What is atraumatic care?
Ensuring that every exposure to healthcare does not result in fear, anxiety, or trauma.
This prevents impacting their health seeking behaviours as adults.
What is a genogram?
A pictorial display of a person’s family relationships and medical history.
What is an eco map?
A graphical representation of all the systems that play a role in a person’s life
What are the causes of infertility in women?
Ovarian factors
Tubal factors
Peritoneal factors (endometriosis)
Uterine factors
Vaginal-cervical factors
BMI >35 or <19
What is hysterosalpingography?
X-ray after shooting dye into uterus to see if tubes are blocked
What is a laparoscopy?
Minor surgery, incision into abdomen for camera
What are causes of infertility for males?
Undescended testes
Hypospadias
Varicocele (varicose vein of the scrotum)
Low testosterone levels
Substance use
Scrotum temperature
Smoking
How is infertility diagnosed (time frame)
1 year of trying if woman < age 35
6 months of trying if woman > age 35
What is spinnbarkeit?
Ovulating cervical mucous
What are three methods to test for male infertility?
semen analysis
hormone analysis
scrotal / transrectal ultrasound
What type of lubricant will make it harder for pregnancy to occur?
Water based lubricant
What is gametogenesis?
Formation of sex cells (eggs + sperm)
Oogenesis
Egg creation
Spermatogemesis
Sperm creation
Conception
Sperm meets egg and implants into uterus
Teratogen
Unintended negative effect on the development of a pregnancy
When during a pregnancy is spontaneous abortion common?
1-2 weeks
When during a pregnancy can major congenital anomalies occur?
From 3-7 weeks
When during a pregnancy can functional defects and minor anomalies occur?
8-38 weeks
What is the yolk sac?
Gives fetus nutrients and oxygen before placenta is grown
How long does it take for the placenta to fully grow?
12 weeks
What are the 2 layers of the amniotic sac?
Amnion
Chorion
Amnion
Covering on the outside of the amniotic sac, contains amniotic fluid
Chorion
Covering on the fetal side of the amniotic sac, contains major umbilical chord blood vessels
What blood vessels are in the umbilical chord?
1 vein
2 arteries
When does the placenta deliver, and what are the risks if it doesn’t?
Normally delivers within 30 minutes
If not, there is a significant risk of postpartum hemorrhage
Will go to OR for surgical removal
What are the four main functions of the placenta?
Gas exchange (placenta = lungs of the fetus!!!)
Nutrition
Hormone production (placenta makes hormones that sustain pregnancy, like HGC, progesterone, estrogen)
Waste removal
Placentophagy
Eating one’s own placenta
What are the benefits of placentophagy?
Extra nutrients and iron
What are the risks of placentophagy?
Risk of infection if placenta grows bacteria before consumption.
Risk of baby death from breastfeeding after eating placenta if mother has group b strep (GBS) (30% of population carries it)
What is the benefit of delayed chord clamping?
If the clamping of the umbilical chord is delayed for 60-90 seconds, the placenta continues to send oxygen and nutrients to the baby.
At 6 months of age, the baby will have increased iron levels
What is the purpose of amniotic fluid? (3)
Protects umbilical chord from compression.
Reduces friction.
Temperature stabilization
Oligohydramnios
Low amount of amniotic fluid
Polyhydramnios
High amount of amniotic fluid
more common in people with diabetes
When is the fetal stage?
10 weeks gestation
What is fetal viability and when is it?
Fetal viability is if the fetus can survive outside of the uterus
22 weeks gestation
Foramen ovale
Fetus has shunt (hole) between both atriums to keep blood moving so half of blood isn’t going to lungs
Ductus arteriosus
Shunt between pulmonary artery and aorta, allows oxygenated blood to bypass the pulmonary circulation
Ductus venosus
Connects umbilical chord to inferior vena cava, allows oxygenated blood in the umbilical vein to bypass the liver
Fetal surfactant
Supports air breathing, helps to lower surface tension of lungs thus preventing collapse
What is the L/S ratio
a test of fetal amniotic fluid to assess for fetal lung immaturity
normal value is 2 - 2.5
What is practice breathing?
Lungs contract and expand without gas exchange in utero near end of pregnancy
Hepatic system
iron storage (first 5 months of life, iron from mom)
Why are babies given a shot of vitamin K at birth?
a single vitamin K shot at birth protects your baby from developing dangerous bleeding which can lead to brain damage and even death.
Meconium
baby’s first bowel movement, usually passed within 48 hours postpartum
is a very dark green, almost black color
When will babies begin to react to sound and movement in utero?
24 weeks
Development of neural tube
neural tube = brain + spinal chord
initally open at the end
if neural tube does not close = spinal bifida
When do the genetalia differentiate?
9 weeks
What holds the unfused skull bones together?
fibrous connective tissue
Vernix caseosa
thick white moisturizer covering baby’s skin at birth
Lanugo
Body hair lost in first few months, helps keep vernix caseosa on skin
Monozygotic
one egg, identical twins
Dizygotic
two eggs, non-identical twins
Monochorionic
one placenta
Dichoriotic
two placentas
Monoamniotic
one amniotic sac
Diamniotic
two amniotic sacs
Chlamydia
bacterial sti
often asymptomatic
can lead to reproductive complications
Gonorrhea
bacterial sti
2/3 cases are men
can lead to reproductive complications
symptom: thick discharge, painful urination, pain
Syphilis
bacterial sti
progresses in stages
infectious in first year after contraction
individuals develop small, painless sore
3rd stage of syphilis can lead to death
Genital herpes
viral sti
HSV-1 = cold sores
HSV-2 = genital sores
has flare ups
Hepatits B
viral sti
found in body fluids
chronic infection damages liver
no outward signs of infection (flu-like symptoms)
Human Immunodeficiency Virus
viral sti
attacks body’s immune system
fatal stage of HIV = AIDS
transmitted through body fluids
Human Papillomavirus
viral sti
most common sti
low risk = anogenital warts, lesions
high risk = cervical cancer
transmitted through sexual activity
What are the 4 types of contraception methods?
Behavioural methods
Barrier methods
Hormonal methods
Permanent methods
What are 4 types of behavioural methods for contraception?
Abstinence (no sex)
Fertility-awareness
Withdrawal (coitus interruptus)
Lactational amenorrhea method
What are 4 barrier methods for contraception?
Condom (male & female)
Diaphragm
Cervical cap
Sponge
What are 7 hormonal methods for contraception?
Oral contraceptive
Injectable contraceptive
Transdermal patch
Vaginal ring
Implantable contraceptive
Intrauterine contraceptive
Emergency contraceptive
What are 2 permanent methods for contraception?
Tubal ligation
Vasectomy
How do oral contraceptives work?
They suppress ovulation by adding estrogen and progesterone to the body, mimicking pregnancy.
How do mini-pills (oral contraceptives containing only progesterone) work?
They thicken the cervical mucus to prevent penetration of the sperm
Up to how many months do injectable contraceptives work?
Up to 3 months
What is Depo-provera?
An intramuscular injectable of progesterone only contraceptive given every 12 weeks
What is a risk of using injectable contraceptives?
Loss of bone density
For how many weeks is a transdermal patch effective?
3 weeks, followed by 1 week patch free
What is the vaginal ring?
Hormonal method (both estrogen and progesterone)
Inserted in vagina for 3 weeks and then 1 week ring free
What are implantable contraceptives?
Subdermal time-release method.
Delivers synthetic progestin that inhibits ovulation.
Is effective for 3 years.
What are intrauterine contraceptives?
Can be hormonal or non-hormonal.
Prevent pregnancy by inhibiting sperm mobility and viability.
Usually can be effective for 5 years.
What is the copper IUD?
non-hormonal intrauterine contraception.
can remain in place for 10 years.
works by releasing copper ions, which are spermicidal.
What is emergency contraception?
used within 72 hours of unprotected sex.
reduce risk of pregnancy by 80%