Find study materials for any course. Check these out:
Browse by school
Make your own
To login with Google, please enable popups
To login with Google, please enable popups
Don’t have an account?
To signup with Google, please enable popups
To signup with Google, please enable popups
Sign up withor
*The zygote moves through the uterine tube by ciliary action & some irregular peristaltic activity.
*It takes 3-4 days to enter the uterine cavity.
*During this time, the zygote is in a phase of rapid cell division called mitosis.
*after the blastocyst is free in the uterine cavity for 1 or 2 days, the exposed cell walls of the blastocyst (Called trophonoblast) secrete enzymes that are able to break down protein & penetrate cell membranes.
*These enzymes allow the blastocyst to enter the endometrium and implant. the action of the enzymes normally stops short of the myometrium, but may cause slight bleeding in some individuals.
*Although bleeding is rarely more than spotting, it may confuse some women, who think they had a very light and short menstrual cycle when really they are pregnant.
*The condition of uterine lining is critical for implantation (embedding of fertilized ovum in the uterine mucosa) of they zygote.
*usually occurs in the fundus of the uterus on either the anterior or posterior surfaces.
*if uterine conditions are not suitable, implantation is unlikely to occur. If intrauterine or hormonal conditions cannot sustain the implanted embryo, a spontaneous abortion occurs, most occur during the first 8 wks of pregnancy for these reasons.
*Ectopic pregnancy (implant occurs outside uterus) also poses serious problems
*During the 1st few weeks after implantation, primary villi (short vascular processes or protrusions growing on certain membranous surfaces)appear.
*These villi use maternal blood vessels as a source of nourishment & oxygen for the developing embryo. Also during these 1st few weeks the 1st stages of the chorionic villi.
*Chorionic Villi secrete HCG, a hormone that stimulates the continued production or progesterone and estrogen by the corpus luteum. This is why ovulation and menstruation cease during pregnancy.
*The chorionic villi become the fetal portion of the placenta.
*During this period, the fertilized ovum develops from the 2 original cells into a many-celled organism.
*The zygote develops 2 separate and distinct cavaties; the amniotic cavity and the yolk sac.
*A 3rd layer of primary cells, the mesoderm (embryonic middle laer of germ cells giving rise to all types of muscles, connective tissue, bone marrow, blood, lymphoid tissue, and all epithelial tissue), is located between the 2 cavities.
Embryonic & Fetal Development
*During the embryonic stage, 3 primary cell layers differentiate into tissue and layers, which form placenta, embryonic membranes, and the embryo itself.
*A simple heart begins beating, and rudimentary (basic, initial, or primary) forms of all the major organs and systems develop.
*Starting w/the 9th week the embryo is referred to as the Fetus, and the fetal stage begins.
*The placenta is a dislike organ made up of about 20 sections called cotyledons. it is only present during pregnancy.
*At full term the placenta looks like a lg. red disk w/ a diameter of 8in(20cm) & a thickness of 1in(2.5cm). Normally weighs between 1 and 1.5 lbs(450-600g). The bulk is fetal origin.
*The side attached to the uterine wall "Dirty Duncan" appears to be dark red and has a rough surface; Cotyledons are apparent as distinct lobes w/clefts.
*The fetal side is smooth and shiny "Shiny Schultze"
*Functions as an endocrine gland secreting HCG, & the steroidal hormones estrogen & progesterone, which maintains the pregnancy. is the site of the exchange of nutrients, oxygen, and waste products between the fetus and the maternal circulation.
*Allows transfer of oxygen & nutrients through diffusion, & active transport, & blocks the transfer of certain substances. "placental barrier"
*after delivery placenta is of no use and is expelled.
Embryonic and Fetal Physiology:
*the amniotic sac is composed of 2 layers, both originating in the zygote.
*Chorion: outer layer, attaches to the fetal portion of the placenta
*Amnion: Inner layer, blends w/the fetal umbilical cord.
*These appear fragile, but in fact they are strong enough to contain the fetus and amniotic fluid even at full term.
*Joins the embryo to placenta.originates in fetal portion of the placenta and is normally attached near the center.
*typically 20-22in(50-55cm) long & less than 1in(2.5cm) in diameter at time of delivery.
*The major part of he cord is a pale white, gelatinous mucoid substance called Wharton's jelly (a gelatinous tissue that remains when the embryonic body stalk blends with the yolk sac within the umbilical cord). This prevents compression of blood vessels
Embryonic and Fetal physiology
*acts as a cushion against mechanical injury, helps regulate fetal temp, and allows the developing embryo or fetus room for growth.
*The amt of fluid changes from about 30ml(1oz) at 10 weeks to as much as 1L at delivery.
*A variety of technologic and assessment tools can be used to evaluate fetal well-being.
*these tools are used to evaluate maternal and fetal health problems, fetal congenital anomalies, and fetal growth, and maturity.
*Aspiration of small amount of amniotic fluid to reveal sex and chromosomal abnormalities, health status, and maturity of fetus.
*Performed at 16th wk of pregnancy to detect abnormalities; performed later in pregnancy to determine lung maturity
*the response of fetal heart rate to decreased oxygen supply during contractions measured via external fetal monitoring.
*performed after 32nd week of pregnancy by stimulation of uterine contractions
*Fetal movement and fetal heart rate are recorded by external fetal monitors to evaluate the response of fetal heart rate to fetal movement.
*Performed when risk is present for placental insufficiency, after the 27th to 30th week of pregnancy by stimulation of uterine contractions
*Enlarges during pregnancy as a result of hormonal stimulus.
*By the 3rd trimester, it is egg shaped, and has increased in weight to 2.2 lbs(1000g)
*divided into 3 distinct periods: Antepartal, Intrapartal, & Postpartal.
*Pregnancy spans 9 months, approx. 40 weeks. is divided into 30month periods or trimesters.
*1st Trimester: week 1 through 13
*2nd Trimester: weeks 14 through 26
*3rd Trimester: weeks 27 through gestation (38-40wks)
*1st part of cycle. Or prenatal
*Begins with conception and ends with the onset of labor.
*begins with the onset of labor and ends with the delivery of the placenta.
*also called perinatal
Ideally the woman has been receiving regular medical attention and is already known by the health care provider. Unfortunately, because of cost or frequent changes of residence, many people do not receive regular, routine health care.
*On the 1st visit, obtain demographic data such as age, occupation, and marital status, along w/insurance information. The basic information helps the primary care practitioner identify potential areas of concern.
*Consequently, the most useful means of reducing the incidence of these disorders is by preventing their transmission. As more becomes known about genetic disorders, more accurate predictions can be made about the probability of a couple passing a disorder to their offspring.
*Assessment begins w/a personal medical Hx and a review of systems. Assess lifestyle patterns. A basic physical assessment is completed.
*Normal human pregnancy, counting from the first day of the last menstrual period, is about 280 days, 40 weeks, 10 lunar months(28days each) or slightly more than 9 calendar months.
*The most common method is called Nagele's rule: Start with the 1st day of the woman's last menstrual period and count back 3 months, then add 7 days.
*If the woman does not keep a menstrual record, calculation of EDB may be difficult. The primary care practitioner must then rely on observations.
*Gravida:indicates a pregnant woman.
*Primigravida (one pregnancy); Nulligravida (NONE); multigravida (Multiple)
*Para: (to bring fort) Indicates the number of births
*primipara (one); Nullipara (None) and Multipara (Multiple)
*Abortion:loss of a fetus before the age of viability (capable of living)
*Routine care during pregnancy begins w/the initial exam and Hx, as previously described. Appt's are recommended once a month through the seventh month, once every 2 wks for the next month, & then once every week until delivery.
*Smoking during pregnancy can be dangerous to the developing fetus; Drinking alcoholic beverages during pregnancy is also contraindicated;
*Women should avoid taking any medication or drugs during pregnancy, including over-the-counter drugs.
*Visual disturbances: diplopia, blurring, or spots.
*headaches, severe, sudden, or continuous.
*Edema: Swelling of face presacral area, or fingers
*Rapid wt. gain, in excess of normal gain for gestation;
*Pain: severe abd. or epigastric pain
*Signs of infection: fever, chills, diarrhea, changes in vaginal drainage, pain or burning w/urination
*Vaginal bleeding (No matter how slight):
*Vaginal drainage (Aside from normal mucus):
*Persistent vomting; *Muscular irritability or convulsions
*Absence or decrease in fetal movement once felt
*Craving & eating substances that are not normally considered edible.
*Substances ingested include clay or laundry starch. Although not toxic, they may interfere with iron absorption, resulting in anemia.
*Large amounts of clay may also result in fecal impaction.
*Some women have excessive salivation (ptyalism)
*Nausea is common in the early stages of pregnancy. Morning sickness rarely lasts beyond the 4th month.
*The most severe form is called Hyperemesis Gravidarum
*Linea alba(Midline of the abd. from the pubis to umbilicus) which darkens is called the linea nigra.
*Chloasma, the mask of pregnancy,an irregular darkening of the cheeks, forehead, and nose.
*Striae Gravidarum, or stretch marks, are reddish, wavy streaks that can appear on the thighs, the abd, & breasts.
*Spider Nevi(A branch growth of dilated capillaries on the skin) & palmar erythema(Reddened palms) are seen
*Slowing of intestinal peristalsis can result in abdominal distention, flatulence, and constipation.
*Hemorrhoids can result from straining as a result of constipation. They can also be caused by the enlarged uterus putting pressure on the pelvic blood vessels.
*Women w/Hx of cholelithiasis may experience problems w/this as a result of an increased cholesterol level, which is common during pregnancy.
*Adequate fluid intake, dietary roughage, and exercise may help reduce problems r/t constipation
*Frequency of urination is a common complaint of pregnancy.
*During pregnancy the mother must excrete not only her own waste products but also those of the fetus.
*Early in pregnancy the enlarging uterus irritates the bladder by putting pressure on it.
*Patients should continue normal activity throughout an uncomplicated pregnancy.
*Fatigue is a common complaint during pregnancy.
*Changes in balance and posture occur as the fetus increases in size. To compensate for the shifting center of gravity, the lumbodorsal curve increasis (Lordosis)
*Many women wear support hose to reduce edema; resting w/ legs elevated is also helpful.
Sexuality & Reproductive System:
*Begin in early pregnancy.
*Many c/o tingling and & a feeling of fullness. Increased sensitivity is also common.
*Generally, the breasts grow in preparation for lactation.
*Nipples and areolae darken.
*Colostrum may be secreted by the nipples in late pregnancy.
*Unless pregnancy has complications or the bag of waters has ruptured, there is no physiologic reason to limit sexual activity during pregnancy.
*Many women experience a decrease in desire as a result of hormonal changes and discomfort.
*Discussion of various coital positions and sexual activity that does not include intercourse is appropriate.
*Vaginal bleeding at any time during pregnancy should be reported to the physician at once.
*Sexuality activity should cease until the cause of the bleeding is determined and should be resumed only when the physician determines that no danger exists.
*All the physical & hormonal changes of pregnancy place an additional stress on the woman.
*Mood swings & ambivalence(Conflicting emotions) are common as the woman works through her fears & comes to grips w/the reality of pregnancy and how it will affect her life.
*Listening & allowing the woman adequate time to verbalize her fears can also help reduce anxieties.
*Pregnancy introduces a totally new role, that of mother.
*Culture has much to do w/how she defines her role
*Dynamics also change between the woman and the baby's father, particularly with the 1st pregnancy.
*The mother is no longer just a wife or girlfriend; she is also a mother.
*the rapid changes in body shape and size can lead to changes in self image.
*Many women feel unattractive when they are pregnant. They may also feel a loss of control related to the changes taking place
*Some classes are general, whereas others are targeted toward specific groups such as adolescents, those having cesarean or vaginal birth after cesarean delivery, siblings, or grandparents.
*Common methods of prepared childbirth include Dick-Read, which focuses on progressive relaxation techniques & avoidance of analgesics; Bradley, which stresses control of environmental factors, such as lighting, temp., and noise, to provide a calm, supportive environment for childbirth;
Childbirth preparation Classes
Sign up for free and study better.
Get started today!