1. Anatomy and Physiology of Pregnancy
Chapter 7
Anatomy and Physiology of Pregnancy
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2. Gravidity and Parity
Understanding of following terms is essential to study of maternity care:
Gravida: woman who is pregnant
Gravidity: pregnancy
Multigravida: woman who has had two or more pregnancies
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3. Gravidity and Parity (Cont.)
Multipara: woman who has completed two or more pregnancies to stage of fetal viability
Nulligravida: woman who has never been pregnant
Nullipara: woman who has not completed a pregnancy with fetus or fetuses who have reached stage of fetal viability
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4. Gravidity and Parity (Cont.)
Parity: number of pregnancies in which fetus or fetuses have reached viability, not number of fetuses (e.g., twins) born. Whether fetus is born alive or is stillborn (fetus who shows no signs of life at birth) after viability is reached does not affect parity
Postdate or postterm: pregnancy that goes beyond 42 weeks of gestation
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5. Gravidity and Parity (Cont.)
Preterm: pregnancy that has reached 20 weeks of gestation but before completion of 37 weeks of gestation
Primigravida: woman pregnant for first time
Primipara: woman who has completed one pregnancy with fetus or fetuses who have reached stage of fetal viability
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6. Gravidity and Parity (Cont.)
Term: pregnancy from beginning of week 38 of gestation to end of week 42 of gestation
Viability: capacity to live outside uterus; about 22 to 25 weeks gestation are on the threshold of viability
These very premature infants are vulnerable to brain injury
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7. Summarizing Obstetric History
Two digits
G – gravida
P - para
5 digits
GPTAL
Gravidity, term, preterm, abortions, living children
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8. Pregnancy Tests
Human chorionic gonadotropin (hCG) is earliest biochemical marker of pregnancy
Pregnancy tests based on recognition of hCG or β subunit of hCG
Can be detected in serum or urine as early as 7 to 8 days after ovulation
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9. Pregnancy Tests (Cont.)
Many different pregnancy tests are available
Enzyme-linked immunosorbent assay (ELISA) testing is most popular method of testing for pregnancy
ELISA technology is the basis for most over-the-counter home pregnancy tests
Medication use, hormone based tumors, or improper collection may cause inaccurate results
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11. Adaptations to Pregnancy
Signs of pregnancy
Presumptive
Those changes felt by the woman
Probable
Those changes observed by an examiner
Positive
Those signs attributed only to the presence of the fetus
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12. Adaptations to Pregnancy (Cont.)
Reproductive system and breasts
Uterus
Changes in size, shape, and position
Changes in contractility
Uteroplacental blood flow
Cervical changes
Changes related to the presence of the fetus
Ballottement
Quickening
Vagina and vulva
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20. Adaptations to Pregnancy (Cont.)
Breasts
Fullness, heaviness
Heightened sensitivity from tingling to sharp pain
Areolae become more pigmented
Montgomery tubercles
Colostrum
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22. Adaptations to Pregnancy (Cont.)
General body systems
Cardiovascular system
Blood pressure
Supine hypotensive syndrome
Blood volume and composition
Cardiac output
Circulation and coagulation times
Increases in various clotting factors
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25. Adaptations to Pregnancy (Cont.)
General body systems
Respiratory system
Pulmonary function
Basal metabolism rate
Acid-base balance
Renal system
Anatomic changes
Functional changes
Fluid and electrolyte balance
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26. Adaptations to Pregnancy (Cont.)
General body systems
Integumentary system
Chloasma (mask of pregnancy)
Linea nigra
Striae gravidarum
Angiomas
Palmar erythema
Musculoskeletal system
Neurologic system
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30. Adaptations to Pregnancy (Cont.)
General body systems
Gastrointestinal system
Appetite
PICA
Mouth and teeth
Esophagus, stomach, and intestines
Gallbladder and liver
Abdominal discomfort
Endocrine system
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31. Question Probable signs of pregnancy are: determined by ultrasound.
observed by the health care provider.
reported by the client.
diagnostic tests.
ANS: B
Feedback
A Incorrect: Fetal visualization is a positive sign of pregnancy.
B Correct: Probable signs are those detected through trained examination.
C Incorrect: Presumptive signs are those reported by the client.
D Incorrect: The term diagnostic test is open for interpretation. To actually diagnose pregnancy, one would have to see positive signs of pregnancy.
DIF: Cognitive Level: Comprehension
OBJ: Client Needs: Health Promotion and Maintenance
TOP: Nursing Process: Assessment
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