Maternal and Fetal Health Lecture Notes

Key Abbreviations

• IUP/IUFD: Intrauterine pregnancy/intrauterine fetal demise
• SAB: Spontaneous abortion
• TAB: Therapeutic abortion
• LMP: Last menstrual period
• ROM: Rupture of membranes
• SROM: Spontaneous rupture of membranes
• AROM: Artificial rupture of membranes
• PROM: Prolonged rupture of membranes (>24 hours)
• PPROM: Preterm premature rupture of membranes
• SVD: Spontaneous vaginal delivery
• FHR: Fetal heart rate
• EFM: Electronic fetal monitoring
• NST/CST: Non-stress test/Contraction stress test
• BPP: Biophysical profile
• VBAC: Vaginal birth after cesarean
• PTL: Preterm labor

Pregnancy Duration and Stages

• Gestational Age: 40 weeks from LMP
• Fetal Age: Typically 2 weeks less than gestational age
• Trimesters:
  • First: 0-13 weeks
  • Second: 14-26 weeks
  • Third: 27-40 weeks
• Term Categories:
  • Preterm: Before 37 weeks
  • Early Term: 37-38 6/7 weeks
  • Full Term: 39-40 6/7 weeks
  • Late Term: 41-41 6/7 weeks
  • Postdate/Postterm: Beyond 42 weeks

Gravidity and Parity (GTPAL System)

• Gravidity (G): Total number of pregnancies
• Term Births (T): Births after 37 weeks
• Preterm Births (P): Births between 20-37 weeks
• Abortions/Miscarriages (A): Before 20 weeks
• Living Children (L)

Pregnancy Signs

• Presumptive Signs: Ammenorrhea, fatigue, breast changes, quickening
• Probable Signs: Positive pregnancy test, uterine changes
• Positive Signs: Fetal movement, heart tones, ultrasound

Pregnancy Physiology

• Hormones:
  • Prolactin: Milk production
  • Estrogen: Growth of fetal organs
  • Progesterone: Muscles relaxation
• System Changes:
  • Cardiovascular: BP stable, CO increased
  • Respiratory: Increased BMR, mild alkalosis
  • Renal: Increased GFR, risk of UTIs
  • Musculoskeletal: Lordosis, back pain
  • GI: Heartburn, constipation
  • Hematological: Hypercoagulability

Naegele's Rule for EDD Calculation

• Formula: Last Menstrual Period - 3 months + 7 days + 1 year

Stages of Labor

• Stage 1: Cervix dilation
• Stage 2: Delivery of baby
• Stage 3: Delivery of placenta
• Stage 4: Recovery

True vs. False Labor

• True Labor: Regular contractions, cervix changes
• False Labor: Irregular, no cervix change

Fetal Heart Rate Monitoring

• Normal: 120-160 BPM
• Decelerations:
  • Early: Head compression
  • Variable: Cord compression
  • Late: Uteroplacental insufficiency

Hypertensive Disorders in Pregnancy

• Chronic HTN: Before 20 weeks
• Gestational HTN: After 20 weeks
• Preeclampsia: HTN with systemic effects
• HELLP Syndrome: Hemolysis, elevated liver enzymes

Postpartum Assessment (BUBBLES)

• Breasts: Soreness, lactation
• Uterus: Involution check
• Bladder: Monitoring for retention
• Bowels: Prevent constipation
• Lochia: Post-delivery discharge
• Emotional Status: Monitor for postpartum depression

Postpartum Hemorrhage

• Definition: Loss >500 ml (vaginal) or >1000 ml (cesarean)
• Drugs for Treatment:
  • Oxytocin, Methylergonovine, Hemabate, Misoprostol

Note

• Always factor in social support, past experiences, and knowledge during labor and delivery for psychological well-being.

This compilation provides essential highlights and foundational understanding for managing maternal and fetal health. Always refer to up-to-date clinical guidelines and protocols in practice.