HESI REVIEW MATERNITY CARE

HESI REVIEW MATERNITY CARE

Fall 2018

Ovarian Cycle

•        Follicular phase (day 1-14)

–    Maturing of the graafian follicle

–    1^st FSH, then add EST, PRG, then add LH

•        Ovulation

–    Rupture of the follicle, releasing ovum

–    Changes in EST, PRG

•        Luteal Phase (day 15-28)

–    Ovum is either fertilized or not

–    Either hCG, if fertilized or not, then FSH, LH

Endometrial Cycle

•        Menstrual Phase

–   Menstrual flow

–   𝖳 FSH

•        Proliferative Phase

–   Endometrium increases, mucous changes

– 𝖳 EST

•        Secretory Phase

–   Cellular growth, getting ready for implantation

– 𝖳 PRG

•        Ischemic Phase

–   If no fertilization, necrosis of endometrial lining

–   ¯ EST, PRG    𝖳 LH

–   If fertilization/pregnancy, then EST and PRG stay high and hCG begins to be made and cycle stops

Hormones

•      FSH: Follicle Stimulating (causes period and egg to grow)

•      LH: Luteinizing Hormone (causes ovulation)

•      hCG: supports pregnancy (preg test measures)

•      Progesterone: supports pregnancy, inhibits menstrual hormones

•      Estrogen: supports pregnancy

•    Hcg, Pro, Est: made in corpus luteum, then placenta after 12 weeks

•      Prolactin: prepares body for lactation

•      Relaxin: relaxes ligaments

Signs of Pregnancy

•       Presumptive signs:

–   Amenorrhea, N/V, Breasts, voiding, fatigue

•       Probable signs:

–   Abd enlargement, Uterine enlargement, Cervical Δ’s (Goodell, Hegar, Chadwicks,)

+ hCG pregnancy test

•       Positive Signs:

–   Fetal heart tones or movement by HCP

–   Positive confirmation of pregnancy on u/s

Pregnancy Check Ups

•        HgB (>11) and Hct (>33), WBC, PLT should be normal

•        HIV, Hep, PPD, Blood type and Rh factor

•        Test for Chlamydia and Gonorrhea

•      TORCH: Toxoplasmosis, Other: Syphilis, Rubella, Cytomegalovirus, HSV