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OB
Ovulatory Hormones I - Follicular Phase
Characteristics
0-14 Days
GnRH Stimulates FSH and LH
Follicle Secretes Estrogen
Negative Feedback from Estrogen
Increased Estrogen Leads to Positive Feedback
FSH and LH Surge
LH Spike Leads to Ovulation
2 mins
Ovulatory Hormones II - Luteal Phase
Days 15-28
Corpus Luteum
Secretes Progesterone
Negative Feedback inhibits FSH and LH
No pregnancy forms Corpus Albicans
Stops Estrogen Secretion
Endometrial Sloughing - Menses
GnRH secretion produces new follicular phase
2 mins
Fetal Circulation
Placenta
Umbilical Vein
Ductus Venosus
Right Atrium
Foramen Ovale
Left Atrium
Aorta
Right Ventricle
Ductus Arteriosus
Umbilical Arteries
2 mins
Postnatal Circulation
Infant Breathes
Decreased Pressure in Pulmonary Vasculature
Decreased Right Heart Pressure
Increased Left Atrial Pressure
Closes Foramen Ovale
Increased O2
Decreased Prostaglandins
Closed Ductus Arteriosus
Pharmacologic Intervention of Ductus Arteriosus
Open with Prostaglandins
Closed with Indomethacin
3 mins
Patent Ductus Arteriosus
Continuous
Machine like murmur
Often Due to Congenital Rubella
Prematurity
1 min
Prenatal Nutrition
Prenatal Vitamins
Iron Supplement 30 mg Daily
Folate/Folic Acid 400 mcg Daily
Appropriate Weight Gain Recommendations
340 Calorie Increase
25 gram Protein Increase
Foods and Substances to Avoid
Coffee, Alcohol, Tobacco
Fish Containing High Mercury Levels
3 mins
Prenatal Care
Prenatal Visits
Vital Signs, FHR
Fundal Height
Urine Dipstick
Weight
Prenatal Screening
Laboratory Testing
2 mins
Lab and Diagnostic Tests During Pregnancy
Complete Blood Cell Count
Blood Typing
Rubella Titer
Hepatitis B
HIV Testing
Urinalysis
Diabetes
Pap Smears
2 mins
Hyperemesis Gravidarum
Signs and Symptoms
Excessive Vomiting
Significant Weight Loss
Dehydration
Hypotension
Electrolyte Imbalance
Interventions
Antiemetics
Frequent Small Meals
IV Therapy
2 mins
Contraception
Indications
Preventing Unplanned Pregnancy
Barrier Methods
Spermicides
Diaphragm
Cervical Cap
Contraceptive Sponge
Male Condom
Hormonal Method
Oral Contraceptive
Intrauterine Device (IUD)
Injectable Progestins
2 mins
Infertility
No Conception After 1 Year
Interventions
Artificial Insemination
In Vitro Fertilization (IVF)
Drug Therapy
Clomiphene Citrate (Clomid)
Menotropins
GnRH Agonists
Considerations
Treat Underlying Disorders
Emotional Support
Multiple Gestations
3 mins
Presumptive Signs of Pregnancy
Amenorrhea
Fatigue
Urinary Frequency
Nausea and Vomiting
Breast Changes
Quickening
1 min
Probable Signs of Pregnancy
Goodell Sign
Chadwick Sign
Hegar Sign
Positive Serum and Urine Sample
Braxton Hicks Contractions
Ballottement
2 mins
Positive Signs of Pregnancy
Fetus on Ultrasound
Fetal Heart Rate by Doppler or Fetoscope
Fetal X-ray
Fetal Movements
1 min
Discomforts of Pregnancy - First Trimester
Breast Tenderness
Supportive Bra
Nausea and Vomiting
Frequent Small Meals
Urinary Frequency and Urgency
Frequently Empty Bladder
Leukorrhea
Perineal Pad
Ptyalism
2 mins
Discomforts of Pregnancy - Second Trimester
Supine Hypotension
Side-lying Position
Food Cravings
Heartburn (Pyrosis)
Constipation
Moderate Exercise
Varicose Veins
Elevate Legs
Backache
Pelvic Tilt Exercise
Considerations
Nutrition
2 mins
Discomforts of Pregnancy - Third Trimester
Shortness of Breath (SOB)
Rest Periods
Return of Urinary Frequency and Urgency
Empty Bladder Regularly
Leg Cramps
Stretching Exercises
Ankle Edema
Elevate Legs
2 mins
Amniocentesis
Mechanism
Transabdominal Puncture
> 14 weeks gestation
Indications
Genetic and Congenital Anomalies
Fetal Hemolytic Disease
Fetal Lung Maturity
Complications
Miscarriage
Hemorrhage
Infection
Considerations
RhoGAM (Rh Immune Globulin)
2 mins
Lab and Diagnostic Tests During Pregnancy (1st Visit)
Diagnosis
Complete Blood Count (CBC)
Blood Typing and Rh
Rubella
HIV
Hepatitis B
Tuberculosis Skin Mantoux Test (PPD)
Sexually Transmitted Infections
Chlamydia
Neisseria gonorrhoeae
Syphilis
Pap Smears
Urinalysis
Sickle Cell Screening (If Indicated)
2 mins
Lab and Diagnostic Tests During Pregnancy (Other Visits)
Diagnosis
10-13 Weeks
Offer Chorionic Villus Sampling (CVS)
15-18 Weeks
Quad Screen
18-20 Weeks
Ultrasound
Anatomic Screening
24-28 Weeks
One-Hour Glucose Challenge Test
35-37 Weeks
Streptococcus Agalactiae
3 mins
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