pregnancy

pregnancy

1. anatomy of the female reproductive organs

   • fallopian tube
     • fertilization occurs there, also a tunnel for ovum to travel form ovaries to uterus
   • vagina
     • receives sperm and conveys uterine secretions outside the body
   • uterus
     • houses the developing embryo
   • ovaries
     • produce eggs and hormones

2. gametogenesis

   • sperm
     • fertilizes ovum
       • produce a zygote
         • implants into the endometrium of the Fallopian tube
           • becomes an embryo
             • primary germ layers
               • ectoderm
                 • skin
                 • nervous system
               • mesoderm
                 • muscles
                 • bones
                 • blood
               • endoderm
                 • endocrine
                 • GIT
   • ovum

3. hormonal changes during pregnancy

   • peak of FSH and LH during ovarian cycle
   • peak of estrogen and progesterone during mesntrual cycle

4. pregnancy tests

   • urine tests
     • detect hog in urine about a day after the first missed period
   • blood tests
     • qualitative hCG test
       • checks if there is hcg in your blood
     • quantitative hCG test
       • measures the specific level of HCG in the blood.
   • Routine tests in pregnancy:
     • Screening for HIV, syphilis and hepatitis B
     • Blood pressure
     • Gestational diabetes
     • Blood group and rhesus status
     • Ultrasound exam

5. nutritional needs

   • protein
     • why
       • Growth of the fetus
       • Development of the placenta
       • Enlargement of the uterus
     • where
       • egg
       • lean meat
       • diary
   • folic acid
     • why
       • preventing birth defects
     • where
       • dark green vegetables
       • beans
       • fruit
   • iron
     • why
       • Vital for Red Blood Cell formation.
       • Essential for oxygen transport.
       • increase in maternal blood volume.
     • where
       • red meat
       • dried fruit
       • green vegetables

6. Vaccination

   • what
     • Flu shot
     • Tdap vaccine
   • why
     • protect the mother from infections
     • protect the child after birth before taking vaccines.
   • is it safe?
     • if it has a living virus
       • it might cause harm to the baby.
         • what are they?
           • Shingles vaccine
           • Measles, mumps and rubella (MMR) vaccine
           • Chickenpox (varicella) vaccine
     • if it doesn't have any living virus
       • it will not cause any harm to the baby

7. maternal physiological changes

   • Respiratory System Changes
     • respiratory minute volume increases:
       • to compensate for the oxygen demands of the fetus and the increased maternal metabolic rate.
     • dyspnea
       • The growing uterus exerts upward pressure on the diaphragm, decreasing the volume of each inspiration.
     • respiratory mucous swell
       • increased blood flow during pregnancy
   • Digestive and Urinary System Changes
     • Nausea and vomiting “morning sickness”:
       • increased circulation of pregnancy-related hormones, specifically estrogen, progesterone, and hCG.
       • Decreased intestinal peristalsis.
     • Frequent urination
       • The downward pressure of the uterus compresses the urinary bladder.
       • maternal urinary system processes both maternal and fetal wastes.
     • heartburn
       • upward, constrictive pressure of the growing uterus on the stomach.
   • weight gain
     • blood volume
     • uterus
     • baby
   • Integumentary System Changes
     • stretch marks
       • formed within the dermis and appear as red or purple marks during pregnancy that fade to a silvery white color in the months after childbirth.
     • The dermis stretches extensively:
       • to accommodate the growing uterus, breast tissue, and fat deposits on the thighs and hips.
     • increase in melanocyte-stimulating hormone:
       • -along with increased estrogens, it causes a line of pigment called the linea nigra.
   • Circulatory System Changes
     • heart rate increase
     • BP decreases in 1st and 2nd trimesters and go back to normal in 3rd trimester
     • stroke volume increases
     • cardiac output increases

8. Postnatal visits

   • specific to women who have just given birth
   • support women with post-partum depression
   • first visit must be during the first 24 hours of birth
     • can be followed by three separate visits.
   • why?
     • Includes a physical exam on the mother.
     • Familiarizes the mother with all the changes
     • it is important that a professional keeps the mother company as she and her baby are prone to complication in the first 24hrs
   • how they can help the mother?
     • Discuss breastfeeding.
     • Discuss a healthy environment for both the mother and the baby.
     • Schedule immunization of the baby

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