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Maternal weight gain - ✔✔Healthy weight BMI: 25 to 35 lb 1st trimester: 3.5 to 5 lb 2nd & 3rd trimesters: 1 lb/week BMI < 19.8: 28 to 40 lb 1st trimester: 5 lb 2nd & 3rd trimesters: 1+ lb/week BMI > 25: 15 to 25 lb 1st trimester: 2 lb 2nd & 3rd trimesters: 2/3 lb/week McDonald's rule - ✔✔take the tape measurer from the symphysis pubis to the top of the fundus. the measurement should match the number of weeks you are, within 2-4 wks after 24 wks gestation Nutrition in pregnancy - ✔✔-energy and nutrient needs are high during pregnancy, additional 300-450 calories/day -a balanced diet that includes an *extra serving from each food group* can usually meet a woman's increased needs -a balanced diet and appropriate weight gain can help keep mother and baby healthy foods to avoid while pregnant - ✔✔- raw eggs - unpasteurized milk + cheese - soft cheese (feta, brie, Camembert, queso fresco) - unwashed fruits / veggies - raw fish / shellfish
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Maternal weight gain - ✔✔Healthy weight BMI: 25 to 35 lb 1st trimester: 3.5 to 5 lb 2nd & 3rd trimesters: 1 lb/week BMI < 19.8: 28 to 40 lb 1st trimester: 5 lb 2nd & 3rd trimesters: 1+ lb/week BMI > 25: 15 to 25 lb 1st trimester: 2 lb 2nd & 3rd trimesters: 2/3 lb/week McDonald's rule - ✔✔take the tape measurer from the symphysis pubis to the top of the fundus. the measurement should match the number of weeks you are, within 2-4 wks after 24 wks gestation Nutrition in pregnancy - ✔✔-energy and nutrient needs are high during pregnancy, additional 300- 450 calories/day
Para (parady): # of live births at or after 20wks can be broken down into: T=term P=preterm A=abortion L=living WOMAN HAS TWO KIDS, ONE ABORTION, AND IS CURRENTLY PREGNANT: G4P or G4T2P0A1L Physiologic changes in pregnancy - ✔✔Increased: estrogen/progesterone need for glucose relaixin (softening of joints) blood volume 40% Increased cardiac output Increased heart rate Decreased blood pressure (slightly) UTI acid pH of vagina O2 consumption and respiratory rate, respiratory alkalosis melanin Hemodynamic changes in pregnancy - ✔✔total blood volume increases up to 50%. Can lead to hemodilution and physiologic anemia functions to: meet demands of enlarged uterus, protect against impaired venous return safegaurd against effects of blood loss at delivery
Cardiac output during pregnancy - ✔✔HRxSV= CO increases during pregnancy HR typically up by 10-15 BPM Peaks immediately post delivery which can result in cardiovascular instability can cause EKG changes bP typically falls until mid-pregnancy returns to pre-pregnant baseline by term - vascular resistance decreases during pregnancy fetal circulation - ✔✔oxygenated, nutrient-rich blood from placenta carried to fetus via umbilical vein → half enters Ductus venosus (allows blood to bypass the liver) →carried to inferior vena cava → RA → RV → Ductus arteriosus (conducts some blood from the pulmonary artery to the aorta [bypassing the lungs/fetal pulmonary circulation]) → aorta. Other half enters liver/portal vein → RA → Foramen ovale (allows blood to bypass pulmonary circulation by entering the left atria directly from the right atria since there is no gas exchange in fetal lung) → LA → LV → aorta. Placental Abnormalities - ✔✔- placenta previa
sterile pH=7.0-7.5, nitrazine test for pH ferning amniotic fluid volume - ✔✔production - fetal urine is primary source, 400-1200mL/day. secondary source is fetal lungs 300-400mL/day. 200 - 500mL is reabsorbed daily through fetal swallowing increases from 250- 800 between 16 and 32 weeks. estimated by AFI =>6cm-<=20cm is normal oligohydramnios - ✔✔too little amniotic fluid AFI< can cause growth abnormalities caused by: infection kidney dysfunction PROM polyhydramnios - ✔✔excessive amniotic fluid AFI> caused by:Maternal DM, Rh isoimmunization GI or renal disorders spinal deformities