COMPRE: MATERNAL AND CHILD

OB QUEEN <3

Female
- Cells:
- Gonads:
- Hormones:

Cells: Egg cells
Gonads: Ovaries
Hormones: Estrogen

Male
- Cells:
- Gonads:
- Hormone:

Sperm
Testis
Testosterone

What do you call when the ovary goes to the fallopian tube?

OVULATION

Egg + Sperm Cell =

FERTILIZATION

This is the hormone that is key for ovulation, it prepares the uterus, and prepares the breast for lactation

ESTROGEN

At birth how much egg cell does a girl have?

2 million/ ovary

Egg cell count for 7 yrs old?

500,000 / ovary

Egg cell count for 22 years old?

300,000/ ovary

What happens when there are no egg cells anymore?

MENOPAUSE

what is required for the sperm for it to fertilize?

SPERM MATURITY

What is an average ejaculation?

2.5 ml

per ml of ejaculation is how much sperm?

20 - 200 million

per ejaculation =

400 million

During puberty _________ certain hormones need to spike up

9 - 16 yrs old

Due to low __________ detected by the hypothalamus during puberty, it releases the __________

Estrogen, Gonadotrophin Releasing Hormone

Gonadotrophin means?

Gonads = ovaries, trophy = Growth

GNRH then stimulates the ______ to release _______

APG, FSH

Each egg is surrounded by follicles which will mature to __________, __________, _________ and the most mature _____________

Primordial follicle, primary, secondary, GRAAFIAN FOLLICLE

GRAAFIAN FOLLICLE will cause the surge of _________________ to _________________ phase

Estrogen, Proliferation

P
O
S
I
M
means?

Proliferative/Estrogenic/Follicular (14 days)

Ovulation (14th day)

Secretory, Progesteronic/Luteal phase (8-10 days)

ISCHEMIC PHASE (1-3 days)

Menstrual Phase (Day 1 of cycle)

What phase can shorten or lengthen the cycle of menstruation?

PROLIFERATIVE PHASE

ONce the hypothalamus detects an increase in Estrogen it then signals the GNRH to ___________

Decrease

APG now produces _______

Luteinizing Hormone

Lutein means?

Ovulation

How long does it take for sperm to reach the cervix?

Around 90 seconds

The egg waits at which part of the Fallopian tube?

Near the fimbriae

How long does the Egg cell stay and how long does sperm stay?

Egg cell: 2 days
Sperm: 5 days
Fertile window: 1 week

Lutein causes an increase in _______________ and the yellow body it produces is the _______

PROGESTERONE
Corpus Luteum

this hormone helps in protecting pregnancy by providing a thicker lining, intact lining, thicker mucous, and Relaxes the uterus

Progesterone

The corpus luteum waits for ______ days for hormone _____ from ______

8-10 days
HcG
Chorion

Chorion becomes _________ during ______ of pregnancy

Placenta, second trimester

if no HCG is received by the Corpus Luteum, it enters the ______ phase that lasts for _______ which would then turn to __________ and would proceed with _________ and a decrease in Estrogen and progesterone

Ischemic Phase, 1-3 days, Corpus Albicans, Menstruation

1st menstruation is called:

Menarche

Normal amount of menstruation:

30 - 80 mL if more than 80 mL, report

What do you call an excessive menstruation?

menorrhagia

Duration of menstruation:

3-5 days but 2-9 days is acceptable

Acceptable amount:

1:1, if pads are soaked in less than 1 hour, report.

This is also known as conception or impregnation or when a sperm or egg cell unite

FERTILIZATION

Where do the egg and sperm unite usually?

At the Fallopian tube specifically the AMPULLA

What is the sequence of fertilization?

Ovum

Zygote

Morula

Blastocyst

Embryo

Fetus

This is the fertilized part of the cycle

Zygote

Where mitosis occurs

Morula

Ready to implant “blast”

Blastocyst

This is the cycle where it is already implanted

Embryo

Where is the embryo implanted?

Uterine cavity

Why is the uterine cavity the preferred implantation site?

Uterus has a huge blood supply - 20-40%

myometrium can expand without rupturing

Can contract to expel the fetus

When does organogenesis end? (What week)

8-10 weeks

This is the term used when a couple is unable to conceive after 1 year of trying

Subfertility

How will you identify subfertility in a woman older than 35 years old?

If they are trying for more than 6 mos

Fetal development average weeks and days?

40 weeks, 280 days

Fetal development range?

38-42 weeks

For the first trimester

• Psychological change:

• Psychological task:

• Help:

Change; ambivalence

Task; accept the pregnancy

Help: UTZ for fetal heart to be detected

This is the most delicate part of the pregnancy

1st trimester

1st trimester: FIRST month

Four weeks

Implanted to the embryo

Rudimentary Heart

Spinal cord fusion

Three germ layers

______ is important for spinal fusion especially during _________

Folic Acid, Pre conception

What are the three germ layers?

Ectoderm

Mesoderm

Endoderm

Ectoderm

Eyes, ears, nose

CNS

Touch, taste

Openings of body made up of mucous membranes

Mesoderm

Muscle, muscular system

Enamel of teeth

Skeletal system

Organs (CIRCULATORY, Upper Urinary, Reproductive)

Endoderm

Lower urinary tract

Linings

Lalamunan (thymus, thyroid, tonsils, trachea)

Lungs

First trimester: SECOND month

Sac

Extremities

Contraction of heart is SEEN

Organogenesis is done (8 weeks)

Noticeable face

Digestive organs (d/t swallowing of amniotic fluid)

First trimester: THIRD month

Toothbuds and bones (Calcium 1g/day)

HEAR heart sounds

Ihi is formed

Reflex: babinski

Doppler technology

During the third trimester can we perform amniocentesis?

No, we use chorionic villi sampling because the amniotic fluid is still from the mother

2nd Trimester

• psych change

• Psych task

• Help

Change: narcissism/introversion

Task: accept the baby

Help; quickening

2nd trimester: FOURTH MONTH

Fetoscope/Fine downy hair (Lanugo)

Ordinary Stethoscope (but mas common sa 5th)

Urinates

Reveal gender/sex

2nd Trimester: Fifth Month

Fetal movements (quickening, P: 18-20 weeks, M: 16 weeks)

IgG transfer

Vernix caseosa

E (VC) usually lanugo and VC is decreased during the 36th week so it is expected that term babies only have a few

2nd Trimester: Sixth Month

Scalp hair

Sound

Surfactant

Survivability (24 weeks)

In pre term babies, what usually occurs d/t the lack of surfactant?

Respiratory Distress syndrome

For the babies survival, what is the recommended weight?

500 g

3rd Trimester

• psychological change

• Psych task

• Help

Change: impatient

Task: preparation for parenthood

Help: 4NS

• Name

• Nappies

• Nest building

• Natal wishes

3rd Trimester: Seventh Month

Scrotum

Eyes delicate

Vessel development in eyes (in preterm babies, ventilatory support could lead to blindness)

Eye blinking peaks

Ninety percent survival rate

3rd Trimester: Eight Month

Extends when startled (Moro reflex)

• This reflex is done to test for brachial plexus injury

Iron stores in liver til 6 mos

Grows faster (must be 50 cm in length)

Hermit Faced

Tips of nails are equal to fingertips

3rd Trimester: NINTH MONTH

Near Term

Increased fats (3000 g [2,500-3000]

Nearly 100% Survival

Turn around

Head down (cephalic presentation)

3rd Trimester: Tenth Month

Term - 39-40 weeks

Engaged to the pelvis

• Landmark; ischial spine, station 0

• Primi; 38 weeks

• Multi; varies

Near Birth CCMM

• contractions

• Cervical silation

• Membrane rupture

• Mucus plug

What are the components of EINC?

Drying (immediate)

Early STS contact

Delayed cord clamping

Breastfeeding (exclusive)

What are the other terms for EINC?

Unang yakap

Kangaroo care

Labor and Delivery: expulsion of fetus + placenta, what are the 4P’s

Power

Passageway

Passenger

Psyche

What are the sources of power?

Uterine contractions

Bearing down or mother

What are the passageway?

Pelvis: gynecoid

Cervix - 10 cm

Vagina

What do we consider with the passenger?

Presentation

Size

Position

In psyche, how do we help the parent?

Pain management

Education

The stage of labor where health teaching of controlled slowed breathing should occur?

First stage

What happens in the first stage of labor?

Onset of labor —> Cervical dilation of 10 cm

3 phases of first stage of labor?

Latent

Active

Transitional

Latent phase

0-3 cm dilation

Mild

1-2 / 10 mins (20-30 secs)

Nullipara: 8-20 hrs

Multipara: 5-14 hrs

Active phase

We administer drugs

4-7 cm dilation

2-3/10mins (40-60 secs)

Nullipara: 1hr - 1-1.2cm

Multipara; 1hr - 1.5 cm

Transitional phase

8-10 cm

NO DRUGS!

strong

3-5/10 mins (60 - 70 secs)

Second stage of labor occurs during?

10 cm dilated - fetal expulsion

How does 2nd stage occur?

Bearing down during contraction

Duration of second stage? Nulli and Multi

Nulli: 1-2 hours

Multi: 30 mins - 1hr

What do we check first once the baby’s head is out?

Nuchal cord

If cord is maluwag what do we do?

Slip hand/finger under cord then release fetal head

If cord is tight?

Clamp 2x then cut

What happens in the third stage of labor

Fetal Expulsion up to delivery of placenta

Average time for third stage of labor

5-15 minutes report if more than 30 mins

what do we watch out for in third stage of labor?

UTERINE INVERSION

How to manage Third stage of labor?

watchful waiting

Signs of 3rd stage of Labor (LUVS)

Lengthening of the Cord
Uterine Firm (Calkin’s Sign)
Visible in Vagina
Sudden gush of blood

How to help in placental delivery?

Bear down gently
Fundal Pressure gently (in contracted uterus)

Active management of third stage of labor?

TONE - Oxytocin after the delivery of the Anterior Shoulder
BRANDT ANDREW MANEUVER - Controlled cord traction
EARLY clamping and cutting of the cord

why is early clamping and cutting done?

To decrease the risk for postpartum hemorrhage