Chapter 4

Pg. 64-during pregnancy, high levels of estrogen and progesterone produced by the placenta stimulate growth of the alveoli and ductal system to prepare them for lactation.

Chapter 6
Pg.92- the preembroyonic period is the first 2 weeks after conception. Around the fourth day after conception, the fertilized ovum, now called the zygote, enter the uterus When the conceptus is a solid ball of 12 to 16 cells, it is called a morula because it resembles a mulberry. Pg.93-the upper uterus is richly supplied with blood for optimal fetal gas exchange and nutrition. The embryonic period of development extends from the beginning of the third week through the eighth week after conception. Basic structures of all major body organs are completed during the embryonic period. Pg.95- in the chart: know heart beat should be detectable with regular fetoscope at 20weeks Pg.99-vernix caseosa, a fatty, a cheeselike secretion of the fetal sebaceous glands, covers the skin to protect it from constant exposure amniotic fluid Pg.100-101 know the placenta section Pg.103 read the third paragraph under the heading Fetal Membranes and Amniotic Fluid. Know the 5 bullets Pg.104 the fetal umbilical cord has two arteries that carry deoxygenated blood and waste products away from the fetus to the placenta. Pg.105 the entire cord is cushioned by a soft substance called Wharton s jelly to prevent obstruction resulting from pressure. Pg. 106 dizygotic twins arise from two ova that are fertilized by different sperm. Dizygotic twins may be the same or different gender.

Chapter 7
Pg.109 spontaneous abortion is frequently called miscarriage. Chadwick s sign Multipara

Pg.113 women should be advised to rest in a side-lying position to prevent or correct the occurrence of supine hypotension Pg.117 areas of pigmentation include brownish patches called melasma, chloasma, ot the mask of pregnancy, which involves the forhead, cheeks, and bridge of nose. Pg.120 women are encouraged to gain an average of 25 to 35 pounds during pregnancy. The fetus, placenta, and amniotic fluid make up less than half the recommended weight gain. Because of hemodilution, colloid osmotic pressure slightly decreases, which favors the development of edema during pregnancy. Pg.121 hyperglycemia occurs when blood glucose levels exceed available insulin, which is needed to transport glucose into cells. Pg.127 read the Visualization of the Fetus Pg. 137 in the chart, now about nausea and vomiting and leg cramps Pg.138 although the cause of nausea and vomiting is unknown, it is believed to be related to increase levels of hCG and estrogen Pg.147 nicotine causes vasoconstriction of vessels in the placenta

Chapter 8
Pg.151 some feel that this is not the right time, even if the pregnancy is wanted and planned. (read under the Ambivalence section) Read the last paragraph under The Self as Primary Focus

Chapter 9
Pg.177 folic acid (also called folate) can decrease the occurrence of neural tube defects in newborns. At least 400 mcg (0.4mg) of folic acid every day Pg.178-179 in the chart know: folic acid comes from green leafy vegetables. Know Iron and Calcium Pg.181 Milk, tea, coffee, and antacids taken with iron decrease absorption. For the best results, it should be taken with water or orange juice. Pg.190 morning sickness usually disappears soon after the first trimester. Carbohydrate food such as dry toast or crackers before getting out of bed in the morning helps prevent nausea Pg. 191 eating disorders include anorexia nervosa () and bulimia.

Some women have cravings for nonnutritive substances. The practice of eating substance not normally considered food is called pica. Ice, clay, corn starch, etc. Pg.192 read caffeine, know daily caffeine should be limited during pregnancy to 300mg per day.

Chapter 10
Pg.202 know definition of contraction Stress Test Pg.203 know definition of nonstress test The development of additional methods has allowed the detection of physical abnormalities in the fetus and greater accuracy in the monitoring of the fetal condition, including growth rate. She may experience anxiety throughout the pregnancy if tests continue to raise questions about the well-being of the fetus Pg.205 at this time the crown-rump length of the embryo is the most reliable indicator of gestational age. Pg.206 gestational age determination by ultrasonography is increasingly less accurate after the first trimester. Pg.207 elevated MSAFP levels are associated with open neural tube defects and body wall defects Pg.208 although MSAFP is a prominent noninvasive test for an open body wall defect such as a neural tube defect, low levels of the protein are linked to chromosome defects. Pg.210 a test for fetal lung maturity is recommended when delivery is considered before 38 weeks of gestation or if the actual gestation is uncertain Pg.214 read the bullet Reactive(reassuring) Pg.215 the CST records the response of the FHR to stress induced by uterine contractions, identifying the fetus whose oxygen reserves are insufficient to tolerate the recurrent mild hypoxia of uterine contractions.

Chapter 11
Pg.226 the first-trimester classes cover information on adapting to pregnancy, dealing with early discomforts such as morning sickness and fatigue. Pg.227 women whose last prepared childbirth was more that 2 or 3 years ago often take a refresher class for an update or current practices and a review of techniques. Pg.230 LeBoyer Method of Childbirth: to decrease the trauma at birth, lights are dimmed and noise is decreased to help the newborn adapt to extrauterine life more easily.