Filbert Zhang

HSCI 020 Notes

12/07/10

Prenatal: The care of the pregnant woman before delivery of the infant

Obstetrics Terminology

1. Braxton Hicks contractions: intermittent and irregular painless

contractions that occur throughout pregnancy
a. Occur more frequently at end of pregnancy
b. May be mistaken for true labor pains
c. Mostly painful because of dehydration
2. Dilation (of the cervix): The stretching of the external os from an opening of
a few millimeters to an opening large enough to allow passage of an infant
(approx 10cm)
3. Effacement: The thinning and shortening of cervical canal form normal
length (1 to 2 cm)
4. Embryo: The child in utero from the time of conception to the beginning of
the first trimester (the first 2 months of development)
5. Engagement: The entrance of the fetal head or the presenting part into the
pelvic inlet
6. Fetus: The child in utero, form the third month after conception to birth
7. Fundus: The dome-shaped upper portion of the uterus between the fallopian
tubes
8. Gestation: The period of intrauterine development from conception to birth
9. Gestational age: The age of the fetus between conception and birth
10. Infant: a child form birth to 12 months of age
11. Multigravida: A woman who has been pregnancy more than once
12. Multipara: A woman who has completed two or more pregnancies to the age
of viability
a. Regardless of whether they ended in live infants or stillbirths
13. Nullipara: A woman who has not carried a pregnancy to the point of
viability (20 weeks)
14. Position: The relation of the presenting part of the fetus to the maternal
pelvis
15. Postpartum: Occurring after childbirth
16. Preeclampsia: A major complication of pregnancy (cause unknown)
a. Symptoms
i. Increasing hypertension
ii. Albuminuria
iii. Edema
b. If nor treated: may develop into eclampsia
i. Could cause maternal convulsions and coma
c. Occurs between the 20th week of pregnancy and the end of the first
week postpartum
 17. Presentation: Part of fetus closest to cervix and will be delivered first
a. Cephalic presentation: head is presenting against cervix
b. Breech presentation: buttocks or feet are presented first
18. Primigravida: A woman pregnant for the first time
19. Primipara: A woman who has carried a pregnancy to viability (20 weeks) for
the first time
a. Regardless of whether the infant was stillborn or alive at birth
20. Puerperium: The period of time (usually 4 to 6 weeks) after delivery in which
uterus and body systems return to normal
21. Quickening: The first movement of the fetus in utero as felt by the mother
a. Occurs between 16 to 20 weeks
22. Toxemia: A pathologic condition that includes preeclampsia and eclampsia
23. Trimester: Three months or one third of the gestational period
a. The 9 months of pregnancy divided into 3 trimesters

Prenatal Visits

Prenatal and postpartal care divided into categories

1. First prenatal visit

2. Return prenatal visit
3. Six weeks’ postpartum visit

First Prenatal visit

1. Occurs after a woman misses second menstrual period

a. If problems exist: patient is seen after first missed period
2. Often stressful for patient
a. Regardless of whether or not pt is happy about pregnancy
b. Helpful to relax and reassure patient
3. Components
a. Completion of prenatal record form
b. Initial prenatal exam: complete physical exam
c. Prenatal patient education

The prenatal Record

1. Purpose
a. Provided information regarding past and present health status of
patient
b. Data base and flow sheet for subsequent visits
c. Identification of high-risk patients
2. MA responsible for obtaining information for prenatal record
a. Opportunity for MA to:
i. Develop rapport with patient
ii. Relay information to patient
 1. Changes taking place in body
2. Signs/symptoms of labor
3. Nutrition…
3. Components of the Prenatal Record
a. Past Medical History
i. Conditions that could affect mother and fetus
ii. Immunizations and childhood diseases:
1. To assess antibody protection against disease
2. Rubella: can not give to pregnant woman, harmful to
fetus
b. Menstrual History
c. Obstetric History
i. Information on previous pregnancies
1. Gravidity (G): Number of times patient has been
pregnant
a. Regardless of duration of pregnancy
b. Including the current pregnancy
2. Examples:
a. Multiple births (twin) is still considered one
pregnancy
3. Parity (P): The condition of having borne offspring
regardless of the outcome

Initial Prenatal Examination

1. Purpose
a. Confirm the pregnancy
b. Establish baseline for woman’s state of health
c. Identify high-risk prenatal patients

RH Factor and ABO Blood Type

1. RH Factor and ABO Blood Type

a. Purpose: to anticipate ABO and RH incompatibilities
b. If mother is RH-negative: father must be tested
i. If father RH-positive: Rh incompatibility may exist
ii. RH antibody titer test is performed throughout pregnancy
1. To determine if mother’s antibody level is increasing
c. Increased Rh antibody level: could be dangerous to fetus
i. Could result in:
1. Severe anemia
2. Jaundice
3. Brain damage
4. Heart failure
5. Sometimes death of fetus
Glucose Challenge Test (GCT)

1. Glucose Challenge Test (GCT)

a. Performed between 24 and 28 weeks
b. Screens for gestational diabetes mellitus (GDM)
c. Patient drinks 50 grams of a glucose solution
i. Glucose measure 1 hour later
d. 140 mg/dL is the magic number

Fundal Height Measurement

1. Physician places one end of a cm tape measure on the superior aspect of

symphysis pubis and measure to top of uterine….

Fetal Heart Tones

1. Fetal Heart Tones (FHT)

a. Normal fetal heart rate (FHR): 120 to 160 bpm
b. Slow or rapid heartbeat: usually indicates fetal distress

Amniocentesis……..