1) Bacteria cannot pass through the placenta but drugs, alcohol, nutrients, antibodies can.
2) Passive Immunity (third trimester) passed down from the mother lasts till few months after birth.
3) Amniotic Fluid is 800-1200 mL at the end of pregnancy
Diet changes during pregnancy:
1) increase calories by 300
2) increase protein
3) increase calcium and phosphorous together
4) increase iodine
5) increase iron
Nigel’s rule= first day of last menstruation , add seven days and 9 months
Gravida- number of pregnancies
Parita- number of births
Fundal Height in CMs= Gestational Age
Week 16- Fundal height halfway between pubic area and umbilicus
Week 22- Fundal Height at the umbilicus spot
Week 36- Xyphoid Process
Vital signs changes:
BP decreases during 2nd semester while HR increase by 10-15.
3 types of Pregnancy Signs
, 1- Presumptive- early symptoms of pregnancy
- Missing period
- Breasts enlargement
- N/V
- Quickening (fetal movement felt by mother. Usually at 16 weeks of gestation-20th week)
2- Probable
- Positive pregnancy test
- Uterine enlargement
- Chadwick’s sign= purple discoloration of vagina around (week 4)
- Goodell’s Sign- softening of cervix (week 5)
- Hegar sign- softening of lower uterine segment (week 6)
- Braxton Hick’s contractions
- Ballotment – rebounding of fetus upon examiner’s touch on the abdomen
Adolescent Pregnancy interventions
1) provide extra perinatal care due to lack nutrition, lack of knowledge , lack of development
2) refer adolescent to support groups that can counter the negative socioeconomic environment
Folic acid to prevent neural tube defects such as Left Cleft Lip, Myelengoccal
Alcohol can lead to fetal alcohol syndrome
Usual Antepartum schedule is
Weeks 28-32- ONCE
Weeks 32-36- every two weeks
Weeks 36-40- once every week
1) Sexually transmitted disease Trichomoniasis- Causes pre-mature rupture of membranes
2) If pregnant mother is Rh Negative, must get repeated screenings and receive RHOgam at 28 weeks of
gestation.
3) Rubella vaccine should not be administered at the same time that RHOgam is administered because
the vaccine won’t be as effective
Disorders of Labor and Delivery
1) Supine Hypotension- If happens, position mother on her side to get the uterus weight off of the vena
cava
2) Premature rupture of membranes- Be aware of infection! Also do plenty of vital signs/ assessment
The symptoms of premature labor are: 1) Back pain that wouldn’t go away 2) Contractions/cramps that
are not alleviated by water and laying down 3) watery discharge during lying down.
3) Variable Decelerations- PROLAPSED CORD- when mother can feel the chord coming out. In that
case, position mother on Trendelenberg (or Sim’s lateral or knee chest) position, then SOHIB. Stop
Pitocin, Oxygen, Assess for Hypoxia, IV fluids, Immediate Birth
4) Early Decelerations- HEAD compression – it is okay if Heart beat variability is within normal range
doesn’t need interventions
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