G (Gravida): the number of pregnancies

• T (Term): number of infants born at ≥ 37

• P (Preterm): born after 20 weeks but before the completion of 37 weeks.

• A (Abortion): pregnancies ending in either spontaneous or therapeutic abortion before the end of 20 weeks.

• L (Living): number of currently living children.

o Due Date: from the month of their last period add nine months, then add seven days to the first day of their last period.

o Nägele’s Rule: most common method of determining the EDB, which uses 280 days asthe mean length of pregnancy. To use

this method, begin with the first day of LMP, subtract 3 months and add 7 days. For

SIGNS OF PREGNANCY

• Presumptive Changes

Subjective symptoms experienced by the woman. Doesn’t confirm pregnancy.

o Morning sickness

o Excessive fatigue

o Urinary frequency

o Breast changes

o Quickening

• Probable Changes

Objective changes that occurin pregnancy. Doesn’t confirm pregnancy since it could be due to others things

o Goodell’s - Softening of the cervix

o Chadwick’s - Dark violet coloration of cervix

o Hegar’s - Softening of lower part of uterus

o Progressive uterine enlargement

o Enlargement of the abdomen with amenorrhea (no period)

o Braxton-Hicks contractions

o Fetal outline

Ballottement: passive fetal movement elicited when the examiner insertstwo fingersinto the vagina and pushes against the

cervix. This action pushes the fetal body up and asit falls back down, the examiner feels a rebound

o Pregnancy test

• Positive Changes

Diagnostic test that confirm pregnancy

o Fetal heartbeat: detectable by doppler ultrasound

o Fetal movement: detected by echocardiography or transvaginal sonography

o Fetal soufflé: blowing murmur,synchronous with the fetal heartbeat

TRUE VS FALSE LABOR: Many times the only way to tell between true or false isto asses effacement and dilation.

TRUE LABOR:

• Contractions of TRUE LABOR produce progressive DILATION and EFFACEMENT of the Cervix, occur regularly with increase in

frequency, duration and intensity.

• The discomfort of true labor contractions usually startsin the back and radiates around the abdomen. pain is not relieved by

ambulation (walking may actually intensify pain)

FALSE LABOR:

• The contractions of FALSE LABOR DO NOT produce cervical effacement and dilation. They are irregular, and do not increase in

frequency, duration, and intensity, perceived as a hardening or “balling up” without discomfort, or discomfort may occurin the lower

abd. or groin.

• Discomfort may be relieved by ambulation, change position.

SIGNS OF ONSET OF LABOR

• S/S of impending labor

• Lightening (when the fetus beginsto settle into the pelvic inlet (engagement).

• Braxton Hicks Contractions

• Cervical Changes: softening of the cervix is called ripening

• Bloody Show: with softening and effacement of the cervix the mucous plug is often expelled.

• Rupture of Membranes(ROM)

• Sudden Burst of energy (nesting)

• Other signs: weight loss of 1-3 lb resulting from fluid loss, diarrhea, indigestion, or N/V just before the onset of labor.