pregnancy Flashcards
The pregnancy support system
A human egg is just large enough to be seen
After fertilisation, egg begins to divide, first into 2 cells, then 4, then 8 and so on until it is a mass of cells(resembling a bunch of grapes)
The egg attaches itself to the walls of uterus, called and embryo
these cells make the embryo but also placenta, umbilical chord, and amniotic sac
These structures are put in place to support baby and are expelled at birth
embryo develops blood, bone and muscles and heart starts beating around 3 weeks after conception
From about 8 weeks it is called a foetus
Cervix
A ring of muscle that surrounds outlet of uterus
Expands at birth
cervical mucus
The muscle forms a plug which seals the uterus during pregnancy and prevents infection
Uterus wall
Made of muscle
The muscle tissue expands as embryo grows
A uterus weighing 30g at start of pregnancy may weigh 1kg at then end
Placenta
A large thick, disk like structure firmly attached to wall of uterus
A very important organ which baby will get oxygen and nutrients from
grows along with baby and is 15cm in diameter and 500g in weight at birth
Blood from baby flows back and forth from umbilical chord to placenta, collecting nutrients and oxygen and getting rid of c02 and waste matter
Antibodies, viruses alcohol, medication and chemicals from smoke can cross the placenta from blood of mother to blood of baby.
Amniotic sac
contains amniotic fluid
the baby will grow in the sac
Amniotic fluid
acts as a cushion against shocks
protects baby from being harmed
protects baby from conception
keeps foetus at 37*C constant temp/ body temp
umbillical chord
links baby with placenta
will grow 50cm long and 2cm wide
contains 3 blood vessels from the baby-this is how nutrients get back to the baby
One vein carries nutrients and oxygen from the placenta to the baby
Two arteries carry waste from the baby back to the placenta.
6 weeks
6mm long size of a pea
arms and legs starting to form known as limb buds
tiny dents where ears are meant to be and thickenings where eyes will be
heartbeat 110bpm
embryo is covered with thin layer of transparent skin
14 weeks
around 8.5cm long from head to bottom , size of kiwi fruit, weighs about 55g
head is rounder and in more proportion with body
baby is kicking around and heartbeat is around 170bpm, may be heard using ultrasound on mothers abdomen
foetus can swallow, frown, clench fist and move by turning head and kicking
small amounts of amniotic fluid are swallowed by baby and pass into stomach
kidneys kick in a fluid is passed out again as urine
sex organs develop
20 weeks
25.6cm long, size of banana and weighs 350g
head and body will be more in proportion
Fat under skin make it less wrinkled and they are now covered in a white greasy layer of vernix, protects skin from drying out in the amniotic fluid, it helps babies make their way down birth canal, baby will be more active each day
As well as kicking, punching or turning around, the baby could be sucking their thumb
mother can feel movement in uterus as baby practices using its muscles
eyelashes and hair grow on head
28 weeks
development is almost complete
foetus is around 37.6cm long weighing the size of an aubergine and weighs about 1kg
babies heartbeat is around 140bpm
has fingernails, eyes open has eyelashes and can hiccup
will spend the remaining time in uterus growing stronger and larger
become more plump as layer of fat is stored under skin
by week 32 the baby is usually lying head downwards and ready for birth
40 weeks
foetus is around 51.2cm long from head to heel, approximately size of pumpkin
weight 3.5kg but some may be as large as 4.5kg
heartbeat will be around 130bpm
with little room left in uterus at 40 week, baby should be nearly ready for birth
movements do not slow down, if they do it could be a sign that something is wrong ,baby is usually lying with its head downwards, ready for birth
baby’s head can engage or move down into pelvis ,before birth. Sometimes head does not engage until labour has started
Preterm babies
Preterm babies are born before 37 weeks, if born at 37 weeks the baby may be a little slow to feed
born before 33 weeks will possibly have serious problems like immature lungs
if born before 28 weeks there are significant problems but survival rate is remarkable, physical difficulties
if born before 24 weeks, little chance of surviving. The lungs have not yet finished developing and baby will not be able to breath properly
Most preterm babies weigh less than 2.5kg, being small and under developed , they may need special care
stage 1
Regular strong contractions occur, start very slowly
become stronger ,more frequent.
During first stage of labour contractions of the muscles in the wall of the uterus gradually open cervix
membranes rupture, usually at very beginning of labour and it comes an end when cervix is opened enough for babies
head to pass through
Some lie on back, side, prefer to crouch or kneel for at least part of the labour.
Longest stage of labour
stage 2 baby passes through birth canal
uterus, cervix and vagina is now one continuous birth canal
contractions are very strong and they push baby headfirst through birth canal
when widest part of babies head gradually emerges from vagina it is called crowning
when head is fully emerged midwife may clear mucus from nose and mouth
baby may start to breath and even cry before rest of body slides out into the world
sometimes vagina opening will not stretch further enough for head to pass through
An episiotomy is sometimes carried out under local anaesthetic, small cut is made to widen opening between vagina and anus and prevent skin from tearing
Stage 3
baby becomes a separate person
once baby is breathing, the umbilical chord is clamped in two and cut separating mother from baby
clamping chord prevents bleeding
cutting cord does not hurt either mother or baby
when baby appears skin is a bluish colour, as soon as breathing starts, skin quickly turns pink
contractions continue until placenta becomes separated from wall of uterus and pushed out through the vagina
release of hormone oxytocin makes uterus contract and become smaller, make
makes placenta start to separate from uterus; some bleeding will occur as placenta is passed
mother may be given an injection of syntometrine to speed up process and prevent excessive blood loss
if haemorrhage occurs, oxytocin or ergometrine may be injected which helps the womb contract and stop the bleeding
medical
midwives and anaesthetists in hospital administer these methods of pain relief, pregnant women may experience side effects of medication
complementary
different approach to pain management, which includes therapies that are not usually part of conventional care such as hydrotherapy, may not be available in all hospitals
Pethidine
morphine like opioid, helps relieve pain by making women more relaxed. The midwife will inject pethidine into deep muscle, thigh or bottom , takes 20 to 30 minutes to take effect
Advantages
administered by midwife
helps mother relax
quick working
Disadvantages
may cause drowsiness, nausea and dizziness
Cause mum to feel less in control
crosses placenta to baby
may affect babies breathing
born drowsy
may affect sucking reflexes
cannot be given too close to birth
Entonox
mixture of nitrous oxide, inhales it through mask or mouthpiece when contractions occur to help mange pain
Advantages of Entonox
Mother in control of usage
quicky wears off when mother stops breathing in it
will not harm baby
used during water bath
helps mother take deep breath concentrate on slower breathing
midwife cand administer
Disadvantages
Does not take away all the pain
may cause mother to feel lightheaded and nauseous
used for long periods of time, causes dry mouth
not as useful during second stage of labour when mum has to push baby out
Remifentanil
powerful morphine type drug, administered through drip inserted into vein in arm or hand attached to a patient controlled analgesia pump(PCA), presses button on pump for every contraction and a small does of remifentanil is given directly into bloodstream providing pain relief on demand, reducing severity of pain
Advantages
women controls when it is administered
helps mother feel relaxed during contractions
pain relief wears off quickly in between use helping mother feel in control
Disadvantages
Experience nausea, vomiting, drowsiness and dizziness
may not take pain away so additional pain relief can be used like gas and air
can pass to baby and cause them to be drowsy after delivery
Epidural
regional anaesthesia, stops pregnant women feeling contractions by making her go to sleep by blocking nerves that carry pain sensation to brain
an anaesthetist uses needle in a small plastic tube called a catheter into an area around spine the epidural space where nerves of uterus, birth canal and spinal chord meet, epidural completely numb women from waist down
Advantages
mother will feel calmer and less stressed during her labour
offers complete pain relief
does not cause drowsiness enables pregnant women to make informed decisions about labour and delivery
top ups can be given throughout labour to maintain pain relief
Disadvantages
cannot feel contractions so relies on midwife to tell her when to push
can take up to 40 minutes to be in effect
catheter will be fitted in urinary tract as mother will not be able to pass urine
midwife will monitor pregnant women’s blood pressure regularly as epidural may cause her blood pressure to fall. most women will be given intravenous drips of fluid to prevent this from happening
small risk of headaches
needs to be given by an anaesthetist
Tens( transcutaneous electrical nerve simulation)
form of pain relief controlled by handheld device, sends mild electrical impulses to sticky pads on lower back
electrical impulses stimulate nerves that run down spinal cord to block the transmission of pain and release endorphins
Advantages
portable
no lasting side effects
can be used for home and hospital birth
easy to use and no drugs cross the placenta
distracts mum from pain
Disadvantages
may only offer pain relief in early stages of labour
not all hospitals have tens machines so it may need to be hired
cannot be used in an birthing pool
cannot be used by women with pacemakers or heart conditions as it interferes with heart rhythm
mum is unable to take shower or bath to relax.
Hydrotherapy
involves pregnant women immersing herself in warm water in a birthing pool(36.5* to 37*) to chest level during labour.
warm water helps to relax mother during contractions by reducing adrenalin and promoting release of body’s natural hormones to cope with labour pains, midwifes must regulate temp of water as if it is too hot, may lead to exhaustion , blood pressure problems and contractions may slow down
Advantages
water decreases effect of gravity and can help women move more freely and change into a comfortable position
relaxes muscles back and abdominals
encourages endorphins to release
Disadvantages
does not take away all pain
possible risk of infection
not offered in all hospitals
can be more difficult for midwife to monitor baby
Acupuncture
ancient Chinese medicine, fine needles are inserted at certain sites in the body stimulating sensory nerves under the skin and in the muscles, resulting in the body producing natural substances eg pain reliving endorphins
Advantages
helps body produce natural painkillers-endorphins
will not harm baby
can help women to relax
no medical staff needed- can be used for home birth
no drugs, natural method
Disadvantages
Acupuncture is not provided by the NHS so treatment must be paid for
Needles in back may be uncomfortable-unable to lie down or sit comfortable
need acupuncturist to put in needles
Homeopathy
natural form of medicine used treat the both acute and chronic conditions
aims to trigger the body’s natural system of healing, aims to trigger body natural healing system, safe to use and rarely cause side effects
Advantages
does not interfere with medications being taken
non-invasive
Disadvantages
pregnant women must by products from a homeopath
Hypnobirthing/ breathing techniques
involves visualisations, relaxation and deep breathing techniques
breathing deeply, in and out through nose and out through mouth, can help women stay calm and reduce discomfort during labour
Advantages
manages stress hormones such as adrenaline and reduce anxiety, which lead to calmer birth
may help mother feel prepared and in control when labour starts
involve birthing partner during labour
helps mother focus which can distract from pain of labour
Disadvantages
take away pain
if mother panics, she may not be able to remember techniques taught
taught privately so will be a financial cost
Aromatherapy
use of essential oils, come from plants, such as herbs and flowers and are highly concentrated
may send chemical messengers to part of brin that affects pregnant women’s mood and feeling
scents are breathed in or when absorbed by skin through massage
Advantages
help reduce fear, stress and anxiety, headaches, dizziness, and nausea during labour
no harm baby
help birthing partner to be more involved in labour
Disadvantages
pregnant women will have to buy essential oils
qualified aromatherapist must mix the oils
