SIGNS

*presumptive - morning sickness [HCG from placenta (acidic) - provide crackers

(alkaline)]
*probable - pregnancy test
*positive - UTZ; quickening at 1st trime
->primi: 5th month
->multi: 4th month

Diagnostic Tests
*transvaginal utz - empty bladder
*abdominal utz - full bladder
Ultrasound: Volume of amniotic fluid; gender of the fetus

Fetal Cord: 50-60 (normal length)

Nuchal Cord/Cord Coil - Long
Abruptio placenta - Short

Nitrazine Test - amniotic fluid (pale yellow; urine-like)

*blue - alkaline - (+) rupture
*yellow - acidic - (-) rupture

OB Bag
*Benedicts Solution
*Gentian Violet - mouth sore (stomatitis)
*Acetic Acid - vinegar of the OB bag

Acetic Acid Test

- to determine proteinuria (sign of abnormality) -> PIH
*Procedure:
1. Fill the test tube with sample (2/3 maternal urine)
2. Put 1/3 acetic acid
3. When mixed, mixture should be clear.
4. Heat for 1-2 minutes only.
5. Clear (-)proteinuria; Cloudy (+)proteinuria

Benedicts Test - blue

- to determine glycosuria (sign of abnormality) -> GDM (common)
*Macrosomic - NSD (7 mos) -> premature -> betamethasone (steroids, promote fetal
lung maturation to prevent respiratory distress)
*Macrosomic - CS (9 mos)
*Procedure:
1. Put 5ml of benedicts solution in the test tube.
2. Heat the solution for 1-2 minutes.
3. Put 8-10 gtts of maternal urine.
4. Blue (-)glycosuria; Green (+1)glycosuria;
Yellow (+2)glycosuria; Orange (+3)glycosuria;
Red (+4)glycosuria

CS
*classis CS - vertical incision (injures muscle layer, causing impairment of
uterine contraction) - CS forever - same area always - up to 3
myometrium - muscle layer of the uterus (with horizontal patterns) - promote
uterine contraction
*bikini (transverse) - horizontal incision (causes minimal muscle injury only) -
able to deliver again via NSD (Viganal Birth After CS- VBAC)
-> MAS MAHAL
meconium staining - aspiration - emergency - classic

Alpha Feto Protein - blood exam for fetal abnormality

 fetus -> alpha feto protein -> maternal blood (specimen)
- to determine Down Syndrome during fetal development
- to determine Neural Tube Defect
*Normal Level: 38-42 mg/dl
* <38 mg/dl: Down Syndrome (Trisomy 21)
Normal Chromosomes: 23 pairs; 46 chromosomes
Down Syndrome: excessive chromosomes (duplication of chromosome 21)
* >42 mg/dl: Neural Tube Defect (Spinal Cord Defect/Spina Bifida)
Cause: Folic Acid Deficiency (Foods to take: green leafy vegetables)

OBSTETRIC FORMULA
1. Naegel's Rule - Expected Date of Confinement (EDC) or Expected Date of Delivery
(EDB)
*ask for the mother's last menstrual period (LMP) - consider the first day of
the LMP
[-3, +7, +1 :April-Dec] [+9, +7, same year: Jan-Mar]

2. Haase's Rule - Fetal Length

1-5, mutiply by itself. 6-9, multiply by 5
1 - 1 cm 6 - 30 cm
2 - 4 cm 7 - 35 cm
3 - 9 cm 8 - 40 cm
4 - 16 cm 9 - 45 cm
5 - 25 cm

3. Johnson's Rule - Fetal Weight

1. Measure fundal height in cm (mother)
2. Check if floating or engaged (fetus) - Leopold's Maneuver
For engaged fetus: FH-12x155 grams
For floating fetus: FH-11x155 grams

4. Mc Donald's Rule - AOG

(FHx2)/7

5. Bartholomew's - AOG
1. Assess location of fundus.
Landmarks:
*Symphisis Pubis - 12 weeks/3mos
*Umbilicus - 20 weeks/5 mos
*Xyphoid Process - 8mos
*1-2cm below the xyphoid - 9 mos (lightening)

6. Maternal Weight Gain

Normal total weight gain during pregnancy: 25-35 lbs
>35 lbs: edema (PIH)

1st trime: 1 lb/month (total: 3 lbs)

2nd trime: 1 lb/week (total: 12 lbs)
3rd trime: 0.8-0.9 lbs/week (total: 8-11 lbs) - decreased production of
amniotic fluid