Folic Acid Prenatal Vitamins

Folate, Vitamin B9 Iron

(Cyanocobalamin
(anemia) & Vitamin
B12)

Prevents neural Low Hemoglobin

tube defects.. *take w/ Vitamin C*

High doses of folic GI upset, teeth staining,

acid can mask B12 dark green/black stools.
deficiency leading to
decreased cognitive Increase fluid/fiber to
function. prevent constipation.

Nutrition
Increase Folic Acid to 600
mcg/day (neural tube)

Increase protein, increase

60 mg/day

Increase iron (taken w/

Vitamin C) increase 27
mg/day-->RBC-->O2, to
Fetus
25- 28 Eye lids open
Weeks Kicks & stretches.
Grasping motion &
respond to sound.

Increase weight r/t

29-32 development complete.
Weeks Bones harden..skull soft &
flexible
Lanugo begins to disappear
Hair on head
Increase adipose

33-36 Lungs are maturing, getting

Weeks ready to function
Less wrinkled
Sleeping patterns

36-40 Labia majora/minora testes

Fetus drops-->lightening
Weeks
engagement

1/2 lb./week
1-8 Heartbeat at 8 Weeks
Weeks Heart forms at 3 Weeks

Called embryo

9-12 Organs starting

Weeks RBC produced by liver

13-16 Arms & legs flex

Weeks Kidneys functioning,
producing urine
Lanugo on head

17-20 Skin is wrinkled, body is

Weeks covered w/ vernix & brown fat
developing Nails
Fetus active & sleeps
Ovaries-eggs
Testes descend

21-24 May hiccup, increased brain

Weeks developement, tear ducts,
finger & toe prints, lungs are
fully formed but not ready to
function.
Alveoli, surfactant, respiratory
movement
 Congestion Normal Saline Can use Zyrtec

Constipation Increase Fiber & Fluid

Epistaxis Humidifier
(bleeding
from the
nose)

Fatigue Rest & Naps

Gingivitis Brush w/ soft toothbrush & floss

Heartburn Small & Frequent meals. Avoid laying down

afterwards.
Avoid spicy & greasy food.

Hemorrhoids Warm sitz bath, witch hazel

Nausea & Crackers before leaving the bed. Bland &
Vomiting small frequent meals.
Varicose Veins Elevate legs, compression socks, walk & avoid
prolonged standing.
 (LMP-14 Weeks) (15-28 Weeks) (29 Weeks to Birth)
2 Visits Visit every 4 weeks Visit every 2-3 weeks
*Initial Low msAFP=Down Syndrom Visits after 36 weeks are
*4 Weeks later High msAFP=Neural Defect weekly
Blood Type, RH Factor, Triple/Quad Screen, Ultrasound
CBC (H/H), RBC, WBC, H/H (hemoglobin/hematocrit) Group B (35-37 Weeks)
Syphilis, HIV, HepB, Gestational Diabetes (24-28 wks) H/H (hemoglobin/hematocrit)
Rubella, Urine analysis Rh Antibody (26-28 wks) Nonstress Test for High Risk
& culture, Pap check for
Gonorrhea & Chlamydia
Rhogam given at 28 wks. Leopold Maneuver (Check
History & Physical Exam fetal position)
GTPAL Amniocentesis
Fundal Height Pelvic Exam
Fetal Wellbeing

Relief measures-------------------> *Prep for delivery

Fetal Development ----------> *Childbirth classes
Warning Signs ----------------------> *Signs of labor
Nutrition -----------------------------------> Follow up *True vs False
Reduce Risks Begin Birth Teaching *Parenting Education
Kick count
Physical changes of Fetal movement Bottle vs Breastfeeding
pregnancy & 24-28 weeks Infant-Pediatrician
discomforts Prepare siblings.

Visit: Vital signs, Weigh,

Assessment, urine dip
Warning Signs!!
Dip Glucose, protein, & ketones *Diarrhea, fever, chills
*Severe abdominal cramping
Fundal Height *Severe vomiting
*Vaginal bleeding
Fetal Heart Rate (FHR) *Decreased fetal activity
*Both fetal &
maternal tissue *Sac- amniotic chorionic *Connects fetus to
membranes
*Chorionic membrane
*Stretch to
placenta
(Fetal side) *2 Arteries, 1 Vein
*Endometrium accommodate fluid
(Maternal side) lobes *Sterile environment *Arteries: Carry
*Placental ____________________ deoxygenated blood
membrane *Vein: carries
Fluid- Cushion fetus
separates maternal
*Protect
oxygenated blood
& Vessels surrounded
fetal blood- prevents *Movement
mixing. *Consistent thermal by Wharton's Jelly
environment (prevents
Job: Metabolic & gas ____________________ compression)
Produce hormones
exchange
human placental
20%
Fetus: waste and cardiac/vascular
CO2 to maternal lactogen (hPL)
blood by diffusion Progesterone: defect w/ only 1
Maternal: glucose & implantation & decrease Artery & 1 Vein
amino acids & 02 contractility
to Fetus by diffuse & Estrogen: Enlarge
achieve transport breast & Uterus
HCG

*Excess amount of *Decreased amount of

amniotic fluid amniotic fluid r/t decreased
*Increased risk of placental
chromosomal function.
disorders and *Increased congenital
gastrointestinal, renal
cardiac, and neural problems
tube
disorders
 Explained By Other Signs Are Probable Baby Can Be Heard, Felt, Seen

*Amenorrhea *Chadwick's Sign- *Auscultation of FHR

*Nausea & vomiting blueish purple coloration (10-12 weeks)
*Breast changes (6-8 weeks) *Observation & palpation
2-3 weeks *Goodell's Sign- of fetus (20 weeks)
*Enlarged & tender. softening of cervix
*Fatigue (8 weeks)

*Increased urination *Uterine & abdominal *Ultrasound of fetus

*Quickening (flutter) growth Cardiac Heartbeat
(18-20 weeks with *Skin hyperpigmentation (4-8 weeks)
first *Chloasma Linea Nigra *Vaginal Ultrasound
pregnancy. *Nipples & areolas (4.5 -5 weeks)
(14-16 weeks with darker
more than 1 *Ballottement
pregnancy.
*Positive pregnancy test
(morning urine)
HCG Blood test

Last Menstrual Period

Plus 9 Months Plus 7 Days

or

Last Menstrual Period

Minus 3 Months Plus 7 Days