• Family types
o Nuclear (male partner, female partner, their children)
o Extended (family unit plus other family member in the same household)
o Married-blended (post death/divorce
o Commune (group of men, women, an
...
• Family types
o Nuclear (male partner, female partner, their children)
o Extended (family unit plus other family member in the same household)
o Married-blended (post death/divorce
o Commune (group of men, women, and children living together)
o Cohabitation (unmarried man and woman living together)
o No-parent (children living independent, in foster care, or with close relative)
• Family Systems Theory
o Changes that occur in one member affect the entire family
o Sum of the parts is greater than the whole
o Balance and homeostasis (strive to return to “normal” state)
o Subsystems
Spouses
Children
Girls or boys
Mother/child
• Duvall’s Family Developmental Theory
o Each stage has certain tasks that need to be accomplished before moving on to next stage
Beginning (just married)
Childbearing (new child)
Preschool (child’s life becomes parent’s life)
School age (personal values are shaped and clarified)
Adolescent/teenage (teaching about sex, drugs, and health promotion)
Launching (empty nest)
Middle age (more socialization)
Retirement
• Structural-Functional Theory
o Functioning of the family and the roles assumed by each member
o Roles include: provider, housekeeper, child caregiver, socializer, sexual partner, therapist, recreational organizer, and kinship (social etiquette/moral teacher)
• Community Theory
o Emotional problems result from the way people interact with each other in the context of the family
o Unhealthy families give mixed or double-binding messages, nonverbal expressions that are inconsistent and incongruent with the verbal message.
o Healthy families have clear rules and communication is clear and congruent and nonverbal cues match what is being said.
• Group Theory
o Norms (rules of conduct), roles, goals, and power structure
o Division of household chores, expectations of homework, and curfew enforcement
o Stages of groups:
Forming (through marriage or cohabitation)
Storming (disordered time of confusion or chaos)
Norming (adjust to members by applying rules that everyone agrees to)
Performing (accomplishes their goals and produces results)
Adjourning/terminating (when member dies, divorce, or leaves the family)
• Bowen Family Systems Theory
o Views the family as an emotional unit and uses systems thinking to describe the complex interactions within the family unit
o Useful when identifying family problems or challenges that are rooted in communication, connecting between members, and teaching values
o Views birth order as a predictor of certain patterns of behavior
o Triangulation occurs when the dyad diverts attention away from its own conflict by focusing on a third person such as the child, teacher of the problem child, or police officer who comes into a domestic disturbance.
o The multigenerational transmission process describes how one learns or transmits family emotional systems across generations.
o Family projection process is how and what children are taught
• Family Assessment
o Family size and structure
o Parenting style
Authoritarian (dictatorial)
Laissez-faire (permissive)
Authoritative (democratic)
o Religious, cultural, and social-economical orientation
• Tools to facilitate the family assessment
o Qualitative and quantitative surveys
o Genogram or ecomap
o Strengths and problems list
• Components of the family assessment
o Communication patterns
o Roles and relationships
o Family developmental stage
o Family rituals
o Triangulation
o Presence of dyads and other subsystems
• Examples of Family Nursing Diagnoses
o Altered Family Process
o Caregiver Role Strain (actual and risk for)
o Dysfunctional Family Processes: Alcoholism
o Family Coping: Compromised Family Coping: Disabled
o Impaired Parenting (actual and risk for)
o Ineffective Family Therapeutic Regimen Management
o Readiness for Enhanced Family Coping
o Readiness for Enhanced Parenting
o Risk for Parent-Infant-Child Attachment
o Social Isolation
o Spiritual Distress
• Family with special needs
o The loss of a home, job, family member, or close friend are all unexpected and unplanned-for events that initially send the family into a state of chaos and often require outside help for the process of reorganization
o Situational crises include environmental disasters such as floods, hurricanes, or fires
o Developmental crises occur as part of expected growth events that can take place during any developmental stage of the family or its individual members.
• Gene Inheritance
o Nucleus has 23 pairs of chromosomes (22 autosomes and 1 sex chromosome)
o Multifactorial (combination of genetic and environmental factors)
o Unifactorial (single gene inheritance, such as autosomal dominant, autosomal recessive, X-linked disorders)
• Autosomal Dominant
o Single altered gene
o Can be from one parent
o 50% chance of passing altered gene to offspring
o Can be from mutation
o Examples: Huntington’s disease, achondroplasia, neurofibromatosis, Marfan’s syndrome
• Autosomal Recessive
o Each parent has the altered gene (carrier
o 25% chance of passing trait
o 50% chance of passing altered gene (carrier)
o Examples: PKU, maple syrup disease, sickle cell anemia, cystic fibrosis, tay-sach’s disease)
o Greater chance of occurrence in this population
• X-Linked Dominant
o Altered gene on X chromosome
o If the father has the dominant gene (Xy):
All of daughters will inherit gene
None of sons will inherit gene
o If the mother has the dominant gene (Xx):
50% chance of inheriting the gene
Some chance for son or daughter
• X-Liked Recessive
o More common than X-linked dominant disorders
o Trait occurs more frequently in males r/t X
o Male with trait will pass gene to all daughters
o Female with gene (carrier) has 50% chance of passing on the gene
o Examples: Hemophilia A, Duchenne muscular dystrophy
• Process of fertilization
o Ovulation – cervical mucus changes
o Deposit of 200 – 600 million sperm
o Approximately 200 sperm reach fertilization site
o Oocyte (female) and sperm (male) meet in fallopian tube
• Cellular Multiplication
o Cleavage (mitotic cell division of the zygote)
o 3 to 4 days after fertilization, there are approximately 16 cells and the zygote is called a morula and enters the uterus
o Once the morula enters the uterus, fluid passes into the intercellular spaces of the inner cell mass and forms a large fluid-filled cavity
o The morula is now called a blastocyst and contains an inner mass of cells called the embryoblast
o The embryo develops from the embryoblast and contains an outer cell layer called the trophoblast.
o The chorion and placenta develop from the trophoblast
• Implantation
o The zygote is propelled by cilia and peristalsis
o Reaches uterine cavity in 3-4 days
o Nidation (implantation into the endometrium) occurs by the 10th day after fertilization
• Placenta
o Provides oxygenation, nutrition, waste elimination, and hormones
o Protects the fetus
• Placental Hormones
o Human Chorionic Gonadotrophin (hCG) maintains the corpus luteum during pregnancy (which produces progesterone)
o Human placental lactogen (hPL) regulates glucose availability for fetus and promotes fetal growth
o Progesterone suppresses maternal immunological response to fetal antigens (preventing fetal rejection)
o Estrogen allows/promotes growth in several ways
• Yolk Sac
o Develops 8 to 9 days after conception
o Essential for transfer of nutrients during second and third weeks of gestation
o Hematopoiesis (formation and development of red blood cells) occurs in the wall of the yolk sac beginning in the third week
o As the pregnancy progresses, the yolk sac atrophies and is incorporated into the umbilical cord
• Umbilical Cord
o Usually located in center off placenta
o 55 cm long (21 inches); 1 to cm in diameter
o Consists of one vein and two arteries
o Wharton’s Jelly is specialized connective that protects the umbilical cord from compression
• Fetal Circulation
o Heart begins to beat and circulate blood by end of third week
o Blood flows through the vein from the placenta to the fetus
o The arterial PO2 of the fetus is about one-fourth of the maternal PO2 because of the structure and function of the placenta
o Low PO2 is important to maintain fetal circulation
• Three Fetal Shunts
o Ductus venosus (bypasses liver):
Some blood circulates through the liver, but most bypasses the liver through the ductus venosus and enters the inferior vena cava.
o Foramen ovale (right atrium open to left atrium, left ventricle open to aorta):
Blood from the superior vena cava enters the right atrium, passes through the foramen ovale, through the right ventricle, and into the aorta supplying blood to the head and upper and lower extremities.
o Ductus arteriosus (bypasses lungs):
Blood returning from the head enters the right atrium and then flows through the right ventricle and into the pulmonary artery. Most of this blood bypasses the lungs through the ductus arteriosus. A small amount of blood flows through the pulmonary circulation, back into the right atrium, right ventricle, and then into the aorta.
• Embryonic Membranes (two)
o Chorion (THICK outer membrane, forms fetal portion of placenta)
o Amnion (THIN inner membrane, contains amniotic fluid)
• Purposes of Amniotic Fluid
o Protects and cushions the fetus
o Maintains normal body temperature
o Allows for symmetrical fetal growth
o Aids in fetal musculoskeletal development by providing freedom of movement
o Prevents the amnion from adhering to the fetus
o Essential for normal fetal lung development
• Amniotic Fluid
o First appears at about 3 weeks.
o 30 mL at 10 weeks and 800 mL at 24 weeks
o Fetal urine and lung secretions primary contributors of the total fluid volume
o Slightly alkaline and contains antibacterial and other protective substances similar to those found in maternal breast milk
• Three Phases of Human Growth and Development
o First Phase – Embryonic Period (conception to week 2)
Rapid cellular multiplication and differentiation
Establishment of embryonic membranes and primary germ layers
o Second Phase – Embryonic Period (week 3-8)
Organogenesis: formation and differentiation of fetal organs (2nd week through the eighth week)
Germ layers: ectoderm, mesoderm endoderm
The embryo's nervous system is particularly vulnerable to environmental insults.
o Third Phase – Fetal Period (week 9 until birth)
Rapid body growth and differentiation of tissues, organs, and systems
Less vulnerable stage
• The Fetal Period
o Weeks 9-12
Ossification centers appear
Intestines leave umbilical cord and enter abdomen
External genitalia by week 12
Urine production begins
o Weeks 13-16
Coordinated movements of limbs
Ossification of skeleton
Ovaries differentiated
o Weeks 17-20
Growth slows
Quickening (flutter movement of baby)
Vernix caseosa (cream cheese cover)
Lanugo (fine hair)
By 20 weeks’ fetus in 300 g and 19 cm
Fetal loss before 20 weeks considered abortion
o Weeks 21-25
Gains weight
Skin pink
Rapid eye movement
Surfactant production begins around 24 weeks (lines alveoli)
o Weeks 26-29
If born, fetus has a good chance of survival
Breathes air
CNS can regulate temperature and direct rhythmic breathing
Eyelids are open
Developing subcutaneous fat
o Weeks 30-34
Pupillary light reflex
Growing in size
o Weeks 35-40
Strong hand grasp
Orientation to light
37 weeks considered full term
38 to 40 weeks: 3000-3800 g and 45-50 cm (17.3 – 19.2 in)
• Threats to Fetal Development
o Chromosomes
o Tetragons (medications, vitamins, alcohol, tobacco, caffeine, drugs, radiation, methyl mercury, and lead)
o TORCH infections
o Maternal age
o Environment
• FDA Pharmaceutical Pregnancy Categories
o Category A – demonstrates no risk
o Category B – animal studies demonstrate no risk but no human studies
o Category C – animal studies demonstrate a risk, but potential benefits may outweigh the risks)
o Category D – human studies demonstrate a risk. Potential benefits may outweigh risks.
o Category X – animal or human studies demonstrate a risk. The risks outweigh the potential benefits.
• TORCH Infections
o Toxoplasmosis
Parasite caused by raw/poorly cooked meat, cat feces, contaminated soil)
Asymptomatic or flu-like symptoms
Can cross placenta membrane
Damages fetal eyes and brain
o Other
Syphilis
Hepatitis B
HIV
Varicella-zoster (chickenpox)
Human parvovirus (B19)
o Rubella (German measles)
Congenital anomalies
Intellectual disabilities
Developmental disabilities
Hearing loss/vision loss
Heart defects
o Cytomegalovirus (CMV)
No S/S in majority
First trimester transmission can result in spontaneous abortion
o Herpes simplex
• Maternal Age (35 and above)
o Increased risk of chromosomal abnormalities
o Trisomy (Down’s Syndrome)
o Deletion
o Translocation
• Maternal Age (Adolescent)
o Adolescent developmental tasks conflict with tasks of pregnancy
o May not seek prenatal care
o Not future oriented
o May not accept reality of unborn child
o Parents may assume role of caregiver
• Multifetal Pregnancies
o Monozygotic
Develop from one zygote
Division occurs at end of first week
o Dizygotic
Develops from two zygotes
Separates amnions and chorions
• Hormonal Influences
o Progesterone (maintenance and acceptance of pregnancy)
Slows GI tract
Increased blood flow to tissues
o Estrogen (growth)
Breast tissue
Stretching of uterine muscles
o Ovarian hormones
Maintain endometrium
Provide nutrition
Aid in implantation
• Uterus
o Estrogen/progesterone help muscles undergo hyperplasia/hypertrophy
o Estrogen causesmuscles to contract
• Braxton-Hicks Contractions
o Irregular, not as painful
o Prepares uterine muscles for labor
o Lasts less than 60 seconds
o Does NOT cause cervical changes
• Cervix
o Chadwick’s sign – bluish purplish hue of cervix, vagina, vulva caused by increased blood flow and engorgement
o Goodell sign – cervical softening
o Operculum – mucus plug helps keep harmful agents out of uterus
o Leukorrhea – whitish discharge
o Call provider if discharge is bloody or yellow/green, has a foul odor, itching, or pain
• Vagina and Vulva
o Thickening of vaginal mucosa
o Rugae deepen
o More susceptible to yeast infections
o pH decreases from 6.0 to 3.5
• Neurological System
o Pregnancy brain
o Carpal tunnel syndrome
o Orthostatic hypotension
o Supine hypotension
o Always turn to left side
• Urinary System
o Urinary urgency, frequency and nocturia
o Increase incidence of UTIs
o UTI can send you into pre-term labor
o Drink lots of water – flush system (8-10 glasses a day)
• Musculoskeletal System
o Waddle gait
o Lumbar lordosis
o Abdominal wall weakens
• Paternal Adaptation
o Couvade – experiences pregnancy related S/S
• Prenatal Assessment
o Presumptive (subjective):
Amenorrhea
Nausea/vomiting
Urinary frequency
Breast tenderness
Striaegravidarum (stretch marks)
Fatigue
Perception of fetal movement
o Probable (objective):
Abdominal enlargement
Piskacek sign (asymmetrical)
Hegar sign (softening uterus)
Goodell’s sign (softening cervix)
Chadwick sign (blueish color)
Braxton-Hicks
Positive pregnancy sign
Ballottement
o Positive (objective):
Fetal heartbeat
Fetal movements
Visualization of fetus
• Pregnancy Classification System
o Gravida (number of times pregnant)
o Parity (number of pregnancies (not babies) carried to viability (generally 24 weeks)
• GTPAL Classifications
o G – gravida (number of pregnancies)
o T – term pregnancies
o P – pre-term pregnancies (less than 37 weeks)
o A – abortions (spontaneous/elective) (less than 20 weeks)
o L – living children
• Estimated date of birth (EDB)
o Naeogale’s rule
o First day of last menstrual period
o Add 7 days
o Subtract 3 months
o Add one year
• Nurses Role
o CAREing for the patient
o C – communicate
o A – advocate
o R – respect
o E – empower women
• Diagnostic tests
o Rh factor, antibody screening
o STIs
o HIV
o Cervical cancer
• Leopold Maneuvers
o First: (fundal grip) used to determine fetal body part that occupies uterine fundus
o Second: (umbilical grip) determine location of fetal spine
o Third: (Pawlick’s grip) determine ballottement or engagement
o Fourth: (pelvic grip) determine location of fetal brow (flexion/extension)
• Fetal Heart Auscultation
o 120 – 160 bpm
o Fetoscope
o Girls have higher HR than boys
• Recommended Pregnancy Weight Gain
o Underweight (<18.5) – 28-40 lbs
o Normal weight (18.5 – 24.9) – 25-35 lbs
o Overweight (35.0 – 29.9) – 15-25 lbs
o Obese (>35.0) – 11-20 lbs
• Eating Disorders with Pregnancy
o PICA – eating weird things
o Anorexia nervosa, bulimia nervosa
• Third trimester complications
o Abruptio placentae(causes fetal hypoxia)
o Gestational diabetes
o Placenta privia
• Childbirth methods
o Lamaze
Empowerment
Dispelling myths
Controlled breathing, position, massage, relaxation
o Bradley
Inward relaxation
Normal breathing
• Rh Factor/Disease
o Antigens (proteins) occurring on the surface of RBC’s
o Rh disease occurs during pregnancy when there is an incompatibility
o Subsequent Rh+ pregnancies cause the memory B lymphocytes to activate immune response and attack the fetal RBC’s
o Can lead to fetal anemia, jaundice, edema, and congestive heart failure
o Mother will receive Rhogam IM at 28 weeks and again within 72 hours after delivery of Rh+ baby
o Rhogam prevents hemolytic disease in future Rh+ pregnancies
• Gestational Hypertension
o New onset after 20 weeks gestation
o BP greater than or equal to 140/90 on at least two occasions in one week
o Transient hypertension – BP returns to baseline within 12 weeks postpartum
o Chronic hypertension – BP does not return to normal within 12 weeks postpartum
• Preeclampsia
o Multi-organ disease process
o Unknown etiology
o Categorized as mild or severe
o Occurs in 6-8% of pregnancies, 10-15% of maternal deaths worldwide are associated with preeclampsia/eclampsia
• Preeclampsia Risk Factors
o Past history/family history of preeclampsia
o First pregnancy
o Diabetes
o Chronic hypertension
o Obesity
o Multiple gestation
o Maternal age >40
• Mild Preeclampsia
o BP 140/90 (two occasions, 6 hours apart)
o Proteinuria +1
o May exhibit edema
o May have transient headaches
• Severe Preeclampsia
o BP 160/100
o Proteinuria +3
o New onset CNS/cerebral/visual disturbances
o Extensive peripheral edema/pulmonary edema
o Hyperreflexia with possible ankle clonus
o Epigastric and/or upper quadrant pain
o Hepatic dysfunction
o Thrombocytopenia
o Oliguria
o Creatinine >1.2 mg/dL
• Epigastric Pain
o Frequently report increased use of antacids
o Likely related to hepatic ischemia
o May be misdiagnosed
• HELLP Syndrome
o Hemolysis, elevated liver enzymes, low platelet count
o Complication of high blood pressure during pregnancy
o Laboratory diagnosis
o S/S usually occur in 3rd trimester or shortly after giving birth
o Flu-like symptoms, vision problems, vision problems, N/V, shoulder pain, and bruising
o Interventions:
Corticosteroids/magnesium sulfate
Induce labor/C-section
• Ectopic Pregnancy
o Implementation outside of uterus
o Risk factors:
History of STIs or pelvic inflammatory disease
Prior ectopic pregnancies
Previous tubal, pelvic, or abdominal surgery
Endometriosis
Current use of exogenous hormones (estrogen, progesterone)
IVF
Use of intrauterine device
o Signs and Symptoms:
Pelvic/abdominal pain
Missed period
Palpable mass
Ruptured: active bleeding, hypotension, tachycardia, vertigo, shoulder pain
o Medical Management:
Surgical removal (salpingectomy/laparoscopy)
Methotrexate
Rhogam
• Gestational Trophoblastic Disease (GTD)
o Also known as hydatidiform mole or molar pregnancy
o Chorionic villi degenerate into a mass of fluid-filled grapelike clusters
o Incidence increases with maternal age
o Must avoid pregnancy for one year
o Concern for malignancy
• Hyperemesis Gravidarum
o Excessive vomiting
o Produces weight loss, dehydration, and hypokalemia
o May be related to increasing HCG or estrogen levels
o Interventions:
Correct dehydration
Correct fluid and electrolyte imbalances
Parenteral nutrition
Anti-emetics (vitamin B6, Reglan, Dramamine)
• Spontaneous Abortion (SAB)
o Pregnancy loss before 20 weeks gestation
o Threatened:
Vaginal bleeding and fetal cardiac activity
No cervical dilation
o Inevitable:
Vaginal bleeding and possible cramping
Cervical dilation
o Incomplete:
Some products if conception pass/some remain in uterus
o Missed:
Fetal death but miscarriage has not yet occurred
o Recurrent
Occurrence of 3 or more SAB’s
Etiology often unknown
• Incomplete Cervix
o Painless dilation & effacement of cervix
o Patient usually reports history of multiple 2nd trimester losses
o Etiology – acquired or congenital
o Management – cervical cerclage
• Cerclage
o Also known as a cervical stitch
o Tocolytics are given to prevent uterine contractions
o Removed around 37 weeks
o Increased risk of infection
• Preterm Labor (PTL)
o Labor that occurs between 20 and 37 weeks
o Severely preterm prior to 33 weeks gestation
o S/S: persistent uterine contractions and cervical changes
o Management:
Tocolytics are temporarily given to delay delivery to administer Betamethasone (corticosteroid) to facilitate lung maturity
• Premature Rupture of Membranes (PROM)
o Rupture of membranes before the onset of labor
o Preterm PROM – rupture of membranes prior to 37 weeks
o Increased risk of infection
o Signs of maternal infection:
Temp >100.4
Foul-smelling vaginal discharge
Elevated WBC’s
Uterine tenderness
Maternal and/or fetal tachycardia
• Placenta Previa
o S/S: painless vaginal bleeding
o Management: stabilization and fetal monitoring
o NO VAGINAL EXAMS
• Abruptio Placentae
o S/S: third-trimester bleeding associated with severe abdominal pain
o Management: monitoring and delivery
• Disseminated Intravascular Coagulation (DIC)
o External or internal bleeding
o Abnormal clumps of thickened blood (clots) form inside blood vessels
o The abnormal clots use up the blood's clotting factors, which can lead to massive bleeding in other places
o Management: indwelling catheter, oxygen, blood products
Medications to know
• Methotrexate
o Treats ectopic pregnancies (non-ruptured <4 cm)
o Stops cells from dividing
• Terbutaline
o Produces bronchodilation
o Helps prevent and slow contractions temporarily in preterm labor
• Betamethasone
o Suppresses inflammation and the normal immune response
o Prevents respiratory distress syndrome in newborn (promotes lung maturity)
• Oxytocin (Pitocin)
o Stimulates uterine smooth muscle
o Induction of labor
o Prevention of postpartum hemorrhage
• Rhogam
o Prevention of antibody response and hemolytic disease of the newborn
o Administered to Rh negative patients who have been exposed to Rh positive blood by pregnancy
• Rubella Vaccine
o Stimulates the immune system to produce antibodies against rubella virus
o Protects against the viral disease rubella
• Magnesium Sulfate
o Anticonvulsant
o Increases seizure threshold
o Reduces incidence of placenta abruption
o ALWAYS piggyback mag sulfate
o Can cause decreased respirations, bradycardia, drowsiness, hypothermia, flushing, sweating, and diarrhea
o Antidote: Calcium Gluconate
Maternal Child Vocab to know
• EDC/EDD
o The estimated date of confinement, also known as expected date of delivery/estimated due date
• Gravida
o Indicates the number of times a woman is or has been pregnant, regardless of the pregnancy outcome. A current pregnancy, if any, is included in this count.
• Parity, or "para"
o Indicates the number of pregnancies reaching viable gestational age (including live births and stillbirths).
• Striae
o Stretch mark
• Braxton Hicks
o Irregular uterine contractions
• Linea Nigra
o Dark vertical line between your belly button and pubic area
• Chadwick’s sign
o Bluish discoloration of the cervix, vagina, and labia resulting from increased blood flow
• Amenorrhea
o The absence of menstruation — one or more missed menstrual periods.
• Hyperemesis Gravidarum
o condition characterized by severe nausea, vomiting, weight loss, and electrolyte disturbance
• Leopold’s maneuver
o Way to determine the position of a fetus inside the woman's uterus
• Colostrum
o The first milk your breasts produce during pregnancy
• Quickening
o The moment in pregnancy when the pregnant woman starts to feel or perceive fetal movements in the uterus
• Lightening
o The baby settles, or drops lower, into the mother's pelvis
• Doppler
o Measures the blood flow through the umbilical cord and around different parts of your baby's body
• Fetoscope
o For listening to fetal heart tones. Fetal tones can be detected as early as 18 weeks
• Amniocentesis
o Used in prenatal diagnosis of chromosomal abnormalities, fetal infections, and also for sex determination. Small amount of amniotic fluid is sampled.
• Maternal Serum Alpha Fetal Protein(MSAFP)
o Test that examines the level of alpha-fetoprotein in the mother’s blood during pregnancy
• hCG
o Human chorionic gonadotropin is a hormone produced by the placenta after implantation
• LMP
o Last menstrual period
• Menarche
o First occurrence of menstruation
• Nagle’s rule
o Predicts an estimated due date based on the onset of the woman's last menstrual period. You simply add on nine months and seven days to arrive at the due date.
• Fundal Height
o A measure of the size of the uterus used to assess fetal growth and development during pregnancy
• Bishop’s Score
o A pre-labor scoring system to assist in predicting whether induction of labor will be required
• Freidman’s Curve
o Graph that obstetric care providers have traditionally used to define a “normal” length and pace of labor
• Effacement
o Also called cervical ripening, refers to a thinning of the cervix
• Station
o This is also called engaged, refers to where the presenting part is in your pelvis
• Leukorrhea
o A whitish or yellowish discharge of mucus from the vagina
• Non-stress Test (NST)
o Also known as fetal heart rate monitoring, is a common prenatal test used to check on a baby's health
• Contraction Stress Test
o Measure the baby's heart rate during uterine contractions
• Biophysical Profile
o Measures your baby's heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around your baby.
• Amniotic Fluid Index
o A quantitative estimate of amniotic fluid and an indicator of fetal well-being. It is a part of the biophysical profile.
• Vertex
o Head-first presentation
• Breech
o Bottom-first presentation
• Corpus Luteum
o Temporary endocrine structure involved in ovulation and early pregnancy, secretes estrogens and progesterone
• Ptyalism
o A condition which causes excess saliva. It frequently affects women in the early stages of pregnancy.
• Pica
o Persistent eating of substances such as dirt or paint that have no nutritional value
• Fetal Fibronectin
o A “glue-like” protein that holds the developing baby in the womb.
• Amnisure
o A test to detect premature rupture of the membranes during premature labor
• Apgars
o Activity, Pulse, Grimace (reflex irritability), Appearance (skin color), Respirations
• Moro reflex
o (or startle reflex) is an involuntary response to excessive sensual stimulus, in which the baby feels like they are falling
• Ballard scale
o The sum of all 12 criteria represents the neuromuscular and physical maturation of the fetus
• Caput
o Swelling of the scalp in a newborn
• Erythema Toxicum
o Common rash in neonates
• Lanugo
o The first hair to be produced by the fetal hair follicles, and it usually appears on the fetus at about 5 months of gestation
• Acrocyanosis
o Bluish or purple coloring of the hands and feet caused by slow circulation
• Meconium
o Large dark, black or greenish-black, thick, tarry, sticky bowel movements that newborn babies have during their first two or three days after birth
• Gastroschisis
o Birth defect of the abdominal (belly) wall. The baby's intestines are found outside of the baby's body, exiting through a hole beside the belly button.
• Anencephaly
o A baby born with an underdeveloped brain and an incomplete skull.
• Omphalocele
o Rare abdominal wall defect in which the intestines, liver, and occasionally other organs remain outside of the abdomen in a sac
• Meningocele
o A protrusion of the meninges through a gap in the spine due to a congenital defect
• Myelomeningocele
o Birth defect in which the backbone and spinal canal do not close before birth
• Bulb syringe
o Nasal aspirator can efficiently remove mucus from the baby's nose
• Necrotizing enterocolitis
o A serious disease that occurs when the intestinal tissue become damaged and begins to die
• Necrotizing osteochondritis
o A joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow
• FOC – Frontal Occipital Circumference (Head Circumference)
o Is measured over the most prominent part on the back of the head (occiput) and just above the eyebrows (supraorbital ridges).Generally measured on infants and children until age three years.
• Torticollis
o A rare condition in which the neck muscles contract, causing the head to twist to one side.
• Involution/subinvolution
o Medical condition in which after childbirth, the uterus does not return to its normal size.
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