Chapter 34- Obstretrics and Neonatal Care

Ovaries

two glands located on either side of the uterus that are similar in function to the male testes. Each ovary contains thousands of follicles, and each follicle contains an egg (the female contribution to conception). Females are born with all the eggs they will release in their lifetime.

The primary female reproductive organs that produce an ovum, or egg, that, if fertilized, will develop into a fetus.

fallopian tubes

extend our laterally from the uterus, with one tube associated with each ovary. When an egg is released from the ovary it travels through the fallopian tube to the uterus. Fertilization, which occurs when a sperm meets an egg, usually takes place when the egg is inside the fallopian tube.

the tubes that connect each ovary with the uterus

uterus

the muscular organ that protects and encloses the developing fetus; also called the womb; responsible for contractions during labor helping to push the fetus through the birth canal

Birth canal

made up of the vagina and the lower third, or neck, of the uterus, called the cervix

cervix

the lower third, or neck, of the uterus

During pregnancy it contains a mucus plug that seals the uterine opening, preventing contamination from the outside. When the cervix begins to dilate, the plug is discharged into the vagina as pink-tinged mucus.

Bloody show

a small amount of blood in the vagina that appears at the beginning of labor and may include a plug of pink-tinged mucus that is discharged when the cervix begins to dilate; often signals the beginning of labor

The female reproductive system includes ________

the ovaries, fallopian tubes, uterus, cervix, vagina, and breasts

fetus

the developing unborn infant inside the uterus, from 10 weeks after fertilization until birth

the approximate time of delivery is _____ of gestation

9 months (40 weeks)

Documentation of the last menstrual period (often noted as LMP) should be included in the history section of the patients chart. The last menstrual period is documented as ________, documentation should also include _______ and ______. For women who have experienced menopause, the _________ should be charted

Documentation of the last menstrual period (often noted as LMP) should be included in the history section of the patients chart. The last menstrual period is documented as the first day of the patients last menstrual period , documentation should also include the average number of days that the pt experiences bleeding and the average number of days between the start of each cycle. For women who have experienced menopause, the month and year of the last known menstrual period should be charted

Vagina

outermost cavity of the female reproductive system and forms the lower part of the birth canal. It is about 3-5 inches (8-12 cm) in length, beginning at the cervix and ending as an external opening of the body. The vagina completes the passageway from the uterus to the outside world for the newborn.

perineum

the area of skin between the vagina and anus

early signs of pregnancy include increased ____ and ______ of the breasts

size and tenderness

where is milk produced shortly after a baby is born? where is this milk carried to?

shortly after the baby is born, mammary glands within the breasts begin to produce milk, which is carried through small ducts in the nipples.

placenta

the tissue (disk-shaped structure) attached to the uterine wall that nourishes the fetus through the umbilical cord

what structure prevents blood from mixing between the fetus and the pregnant woman? how?

placental barrier; it consists of two layers of cells, keeping the circulation of the woman and the fetus separated but allowing nutrients, oxygen, and carbon dioxide to pass between the fetus and woman.

why is anything ingested by a pregnant woman potentially able to affect the fetus?

many drugs and toxins are able to pass through the placental barrier

what happens to the placenta following delivery of the newborn?

the placenta separates from the uterus and is delivered

umbilical cord

the structure that connects the pregnant woman to the fetus via the placenta; contains two arteries and one vein.

the flow of oxygen through the fetal circulation is altered ______ and transitions to normal physiology _______

the flow of oxygen through the fetal circulation is altered while in the womb and transitions to normal physiology within minutes after birth

what is the function of the umbilical veins? what is the function of the umbilical arteries? where does the fetus get its oxygen and nutrients?

the umbilical veins carries oxygenated blood from the placenta to the heart of the fetus, and the umbilical arteries carry deoxygenated blood from the heart of the fetus to the placenta. oxygen and other nutrients cross from the woman’s circulation through the placenta and then through the umbilical cord to the support the fetus as it grows

amniotic sac

the fluid-filled, baglike membrane in which the fetus develops.

approximately how much amniotic fluid is within the amniotic sac? what is the purpose of the fluid?

500-1000 mL, the fluid helps insulate and protect the fetus

When and why does the amniotic sac rupture? what does this typically look like?

when the sac ruptures, usually at the beginning of labor, the amniotic fluid is released in a gush. It is typical for the patient to tell you that her “water broke”. Some women may experience a small leak rather than a gush of fluid. This fluid helps to lubricate the birth canal and remove any bacteria.

when is a pregnancy considered full term? what is this called?

a pregnancy is considered full term when it reaches 39 weeks but has not gone beyond 40 weeks, 6 days. A pregnancy that has reached full term is referred to as terrh gestation.

which body systems undergo major physiologic and anatomic changes during pregnancy?

reproductive, respiratory, cardiovascular, musculoskeletal

what changes occur in the reproductive system during pregnancy? What risks do these changes create?

hormone levels increase to support fetal development and prepare the body for childbirth. These increased hormone levels also put the pregnant woman at an increased risk for complications from trauma, bleeding, and some medical conditions. As the fetus develops, the uterus grows, stretching to accommodate a full-term fetus. As the size of the uterus increases, so does the amount of fluid it contains. These factors eventually result in displacement of the uterus out of its well-protected position within the pelvic area and may expose it to injury. By the 20th week of pregnancy, the top of the uterus is at or above the belly button. This increases the chance of direct fetal injury in trauma.

what changes occur in the respiratory system during pregnancy? what risks do these changes present?

in the second trimester of pregnancy, the rapid growth of the uterus leads to changes in the respiratory system. as the uterus grows, it pushes up on the diaphragm, displacing it from its normal positions and leading to reduced tidal volume with each breath. To make up for this, the pregnant female’s respiratory rate must increase. Pregnancy also increases the patient’s overall demand for oxygen as her metabolic demands and workload increase to support the developing fetus. these changes lead to an overall reduction in respiratory reserve and decreased ability to compensate during times of respiratory distress.

what changes occur in the cardiovascular system during pregnancy? What risks do these changes bring?

overall blood volume gradually increases throughout the pregnancy to allow for adequate perfusion of the uterus as the fetus grows and to prepare for the blood loss that will occur during childbirth. Blood volume may increase by as much as 50% by the end of the pregnancy. the number of red blood cells also increases, which increases the woman’s need for iron. pregnant women often take prenatal vitamins containing iron to avoid becoming anemic, a condition in which a person has too few red blood cells, resulting in a decreased ability to transport oxygen throughout the body. blood clotting factors also change as the woman’s body prepares for childbirth. The speed of clotting increases to protect against excessive bleeding during delivery. By the end of the pregnancy (third trimester), the pregnant patients heart rate increases up to 20% (about 20 more beats per minute) to accommodate the increase in blood volume. Cardiac output is significantly increased by the end of the pregnancy. Although an otherwise healthy woman may tolerate increased cardiovascular demand without issue, women with underlying medical conditions may be more susceptible to cardiac compromise.

what changes occur in the GI system during pregnancy? What risks do these changes bring?

what changes occur in the musculoskeletal system during pregnancy? What risks do these changes bring?