2017_Physical_Physio Changes in Pregnancy_Fetal Surveillance Outline.docx

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Physiologic/Physical Changes in Pregnancy Antenatal Fetal Surveillance Outline OBJECTIVES: 1. Identify and discuss the physiologic and physical changes that occur during pregnancy 2. Discuss the different methods that are used to assess fetal wellbeing during pregnancy TERMS: HUMAN GESTATIONAL PERIOD: Prenatal/Antepartum o between conception and birth o trimesters: ~ 13 weeks o 0-13 (first trimester), 12-26 (second trimester), 26-40 (third trimester) o the very first day of her last menstrual period Intrapartum Postpartum Nägele’s Rule o EDD = LMP (first day of last menstrual period) - 3 Months + 7 Days Term vs Preterm o in literature the due date is EDD +/- 2 weeks 38 - 41 6/7 weeks o in practice 0 - 20 weeks is abortion SAB = miscarriage TAB/TOP = termination of pregnancy 20 - 37 weeks is preterm 34 - 36 6/7 weeks is near term 37- 41 6/7 weeks is term 34 - 36 6/7 weeks is near term o 42 weeks gestation = post mature PREGNANCY ° Gravida o how many times you’ve been pregnant o pregnancy term ° Nulligravida
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Physiologic/Physical Changes in Pregnancy Antenatal Fetal Surveillance Outline o never been term ° Primigravida o pregnant one time ° Multigravida o been pregnant more than once BIRTH ° Para o birth terms o delivered after the 20th week ° Nullipara o never given birth ° Primipara ° Multipara Pregnancy and Birth History G – number of pregnancies including current pregnancy T – number of births at 37 weeks or later P – number of births delivered between 20 and 37 weeks A – number of pregnancies ending before 20 weeks; either spontaneous or therapeutic/elective L – number of currently living children PRACTICE : Cassie is pregnant for the second time. She has a 4-year-old daughter who was born at term. Calculate her gravida and para using the TPAL format: - G2P1001 PRACTICE: Cassie is pregnant for the fourth time. She has a 4-year-old daughter who was born at term, a 2-year-old son born at 34 weeks, and she terminated a pregnancy at 8 weeks when she was 18 years old. Calculate her gravida and para using the TPAL format: - G4P1112 SIGNS AND SYMPTOMS OF PREGNANCY Subjective (Presumptive) Changes: ° Amenorrhea ° Nausea and vomiting (happens in first trimester) ° Excessive fatigue ° Urinary frequency ° Breast changes ° Quickening: when mother feels the first movement of the baby o feels like gas bubbles, butterfly kisses, fluttering
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Physiologic/Physical Changes in Pregnancy Antenatal Fetal Surveillance Outline Objective (Probable) Changes: ° Changes in pelvic organs ° Enlargement of abdomen ° Braxton Hicks contractions: feel the stomach tightening ° Abdominal striae ° Uterine souffle: the sound you hear as the uterine arteries start to increase in flow ° Changes in skin pigmentation ° Ballottement: movement of the baby that can be felt against your fingers ° Positive pregnancy tests o testing Hcg - human chorionic gonadotropin - comes from developing placenta, not the fetus you can have a developing placenta and not a fetus o when you can detect Hcg
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