1. Pregnancy and Newborns

2. 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

3. 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

4. Effects of Pregnancy on Mother Effects of Pregnancy on Mother

5. 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

6. Gastrointestinal System excessive salivation morning sickness: increase of hormones heartburn: esophagus & stomach is crowded constipation: motility of digestive tract declines

7. Urinary System urination more frequent & sometimes uncontrollable uterus compresses bladder kidneys also have to dispose of fetal wastes

8. Respiratory System lung volume decreases nasal stuffiness

9. 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

10. ParturitionParturition Birth 280 days after conception

11. 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

12. 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

13. 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

14. 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

15. 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

16. Methods of delivery Vaginal delivery Cesarean Section

17. 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

18. 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

19. 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