KEY TERMS
age of viability - The earliest age at which
fetuses survive if they are born is generally
accepted as 24 weeks or at the point a fetus
weighs more than 500–600 g
amniotic membrane - is a dual-walled sac with
the chorion as the outmost part and the amnion
as
the innermost part.
Cephalocaudal - (head-to-tail)
chorionic membrane - outermost fetal
membrane.
chorionic villi - As early as the 11th or 12th day
after fertilization, miniature villi, resembling
probing
fingers and termed chorionic villi, reach out
from the trophoblast cells into the uterine
endometrium to begin formation of the
placenta
decidua - (the Latin word for “falling off”)
embryo - Once implanted, the zygote is called
an embryo.
estimated date of birth - Because women are
no longer “confined” after childbirth, the
acronym EDB (estimated date of birth) is more
commonly used today.
fertilization - (also referred to as conception
and impregnation) is the union of an ovum
and a spermatozoon.
Fetoscopy - in which the fetus is visualized by
inspection through a fetoscope (an extremely
narrow, hollow tube inserted by amniocentesis
technique), can be yet another way to assess
fetal well-being.
fetus - unborn child
foramen ovale - an opening in the atrial septum
hydramnios - excessive amniotic fluid (more
than 2,000 ml in total or pockets of fluid larger
than 8 cm on ultrasound)
implantation - or contact between the growing
structure and the uterine endometrium, occurs
approximately 8 to 10 days after fertilization.
McDonald’s rule - another symphysis–fundal
height measurement, is an easy method of
determining
midpregnancy growth
Meconium - a collection of cellular wastes, bile,
fats, mucoproteins, mucopolysaccharides, and
portions of the vernix caseosa (i.e., the
lubricating substance that forms on the fetal
skin), accumulates in the intestines as early as
the 16th week.
nonstress test - measures the response of the
fetal heart rate to fetal movement.
oligohydramnios - a reduction in the amount of
amniotic fluid.
Organogenesis - (organ formation)
surfactant - a phospholipid substance, is formed
and excreted by the alveolar cells of the lungs
beginning at approximately the 24th week of
pregnancy
trophoblast - cells in the outer ring
umbilical cord - is formed from the fetal
membranes, the amnion and chorion, and
provides a circulatory pathway that connects
the embryo to the chorionic villi of the
placenta.
zygote - the chromosomal material of the ovum
and spermatozoon fuse to form a zygote
KEY POINTS FOR REVIEW

Being aware of healthy fetal growth helps in

planning nursing care that not only meets
Quality & Safety Education for Nurses (QSEN)
competencies but also best meets a family’s
need for health teaching.

The union of a single sperm and egg

(fertilization) signals the beginning of
pregnancy.

The fertilized ovum (zygote) travels by way of a

fallopian tube to the uterus, where implantation
takes place in about 8 days.

From implantation to 5 to 8 weeks, the growing

structure is called an embryo. The period after 8
weeks until birth is the fetal period.

Growth of the umbilical cord, amniotic fluid,

and amniotic membranes proceeds in concert
with fetal growth. The placenta produces a
number of important hormones: estrogen,
progesterone, hPL, and hCG.

Various methods to assess fetal growth and

development include fundal height, fetal
movement, fetal heart tones, ultrasonography,
MRI, MSAFP, amniocentesis, PUBS, quadruple
screening, and fetoscopy.

A biophysical profile is a combination of fetal

assessments that predicts fetal wellbeing better
than measuring single parameters.
KEY TERMS
Ballottement - (from the French word ballotter,
meaning “to quake”) during a pelvic exam, the
fetus can be felt to bounce or rise in the
amniotic fluid up against a hand placed on the
abdomen.
Braxton Hicks contractions - “practice”
contractions, serve as warmup exercises for
labor and also play a role in ensuring the
placenta receives adequate blood.
Chadwick’s sign - increase in circulation
changes the color of the vaginal walls from their
normal light pink to a deep violet
couvade syndrome - sympathetic pregnancy
(couvade) describes a situation in which
otherwise healthy men — whose partners are
expecting babies — experience pregnancy-
related symptoms.
diastasis - Often, the abdominal wall has
difficulty stretching enough to accommodate
the growing fetus, causing the rectus muscles
underneath the skin to actually separate
Goodell’s sign - Increased fluid between cells
causes it to soften in consistency, and increased
vascularity causes it to darken from a pale pink
to a violet hue
Hegar’s sign - extreme softening of the lower
uterine segment
Lightening - settling of the fetus into the
midpelvis
linea nigra - narrow, brown line (linea nigra)
may form, running from the umbilicus to the
symphysis pubis and separating the abdomen
into right and left halves
melasma - (chloasma) or the “mask of
pregnancy.” Darkened or reddened areas may
appear on the face as well, particularly on the
cheeks and across the nose.
Montgomery’s tubercles – The sebaceous
glands of the areola (Montgomery’s tubercles),
which keep the nipple supple and help to
prevent nipples from cracking and drying during
lactation, enlarge and become protuberant.
Multipara - a woman who has had one or
more children
operculum - mucus plug, called the operculum,
forms to seal out bacteria and help prevent
infection in the fetus and membranes.
Polyuria - increased urination
Primigravida - a woman in her first pregnancy
quickening - or the first moment a woman feels
fetal movement.
striae gravidarum - streaks (striae gravidarum)
on the sides of the abdominal wall and
sometimes on the thighs
KEY POINTS FOR REVIEW
The ability of a woman to accept and enjoy a
pregnancy depends on social, cultural, family,
and individual influences.
The psychological tasks of pregnancy are
centered on ensuring safe passage for the fetus.
They consist of, in the first trimester, accepting
the pregnancy; in the second
trimester, accepting the baby; and in the third
trimester, preparing for parenthood.
Common emotional responses that occur with
pregnancy can include grief, narcissism,
introversion or extroversion, stress, couvade
syndrome, body image and boundary confusion,
emotional lability, and changes in sexual desire.
Physiologic changes that occur with pregnancy
are both local, such as uterine, ovarian, and
vaginal changes as well as systemic changes
such as those that occur in the endocrine,
respiratory, cardiovascular, urinary, and
immune systems.

Women may have read about the expected

psychological and physiologic changes of
pregnancy but once they are experiencing them
may find them more intense than anticipated.

The confirmation of pregnancy may be assisted

by three levels of findings: presumptive
(subjective), probable (objective), and positive
(documented).

The positive signs of pregnancy are

demonstration of a fetal heartbeat separate
from the mother’s, fetal movement felt by an
examiner, and visualization of a fetus by
ultrasound.

Although a woman may be in a prenatal

healthcare setting for only an hour, if her
pregnancy is confirmed at that visit, she
invariably feels “more pregnant” when she
leaves. Early diagnosis or confirmation is
important so a woman can begin to change
unhealthy habits or have adequate time to carry
out a therapeutic termination of pregnancy.

Teaching women common psychological and

physiologic changes that occur with pregnancy
helps to plan nursing care that not only meets
QSEN competencies but also best meets a
family’s total needs.