QUIZ MATERIAL

1. What hormone is responsible for maintaining pregnancy?

a. Progesterone
2. What hormone is responsible for producing a calming effect during pregnancy?
a. Progesterone
3. What are the presumptive signs of pregnancy?
a. Amenorrhea
i. The cessation of menses
b. Nausea
c. Breast tenderness
d. Deepening pigmentation
e. Urinary frequency
f. Quickening
i. Fetal movement felt by the mother
4. What are the probable signs of pregnancy?
a. Goodells sign
i. Softening of the cervix and the vagina cause by increased vascular
congestion
b. Chadwicks sign
i. The purplish or bluish discoloration of the cervix, vagina, and vulva cause
by increased vascular congestion
c. Hegars sign
i. Softening of the lower uterine segment
d. McDonalds sign
i. The ability to flex the body of the uterus against the cervix
e. Abdominal enlargement
f. Braxton Hicks contractions
i. Irregular, painless uterine contractions that begin in the second trimester
g. Ballottement
i. Maneuver by which the fetal part is displaced by the light tap of the
examining finger on the cervix and then rebounds quicly
h. Striae
i. Stretch marks
i. Positive pregnancy test
5. What are the positive signs of pregnancy?
a. Audible fetal heartbeat
b. Fetal movement felt by examiner
c. Ultrasound visualization of fetus
6. What are the physiological and psychosocial adaptations to pregnancy for the Mother and
Father?
a. Mother
i. First Trimester
1. Pain and tingling in breasts
2. Nausea and vomiting (morning sickness)
3. Urinary frequency

4. Fatigue
5. Mood swings
ii. Second Trimester
1. Enlargement of the abdomen
2. Skin pigmentation
3. Striae gravidarum
4. Vascular spiders
5. Constipation
6. Heartburn or gastric reflux
7. Leg cramps
8. Groin pain from round ligament stretching
9. Leukorrhea
iii. Third Trimester
1. Dyspnea
2. Leg and feet cramps
3. Constipation
4. Indigestion, heartburn, gastric reflux
5. Pedal edema
6. Fatigue
7. Vaginal discharge
8. Urinary frequency
9. Braxton-Hicks contractions versus True labor
iv. Changes in emotional responses
v. Monetary adjustments
vi. Adjust to transitions in relationships
7. What laboratory values are ordered during each trimester of pregnancy?
a. First Trimester (Routine)
i. Blood type and Rh factor and antibody screen
1. Determines risk for maternal-fetal blood incompatibility
ii. Complete blood count (CBC)
1. Detects anemia, infection, or cell abnormalities
iii. Hemoglobin or hematocrit
1. Detects anemia
iv. VDRL or rapid plasma regain (RPR)
1. Syphilis screen mandated by law
v. Rubella titer
1. Determines immunity to rubella
vi. Tuberculosis screening PPD skin test or serum blood test (QuantiFERONTB Gold)
1. Screening test for exposure to tuberculosis
vii. Hepatitis B screen
1. Identifies carriers of hepatitis B
viii. Human immunodeficiency virus (HIV) screen
1. Detects HIV infection
ix. Urinalysis and culture
1. Detects infection, renal disease, or diabetes

x. Papanicolaou (Pap) test

1. Screens for cervical cancer
xi. Cervical culture
1. Detects group B streptococci or sexually transmitted infections
such as gonorrhea, chlamydia
b. First Trimester (If Indicated)
i. Hemoglobin electrophoresis
1. Identifies presence of sickle cell trait or disease
ii. Endovaginal ultrasound
1. Performed when high risk of fetal loss is suspected
c. Second Trimester (Routine)
i. Blood glucose screen: sample drawn 1 hour after 50 g of liquid glucose is
ingested
1. Routine test done at 24-28 weeks of gestation to identify
gestational diabetes; results above 135 mg/dL necessitate medical
follow-up
ii. Serum alpha-fetoprotein
1. Optional routine test to identify neural tube or chromosomal defect
in fetus
iii. Ultrasonography
1. Optional noninvasive routime test to identigy some anomalies and
confirm EDD
d. Second Trimester (If Indicated)
i. Aminocentesis
1. Performed at 16-20 weeks of gestation when high-risk problem is
suspected
e. Third Trimester (If Indicated)
i. Real-time ultrasonography
1. Performed when problem is suspected
8. What is important to remember in regards to nutrition and pregnancy?
a. An adequate dietary intake of docosahexaenoic acid-omega 3 fatty acid (DHA) is
essential for optimal brain development of the fetus and infant.
i. Fish (mackerel, Atlantic and sockeye salmon, halibut, tuna, and flounder)
ii. Egg yolk
iii. Red meat
iv. Poultry
v. Canola oil
vi. Soybean oil
b. Appropriate weight gain during pregnancy varies
i. Normal-weight women: 25 to 35 pounds
1. Normal-weight women carrying twins: 37 to 54 pounds
ii. Underweight women: 28 to 40 pounds
iii. Overweight women: 11 to 25 pounds
1. Overweight women carrying twins: 31 to 50 pounds
iv. Obese women: 11 to 20 pounds
1. Obese women carrying twins: 25 to 42 twins

c. A calorie increase of about 300 kcal/day is recommended.

d. Four nutrients are especially important in pregnancy.
i. Protein
1. Necessary for metabolism and to support the growth and repair of
maternal and fetal tissues.
2. Recommended intake of protein is around 60 g/day during
pregnancy.
3. Beans, lentils, legumes, breads and cereals, seeds and nuts
ii. Calcium
1. 1,200 mg of calcium is recommended for pregnant women.
2. Cereals, legumes, nuts, dried fruits, broccoli, green leafy
vegetables, and canned salmon
iii. Iron
1. There is a heavy demand for iron is because the fetus must store an
adequate supply to meet the needs in the first 3 to 6 months after
birth.
2. The pregnant woman increases erythrocyte production.
3. 30 mg/day of iron is recommended for pregnant women.
4. Most health care providers prescribe iron supplements.
5. Red and organ meats, molasses, whole grains, iron-fortified cereals
and breads, dried fruits, and dark-green, leafy vegetables
iv. Folic acid
1. Folic acid is essential for the formation and maturation of both red
and white blood cells in bone marrow, as well as reduce the
incidence of neural tube defects such as spina bifida and
anencephaly.
2. 0.4 mg/day of folic acid is recommended for pregnant women.
3. Liver, lean beef, kidney and lima beans, dried beans, potatoes,
whole-wheat bread, peanuts, and fresh, dark-green, leafy
vegetables
9. What is Leopolds Maneuver?
a. Four-part clinical assessment method
i. First maneuver
1. Determines which fetal body part occupies the uterine fundus
ii. Second maneuver
1. Determines the location of the fetal back or spine
iii. Third maneuver
1. Compares the fetal part in the fundal region with the part in the
lower uterine segment, primarily to confirm that the fetus is in a
cephalic presentation
iv. Fourth maneuver
1. Determines if engagement has occurred or not
b. Used to determine the lie, presentation, and position of the fetus
10. What is the importance of prenatal classes?
a. Promotes a positive childbearing experience
b. Familiarizes them with hospital routines

c.
d.
e.
f.

Prepares them for a natural, nonmedicated birth

Teaches them breathing patterns and distraction techniques
Gives the partner the skills necessary to be an active and informed labor coach
Teach the couple as parents to be childbirth consumers and to take responsibility
for their childs birth
g. Follow current medical polices
h. Represent the most common type of childbirth education class in their area
i. Teach relaxation and natural breathing
j. Stress good nutrition and exercise
k. Discuss medication options without making value judgements
11. What is a doula?
a. A doula is a labor coach.
b. A person whose only ob is to support and encourage the woman in the task of
giving birth.