Ch.

4 Physiological Aspects of Antepartum Care

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Preconception care: defined as a set of interventions that aim

to identify medical, behavioral, and social risks to a woman's
health or pregnancy outcome through prevention and
management. Consist of health promotion, risk screening,
implementation of interventions of childbearing aged women
before pregnancy with the goal of modifying risk factors that
could negatively impact pregnancy.
Papsmear: screening test for cervical cancer
Anticipatory guidance: the provision of information and
guidance to women and their families that enables them to be
knowledgeable and prepared as the progress of pregnancy
and child birth unfolds. includes health maintenance, self-care,
lifestyle choices to contraception and safety behaviors
Body Mass Index: a number calculated based on a persons
height and weight, represents a measure of body fat. Can be
used as an easy method of screening the nutritional status of
women and identifying weight categories that may lead to
health problems.

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First Trimester: First day of LMP through 14 completed weeks

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Second Trimester: 15-18 completed weeks

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Third Trimester: 29-40 completed weeks

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Presumptive Signs: include all subjective signs of pregnancy i.e.

physiological changes perceived by the woman herself.
(nausea, vomiting, amenorrhea, breast changes, fatigue,
frequent urination, quickening)
Quickening: a woman's first awareness of fetal movement,
occurs around 18-20weeks gestation in Primigravidas. 14-16 in
Multigravidae
Positive signs: the objective signs of pregnancy noted by the
examiner that can only be attributed to the fetus. (Auscultation
of fetal HR, observation and palpation of fetal movement by the
examiner after about 20 weeks, sonographic visualization of the
fetus)

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Chadwick's sign: Bluish

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Chadwick's sign: bluish-purple coloration of the vaginal

mucosa, cervix, and vulva seen at 6-8 weeks
Goodell's sign: softening of the cervix and vagina with
increased leukorrhea discharge, palpated at 8 weeks
Hegar's sign: softening of the lower uterine segment, palpated
at 6 weeks
Melasma (chloasma): aslo referred to as the mask of
pregnancy, brownish pigmentation over the forehead, temples,
cheek, upper lip. occurs in 50-70% of women and is more
common in darker skinned women. Usually occurs after 16th
weeks pregnancy and exacerbated by sun exposure.
Linea nigra: dark line that runs from the umbilicus to the pubis
Ballottement: a light tap of the examining finger on the cervix
causes fetus to rise in the amniotic fluid and then rebound to its
original position, occurs at 16-18 weeks

Gestational age: refers to the number of complete weeks of

fetal development, calculated from the first day of the last
normal period.
Term gestation: a birth that occurs after 37 completed weeks
gestation
G/P: two digit system to denote pregnancy and birth history
Gravida: refers to the total number of times a woman has been
pregnant, without reference to how may fetuses there were
with each pregnancy or when the pregnancy ended. it is simply
how many times a woman has been pregnant, including the
current pregnancy.
Para: refers to the number of births after 20weeks gestation
whether live births or stillbirths. There is no reference to the
number of fetuses delivered with this system, so twins count as
1 delivery, just like a singleton birth. A pregnancy that ends
before the end of 20 weeks gestation is considered an Abortion,
whether it is spontaneous or induced and is not counted in the
G/P system.
G: total number of times pregnant

Amenorrhea: Absence of menstruation

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Naegele's Rule: Standard formula for determining an EDD

based on LMP. LMP-3mo+7days

GTPAL: Gravida, Term, Para, Abortion, Living

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probable signs: objective signs of pregnancy and include all

physiological and anatomical changes that can be perceived by
the health care provider: (Chadwicks sign, Goodell's sign,
Hegar's sign, uterine + abdominal growth, sin
yperpigmentation, chloasma, line nigra, allotment, hcG)

Estimated date of birth (EDB): due date aka Estimated

delivery date (EDD)

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Antepartum (antepartal) period: also referred o as the

prenatal period, begins with the first day of LMP and ends with
the onset of labor.

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T: number of tern infants born after 37 completed or 37 6/7

weeks gestation
P: number of preterm infants born between 20-37 completed
weeks gestation or 37 6/7 weeks
A: number of abortions (either spontaneous or indicted) before
20 weeks gestation ( or <500g at birth)

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L: number of children currently living

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GTPALM: M represents pregnancies with multiple gestations

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Nulligravida: a woman who has never been pregnant or given

birth
Primigravida: a woman who is pregnant for the first time.
Multigravida: someone who is pregnant for at lest the 2nd
time.

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Fundus: upper part of uterus

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Isthmus: lower segment of uterus

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Cervix: lower narrow part or neck of uterus, the external part

interfaces with the vagina
Cervical Os: the opening of the cervix that dilates during labor
to allow passage of the fetus through the vagina

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Braxton-Hicks contractions: intermittent, painless, and

physiological uterine contractions. Begin in the 2nd trimester
but some women do not feel them until the 3rd trimester.
Contractions are irregular with no pattern. As the uterus
enlarges, they are more noticeable
Leukorrhea: an increase of vaginal discharge which os
response to the estrogen-induces hypertrophy of the vaginal
glands
Endometrium: the mucous membrane lining the interior of the
uterus. Allows implantation and establishment of pregnancy
Physiological anemia of pregnancy: a relative anemia in mid
to late pregnancy due to physiological hypervolemia without a
correspondingly proportionate increase in erythrocytes in the
maternal system
Hypervolemia of pregnancy: Blood volume increases by 1,500
mL or 40-45% to support uteroplacental demands and
maintenance of pregnancy.
Supine hypotension: hypotension resulting from compression
of the vena cava when a woman lies supine and the gravid
uterus exerts pressure on the inferior vena cava.
Pica: a craving for and consumption of nonfood substances
such as starch and clay. it can result in toxicity due to ingested
substances or malnutrition from replacing nutritious foods with
nonfood subsances
Lordosis: abnormal anterior curvature of the lumbar spine.
The body compensates for the shift in center of gravity by
developing an increased curvature of the spine.
Diastasis recti: the separation of the uterus abdomens muscle
in the midline caused by the abdominal destination. A benign
condition that can occur in the 3rd trimester
Hyperpigmentation: estrogen and Progesterone stimulate
increased melanin deposition of light brown to dark brown
pigmentation
Striae (stretch Marks): stretching of skin due to growth of
breasts, hips, abdomen, and buttocks plus the effects of
estrogen, relaxin, and adrenocorticoids may result in tearing of
subcutaneous connective tissue/collagen.
Prenatal Period: the entire time period during which a woman
is pregnant through the birth of the baby. a time of transition in
the life of a family as they prepare for the birth of a child.
Prenatal Care: health care relating to pregnancy that a woman
receives during the pregnancy and prior to the onset of labor
Family-centered maternity care: a model of obstetrical care
based on a view of pregnancy and childbirth as a normal life
event, a life transition that is not primarily medical but rather
developmental.
Leopold's maneuvers: a series of four maneuvers used to
palpate a gravid uterus to determine fetal position,
presentation and size

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Fetal movement count (Kick Counts): is a maternal

assessment of fetal movement by counting fetal movements in
period of time to identify potentially hypoxic fetuses, The
pregnant woman is instructed to palpate abdomen and track
fetal movements daily by tracking fetal movements for 1-2 hrs.
10 fetal movements in 2hrs is reassuring and counts may be DC
for the day. 4 movements in 1hr is also reasurring.