Caffeine Intake during Pregnancy - Answer - Caffeine crosses the placenta and may
cause low birth weight
- No more than 200 mg of caffeine is recommended per day
The Role of the Placenta - Answer 1. Transport of nutrient, antibodies, and oxygen to the
fetus
2. Transfer of waste products
3. Gas exchange
4. Protective barrier
5. Produces and secretes hormones
Human Placental Lactogen (HPL) - Answer - Secreted by the placenta starting the 2nd
week after gestation and slowly rises throughout the pregnancy
- Main function include: metabolism regulation, insulin resistance, and preparation of
mammary glands for lactation
Progesterone - Answer - Main functions include: maintains the myometrium, mediates
the immune system function, inhibits production of prostaglandins in the uterus, and
helps the mother's milk to come in
- The withdraw of progesterone leads to contractions and onset of labor
Estrogen - Answer - Main functions include: prepares the breasts for lactation,
promotes growth of the uterus, increases uterine blood flow, and is involved in the onset
and timing of labor
Relaxin - Answer - Main functions include: aids in implantation and placental growth,
inhibits uterine activity during pregnancy, widens the pelvis, and helps to facilitate birth
Oxytocin - Answer - Main functions include: facilitating labor, help prepare for
breastfeeding, and facilitates bonding
HCG - Answer - Main functions include; increasing progesterone production
- Levels double every 48-72 hours during the first month of pregnancy
- Levels continue to rise during the first trimester of pregnancy and then decline after
,- Can be detected in the blood 10 days after conception and detected in the urine 2
weeks after conception
- If a patient comes in with a + pregnancy test and they are spotting, take a blood HCG
level
Implantation & Embryonic Development - Answer - All major organs have developed by
10 weeks gestation
- 10 weeks gestation begins the fetal period
Pregnancy Test - Answer - Test one day after the first missed period
Presumptive Signs of Pregnancy - Answer - Anything your patient can experience
Probable Signs of Pregnancy - Answer - Things a provider finds on exam but could be
caused by other things other than pregnancy
- Signs: breast and skin changes, enlargement of the uterus, Hegar's sign, Goodell's
sign, Chadwick's sign, positive pregnancy test
Hegar's Sign - Answer Softening of the lower uterine segment
Goodell's Sign - Answer Softening of the cervix
Chadwick's Sign - Answer Bluish purple discoloration of the cervix, vagina, and labia
during pregnancy as a result of increased vascular congestion.
Positive Sign of Pregnancy - Answer - Definitive signs of pregnancy
- Signs: pregnancy visualized by ultrasound, audible fetal heart tones, and fetal
movement felt by provider
Estimated Date of Delivery (EDD) - Answer - Pregnancy is 40 weeks or 280 days or 9
calendar months
- Measured from the last normal period
- EDD allows the provider to know when testing needs to be done and to follow fetal
growth
Naegele's Rule - Answer - Gives you an EDD +/- 5 days
- Limitations: based on a 28 day cycle, need to know cycle, may be affected by OCP use
- Rule: 1st day of LMP + count back 3 months + add 7 days + add 1 year = EDD
, Example: LMP 12/18/18
12-3 (months) = 9 (September)
18+7 (days) = 25
2018+1 = 2-19
EDD = September 25, 2019
Example = LMP 1/27/2020
27+7 = 2/3/2020
1-3 = 11/3/2019
2020+1 = 2021
EDD = 11/3/2021
Example = LMP 6/1/2020
1+7 = 8
6-3 = 3
2020+1 = 2021
EDD = 3/8/2021
Example = LPM 4/10/2020
10+7 = 17
4-3 = 1
2020+1 = 2021
EDD = 1/17/2021
Transvaginal Ultrasound - Answer - Most accurate method in the 1st trimester
- Look for yolk sac, embryo, and the double decidual sign (the lining that is shed if a
female is not pregnant)
- Measure crown to rump
Discrepancy between LMP US & EDD - Answer - 1st Trimester: go with the US date if
there is greater than a 7 day difference from the calculation
- 2nd Trimester: use US results if US is greater than 10 days difference from the
calculation
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