Normal Pregnancy: Physiologic & Psychological Changes - Memory Anchors
Memory anchors are not just tricks — they are your brain's shortcuts. Research in cognitive science shows that emotionally vivid, story-driven, and image-based memories are stored more deeply in the brain than plain facts. For the NLE, where you must recall dozens of signs, milestones, and clinical values under pressure, a strong memory anchor can mean the difference between a confident correct answer and a frustrating blank. This collection uses mnemonics, analogies, micro-stories, visual maps, and rhymes designed for Filipino nursing graduates — rooted in clinical accuracy and spiced with cultural familiarity. Study each anchor, rehearse the recall trigger, and watch your retention soar.
Memory anchors
Three categories of pregnancy signs: Presumptive, Probable, Positive
Memory aid
Think of a DETECTIVE solving a pregnancy case. First she has a HUNCH (Presumptive — she suspects it). Then she finds CLUES (Probable — her examiner observes signs). Finally she gets the CONFESSION (Positive — absolute proof). The 3 Ps: Hunch → Clues → Confession. Or use the acronym PPP: 'Parang Pregnant, Probably Pregnant, Positively Pregnant!'
Why it works
The detective story gives a narrative frame to an abstract classification, and the Filipino phrase 'Parang Pregnant' makes it personally relatable and humorous — humor boosts memory encoding.
Example usage
Question: 'A positive pregnancy test is classified as what sign?' Trigger PPP — a positive HCG test is a CLUE (Probable), not the final CONFESSION (Positive). Answer: Probable sign.
Recall trigger
Think: 'Parang, Probably, Positively' — like a detective building a case
Probable signs: Goodell's, Hegar's, Chadwick's — what each refers to
Memory aid
Use the body order from bottom to top and the phrase: 'Good Hips, Cute Vagina' — Goodell's = Cervix softens, Hegar's = isthmus (lower uterine segment) softens, Chadwick's = bluish-violet Colour of cervix/vagina. OR match them alphabetically to body parts: C comes before H and G in importance but think: CHAD turns BLUE (Chadwick = Blue), HEGAR is LOW (lower segment softens), GOOD CERVIX (Goodell = cervix). Vivid image: Imagine Chad, the boyfriend, turning blue with shock when he sees the soft cervix on an exam — 'Hega! (Higa! — Filipino for 'lie down') the lower part is soft!'
Why it works
Combining a Filipino exclamation (Higa!) with a visual of a character named Chad turning blue creates a dual encoding (verbal + visual) that dramatically improves recall of all three signs at once.
Example usage
Question: 'Softening of the lower uterine segment is called?' Trigger: HEGAR says HIGA — it refers to the lower part (isthmus). Answer: Hegar's sign.
Recall trigger
CHAD turns BLUE, HEGAR says HIGA (it's low), GOODELL checks the CERVIX
Positive (diagnostic) signs of pregnancy — only THREE
Memory aid
The three absolute proofs spell FEV: F — Fetal Heart Tones heard by examiner; E — Examiner feels fetal movement; V — Visualization of fetus on ultrasound. Remember: 'FEV is the FEVER of certainty — once you have FEV, you KNOW she's pregnant!' FEV = Fetal sounds, Examiner touch, Visual proof.
Why it works
A three-letter acronym is easy to encode, and the 'fever of certainty' metaphor makes it emotionally charged — certainty feels like a fever-level intensity.
Example usage
Question: 'Which finding CONFIRMS pregnancy?' Look for one of the FEV trio: FHT heard, Examiner feels movement, or Visualization on ultrasound. A pregnancy test alone is NOT in FEV — it is probable.
Recall trigger
FEV — the three fevers of confirmation
Naegele's Rule: LMP − 3 months + 7 days + 1 year = EDD
Memory aid
Sing to the tune of a simple counting song: 'Take the first day of your last period, MINUS 3 months back, ADD 7 days forward, then bump the YEAR on track!' OR use the phrase: 'SUBTRACT 3, ADD 7, go to HEAVEN (next year).' Imagine the baby is doing math: she goes back 3 months in time, then forward 7 days, then jumps one year into the future — that is her birthday.
Why it works
Rhyme and rhythm use the brain's musical memory system (cerebellar-procedural memory), making sequences far easier to recall under exam pressure.
Example usage
LMP = 10 August 2025 → subtract 3 months = 10 May → add 7 days = 17 May → next year = 17 May 2026. EDD = May 17, 2026.
Recall trigger
Subtract 3, Add 7, go to Heaven (next year)
Fundal height landmarks: symphysis pubis ~12 wks, umbilicus ~20 wks, xiphoid ~36 wks
Memory aid
Imagine the uterus as a slowly rising SAN MIGUEL BOTTLE being filled: at 12 weeks, the foam just reaches the BOTTLE NECK (symphysis pubis — base of the pelvis). At 20 weeks, the liquid is at the MIDDLE LABEL (navel/umbilicus). At 36 weeks, it is filled to the BOTTLE TOP (xiphoid). Then at 40 weeks, it drops a little (lightening) — the baby settles into the pelvis. Numbers to pin: 12-20-36 = SYM-NAV-XIP.
Why it works
Mapping abstract anatomical levels onto a familiar object (a bottle) creates a concrete spatial image that the brain can 'see' and retrieve instantly.
Example usage
Question: 'At what gestational age is the fundus expected at the level of the umbilicus?' Recall the middle label of the bottle = 20 weeks.
Recall trigger
The rising San Miguel bottle: 12=bottom, 20=middle, 36=top
Blood volume rises ~40–50% causing physiologic (dilutional) anaemia
Memory aid
Think of HALO-HALO. You have a fixed amount of leche flan and ube (red blood cells), but you pour in a HUGE extra cup of shaved ice (plasma). The dessert looks the same size, but the red cell RATIO is now diluted — less leche flan per spoonful. That is exactly what happens: plasma rises MORE than red cells, so Hemoglobin appears low — not because of true loss, but because of dilution. This is NORMAL in pregnancy. Anaemia threshold: Hgb <11 g/dL (1st/3rd trimester), <10.5 g/dL (2nd trimester).
Why it works
Halo-halo is a quintessential Filipino treat, making the analogy instantly vivid and emotionally resonant; the dilution metaphor is scientifically accurate.
Example usage
Question: 'A pregnant woman has Hgb of 10.8 g/dL in her 2nd trimester. Is this anaemia?' Yes — it is below the 2nd trimester threshold of 10.5 g/dL. Wait — 10.8 > 10.5, so it is NOT anaemia in 2nd trimester. Confirm using the halo-halo rule: threshold is 10.5 in trimester 2.
Recall trigger
Pregnancy blood = halo-halo with too much shaved ice — diluted, not truly anemic
Supine hypotensive syndrome — cause and position of relief
Memory aid
Imagine Ate Maria, 8 months pregnant, lying on her back (supine) watching a teleserye. Suddenly she feels dizzy and her vision dims — the baby is SITTING ON HER IVC (inferior vena cava) like a heavy upo on a hose, blocking blood return to the heart. The nurse rushes in and says: 'Ate, GUMALAW KA SA KALIWA!' (Move to your LEFT!). Ate rolls left — baby rolls off the IVC — blood flows again — Ate wakes up smiling. KEY: Heavy uterus on IVC = Supine Hypotension → ROLL TO THE LEFT.
Why it works
A vivid story set in a familiar Filipino domestic scene (teleserye, kitchen vegetables) creates an episodic memory that is deeply stored and easily retrieved.
Example usage
Question: 'A pregnant woman in her third trimester becomes dizzy while lying flat. What is the priority nursing action?' Recall Ate Maria — move her to the LEFT LATERAL position to relieve IVC compression.
Recall trigger
Ate Maria lying down, nurse shouts 'Gumalaw sa kaliwa!' (Move to the left!)
Embryonic period (weeks 3–8) is the period of greatest teratogen vulnerability
Memory aid
Think of building a BAHAY KUBO. Weeks 3–8 are when the carpenter is laying the FOUNDATION and FRAME (organogenesis — all organs form). If a typhoon (teratogen: drugs, alcohol, radiation, infection) hits during this framing stage, the whole structure is ruined. But if the typhoon comes later (fetal stage, weeks 9+), when walls are already up, it may cause damage but not total collapse — the baby is more resilient. Rule: WEEKS 3–8 = FRAMING STAGE = Most dangerous for teratogens.
Why it works
Bahay Kubo construction is a culturally familiar process; framing the building period as the riskiest phase makes the clinical principle intuitive and visual.
Example usage
Question: 'During which period is the fetus MOST vulnerable to congenital defects from drugs?' Recall Bahay Kubo framing = weeks 3–8 embryonic period. Answer: 3rd to 8th week (embryonic stage).
Recall trigger
Bahay Kubo under construction — weeks 3–8 is the framing; typhoon then = disaster
Umbilical cord has 2 arteries and 1 vein (AVA rule)
Memory aid
AVA is a girl's name — and her cord has the same letters: A-V-A: Artery–Vein–Artery. Two arteries bookend one vein, just like AVA is spelled with A on both sides of the V. Or: '2 arteries, 1 vein — AVA goes to the mall with TWO friends but only ONE bag.' A single artery (only one A in the cord) is a RED FLAG — assess the newborn more closely for renal/cardiac anomalies.
Why it works
Using a Filipino girl's name (AVA) creates a personal, social memory hook. The mall analogy adds a second encoding layer.
Example usage
Question: 'Normal umbilical cord has how many vessels?' AVA = 2 Arteries + 1 Vein = 3 vessels total. If only 2 vessels → alert for anomalies.
Recall trigger
AVA — A-V-A — two arteries around one vein, always
Three fetal circulation shunts: Ductus Venosus, Foramen Ovale, Ductus Arteriosus
Memory aid
The Three DOORS of fetal circulation spell DVD: D — Ductus Venosus (bypasses the liver; veins go there); V — foramen oVale (right-to-left atrial bypass — like a VALve in the heart wall); D — Ductus Arteriosus (pulmonary artery to aorta bypass). Think: The baby watches a DVD while in the womb — three DOORS let blood bypass unprepared organs. After birth, the DVD EJECTS (doors close with first breath).
Why it works
DVD is a concrete cultural object; the three doors metaphor spatially maps each shunt's bypass function, and the ejection at birth cues the closure event.
Example usage
Question: 'Which fetal shunt bypasses the liver?' DVD — D=Ductus Venosus bypasses the liver. A patent ductus arteriosus at birth = the D (ductus arteriosus door) failed to close.
Recall trigger
DVD: Ductus Venosus, foramen oVale, Ductus arteriosus — three bypass doors
GTPAL obstetric history notation
Memory aid
GTPAL = 'Galing Talaga Pag Anak Lang!' (Tagalog: 'Amazing when it's just about giving birth!'). G = Gravida (total pregnancies — every pregnancy counts); T = Term births (born ≥37 weeks); P = Preterm (born 20–36⁶ weeks); A = Abortions/losses (<20 weeks); L = Living children. Remember the order: G-T-P-A-L, like going from CONCEPTION to LIVING CHILD. Tip: Gravida counts the CURRENT pregnancy too.
Why it works
The Tagalog phrase makes the acronym culturally resonant and humorous; students rehearse the phrase which automatically cues the five letters in order.
Example usage
A woman is pregnant now, had one term birth (1 living child), and one miscarriage at 10 weeks. → G2 T1 P0 A1 L1. Apply GTPAL: Gravida=2 (current + term), Term=1, Preterm=0, Abortion=1, Living=1.
Recall trigger
Galing Talaga Pag Anak Lang = G-T-P-A-L
Quickening — first felt by the mother; 18–20 weeks for primigravida, ~16 weeks for multigravida
Memory aid
Imagine a FIRST-TIME MAMA (primigravida) who is shy and unsure — she waits longer to raise her hand in class. She doesn't feel the baby's tap until 18–20 weeks. But the EXPERIENCED MAMA (multigravida) knows that subtle flutter immediately — she raises her hand at 16 weeks. The baby taps equally for both, but only the experienced mama recognizes it earlier. Key image: timid first-timer vs. confident veteran — same tap, different recognition time.
Why it works
The classroom metaphor maps neatly onto clinical reality and creates a character-based story that is easier to recall than raw numbers.
Example usage
Question: 'At what weeks does a primigravida typically first perceive fetal movement?' Recall the shy first-timer who waits — 18 to 20 weeks.
Recall trigger
Timid first-timer = 18–20 weeks; Confident veteran = 16 weeks
Psychological stages by trimester: 1st = Ambivalence, 2nd = Acceptance, 3rd = Preparation
Memory aid
AAP — like the Filipino word for FATHER (APA/AMANG), but here AAP stands for: A — Ambivalence (1st trimester: 'Am I ready? Is this real?'), A — Acceptance (2nd trimester: 'I feel the baby! I love this!'), P — Preparation (3rd trimester: 'I need to pack my bag and buy diapers!'). Think: Ama (father) also goes through AAP alongside the mother — even dads feel ambivalent, then accepting, then panicky about preparation!
Why it works
The Filipino family reference (Ama/father) personalizes the content; Couvade syndrome even makes the father connection clinically accurate.
Example usage
Question: 'A primigravida says she sometimes wishes she were not pregnant even though she planned this pregnancy. What trimester response is this?' AAP — first trimester Ambivalence is NORMAL even in planned pregnancies.
Recall trigger
AAP — like saying APA three ways: Ambivalence, Acceptance, Preparation
Danger signs of pregnancy — 10 key signs to report immediately
Memory aid
Use the mnemonic 'FEVER PACKS': F — Fever and chills; E — Epigastric/RUQ pain; V — Visual changes (blurring, spots); E — Edema of face and hands; R — Ruptured membranes (gush of fluid); P — Painful urination; A — Absent/decreased fetal movement; C — Contractions before 37 weeks; K — Konvulsyon (Convulsions/eclampsia); S — Severe headache / Severe vomiting. If you have FEVER PACKS, your bag is packed — go to the hospital NOW!
Why it works
FEVER PACKS uses a Filipino code-switching (Konvulsyon) that makes it culturally sticky; the 'hospital bag packed' image reinforces urgency and action.
Example usage
Question: 'Which symptom requires IMMEDIATE reporting?' Any item in FEVER PACKS. E.g., 'severe headache with visual spots' = V and S in FEVER PACKS = signs of pre-eclampsia. Report at once.
Recall trigger
FEVER PACKS — pack your bag and go to the hospital
Normal fetal heart rate (FHR) is 110–160 bpm
Memory aid
Picture a JEEPNEY SPEEDOMETER showing 110 km/h on the LEFT (minimum) and 160 km/h on the RIGHT (maximum). The fetal heart runs at JEEPNEY SPEED — not too slow (bradycardia <110), not too fast (tachycardia >160). If the baby's heart is driving outside that speed zone, there is fetal distress. Normal FHR = Jeepney range: 110–160.
Why it works
The jeepney is a quintessential Filipino icon; mapping numbers onto a speedometer creates a vivid visual scale that students can mentally 'read' during the exam.
Example usage
Question: 'FHR of 105 bpm. What does this indicate?' Recall jeepney: 105 is BELOW 110 (left limit) = fetal bradycardia = possible distress. Notify physician.
Recall trigger
Fetal heart = jeepney speedometer: 110–160 bpm
Surfactant adequacy: L/S ratio ≥2:1 at ~34–36 weeks indicates lung maturity
Memory aid
Think of SURFACTANT as the DISH SOAP inside the lungs. Without soap (surfactant), the tiny air sacs (alveoli) STICK TOGETHER and collapse after each breath (like a wet bag collapsing). Surfactant is made enough by ~34–36 weeks. The L/S ratio (Lecithin/Sphingomyelin) is like checking if there is ENOUGH SOAP: if L/S ≥2:1, the soap is sufficient — lungs are mature. If <2:1, the baby needs more time or steroids to make the soap. L=Lecithin (the good soap), S=Sphingomyelin (the baseline). Mature lungs = L is TWICE S.
Why it works
Soap-and-alveoli analogy is scientifically accurate and visually concrete; the dish soap is familiar in Filipino households.
Example usage
Question: 'An amniocentesis shows L/S ratio of 1.8:1. What does this indicate?' Recall: needs to be ≥2:1. 1.8 is LESS than 2 — lungs are NOT yet mature. Risk for RDS if delivered now.
Recall trigger
Surfactant = dish soap; L/S ≥2:1 means enough soap = mature lungs
Progesterone causes GI discomforts: nausea, heartburn, constipation
Memory aid
Progesterone is like a MAKULIT NA TRAFFIC ENFORCER (annoying traffic enforcer) who tells every smooth muscle in the body: 'STOP! HUWAG GUMALAW!' (Stop! Don't move!). The stomach valves don't close well (acid reflux/heartburn), the intestines stop churning (constipation), and the whole digestive system is slowed. Meanwhile, hCG makes the brainstem nauseous in early pregnancy. Result: The pregnant woman feels queasy, gassy, constipated, and has heartburn — all because Progesterone the traffic enforcer froze the smooth muscles.
Why it works
The personification of progesterone as a Filipino traffic enforcer is humorous and culturally familiar; it links the hormone to all the GI effects through one memorable character.
Example usage
Question: 'Why does a pregnant woman experience constipation?' Recall the traffic enforcer — progesterone slows peristalsis (smooth muscle relaxation). Teaching: increase fiber, fluids, and activity.
Recall trigger
Progesterone = traffic enforcer saying 'Huwag gumalaw!' to all smooth muscles
Chadwick's sign — bluish-violet discolouration of cervix and vagina
Memory aid
CHADWICK = CHAD who is BLUE. Imagine CHAD (the boyfriend) turning BLUE-VIOLET with emotion when he sees the bluish cervix for the first time at the prenatal exam. The colour change happens because of increased blood flow and venous congestion in the pelvic tissues. Blue/violet = Chadwick. Easy colour code: C for Chadwick = C for Colour change = Cool blue-violet.
Why it works
Assigning the colour directly to the name via a character (Chad turning blue) creates a vivid, emotionally charged image that is hard to forget.
Example usage
Question: 'A midwife notes a bluish discolouration of the vaginal mucosa during examination. This is called?' Recall Chad turning blue = Chadwick's sign. It is a PROBABLE sign.
Recall trigger
Chad is blue — Chadwick = bluish-violet cervix/vagina
Physiologic lordosis ('pride of pregnancy' posture) and waddling gait from relaxin
Memory aid
RELAXIN is like the body's LUBRICANT SPRAY — it loosens joints and ligaments to widen the pelvis for birth. But it has a side effect: it also loosens the lower back, so the uterus tilts forward and the lower back curves excessively (lordosis). The woman looks like she is walking with great PRIDE (chest out, back arched) — hence 'pride of pregnancy.' And because the hip joints are looser too, she WADDLES like a duck near term. Relaxin = looser joints = Pride posture + Duck walk.
Why it works
The lubricant spray metaphor makes the mechanism of relaxin clear; the pride posture and duck walk images are visual and slightly amusing, boosting retention.
Example usage
Question: 'What hormone is responsible for softening ligaments and joints in pregnancy?' Recall the lubricant spray = Relaxin. Normal result: lordosis and mild pelvic instability.
Recall trigger
Relaxin = WD-40 spray on joints = proud posture + duck walk
Age of viability is ~24 weeks; term is 37–42 weeks
Memory aid
Use the NUMBER LADDER: 20 (quickening felt) → 24 (viable with NICU support) → 34–36 (surfactant adequate) → 37 (term begins) → 40 (full term) → 42 (post-term). Think of climbing a ladder: each rung is a survival milestone. You cannot jump from 20 to 40 — each rung matters clinically. PIN: 24 = SURVIVAL FLOOR (below this, extremely unlikely to survive). 37 = SAFE LANDING.
Why it works
Chunking numbers into a sequential ladder uses spatial-sequential memory, which is highly reliable for ordered numerical information under exam conditions.
Example usage
Question: 'What is the age of viability?' Climb the ladder: 24 weeks = survival floor. Below 24 = previable. Answer: approximately 24 weeks gestational age.
Recall trigger
Number ladder: 20-24-34/36-37-40-42 — each rung = a milestone
Revision game
I am seen by the EXAMINER but I cannot CONFIRM the pregnancy. I turn the cervix soft and I am named after a doctor. What am I?
Answer
Goodell's Sign (probable sign — softening of the cervix)
Memory link
Anchor A2 — CHAD turns BLUE (Chadwick), HEGAR says HIGA, GOODELL checks the CERVIX
I am the only hormone you need to DOUBLE to prove the baby's lungs are ready. What ratio am I?
Answer
L/S Ratio (Lecithin to Sphingomyelin) ≥ 2:1 indicating lung maturity
Memory link
Anchor A16 — Lecithin is the dish soap; leader must be twice as strong as the sidekick
Ate Maria is lying on her back watching her favorite teleserye. Suddenly she feels dizzy. What is pressing on her vein and what should the nurse do?
Answer
The heavy uterus is compressing the inferior vena cava (IVC) causing supine hypotensive syndrome — nurse should position her on her LEFT LATERAL side
Memory link
Anchor A7 — 'Gumalaw sa kaliwa!' (Move to the left!)
I am ambivalent, then I accept, then I prepare. I happen over 9 months in three chapters. Who am I describing?
Answer
The pregnant woman's psychological progression through the three trimesters — AAP: Ambivalence, Acceptance, Preparation
Memory link
Anchor A13 — AAP like saying APA (father) three ways
I have two A's and one V. I connect the baby to the placenta. If I only have one A, the newborn needs closer checking. What am I?
Answer
The umbilical cord — AVA pattern: 2 Arteries and 1 Vein (3 vessels total). A single artery is a warning sign.
Memory link
Anchor A9 — AVA goes to the mall with two friends but only one bag
I am the MOST DANGEROUS TIME in fetal life for drugs and alcohol. I happen in the first two months after conception. What stage am I?
Answer
The Embryonic stage (weeks 3–8) — period of organogenesis and highest teratogen vulnerability
Memory link
Anchor A8 — Bahay Kubo framing stage; typhoon during framing = disaster
A pregnant woman's LMP is October 10, 2025. Using Naegele's Rule, what is her EDD?
Answer
October 10 minus 3 months = July 10. July 10 plus 7 days = July 17. Plus 1 year = July 17, 2026. EDD = July 17, 2026.
Memory link
Anchor A4 and Formula Mnemonic 1 — Subtract 3, Add 7, go to Heaven (next year)
I slow down your intestines, relax your valve between stomach and esophagus, and cause heartburn and constipation. I am a hormone. Who am I?
Answer
Progesterone — the traffic enforcer that tells smooth muscles to stop moving
Memory link
Anchor A17 — Progesterone the makulit na traffic enforcer saying 'Huwag gumalaw!'
Formula mnemonics
EDD = LMP (1st day) − 3 months + 7 days + 1 year
Mnemonic
SUBTRACT 3, ADD 7, go to HEAVEN (next year) — Naegele's Rule in 3 steps
When to use
Every time you need to calculate the Estimated Date of Delivery (EDD/EDC) from a known LMP with a regular 28-day cycle. Confirm with early ultrasound when cycle is irregular.
What each part means
LMP = Last Menstrual Period (use the first day); −3 months = go back 3 calendar months; +7 days = add one week forward; +1 year = the delivery year (adjust as needed if crossing a new year)
McDonald's Rule: Fundal height in cm ≈ Gestational age in weeks (after 20 weeks, ±2 cm)
Mnemonic
McDONALD'S serves your age — the centimeters equal the weeks, just like your order number matches your food at McDonald's: Number 20 = 20 cm = 20 weeks!
When to use
During prenatal abdominal assessment after 20 weeks to screen for appropriate fetal growth. Discrepancy of >2 cm warrants further evaluation (IUGR or macrosomia).
What each part means
Fundal height = distance in centimeters from the symphysis pubis to the top of the fundus; gestational age = weeks of pregnancy. After 20 weeks, 1 cm ≈ 1 week.
L/S Ratio ≥ 2:1 = Lung maturity
Mnemonic
LECITHIN must be AT LEAST DOUBLE Sphingomyelin — L is the leader, S is the sidekick; leader must be twice as strong as the sidekick for the lungs to graduate.
When to use
When amniocentesis is performed to assess fetal lung maturity before planned preterm delivery or elective induction. Critical in preterm labor cases.
What each part means
L = Lecithin (surfactant component, rises near term); S = Sphingomyelin (stable baseline); Ratio = L divided by S; ≥2:1 means lungs produce enough surfactant to prevent alveolar collapse.
Normal FHR = 110–160 bpm
Mnemonic
JEEPNEY RANGE: 110 (start) to 160 (max) — anything outside the jeepney speed zone = fetal distress. Below 110 = bradycardia; above 160 = tachycardia.
When to use
Every prenatal visit for fetal assessment. Also used during intrapartum monitoring. FHR <110 or >160 bpm sustained = notify the physician or midwife immediately.
What each part means
FHR = Fetal Heart Rate measured by Doppler or fetoscope; 110 = lower normal limit (bradycardia if below); 160 = upper normal limit (tachycardia if above)
Anaemia in Pregnancy: Hgb <11 g/dL (1st and 3rd trimester) or <10.5 g/dL (2nd trimester)
Mnemonic
11-10.5-11 = the NUMBER SLIDE: starts at 11, dips to 10.5 in the middle (2nd trimester is the dilution peak), then back up to 11. Like a hammock shape — sags in the middle.
When to use
When interpreting CBC results of a pregnant woman to determine if supplemental iron therapy is needed or if further investigation for anemia is warranted.
What each part means
Hgb = hemoglobin level in g/dL; <11 in 1st/3rd trimester = anemia; <10.5 in 2nd trimester = anemia (normal dip due to maximum plasma volume expansion during mid-pregnancy)
Quick recall chains
Three Signs of Pregnancy in Order (Presumptive → Probable → Positive)
Recall test
Close your eyes: Name the three POSITIVE signs of pregnancy without looking. Then name three probable signs. Then two presumptive signs. If you can do this in 30 seconds, you know this chain.
Memory chain
The detective SUSPECTS (Presumptive), then finds CLUES (Probable), then gets CONFESSION (Positive). The confession has only 3 witnesses: FEV — Fetal sounds, Examiner touch, Visual ultrasound. The case is CLOSED only with all three confessions available — but even ONE of the FEV trio is enough to confirm.
Items to remember
- Presumptive (subjective: felt by woman)
- Probable (objective: observed by examiner)
- Positive (diagnostic: only 3 — FHT, examiner feels fetal movement, ultrasound)
Naegele's Rule Steps in Sequence
Recall test
Given LMP = March 15, 2025 — calculate EDD. Answer: March 15 → subtract 3 months = December 15 → add 7 days = December 22 → year stays 2025 (no year change needed since we go backward into same year). EDD = December 22, 2025.
Memory chain
Baby does time travel: she GOES BACK 3 months, then JUMPS FORWARD 7 days, then LANDS in NEXT YEAR. That landing date = her birthday (EDD). Practice: LMP = July 1, 2024 → July 1 minus 3 months = April 1 → +7 days = April 8 → +1 year = April 8, 2025.
Items to remember
- Step 1: Identify the FIRST DAY of the LMP
- Step 2: SUBTRACT 3 months
- Step 3: ADD 7 days
- Step 4: ADD 1 year (adjust as needed)
Fundal Height Landmarks by Gestational Age
Recall test
Without looking: At what week is the fundus at the level of the umbilicus? At what week is it near the xiphoid? At what week does it drop slightly? Answers: 20, 36, 40.
Memory chain
Imagine the San Miguel bottle filling up: 12 = bottle bottom (symphysis), 20 = middle label (navel), 36 = bottle top (xiphoid), then at 40 the bottle is tilted — baby engages. Odd one to remember: 28 = halfway between 20 and 36 = halfway between navel and top of bottle.
Items to remember
- 12 weeks = symphysis pubis level
- 20 weeks = umbilicus level
- 28 weeks = midway between umbilicus and xiphoid
- 36 weeks = xiphoid level
- 40 weeks = slightly lower than 36 (lightening/engagement)
Fetal Development Key Milestones in Week Order
Recall test
Cover the list. What happens at week 8? Week 24? Week 37? What is the most dangerous period for teratogens? Answers: End of organogenesis; viability; term begins; weeks 3–8.
Memory chain
Baby climbs a LADDER: rung 1–2 = implants (settles in), rung 3–8 = builds all organs (MOST DANGEROUS STAGE), rung 4 = heart starts beating, rung 9+ = grows and fills out, rung 12 = shows gender, rung 16–20 = moves (quickening), rung 24 = can survive outside with help, rung 34–36 = lungs mature (soap ready), rung 37 = TERM (safe landing), rung 40 = full term party.
Items to remember
- Weeks 1–2: Pre-embryonic (implantation)
- Weeks 3–8: Embryonic (organogenesis — highest teratogen risk)
- Week 4: Heart begins to beat
- Week 9+: Fetal stage begins (growth and maturation)
- Week 12: Sex distinguishable
- Weeks 16–20: Quickening
- Week 24: Age of viability
- Weeks 34–36: Surfactant adequate (L/S ≥2:1)
- Week 37: Term begins
- Week 40: Full term
FEVER PACKS — 10 Prenatal Danger Signs
Recall test
Set a 60-second timer. Write out all 10 letters of FEVER PACKS and their corresponding danger signs from memory. If you miss any, review that specific anchor and retry tomorrow.
Memory chain
You have a FEVER and you need to PACK YOUR BAG and go to the hospital RIGHT NOW. FEVER PACKS = 10 items in your emergency bag. If any one of these items is present, PACK and GO. The nurse's job: teach every pregnant woman this list at every visit — it is a core prenatal education requirement under Philippine DOH prenatal care guidelines.
Items to remember
- F — Fever and chills
- E — Epigastric or RUQ pain
- V — Visual changes (blurring, spots)
- E — Edema of face and hands
- R — Rupture of membranes (gush/leak of fluid)
- P — Painful urination
- A — Absent or decreased fetal movement
- C — Contractions before 37 weeks (preterm labor)
- K — Konvulsyon (Convulsions = eclampsia)
- S — Severe headache / Severe vomiting
Diagrams
Signs of Pregnancy — Three-Level Classification
This mind map organizes all pregnancy signs into the three classification levels — Presumptive, Probable, and Positive — making it easy to visually distinguish which signs confirm pregnancy versus merely suggest it. Use this map alongside the PPP and FEV memory anchors.
Naegele's Rule — Step-by-Step EDD Calculation
This flowchart walks through Naegele's Rule step by step, including the caveat about cycle regularity and a worked example using LMP August 10, 2025. Students can follow the arrows like a clinical algorithm, reinforcing the sequence: Subtract 3 → Add 7 → Add 1 year.
Key Fetal Development Milestones by Gestational Week
This timeline maps all critical fetal development milestones from implantation through full term delivery. It visually reinforces the number ladder concept from Anchor A20 and clearly marks the embryonic period (weeks 3–8) as the highest-risk window for teratogen exposure.
Prenatal Danger Signs — FEVER PACKS Decision Flowchart
This clinical decision flowchart shows all 10 FEVER PACKS danger signs branching from a central decision point and converging on the action: Report Immediately. It is designed for quick visual scanning during review and reinforces the urgency associated with each sign.
Maternal Psychological States Across Pregnancy Trimesters
This state diagram maps the three predictable psychological states of pregnancy as sequential phases — Ambivalence, Acceptance, and Preparation — with their triggers for transition. It supports the AAP mnemonic from Anchor A13 and helps students recognize normal maternal psychological responses by trimester.
Maternal Physiologic Changes by Body System
This comprehensive mind map provides a single-view overview of all major maternal physiologic changes organized by body system. Students can use this as a rapid review map before the NLE, connecting each system to the specific anchor and mnemonic that covers it.