Skin, brain, nervous system
Ectoderm
40
Muscles, bones, heart
Mesoderm
41
Digestive tract, lungs
Endoderm
42
- the outer layer of cells of the early embryo (blastocyst) that provides nutrients to the developing embryo and forms the fetal part of the placenta.
Throphoblast
43
- 8-10 days after fertilization
- Upper part of uterus.
- Implantation of blastocysts, hatches, attaches, adheres and invades into endometrium of the female uterus.
Implantation/Nidation
44
- The blastocyst reaches the uterine cavity and makes contact with the prepared endometrial lining.
Apposition (Pre-contact)
45
- The outer layer of the blastocyst (trophoblast) attaches to the receptive surface of the endometrium
Adhesion (Attachment)
46
Invasive trophoblast cells penetrate deeper into the uterine wall, reaching and surrounding matemal blood vessels to establish a connection with the mother's circulation.
Invasion (Penetration)
47
- The blastocyst becomes fully embedded within the uterine endometrium, marking the successful completion of implantation.
Embedding
48
This stage begins after implantation
Second Stage: Embryonic Stage (3rd to 8th Week)
49
What stage is this?
- The embryo starts to take a more distinctly human form, developing crucial body structures.
- Key developments include the formation of the neural tube, which will become the brain and spinal cord, and the initial development of the heart, face, and limbs.
Second Stage: Embryonic Stage (3rd to 8th Week)
50
- the head begins to form, quickly followed by the eyes, nose, ears, and mouth. The blood vessel that will become the heart starts to pulse.
What week is this?
Around the Fourth Week
51
- buds that will form the arms and legs appear.
What week is this?
During the Fifth Week
52
- the embryo has all of the basic organs and parts except those of the sex organs. At this point, the embryo weighs just one gram and is about one inch long.
What week is this?
By the Eighth Week of Development
53
- Once cell differentiation is mostly complete, the embryo enters the next stage and becomes known as a fetus. The fetal period of prenatal develop marks more important changes in the brain. This period of development begins
during the ninth week and lasts until birth. This stage is marked by amazing change and growth.
- The heartbeat grows stronger, and other body systems become further developed.
- Fingernails, hair, eyelashes, and toenails form.
- The brain and central nervous system also become more responsive
What stage is this?
Third Stage: Fetal Stage (9th Week to Birth)
54
- is produced by the placenta after implantation. It supports the function of the corpus luteum. Hormone detected by pregnancy test.
Human Chorionic Gonadotropin (HCG)
55
- helps establish the placenta. It stimulates growth of blood vessels that supply the womb, and it inhibits contraction of the uterus.
Progesterone
56
helps the uterus grow, maintains the uterine lining, and helps fetal organs develop. It increases blood flow to the uterus and stimulate breast tissue growth.
Estrogen
57
- is the main hormone needed to produce breast milk.
Prolactin
58
- inhibits uterus contraction to prevent premature birth. It helps relaxes the uterine muscles, pelvic ligaments and other tissues in preparation for birth.
Relaxin
59
- levels rise at the start of labor, stimulating contractions of uterine muscle. It triggers production of prostaglandins, which increase contractions further.
Oxytocin
60
- It serves important role of regulating maternal glucose, protein and fat level. It produced by the placenta as early as 6 weeks of pregnancy.
- It promotes mammary gland growth in preparation for lactation of the mother.
Human Placental Lactogen/Human Chorionic Somatomammotropin
61
- Finger like projections emerging as the trophoblasts matures.
- About 200 villi.
- Develop by 10th to 11th day of pregnancy.
Chorionic Villi
62
- Protects the fetus from SYPHYLLIS up to 20 to 24 weeks.
- Present as early as 12 days gestation.
- Outer layer of the wall of blastocyst.
Cytotrophoblast/Langhan's Layer
63
- Inner cover of the wall of blastocyst.
- Production of placental hormoneslike HCG, HPL, estrogen and progesterone.
Syncytiotrophoblast/Syncytial Layer
64
- Innermost membrane, where bag of water, amniotic fluid and umbilical cord develops.
Amion
65
- length 50-55 cm
- Has 2 arteries and 1 vein. (AVA)
- Its function is to transport oxygen and nutrients to the fetus from the placenta and to return waste products from the fetus to the placenta.
Umbilical Cord
66
This protects the umbilical cord
Wharton's Jelly
67
- Also called as bag of water; liquor amnii.
- clear, mousy odor.
- With crystalized ferning pattem; 800 to 1200cc; alkaline.
Amniotic Fluid
67
What color of the amniotic fluid if it has a Meconium stain?
Greenich
68
What color if the amniotic fluid is Hemolytic disease/RH or ABO incompatibility?
Gold
69
What color of the amniotic fluid if it's has a infection already?
Grayish
69
- Amniotic Fluid that is Less than 300cc;
- Associated with renal agenesis; renal disease.
Oligohydramnios
70
Amniotic Fluid that has more than 300cc
Polyhydramnios
70
- is a vital organ that develops in the uterus during pregnancy.
- It provides oxygen and essential nutrients to the growing fetus, but also helps eliminate waste products from the baby's bloodstream.
- "tree of life"
- WT: 500 grams
- SIZE: 8 inches in diameter and 1 inch thick
- 15 to 28 cotyledons
- It produces estrogen, progesterone, HCG, HPL
Placenta
71
1st: Maintains corpus luteum at 1st trimester of pregnancy.
2nd: Basis of Pregnancy
HCG (Human Chorionic Gonadotropin)
72
- Mammary gland development and diabetogenic effect/insulin antagonist.
HUMAN PLACENTAL LACTOGEN (HPL) OR SOMATOMAMMOTROPIC HORMONE (AS EARLY AS 6TH WEEK)
73
- Softening of joints and bones specifically the pelvis.
Relaxin
74
- Protective barrier against some microorganism (can pass; HIV, HEPA, CMV, Rubella).
Estrogen and Progesterone
74
- Screening test don't diagnose genetic conditions.
- It means there's a higher risk for genetic disorders.
Perinatal Genetic Screening Test
75
- can identify small changes in the genes that increase the risk the fetus could inherit serious medical conditions.
Carrier Screening
76
- missing or extra parts of chromosomes pair.
Abnormal Chromosome Number
77
- uses ultrasound to evaluate the fetus physical stuctures.
Fetal Anatomy Scan
78
- Removal of tissue sample from the fetal portion of the developing placenta (chorion).
Chorionic Villi Sampling (CVS)
79
Purpose of Chorionic Villi Sampling (CVS)?
And when can it be perform?
- to detect genetic abnormalities like down syndrome and cystic fibrosis
- 8-10 weeks gestation
80
What does fetal limb defects?
- bleeding, infection, and abortion
81
Procedure of Chorionic Villi Sampling (CVS)?
1. Consent
2. Ultrasound - guide
3. Full bladder
4. Position:
- Transabdominal
- Transcervical
5. Vital Signs
82
- Obtaining a sample of amniotic fluid by inserting
a needle through the abdomen into the amniotic sac.
-Done 14-16 weeks of pregnancy with results available in 10 to 14 days.
Amniocentesis
83
- Any factor, chemical or physical, that adversely affects the fertilized ovum, embryo, or fetus.
Teratogen
84
- rating system for medication risk during pregnancy
Drug
85
- Medication no risk to the fetus during pregnancy
Teratogen Category A
86
- No risk in animal studies (there are no adequate studies in humans, but animal studies did not demonstrate a risk to the fetus).
Teratogen Category B
87
- Risk cannot be rule out. There are no satisfactory studies in pregnant women, but animals studies demonstrate a risk to the fetus; potentil benefits of the drugs may overweigh the risk.
Teratogen Category C
88
- Evidence of risk (studies in pregnant women have demonstrated a risk to the fetus; potential benefits of the drug may overweigh the risk).
Teratogen Category D
89
- Contraindicated (studies in pregnant women have demonstrated a risk to the fetus, shown fetal abnormalities.
Teratogen Category X
90
- infection associated with kittty litter
T (Toxoplasmosis)
91
- infection that causes syphilis
O (Others)
92
- viral infection also known as German measles
R (Rubella)
93
- a common viral infection
C (Cytomegalovirus)
94
- 1 and 2 are two members of the human Herpesviridae family, a set of viruses that produce viral infections in the majority of humans. Both HSV-1 and HSV-2 are very common and contagious. They can be spread when an infected person begins shedding the virus.
H (Herpes Simplex Virus)
95
- Exposure to certain medical interventions, work place hazards or heat that can pose a risk to the fetus.
- Radiation and Hyperthermia.
Physical Agent
96
- toxic metals and chemicals that cause risk to the fetus (Mercury; Lead)
Environmental Toxins
97
- choric health conditions that can impact a developing fetus.
Maternal Health Conditions
98
- Establish an acceptance of pregnancy.
1. no tangible signs and symptoms
2. feeling of surprise, ambivalence (existence of two opposing feelings) emotional, money worries, body image changes.
3. Denial: a sign of maladaptation to pregnancy.
4. Developmental Task: to accept the biological facts of pregnancy, "I am Pregnant".
5. Health Teaching: bodily changes, personal hygiene, nutririon
First Trimester of Pregnancy
99
- Accepting the Baby (continuation of pregnancy)
1. With tangible signs and symptoms
2. Role identification - Anticipatory Role (being a mother) the most important part of mid pregnancy
3. Mother identifies fetus as a separate entity due to quickening
4. Mother begins to fantasize the appearance of the baby
5. Change in sexual interest; father examines his own ability to parent
6. Developmental Tasks: to accept the growing fetus as a baby to be nurtured, "I am going to have a baby"
7. Health Teaching: Growth and development of the fetus
Second Trimester of Pregnancy
100
- Preparation for separation of the baby
1. Mother has a personal identification of the appearance of the baby.
2. Mother has fears due to enlarged abdomen allow her to hear the FHT.
3. Labor and delivery are on the mother's mind; safe passage for herself and the newborn.
4. Nesting Behaviour: busy days and restless nights preparing for baby's needs.
5. Fetus prepares for birth and his involvement.
Third Trimester of Pregnancy
101
- signs and symptoms are felt and observed by the mother but does not confirm the diagnosis of pregnancy
Presumptive
102
- signs and symptoms are observed by the mother and the members of the health care team.
Probable
103
- undeniable signs; confirmed by the use of instrument.
Positive
104
Meaning of:
P -
R -
E -
S -
U -
M -
E -
P- Period absent (amenorrhea) (4 WEEKS)
R- Really Tired (fatigue) (12 WEEKS)
E- Enlarge breast (3-4 WEEKS)
S- Sore breast
U- Urination increased (6-12 WEEKS)
M- Movement of fetus (quickening) (16-20 WEEKS)
E- Emesis and nausea (4-14 WEEKS)
105
- sign and symptoms are observed by the mother and the examiner (members of the health care team)
Probable Signs (Objective - Examiner)
106
Meaning of:
P -
R -
O -
B -
A -
B -
L -
E -
P-positive pregnancy test (4-12 weeks)
R-retuming of the uterus (ballottement) - (16 weeks)
O- Outline of fetus can be palpated
B-Braxton hicks contraction (16 weeks)
A- a softening of the cervix (Goodell's sign) -( 5 weeks)
B-bluish of vulva, cervix and vagina(Chadwick's) - (6-8 weeks)
L-lower uterine segment becomes soft (Hegar's sign)-(6-12 weeks)
E- Enlarged uterus
107
- definite indicator of pregnancy
- Sonographic evidence of fetal outline - 8th week
- Fetal heart audible
- Fetal movement felt by the examiner
Positive Signs
108
Meaning of:
F -
E -
T -
U -
S -
F-fetal movement (19-22 weeks)
E-Electronic device detect FHT
T-The delivery of the baby
U- Ultrasound detects the fetus (5-6 weeks)
S- See visible movements of the baby (late pregnancy
109
- Becomes vascular and edematous
- Presence of mucous plug (operculum)
- Becomes vascular and edematous
- Presence of mucus plug
Changes in Cervix
110
- Vaginal secretions, becoming more acidic
- Whitish gray; mousy odor, vaginal discharge (leukorrhea)
Changes in Vagina
111
- Uterine wall thickens from 1cm to 2cms but by the end of pregnancy, it thins to only about 0.5 cm
- Weight increases to about 1000g at full term.
- Change in shape from pear- to ovoid
Changes in Uterus
112
- Shortness of breathing is common
- Marked congestion or stuffiness
- High progesterone level cause pregnant mother to breath faster
Changes in Respiratory System
113
-30-50% increase in the total cardiac volume
- Physiologic Anemia of pregnancy
- Increases heart rate
- Palpitations is common
- Supine Hypotension Syndrome
- Edema and varicosities of the lower extremities
Changes in Cardiovascular System
114
- Slow emptying time of the stomach
- Nausea and vomiting hyper emesis gravidarum
- Decreased pH of the saliva
- Hemorrhoids is common due to constipation, -pressure of the uterus, slow peristalsis
- Flatulence cause by increase progesterone
Changes in Gastrointestinal System
115
- Frequent urination in 1ª trimester,
- normalizes in 2ndtrimester,
- frequent urination in 3rdtrimester
Changes in Urinary System
116
- Calcium and Phosphorus needs are increased
- Gradual softening of the pelvic ligaments
- Leg cramps increase pressure on the lower extremities
Changes in Musculoskeletal Changes
117
- During the first trimester, weight gain of 1.5-3 pounds is normal
- On 2nd and 3rd trimester, weight gain of 10-11 pounds pre trimester is recommended.
- Total allowable weight gain during entire period of pregnancy is 20-25 pounds
- (10-12kg)
Weight Changes
118
Calories of Non-pregnant
2200
119
Calories of Pregant
2500
120
Calories of Lactation
2700
121
- to help prevent neural tube defects (NTDs). NTDs are major birth defects of the baby's brain (anencephaly) and spine (spina bifida). CDC
Folic Acid
121
- to reduce the risk of low birth weight, maternal anemia and iron deficiency. -WHO
Iron
122
This organization recommendation on calcium supplementation during pregnancy for prevention of pre-eclampsia and its complications
World Health Organization (WHO)
123
- medical care during pregnancy
> Identify women at risk and minimize possible complications.
> Establish baseline of present health
> Determine the gestational age of the fetus
> Monitor the fetal development and maternal well being
> Provide educations about pregnancy
Perinatal Care/Antenatal Care
124
According to DOH minimum of 4 prenatal check-up
- 1st trimester of pregnancy - 1st visit
- 2nd trimester of pregnancy - 2nd visit
- 3rd trimester of pregnancy - 3rd and 4th visit
125
- HEALTH HISTORY
- OBSTETRICAL DATA
Pregnancy Status
- OB Score
- GP(TPAL)
Consultation Phase
126
According to OB Book of prenatal check-up
- 1st to 6th month once a month
- 7th to 8th month - twice a month
- 9th month weekly
127
- computation of EDD
Naegle's Rule
128
- AOG by fundic height
Mc Donald's Rule
129
- AOG by determining the position of the uterus in the abdominal cavity
Bartholomew's Rule
130
- to determine the length of the fetus
Haase's Rule
131
- estimation of the fetal weight
Johnson's Rule
132
How many weeks if the fetus is in the level of symphysis pubis?
12 Weeks
133
How many weeks if the fetus is halfway bet umbilicus and symphysis?
16 weeks
134
How many weeks if the fetus is in the level of umbilicus?
20 weeks
135
How many weeks if the fetus is 2 fingers above umbilicus?
24 weeks
136
How many weeks if the fetus is halfway bet umbilicus and xiphoid?
28-30 weeks
137
How many weeks if the fetus is just below the xiphoid?
32-40 weeks
138
- Fetal kick count or Cardiff Count-to-ten method
- Test sensitive for fetal well being at 27 weeks
- Physiology of normal third trimester fetal movement
- Expected findings: 10-12 movement in 1 hour or less than an hour
Daily Fetal Movement Counting (DFMC)
139
- measures the health of the baby during pregnancy. The BPP check's the baby's heart rate, muscle tone, movement and breathing.
- It also measures the amount of amniotic fluid around the baby.
BioPhysical Profile (BPP)
139
- A maximum 30-minute long ultrasound assessment to assess fetal well-being.
- A total score of 8-10 means the baby is healthy
- A score of 6 is considered
Equivocal or uncertain
- Need to be reassess 24hrs.
A score of 4 or less will
Likely be induced for delivery
BPP scoring
140
- Should be done in moderation
- should not be done in uncomfortable position
- avoided 6 weeks prior to EDD (operculum might be dislodge)
- Avoid blowing of air during cunnilingus to prevent air embolism
Sexual Activity
141
What trimester is when "Decrease due to bodily changes"
1st Trimester Sexual Appetite
142
What trimester is when "increase due to increase in estrogen production"
2nd Trimester Sexual Appetite
143
What trimester is when "decrease due to enlarging fetus"
Third Trimester Sexual Appetite
144
- To prepare parents physically and psychologically while promoting wellness behavior that can be used by parents and family thus, helping them achieve a satisfying and enjoying childbirth experience
Childbirth Preparation
144
Exercises of Pregant Women:
- walking
- squatting
- abdominal exercise
- shoulder circling
- Pelvic rocking/tilt
145
Principle:
- Fear causes tension and tension produces pain.
Features:
- Abdominal breathing exercises and relaxation techniques.
Grantly-Dick-Read Method
146
- Principle is based on "imitations of nature"
- Advocates active participation of husband during delivery and encourages him to serve as a "coach".
Bradley Method by Dr. Robert Bradley
147
- Pregnancy, labor, birth and the care of the newbom is an important turning point in a woman's life cycle.
- Features: Mother should go with the flow of contraction rather than struggle with it.
Kitzinger Method by Dr. Sheila Kitzinger
148
- Lamaze by Dr. Ferdinand Lamaze
- Features: Involves discipline, conditioning, concentration with the help of the husband to serve as a coach.
Psychoprophylaxis (prevention of pain through the mind)
149
- quiet room that has low or dim lighting
-minimize noise levels
- not pulling on the baby's head
- baby placed on mom's stomach after she or he is bom
- baby is gently massaged to ease crying
- umbilical cord will not be cut until it has stopped pulsating
- baby may be placed in warm tub of water
Leboyer Method
150
- This stage begins with fertilization (conception), when the sperm fertilizes the egg to form a zygote.
First Stage: Pre Embryonic / Germinal Stage (Week 1-2)
MATERNAL
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