Exam 1 Flashcards
period between conception and before the onset of labor=pregnancy
Antepartum
before birth of infant
Prenatal
period of time shortly before and after birth beginning at approximately 28 weeks and ending 1 to 4 weeks after birth
Risk for preeclampsia during this period
Perinatal
start of labor until birth
Intrapartum
period after delivery
1-4 hours after delievery
Postpartum
period of time after delivery until involution of the uterus is complete–approx. 6 weeks
Puerperium
neonatal – first 4 weeks after birth
Newborn
branch of medicine concerned with the care of women during pregnancy, childbirth, and postpartum
Obstetrics
care rendered by nurse to mother and infant throughout the reproductive process
Focus on health promotion and family
Maternity nursing
Primitive eggs
What will develop into a baby when pregnant
Oocytes
developing organism week 3 through end of week 8
All organs are being formed
Most deadly time for embryo
Embryo
infant in uterus from week 9-birth
Fetus
factors in chromosomes responsible for transmitting inherited traits of individual–units of heredity
Genes
process by which cells divide by meiosis to form gametes
Gametogenesis
2 meiotic divisions result in 4 sperm
•22 single chromosomes and X or Y sex chromosome=23 total
Male – spermatogenesis
2 meiotic divisions result in 1 ovum and 3 small polar bodies
•22 chromosomes and X chromosome
•Second meiotic division is completed if a sperm fertilizes the ovum
Female – Oogenesis
body’s chemical messengers.
•The endocrine and nervous systems work very closely together.
• travel in your bloodstream to tissues or organs.
•The endocrine system constantly adjusts these levels so that the body can function normally. This process is called homeostasis.
Hormones
3 places that send out hormones
- Pituitary
- Thyroid
- Ovaries
Hormone Functions:
- Growth and Development: ex: puberty
- Metabolism
- Sexual function: ex: estrogen makes it slippery by “fluid retention”
- Reproduction: need progesterone: keep uterine lining thick and prevents contractions
- Mood
first one released kicks off hypo pituitary to release LH
GnRH
finish off oocyte to ovum and kicks it off
LH
stimulates ovaries and follicles
FSH
causes maturation and fluid retention
Estrogen
keeps uterus thick and luscious
Keeps it from contracting
Progesterone
Growth and development, like muscle
Testosterone
Insulin resistance to share calories with baby
HPL
milk production
Prolactin
cartilage on body to make room for baby
relaxin
starts contractions
Want it on week 40
Works on breast when testosterone in gone
Allows “let down”
Oxytocin
Beginning when the oocyte is stimulate FSH and LH by GnRH
ovarian cycle
Gonadotropin Releasing Hormone (GnRH) stimulates the release of FSH and LH.
•The immature follicle matures due to Follicle Stimulating Hormone (FSH)
•The oocyte within the follicle is growing
•Luteinizing hormone (LH) allows for final maturation and release of ovum.
•High levels of Estrogen is secreted until ovulation
•Progesterone then surges
Day 14 = a mature graafian follicle appears near the surface of the ovary
•The ovum is now released near the fimbra of the fallopian tube and will travel to the uterus
•Only fertile for 6 to 24 hours
•It reaches the uterus in 72 to 96 hours after being released from the ovary
Follicular phase (phase 1)
Luteal phase(days 15 to 28)
•Begins when the ovum leaves its follicle
•A corpus luteum develops from the ruptured follicle
•If the ovum is fertilized it the corpus luteum will secrete large amounts of progesterone and a small amount of estrogen
•If the ovum isn’t fertilized the corpus luteum will degenerate
•Menstruation will occur 14 days after ovulation if the ovum wasn’t fertilized
Ovarian cycle (phase 2)
Prevents ovulation by inhibiting release of gonadotropins, inhibits ovulation, increase uterine mucous viscosity
•Acne, Endometriosis, Dysfunctional Uterine Bleeding, Premenstrual dysphoric disorder
Makes body think you have HCg, which gnRH won’t produce
contraceptive drugs
Oral: mostly estrogen-progestin combinations
•Injection: Depo-Provera, progestin only
•Transdermal Patch
•Vaginal Ring: NuvaRing
examples of contraceptive
Hypertension: due to increase in cardiac output •Thromboembolism •Alteration in lipid and carb metabolism •Increases in serum hormone concentrations: to have enough energy so you need proper diet •Edema: BP is increasing •Headache •Weight gain •Breast changes •Nausea and vomiting
Adverse effects of contraceptives
•Occurs when a sperm penetrates an ovum and unites with it
•After ovum released it has 6-24 hours to be fertilized
•Sperm can live 72 hours but most fertile during the first 24 hours
•200-600 million sperm released in 2-5 ml of semen
Usually occurs in ampulla of fallopian tubes, close to ovary
•High estrogen at ovulation
•thins cervical mucus
•increases motility of ovum
Fertilization and conception
- Ovum always contributes an X chromosome
- Sperm contributes an X or Y chromosome
- XX= female
- XY= male
- pH level and estrogen levels contribute to sex determination
Sex determination
•Zygote divides many times to form morula and begin travel down fallopian tube to uterus
•
Development
becomes embryo, amnion, and yolk sac membrane
2 layer substance that turns into uterine lining
Inner layer
Blastocysts (Morula 1st layer)
becomes fetal side of the placenta and chorion
outer layer
Trophoblast (Morula 2nd layer)
- Approximately 7-9 days
- Trophoblast layer sends out “feelers” called chorions that burrow into the wall of uterus.
- Common implantation site in upper posterior wall
- Endometrium of uterus now called decidua
Implantation
decidua over the blastocyst
grows over blastocyst - cap
Decidua capsularis
part of the endometrium in which the blastocyst imbeds
Becomes maternal placenta
Thickest part of uterine wall - base
decidua basalis
the remaining uterine lining - outside
decidua vera
•At implantation, previously identical cells begin to differentiate and become specialized
Cell differentiation
•develops from trophoblast and surrounds the amnion, embryo, yolk sac
•Villi extend into decidua basalis and form embryonic placenta
Closest to mom
Chorion
thin membrane that surrounds and protects the embryo
Closest to baby
this and chorion fuse together and form amniotic sac which you need for growth and development
Amnion
- 98% water, slightly alkaline, and contains many nutrients, fetal urine, skin cells, lanugo hair
- Average volume 800-1000ml at birth
- Fetus swallows up to 400 ml/day and urinates it
- Abnormalities
- hydramnios(polyhydramnios) >2000ml (Uterus will grow too much and go into labor)
- oligohydramnios
Amniotic fluid
- Maintains even temperature
- Permits embryo to float and develop symmetrically
- Aids in develop of lungs and gastrointestinal systems
- Cushions against blows to maternal abdomen
Functions of Amniotic Fluid
- Temporary organ
- Forms when chorionic villi extend into decidua basalis
- Forms around week 3 and grows through week 20
- Thickens and matures until 6-8 in. diameter and 1 in. thick
Placenta (1)
- arises from decidua basalis
- Large number of arterioles and venules
- 15-20 segments called cotyledons
- Raw beefy appearance
- “Dirty Duncan”
Maternal Placenta
- develops from the chorionic villi and blood vessels
- Covered by amniotic fetal membrane
- Smoother, grayish, shiny appearance with many blood vessels
- “Shiny Schultze”
- Umbilical cord should attach in center
Fetal Placenta
- Two sides separated by thin membrane
- Maternal and fetal blood pass close to each other but don’t intermix
- Fetal blood may enter maternal circulation when placenta separates at delivery, or if placenta injured during pregnancy–Rh factor
- At birth the baby breathes and the cord is clamped, ending fetal circulation
Placental Circulation
- Gas exchange between mother and fetus
- 2 arteries carry deoxygenated blood to mother
- 1 vein carries oxygenated blood to fetus
- Nourishment and Excretion
- delivers necessary nutrients and clearance of fetus’ metabolic waste products
- Hormone production influences growth and maintains pregnancy
- hCG (human chorionic gonadotropin)
- Estrogen
- Progesterone
- HPL (human placental lactogen)
- Relaxin
- Placental barrier
- Nicotine, drugs, alcohol, viruses cross
Placenta fuctions
- Lifeline between mother and fetus
- Forms concurrently with placenta
- 20-22 inches long, 0.8 inches thick
- 2 arteries (bring deoxygenated to mom) , 1 large vein (Bring oxygenated to baby)
- Wharton’s jelly surrounds the vessels and keeps them separate
- Center insertion. Battledore or velamentous abnormal insertions.
Umbilical cord
- Begins with fertilization through implantation.
- Rapid cell multiplication and differentiation
- Germ layers form
Pre-Embryonic or stage of ovum
- Starts approximately week 4 through end of week 8
- Tissue differentiation in all organs
- Week 3: Brain differentiates in 5 areas and all 12 cranial nerves are present
- Heart forms and begins beating at 4weeks
- Gastrointestinal tract begins to develop
- Lung structure, Liver, Kidneys developing
- Arm and leg buds at 5 weeks with muscle innervation
- Hematopoiesis begins at 6 weeks
- Renal system begins to function at 8 weeks
Embryonic Stage
Keeps cord from kinging
Wharton’s jelly
- Structures refining and perfecting functions
- Week 10–eyelids close and don’t reopen until week 28
- 10-12 weeks heartbeat can be heard by doppler
- 12 weeks
- kidneys producing urine
- digestive system shows activity
- genitals well differentiated
Fetal stage week 9-40
Quickening
Mother feels Fetal movement - 12-20 Weeks
Fetal Stage
Fine hair completely covers baby
Lanugo
Fetal Stage
if baby is born with not enough glucose they use this for energy and heat production
brown fat forming
Fetal Stage
Provides gas exchange in lungs
Alveoli
Fetal Stage
Cream cheese substance that protects skin from embryotic fluid
Vernix Caseosa
Nostrils open, respiratory movements occur without actual breathing, alveoli produces surfactant (important sign of lung maturity)
24 weeks - fetal stage
- eyelids reopen, lashes and eyebrows present
- fetus looks like little old man
- nervous system begins regulatory functions
- testes descend into scrotum
- weight approx.. 2-2 1/2 lbs. (0.9-1.1 kg)
28 weeks - fetal stage
•respiration and thermoregulation possible if fetus delivered
•continue to gain weight–4-4 1/2 lbs. (1.8-2.0 kg)
•Skeleton fully developed but not calcified to ease delivery
Still no adipose tissue for temp
Able to take some oral feeding now
32 weeks - fetal stage
•weight 5-6 lbs. (2.2-2.7 kg) •diminishing lanugo •“filled out” appearance •still has a lot of vernix •soft ear shells and lobes •very few creases on soles of feet Adipose tissue is forming and baby is individualized
36 weeks - fetal stage
- average weight 6-8 lbs. (2.7-3.6 kg)
- Skin pink and smooth
- vernix in skin folds, lanugo on shoulders and upper back
- firm ear shells and lobes
- many creases to sole
- well developed labia, scrotum w/ rugae
38-40 weeks - fetal stage
two ova fertilized by separate sperm=fraternal, nonidentical
•NOT genetically alike
•2 amnions, 2 chorions, 2 placentas that may be fused together
•May be same sex or different sexes
•increases in frequency with maternal age, parity, fertility drugs
•Occurs more in African-American women
Dizygotic Twin
- 1 ova, 1 sperm
- Fertilized egg then divides to produce 2 fetuses=paternal, identical
- Always the same sex, same genes
- If division occurs immediately after fertilization=2 embryos, 2 amnions, 2 chorions and 2 placentas
- More frequently division occurs between 4-8 days after fertilization
- 2 embryos, 2 amnions, 1 chorion, and 1 placenta
- If division occurs after 8 days (rare)
- 2 embryos, 1 amnion, 1 chorion, 1 placenta
- can cause cords to tangle=fetal death
- Very late division–may not divide completely and produce “Siamese” twins
- Identical twins occur in 1 of 250 births
- Fertility drugs increase incidence
- No increased associated with race, age, or parity
Monozygotic Twins
