Conception, Pregnancy & Childbirth Flashcards
1
Q
Male Fertility Issues
A
- Sperm: low count/irregularities, poor motility
- Chronic conditions: diabetes, SCI, etc…
- STI and other infections
- Trauma to testes
- Autoimmune response: antibodies that affect sperm
- Hormones: pituitary imbalance and/or thyroid conditions
- Toxins, Tobacco, Drugs, Alcohol
- High temperature
- Hernia repair
- Undescended testicles
- Mumps after puberty
2
Q
Female Fertility Issues
A
- Irregular Ovulation
- Obstruction or malformation of the reproductive tract (STI etc…)
- Endometriosis
- Toxins, Tobacco, Drugs, Alcohol
- Chronic Conditions — Diabetes, SCI etc…
- Hormone: pituitary imbalance and/or thyroid conditions
Infections - Polycystic Ovary Syndrome
- Body weight, Eating Disorders, Excessive Exercise
- Abnormal Pap smears
- Multiple pregnancy losses
- Age
3
Q
Menstrual Cycle
Has four phases…
A
- Proliferation Phase (9 days)
- Ovulatory Phase
- Secretory (Luteal) Phase (14 days)
endometrium thickens; secretion and blood increase due to follicle’s manufacture of progesterone
estrogens and progesterone decrease suddenly - Menstrual Phase (5 days)
surface of endometrium is sloughed off; bleeding occurs
4
Q
Proliferation Phase
A
- begins with the end of menstruation
- lasts 9-10 days
- egg develops and endometrium proliferates
- also known as the follicular stage when certain ovarian follicles mature
- ovaries prepare for ovulation
5
Q
Ovulatory Phase
A
- A Graafian Follicle ruptures and releases a mature ovum. The other ripening follicle degenerate and are reabsorbed
- Occasionally 2 ovum are released = fraternal
- Ovulation is set in motion when estrogen levels reaches critical levels.
- Basal body temperature usually dips slightly at ovulation and raised by 0.5C on the day following ovulation
- estrogens reach peak level in blood, causing ovary to release egg
6
Q
Secretory (Luteal) Phase
A
- Approximately 15 days
- Graafian follicle become the corpus luteum
- Progesterone and Estrogen levels peak around the 20 or 21st day of cycle causing the glands in the endometrium to secrete nutrients that would sustain a fertilized ovum.
- If no fertilization occurs the corpus luteum decomposes and hormone level fall.
7
Q
Menstrual Phase
A
- approximately 5 days
- Uterine lining (endometrium) is sloughed off into the menstrual flow.
- Caused by the drop in estrogen and progesterone levels.
- Menstruation is the passing of the lining through the cervix and vagina
8
Q
Menstrual Cycle
A
- Rising estrogen and LH surge leading up to ovulation
- In the follicular part of the cycle, the lining of the uterus develops
- In the Secretory (luteal) phase it is maintained by the elevated progesterone secreted by the corpus luteum
9
Q
Prediction Ovulation: Charting basal body temperature
A
- typically there is a small drop in early morning temperature just prior to ovulation.
- the temperature then rises significantly afterwards
10
Q
Prediction Ovulation: Assessing cervical mucus
A
- women can examine and track the consistency of cervical mucus throughout their cycle.
- cervical/vaginal mucus becomes clear, slippery and stretchy, (egg whites) on the days just prior to ovulation
11
Q
Pregnancy Tests
A
- tests designed to detect human chorionic gonadotropin (hCG)
- women produce hCG soon after conception
- hCG can be detected in the urine approximately 3rd week of pregnancy
- blood test can detect hCG as early as the 8th day
12
Q
Length of Pregnancy
A
- most people think of pregnancy as lasting nine month
- it is actually 280 days, usually calculated from the first day of the last menstrual period
- date pregnancy from date of fertilization which is usually 2 weeks after the beginning of the last menstrual cycle
- normal gestation is 266 days or 38 weeks
- most babies are born +/- 10 days
13
Q
Prenatal Development
A
- Germinal Stage: conception to implantation
- Take the Zygote 3-4 days to reach the uterus
- Takes another 3-4 days for the zygote to implant (wander in the uterus)
- Within a few days the cells take on the form of a fluid filled ball of cells class blastocyst.
14
Q
Embryonic Stage
A
- Implantation to 8th week
- Major organs systems begin to differentiate
15
Q
Fetal Stage
A
- 9th week to birth
- By about the 9th or 10th week the fetus starts to response to outside world
16
Q
First Trimesters: conception — 12 weeks
A
The first trimester is from conception through 12 weeks, Conception through the 10th week is referred to as the embryonic period.
- Around the twenty first day the heart begins to start beating.
- This is the critical period of time when all of the major organs and structures are forming — brain, heart, lungs, eyes, ears, arms and legs
- Harmful substances that are ingested can affect the normal growth and development of the fetus
- Around the twenty first day the heart begins to start beating.
17
Q
Second Trimesters: 12-16 weeks
A
- Is a period of rapid growth for the fetus 8cm (3inches)
- Sexual differentiation is beginning to show
- Brain development is very rapid
- Fingers, toes and nails are formed
- Eyes almost fully developed, but lids fused — this happens to - protect nerve fibres
- Heartbeat can be heard with Doppler
18
Q
Second Trimesters: 16 weeks
A
- The baby can feel pain; the fetus may suck its thumb
- The baby makes crying movements
- 15cm and 100gm
- Strong heartbeat
- It moves about, swallows amniotic fluid, and has periods of sleep and wakefulness
19
Q
Second Trimesters: 24 weeks
A
- 28-35cm and 500gm
- Eyelids separated
- Skin wrinkled and red
- Heavy protective creamy coating (vernix)
- May survive if born, but need intensive care, high rate of disability
20
Q
Second Trimesters: 28 weeks
A
- 38cm and 1100gm
- Very wrinkled — no fat yet
- Organs begin to mature and the bones have fully grown but are still soft
- Lungs have not fully grown however it begins to make breathing movements
- The eyelids have finally opened.
- Better survival if born — still need lots of intensive care
- Mom beginning to feel less nausea and fatigue increased energy and wellbeing
- Uterus lifts out of pelvis — less pressure on bladder
- Week 12+ — Pigmentation: linea nigra, mask of pregnancy, breasts dark
- Increased vaginal discharge (milky)
- Week 16+ — Breast fluid: clear, yellow colostrum
21
Q
Third Trimester: 29 weeks — Birth
A
- Major organs developed, time of growth in weight and storage of materials e.g., vitamins, minerals, fatty acids
- The brain has grown rapidly
- Most organs have fully grown expect the lungs
- The kicks and movements of the fetus are now strong enough to be seen and felt on the outside
- The skin is now less wrinkled and red
- Fetus has moved to the birth position
- During the last month of pregnancy, the baby can gain as much as half a pound a week
- The mother may not feel the fetus move as much because it has filled up much of the room, your midwife or doctor may instruct you in fetal movement counts.
- Week 34+ Awkwardness, Depression, Heartburn, Hemorrhoids, Pelvic Pain, Difficulty Sleeping, Stuffy Nose
- Week 37 -, pressure on bladder, increased pelvic pain, Lightening (baby descends into the pelvis)
22
Q
Prenatal Care
A
- Choosing a caregiver: obstetrician, family doctor, midwife
- First Visit: history, physical, blood work, lab work
- Next Visits: weight, blood pressure, growth of uterus, baby’s heart beat, baby’s position, urine — glucose & protein, education
23
Q
Routine Prenatal Tests by Gestation
A
11-16 weeks: genetic screening
18 weeks: ultrasound
24-28 weeks: repeat blood tests, diabetes screen
28-30 weeks: Rh immune globulin to Rh negative women
36 weeks: Group B Strep
41 weeks: non-stress test, biophysical profile
24
Q
Genetic Screening
A
- Maternal serum screen (16-20 weeks)
- neural tube defects
- down syndrome and other major chromosomal disorders
- Chorionic villous sampling (11-13 weeks)
- Amniocentesis (15-20 weeks)
25
Q
Folic Acid
A
- Promotes the development of the brain stem, spinal cord, and red blood cells
- Need is greatest in the first month of pregnancy
- Recommended amount: 0.4 - 1.0mg daily & 4-5mg if at risk
- Risk: family history of neural tube defects
- Arthritis drugs with methotrexate
- Inflammatory bowel disease
- Recommend — prenatal supplement with folic acid
26
Q
Iron
A
- Deficiency: fatigue, cardiovascular
- RDA - 27mg/day
- Take with foods high in Vitamin C
- Caffeine inhibits the absorption — avoid drinking coffee, tea, cole, chocolate with meals
- Avoid taking with calcium
27
Q
Calcium
A
- Important for development of bones and proper muscle function
- Recommended intake: 1000 - 1300mg daily
- If you do not drink milk or eat dairy products:
- Drink calcium fortified beverages like orange juice, soy beverage
- Eat tofu, canned sardines or salmon with the bones
28
Q
Vitamin D
A
- increases the absorption of calcium
- required for both bone development and for maintaining the strength of the mother’s bones
- Recommended: 400 IU
- Sunlight during the summer, but during the winter we get very little
29
Q
Essential Fatty Acids
A
- Dietary fatty acids need for
- proper fetal neural and visual development
- maintenance of pregnancy
- Sources: Fish, Canola, Flax Oil, Nuts, Seeds
- Maintenance of pregnancy — may decrease the risk of preterm birth
30
Q
Water
A
- Carries nutrients to cells
- Carries away waste products
- Keeps you cool
- Drink at least 48-64 ounces “straight” or as other fluids (eg. milk, soup)
31
Q
Caffeine
A
Maximum — 300mg/day Why Worry? - Some appears in the breast milk - Crosses the placental barrier - May stimulate the fetus or baby - High intake increases the risk of premature delivery
32
Q
Artificial Sweeteners
A
Appear “safe” but use in moderation - Aspartame - Sucralose - Acesulfame Potassium Not Safe (effect on fetus unknown) - Saccharin - Cyclamate
33
Q
Alcohol
A
- No safe level of alcohol for an unborn baby
- Impacts physical development and brain growth
- Regular drinking increases the risk of miscarriage
- Risks include Fetal Alcohol Spectrum Disorder (a permanent condition) and low birth weight
34
Q
Smoking: Pregnancy
A
- Premature rupture of membranes
- Placenta previa
- Placental abruption
- Preterm birth
- Birth complications
- Haemorrhage
35
Q
Smoking: Infant
A
- SIDS
- Respiratory problems
- Ear infections
- Hospitalization
36
Q
Signs of Labour
A
- Lightening or Engagement: Relieving the pressure
- Effacement: Ripening of the cervix
- Dilation: Opening of the cervix
- Bloody show: Loss of mucus plug
- Nesting: Spurt of energy
- Rupture of membranes: Your water breaks
- Contractions: When labor pains being
37
Q
First Stage of Birth
A
- Dilation and effacement of the cervix
- Latent (0-3cm)
- Active
- Transition (8-10cm)
38
Q
Second Stage of Birth
A
- Pushing
- Descent of baby through birth canal
- Episiotomy
- Birth of the baby
39
Q
Episiotomy
A
- performed when babies head has crowned
- usually performed when the baby’s shoulders are too wide to emerge without tearing or if baby is in distress (heartbeat drops)
- rates have drop from 1/2 vaginal births to about 1/3
40
Q
Third Stage of Birth
A
- Placenta is expelled
- Uterus begins to contact
- 5 to 60 minutes
41
Q
Breastfeeding
A
- provides optimal nutrition, immunological and emotional benefits for the child’s growth and development
- Breastfeeding is on the rise
2001 — 81.5%
2005 — 87%
