Pregnancy and Pregnancy and NewbornsNewborns

Pregnancy and Pregnancy and NewbornsNewborns

Pregnancy• Pregnancy results from the union of the

ovum and sperm, usually in the fallopian tube

• Growth of an offspring in the uterus lasts about 280 days (9 months)

• The fertilized egg is known as a zygote from the time of conception to 2 weeks

• It is then considered to be the morula and enters the uterus

Implantation• As a blastocyst, it implants in the

uterine wall and is considered to be an embryo through the eighth week

• From 8 weeks to birth, the unborn baby is called a fetus

• During the first 30 days of life, the baby is considered to be a neonate

Effects of Effects of Pregnancy on Pregnancy on

MotherMother

Anatomical Changes

• breasts enlarge & areolae darken• “mask of pregnancy” pigmentation

of facial skin• uterus enlarges • lordosis• placenta produces the hormone

relaxin, that causes ligaments to relax & become flexible for child birth

• weight gain about 25 lbs

Gastrointestinal System

• excessive salivation• morning sickness: increase of

hormones• heartburn: esophagus & stomach

is crowded• constipation: motility of digestive

tract declines

Urinary System

• urination more frequent & sometimes uncontrollable

• uterus compresses bladder • kidneys also have to dispose of

fetal wastes

Respiratory System

• lung volume decreases • nasal stuffiness

Cardiovascular System

• total body water rises as safeguard against blood lose during birth

• blood volume increases 25 - 40 %• blood pressure & pulse rise• uterus presses on pelvic blood

vessels, venous return from lower limbs may be impaired & result in varicose veins

Parturition Parturition

Birth 280 days Birth 280 days after conceptionafter conception

Labor and Delivery

Three stages of labor– First stage: muscle contractions of

the uterus cause the amniotic sac to rupture and the cervix to open (dilate) to about 10 cm in diameter allowing passage of the fetus

– Second stage: delivery of the baby, called parturition

– Third stage: delivery of the afterbirth, or placenta, which takes place about 15 minutes later

Determining EDC• Wheel• Naegele’s Rule, add 3months to LMP,

subtract 7 days• Ultrasound most reliable• Measure crown rump length in early

pregnancy• Vocab: Nullipara, multipara, primigravida• G,P, A, F, P

Assessment Techniques

• Pap smear• Amniocentesis• Ultrasonography• Chorionic villus sampling (CVS)• Fundal heights and FHR• Lab work, blood and urine• Fetal monitoring (nonstress/ stress test)• Pelvimetry

What can go wrong with pregnancy?

• Ectopic pregnancy – Pregnancy that occurs outside of the uterus

• Erythroblastosis fetalis – Condition that may develop in an Rh+ fetus of an Rh-

mother who has developed antibodies against the Rh blood protein in a prior pregnancy

• Fetal alcohol syndrome – Physical and mental birth defects that result from damage

to the fetus by alcohol consumed by the mother

What can go wrong with pregnancy?

• Abruptio placenta: premature separation of placenta

• Choriocarcinoma: malignant tumor of pregnant uterus

• Placenta previa: placenta over cervical os

• Preeclampsia: HTN, proteinuria and edema

Methods of delivery• Vaginal delivery• Cesarean Section

Miscellaneous

Alternatives in conception– Birth control– In vitro fertilization– Surrogacy

• Infertility– One out of every six couples is infertile– Factors include low sperm count, STDs, and stress

• Redefining the sexes – Homosexual and bisexual

Newborns• Apgar scores an infant’s physical condition

– Score 0-2 on heart rate, respiratory effort, muscle tone, grimace, color

• Vitamin K injection• Inherent nose breathers• Lanugo/ Vernix caseosa• Collect cord blood to determine blood type• Breast/ bottle feed• Bonding• Circumcision• fontanelle

Neonatal problems• TTN (Transient tachypneic of the newborn)• Down Syndrome (Trisomy 21)• Erythroblastosis fetalis Hemolytic disease

from RH incompatibility• Hyaline membrane disease acute

respiratory distress syndrome of the newborn• Hydrocephalus fluid on the brain• Pyloric stenosis narrow sphincter from

stomach to duodenum