COMMON TERMS USED IN MATERNITY NURSING

1. Gestation - pregnancy or maternal condition of having a developing fetus in the body.

2. Embryo - human conceptus up to the 10th week of gestation (8th week post conception).
3. Fetus - human conceptus from 10th week of gestation (8th week post conception)
until delivery.
4. Viability - capability of living, usually accepted as 24 weeks, although survival is rare.
5. Gravida (G) - woman who is or has been pregnant, regardless of pregnancy outcome.
6. Nulligravida - woman who is not now and never has been pregnant.
7. Primigravida - woman pregnant for the first time.
8. Multigravida - woman who has been pregnant more than once. Note: Twins or
triplets counted as 1 para.
9. Para (P) - refers to past pregnancies that have reached viability.
10. Nullipara - woman who has never completed a pregnancy to the period of viability.
The woman may or may not have experienced an abortion.
11. Primipara - woman who has completed one pregnancy to the period of viability
regardless of the number of infants delivered and regardless of the infant
being live or stillborn.
12. Multipara - woman who has completed two or more pregnancies to the stage of viability.
13. Living children - refers to the number of children a woman has delivered who are living.

❖ A woman who is pregnant for the first time is a primigravida and is described as
Gravida 1 Para 0 (or G1P0).
❖ A woman who delivered one fetus carried to the period of viability and who is
pregnant again is described as Gravida 2, Para 1. A woman with two
pregnancies ending in abortions and no viable children is Gravida 2, Para 0.

OBSTETRIC HISTORY
TPAL
T - represents full-term deliveries, 37 completed weeks or more.
P - represents preterm deliveries, 20 to less than 37 completed weeks.
A - represents abortions, elective or spontaneous loss (miscarriage) of a pregnancy before
the period of viability.
L - represents the number of children living. If a child has died, further explanation is
needed for clarification.

❖ 7-5-0-2-5, pregnant seven times, had five term deliveries, zero preterm
deliveries, two abortions, and five living children.

GTPALM

o G - represents gravida.
o T - represents full-term deliveries, 37 completed weeks or more.
o P - represents preterm deliveries, 20 to less than 37 completed weeks.
o A - represents abortions, elective or spontaneous loss of a pregnancy before the
period of viability.
o L - represents the number of children living. If a child has died, further explanation is
needed for clarification.
o M - represents the number of multiple gestations and births (not the number of
neonates delivered).
▪ 5-5-0-0-6-1, pregnant five times, had five term deliveries, zero preterm
deliveries, zero abortions, six living children, and one multiple gestation/birth.
CARE OF THE MOTHER
1. ASSESSMENT
A. Initial Prenatal Visit
Health History
o Current pregnancy history
o History of previous pregnancy
o Gynecologic history
o Current medical history-
o Medical history
o Family medical history
o Occupational history
o History of the baby’s father
o Personal Information

Determination of Estimated date of delivery (EDD) or Estimated date of

confinement (EDC)
The average length of pregnancy is 280 days (40 weeks, 10 lunar months or 9 calendar
months) as calculated from the first day of the last menstrual period (LMP).

Nagele’s Rule: -3 calendar months and +7 days

Ex. LMP= May 15, 2020
LMP: 5 15
Formula: - 3 + 7
EDC: 2 22 or February 22, 2021

Age of Gestation (AOG):

1. McDonald’s Rule: Height of fundus/4 (AOG wks)
▪ Measure in cm the length from the symphysis to the
level of fundus
▪ Lunar months: Fundal Height (cm) x 2/7
▪ Weeks of pregnancy: Fundal height (cm) x 8 then
divide by 7
Ex. Fundal Height = 14 cm
Lunar Month: 14cms x 2 = 28 / 7 = 4 months
Weeks Pregnant: 14 cm x 8 = 112 / 7 = 16
weeks AOG

2. Bartholomew’s Rule: based on position of fundus in

abdominal cavity
3rd month = above symphysis
5th month = umbilical level
9th month = below xiphoid process)
 Assessment of Risk Factors in the Prenatal Period

a. Age of Pregnant Women

17 below: Have a higher incidence of
1. Prematurity
2. Pregnancy Induced Hypertension
3. Cephalopelvic Disproportion
Women over 35 years old are at Risk for:
1. Chromosomal Disorders in infants
2. PIH
3. Cesarean Delivery

b. Infections: Use TORCH

T - Toxoplasmosis
O - Other infections
R - Rubella (German measles)
C - Cytomegalovirus
H - Herpes simplex

A. Physical Examination
o Pelvic size for adequacy-Pelvimetry
o Inspection and palpation of breast for normal and questionable
changes of pregnancy.
Laboratory and diagnostic tests
o Urinalysis (UA)
o Blood test- CBC to determine hemoglobin and hematocrit levels.
o Blood type, RH factor and presence of antibodies to blood group
antigen.
o Blood glucose/sugar
o Others.
Evaluation of Fetal well-being.
o Fetal Activity/movement
▪ can be felt by the mother at 18-20th weeks of pregnancy and
peaks at 28-38th weeks.
▪ Sandovsky method: lie in a left recumbent position after meal.
▪ Moves twice every 10 minutes or an average of 10-12 times an
hour.
▪ Less than 10 movements: repeat the test after 1 hour.
▪ 2 hours = 10 movements: REPORT
▪ “Count-to-Ten” (Cardiff method): 10 movements = 60minutes.
o FHR
▪ Fetal heart beats at 120 – 160 beats/minute
▪ Fetal heart sounds at 10th to 11th week by Doppler
▪ Rhythm Strip Testing
▪ Placed in a semi-fowlers position, external fetal heart rate and
uterine contraction monitors are attached abdominally
▪ Recorded for 20 minutes

o Ultrasound
▪ Diagnose pregnancy by visualizing gestational sac as early as
week 4
▪ Date pregnancy by evaluating size or volume of gestational sac
and crown to rump length (CRL)
 ▪ Detect multiple gestation
▪ Monitor fetal growth
▪ Evaluate fetal structure and function: fetal movement, presence
of structural anomalies
▪ Estimate amniotic fluid volume
▪ Evaluate placental and efficiency of function
▪ Facilitate safe performance of other antepartal tests by locating
essential structures.

o Fetoscopy
▪ Fetus is visualized by inspection through a fetoscope;
photograph can be taken.
▪ Purposes: confirm the intactness of the spinal column and obtain
biopsy samples of fetal tissue and fetal blood samples.

o Electronic fetal heart monitoring

▪ Nonstress Test
o To determine the response of the fetal heart rate to the stress to
activity
o Indications: pregnancies at risk for placental insufficiency
1. Postmaturity
2. PIH, DM
3. Maternal history of smoking, inadequate nutrition

▪ Contraction Stress Test

o Contractions were initiated by the intravenous infusion of
oxytocin.
o Difficult to stop and led to preterm labor
o Nipple stimulation: releases oxytocin
o Protocol: Begin testing at 32 weeks gestation

o Amniocentesis
▪ Aspiration of amniotic fluid : done at around 12-14weeks.
▪ Purpose – obtain a sample of amniotic fluid by inserting a
needle through the abdomen into the amniotic sac; fluid is
tested for:
▪ Genetic screening
▪ Chorionic Villus Sampling
o Percutaneous umbilical blood sampling
▪ Also called cordocentesis or funicentesis : aspiration of blood
from the umbilical vein for analysis.
o others

A. Subsequent Prenatal Assessment

History and Physical Assessment
o Vital signs
o Weight gain (distribution per trimester)
o Presence of edema
o Uterine size (fundeic height)
o FHT
o urine for protein and glucose
o danger signals
o signs of impending labor
 Psychosocial Assessment
o Sexual activity
o Preparation for parenting
o Preparation for childbirth, and signs of labor

Nutritional Assessment

o Dietary intake of iron and iron supplement

o Weight gain- 24-30 lbs total weight gain
o First Trimester 1.5 to 3 lbs normal weight gain
o Second and Third trimester 10 – 11 lbs per trimester is recommended
o Total allowable weight gain during throughout pregnancy is 24 – 30 lbs or
10 –14 kgs.
o Pattern of weight gain is more important than the amount of weight gained.
o Nondietary factors affecting weight gain include increased BP and excess fluid
retention.

B. Assessment of Minor Discomforts of Pregnancy

Symptoms of discomfort due to pregnancy vary from woman to woman. The

following are some common discomforts. However, each mother-to-be may
experience symptoms differently or not at all:
o Nausea and vomiting.
o Fatigue
o Hemorrhoids
o Varicose veins.
o Heartburn and indigestion
o Bleeding gums
o Pica (the practice of craving substances with little or no
nutritional value)
o Swelling or fluid retention
o Skin changes
o Stretch marks
o Yeast infections
o Congested or bloody nose.
o Constipation
o Dizziness
o Headaches

Danger Signals of Pregnancy

1. Vaginal bleeding (any amount)
2. Swelling of face or fingers
3. Severe, continuous headache
4. Dimness or blurring of vision
5. Flashes of light or dots before eyes
6. Pain in the abdomen
7. Persistent vomiting
8. Chills and fever
 9. Sudden escape of fluids from the vagina
10. Absence of FHT after they have been initially heard on 4th or 5th month

3. NURSING DIAGNOSIS
1. Health-seeking behaviors related to learning more about the minor
discomforts of early pregnancy such as morning nausea
2. Altered nutrition: less than body requirements related to prolonged vomiting.
3. Altered nutrition: more than body requirements
4. Knowledge deficit
5. Altered role performance
6. Disturbed sleep pattern related to frequent need to empty bladder during night
7. Disturbed body image related to breast and abdominal enlargement in pregnancy
8. Risk for deficient fluid volume related to vomiting secondary to hyperemesis
gravidarum.
9. Health-seeking behaviors related to interest in using herbal remedies to
relieve discomforts of pregnancy
10. Constipation related to reduced peristalsis in pregnancy
11. Fatigue related to increased physiologic need for sleep and rest during pregnancy
12. Acute pain related to frequent muscle cramps secondary to physiologic
changes of pregnancy
4. PLANNING
a. The woman will have a complication-free pregnancy
b. The woman will achieve adequate nutritional status and fluid intake
c. The woman will learn how to relieve common discomforts of pregnancy
d. The woman and her partner will achieve a positive psychosocial adjustment
toward the pregnancy

5. INTERVENTIONS/IMPLEMENTATION
a. Stress the importance of regular prenatal appointments to detect prenatal
complications and to assess fetal growth and development.
▪ Explain prenatal testing to the woman and partner
▪ Prepare the woman and partner for prenatal testing.
▪ Teach the woman about danger signals of pregnancy.
b. Promote an adequate nutritional status and fluid intake.
▪ Stress well-balanced diet
▪ Explain the importance of increasing fluid intake, to prevent UTI and
improve kidney function.
c. Provide client teaching about ways to relieve the common discomforts of
pregnancy.
d. Promote positive psychosocial adjustment to pregnancy.
▪ Discuss sexual concerns with the client and partner as appropriate;
include reasons for altered libido (increased or decreased).
▪ Provide information concerning parenting, sibling and encourage to
attend mother’s class.

6. EXPECTED OUTCOME /EVALUATION

o The woman exhibits no signs of complications, and fetal growth and
development is normal.
 o Maternal weight gain, nutritional status and fluid intake are within normal limits
o The woman reports increased comfort
o The woman and her partner demonstrate a positive psychosocial
adjustment to pregnancy.

7. DOCUMENTATION
▪ Record all data observed and gathered.
▪ Carry out doctor’s orders/prescription
▪ Documents nursing management rendered including medications given.

Example of Nursing Care Plan (NCP)

Assessment Nursing Planning Intervention Rationale (of Expected

Diagnosis intervention Outcome/Evaluation

Encourage verbalization To become aware The woman and her

Subjective: Altered role After 4 hours of sexual concerns with about sexuality partner demonstrate a
“Hindi pa ako performance of nursing the client and partner as while pregnant positive psychosocial
handa related to intervention, appropriate; include adjustment to
magkababy,” as pregnancy the woman reasons for altered libido pregnancy.
verbalized by the and her (increased or
mother partner will decreased).
demonstrate
Objective: positive Provide information To increase
Covering her face psychosocial concerning parenting, knowledge about
Teary-eyed adjustment sibling and encourage to parenting.
smiling toward attend mothers class.
pregnancy
VS a. p
BP= 100/70mmHg s
PR= 90 bpm y
RR= 30 cpm c