Conception/Pregnancy/childbirth

Question 1

Conception

women (takes to get pregant, who, chance)

Answer 1

• fertile and sexually active person with a uterus
• takes a person an average of 5.3 months to get pregnant
• 21% chance of pregnancy with a single act of intercourse
• some get pregnant after the 1st time (often young)

Question 2

conception

male (journey, movement, last in ovulation and uterus)

Answer 2

• journey of sperm is torturous
• 300-500 million in ejaculation
• ~2,000 get to the fallopian tube with the ovum
• ~50 get to the ovum
• sperm move against the flow at 1-2cm/hr (egg moves by cilia with the flow @ 3-4 days)
• conception within 24 hr of ovulation (egg is viable for ~24 hr)(sperm is viable for ~48 hr and up to 6 days)

Question 3

conception

males (fertilization, more than one sperm)

Answer 3

• once fertilized, the wall of ovum becomes impervious
• more than 1 sperm enters and it causes a spontaneous abortion (might not even know it happened)

Question 4

what might lead a W to think that she’s pregnant?

(7)

Answer 4

• most = feelings of fatigue and drowsiness
• some = sense of heightened well-bring
• missed period (sometimes)
• breast tenderness
• urination
• elevated temperture for several weeks
• bowel movements
• vaginal secretions

Question 5

missed signs that a W is pregant

2

Answer 5

• missed period = vigerous excerise pr excess body fat, illness, emotion
• presence of vaginal discharge does not rule it out (spotting with 20% of W)

Question 6

“morning sickness”

(7)

Answer 6

• 1st 6-8 weeks
• queasy sensation upon awaking
• aversion to food or odours of certian food (nausea with or without vomiting)
• some = only in evening
• 1:4 have no morning sickness
• 1:200 have severe vomiting (hospitalization required)
• hormone shift causes the nausea

Question 7

chadwick’s sign

2

Answer 7

• 6-8 weeks
• purplish vagina and cervix (the blood gets centered to the baby)

Question 8

Hegar’s sign

2

Answer 8

• by 6 weeks
• soft area between cervix and uterus by a month after missing period

Question 9

false pregnancy

2

Answer 9

• intense desire of having a kid
• physical symptoms (no period, morning sickness, breast tenderness, fullness in pelvis, sensation of fetal movement)

Question 10

Early Pregnancy Factor

Answer 10

• possible within 48 hours
• found in blood test
• rosette inhibition assay
• expensive and time consuming

Question 11

Human Chorionic Gonadopin

3

Answer 11

• basic one
• radioimmunoassay (near perfect in 7 days)
• standard test involve urine (7-12 days) and blood (6-8 days after the missed period)

Question 12

first response home kit

5

Answer 12

• detect hCG in urine
• as early as 7 days after fertilization
• more reliable if after expected date of menses
• 3% false +’ve
• 20% false -‘ve

Question 13

what are the absolute confirmation things and why do we need to know them?

(3)(2)

Answer 13

1. fetal heartbeat (early as 9 weeks, but reliable by 12)
2. fetal skeleton (ultrasound after 16 weeks)
3. fetal movement (after 16 weeks)
   - adverse effects of fetus
   - avoid drugs, alcohol, birth control pills

Question 14

Which of the following would provide the earlist indication that there is a pregnancy? (missed period, morning sickness, Hegar’s sign, presense of hCG)

Answer 14

• presence of hCG

Question 15

Midwife

assisting, docs, legalized, modern

Answer 15

• women assisting other women in child birth
• taken over by docs in 19th century
• modern midwife = natural birth, inform, identify if they need the hospital
• legalized in BC in 1993

Question 16

true labour

3

Answer 16

• sporadic contractions of uterus
• baby drops (3-4 weeks) before true labour in 1st time mothers
• softening and dialation of cervix (2 weeks)

Question 17

true labour

6

Answer 17

• regular and rythmic uterine contractions
• dilates cervix
• delivery of baby, placenta, and fetal membranes
• fetus, not mother, triggers labour
• fetus’ adrenal gland produces hormones (placenta and uterus)(prostaglandins)
• mother’s posterior pituitary gland releases hormone oxytocin in late stages of labour (more powerful contraction)(fetus expelled from uterus)

Question 18

prostaglandins

2

Answer 18

• contractions that start longer, then get shorter (closer together)
• stimulus that gets uterus to contract

Question 19

labour stage 1

3

Answer 19

• 1st contraction until cervix is fully dilated (10cm/4in)
• longest is typically 15 hr for 1st and 8 hr after that
• 15-20 min apart initally (closer and more intense later)

Question 20

labour stage 2

5

Answer 20

• full dilation of cervix until delivery of baby
• few min/several hours for difficult ones
• fetal membrane ruptures and amniotic fluid gushes out
• umbilical cord cut after breathing starts
• fluid in the mouth that needs to be sucked out for baby to breathe

Question 21

labour stage 3

6

Answer 21

• placenta seperates and is discharged with fetal membranes: after-birth
• uterus contracts and usually some bleeding
• few min to an hour
• examine baby and mother (drops in baby’s eyes)
• perineum may have torn (repair it or episiotomy incision)
• use of episiotomy declining in Canada

Question 22

Caesarean section

5

Answer 22

• baby too large for pelvic opening (or problems with the cord, position, distress, length of labour)
• incise abdominal and uterine walls
• somewhat greater incidence of complications
• recovery longer (5-6 days v. 1-2 days)
• concerns about number of c-sections

Question 23

c-section in canada

7

Answer 23

• most common inpatient surgery
• stay is ~2.7 days
• recovery is longer (2 weeks to pick up baby and 6-8 weeks for anything heavier)
• 30% of hospital births were c-sections
• 26.7% in 2007
• 19.0% in 1997
• more likely if >35 yrs old

Question 24

common signs of fetal distress

3

Answer 24

• compression of the umbilical cord
• compression of major blood vessels in the mother’s abdomen
• maternal illness due to hypertension, anmenia, or heart disease

Question 25

the longest stage of labour is typically (stage 1, 2, or 3)

Answer 25

• stage 1