HC (Finals): Lesson 9 - Maternal Care

Gestation

the period of development in the uterus from CONCEPTION until BIRTH

AOG

age of gestation

measured from the first day of the mother’s last menstrual cycle to the current date

Gravida

a women’s status regarding pregnancy

followed by a numeral designating the number of time the woman has been pregnant

LMP

last menstrual period

1st trimester

acceptance of pregnancy

2nd trimester

acceptance of a fetus as a separate individual

3rd trimester

the woman prepares for the birth of the baby and her role as a mother

emotional responses to pregnancy

• narcissism - self-centeredness (focuses on self and the changes occurring in her body)

• extroversion (increase participation in activities & appear more outgoing)

• inability to make decisions

• emotional lability - mood swings

extroversion

unreserved person

act, state or habit of being predominantly concerned with and obtaining gratification

presumptive pregnancy signs and symptoms

• amenorrhea

• nausea and vomiting

• frequent urination

• breast changes

• quickening

• fatigue

probably pregnancy signs and symptoms

• changes in abdominal shape - tumors or fluid in the abdomen may also change the shape of abdomen

• changes in reproductive organs

• elevation of basal body temperature

• positive pregnancy tests

• Braxton Hicks contractions - may also be cause by growing mass in the uterus

Braxton Hicks

painless non rhythmic contraction of the uterus (not associated with labor)

Auscultation of fetal heart sounds

at about 4 ½ to 5 months of pregnancy

fetal heart sounds can already be heard best at the area of fetal back.

120-160 beats/min

fetal heart rate

funic suffle

a swishing sound synchronous with fetal heart beat caused by blood rushing through the umbilical arteries

early as 14 weeks

x-ray visualization of fetal skeleton

positive sign and symptom of pregnancy

ultrasonographic evidence of pregnancy

psychological changes

a. uterus

b. cervix- more vascular and edematous

c. vagina- increased vascularity

d. ovaries- ovulation and menstruation stops during pregnancy due to the lack of activity of the FSH and the presence of HCG

e. abdominal wall – stretching of wall due to increase in uterine size, results I rupture and atrophy of the connective layer of the skin

more vascular and edematous

cervix

increased vascularity

vagina

ovulation and menstruation stops during pregnancy due to the lack of activity of the FSH and the presence of HCG

ovaries

stretching of wall due to increase in uterine size, results rupture and atrophy of the connective layer of the skin

abdominal wall

changes in pigmentation

sweat glands become extra active

skin

due to increase in estrogen level in the body

may experience fullness or tingling sensation in her breasts

breast

respiratory

shortness of breath; increase in uterine size causes the diaphragm to be pushed or displaced, thereby overcrowding the chest cavity

30 to 50%

In terms of circulatory changes during pregnancy, how does the circulating blood volume adapt to support the exchange of nutrients in the placenta, and what is the corresponding percentage increase?

heart has to increase

As a result of the increased circulating blood volume during pregnancy, what must the heart do to accommodate the additional volume and ensure proper nutrient exchange in the placenta?

Gastrointestinal Changes

• Symptoms: Heartburn, constipation, and flatulence

• Cause: Increasing size of the uterus

  • Mechanism: Displacement of the stomach and intestine toward the back sides of the stomach

Urinary Changes

• Symptom: Frequency in urination

• Cause: Enlargement of the uterus

• Mechanism: Exertion of pressure on the urinary bladder

Skeletal Changes

• Adaptation: Attempt to change center of gravity

• Effect: Forces the pregnant mother to stand straighter and taller than usual

• Purpose: Enhanced comfort while walking

Endocrine Changes

• Hormones: Estrogen and progesterone

• Effect: Suppression of FSH and LH

• Cause: Production of large amounts of hormones during pregnancy

• Location: Due to the presence of the placenta

Weight Change

• Timing: Weight gain faster at mid-pregnancy

• Average Gain: About a pound a week during middle and late pregnancy

Common Complaint: Mild Nausea and Vomiting

• Remedy: Eat crackers, biscuits, or anything sweet.

• Avoid: Fatty foods, salty foods, excessive seasoning and spices, too much coffee, and strongly flavored vegetables.

Common Complaint: Constipation

• Remedy: Exercise regularly; eat plenty of fruits and vegetables.

• Tip: Ensure an adequate intake of fluids.

Common Complaint: Slight Swelling of the Feet

• Remedy: Avoid salty foods.

• Note: Maintain a balanced diet and monitor salt intake to reduce swelling.

Issue: Varicose Veins

• Recommendation: Elevate your legs when possible.

• Tip: Avoid prolonged periods of standing or sitting.

Issue: Leg Cramps

• Action: Lie down and have your toes pushed towards your body.

• Prevention: Stay hydrated and ensure sufficient intake of potassium.

Issue: Paleness, Loss of Weight, or Both

• Consideration: Consult with a healthcare professional.

• Possible Causes: Various factors, including nutritional deficiencies or underlying health issues.

Issue: Fatigue or Tiredness

• Strategy: Ensure adequate rest and sleep.

• Nutrition: Maintain a balanced diet to support energy levels.

• Consult: If persistent, consult with a healthcare provider.

Danger signs and symptoms during pregnancy

1. Vaginal spotting or bleeding

2. Moderate to severe abdominal pain

3. Swelling of the arms and legs

4. Convulsions

5. Rapid weight gain

6. Watery discharge without labor pains, and before the expected time of delivery

7. Blurring of vision, headaches, dizziness, paleness and weakness

8. Frequent and uncontrollable vomiting

When pregnancy is dangerous to mother and child

1. She is over 35 or below 18 years old

2. She has had 4 or more pregnancies

3. She has a history of miscarriages

4. She has a history of difficult labor

5. She has given birth by caesarian section

6. She has a major operation in the abdominal area

7. She is suffering from serious illness

8. She has severe anemia

Prenatal care

1. See a midwife, nurse or doctor  for check-up

2. Have yourself immunized against tetanus at any time during your first pregnancy to protect yourself and the unborn child. Only one booster shot is needed for each succeeding pregnancy

3. Eat a nutritious balanced diet

4. In preparation for breastfeeding, massage your nipple regularly with oil

5. Do not take alcoholic drinks, do not smoke, do not take any medicine which is not prescribed by the doctor

6. Avoid contact with sick people

7. Visit your dentist regularly to check gum infection and tooth decay

Care of the mother after delivery

1. Eat plenty of nourishing food, drink plenty of soup, fluids and fruit juices. Get rest and sleep

2. In the first few days after giving birth, you can resume your bath.

3. If you develop a fever, chills or  headaches, or if you have a foul smelling  vaginal discharge, consult a doctor at once

4. If you feel pain in the abdomen and lower abdomen after giving birth, this could be due to the natural contraction of the uterus as it goes back to its normal size

5. Loss of blood during childbirth can cause paleness or weakness

6. If you delivered normally, it would be good for you to start moving around and do a little walking 24 hours after giving birth