HSCI120 lec 10 pregnancy

what percent of sperm flow back out of vag due to gravity? of those that make it to the fallopian tube, what percent swim up wrong tube? how many sperm make it as far as the egg

50% fall. 50% swim up wrong tube

-200-300 actually make it

during conception, sperm work tgt to dissolve the ______. sperm secretes _____ to do this.

-dissolve the zona pellucida (gelatinous layer)

-secrete hyaluronidase to do this

where does fertilization occur

fallopian tube

typically one sperm enters egg. what prevents other sperm penetrating?

Zona thickens again

what happens after fertilization in the fallopian tube between sperm and egg? how long is this process and where does it end up

-becomes a ZYGOTE

-travels down fallopian tube to UTERUS (5 day journey)

absense of period is not a definity indication of pregnancy, so what are some ways to detect pregnancy

1. Basal body temperature that stays high for 2 weeks after ovulation (temp increase due to progesterone)

2. tender breast/nip, nausea, frequent pee, fatigue

3. Chemical test to detect human chorionic gonadotropin (HCG) in urine/blood

4. other pregnancy test (3rd or 4th month)

delivery date is calculated by

Nagele’s rule

-last menstruation start date

-subtract 3 months

-add 7 days

-add 1 year = EDD (estimated due date)

-margin of error plus or minus 10 days

Gestation vs pregnancy amount of weeks

Gestation (conception to birth) 38 weeks

Pregnancy term (counted from last day of menstruation) 40 weeks

what is the stage called thats the first 8 weeks of pregnancy

embryonic stage

what happens during embryonic stage

1. Placenta develops (connect fetus to uterus wall for gas (O2) & nutrient exchange)

-separates parents circulatory system from fetus’

2. Amniotic sac develops (filled with amniotic fluid protecting embryo from outer damage/temp changes)

-briefly describe what happens in each month for first trimester

1st month of gestation

-most major organs/systems develop (like heart, digestive syst)

2nd month

-umbilical cord develop/connect embryo to placenta

-facial features, hands/feet, tissue/vessels

-by end: kidney, liver, pancreas

3rd month

-embryo now a FETUS

-limbs/fingers pronounced

-nails, hair, eyelids

-GENDER DETECTABLE via ultrasound

effects of pregnancy furing first tri? list a lot

tingling, breasts full, NAUSEA, TIRED, change appetite, lots of pee, more vaginal secreation, irregular bowel,

true or false: morning sickness associated with lower rate of miscarriage

true

second trimester, each month, whats one more thing the fetus can do

-fetal movements between 13-20 weeks (3-4.5 months)

-5th month: heartbeat heard

-6th month: fetus can open eyes

-24th week: fetus sensitive to sound/light

if baby is born before ___ weeks, unlikely to survive

20 weeks

effects of pregnancy during second tri

-ingestion/constipation (fetus put pressure on organs)

-breasts enlarge,nipples darken

-STRETCH MARKS

-NO nausea anymore

what position is fetus in in third trimester? effects of pregnancy?

-head down (prep for delivery)

effects: (most uncomfortable trimester)

-bad balance

-backache, leg cramps, lots of pee

-shortness of breath

-hands swell

-weight gain might be 25-35 pounds

why is sex allowed during pregnancy? why not allowed during labour

-during pregnancy, penis wont harm fetus b/c protected by amniotic sac and mucous plug in cervix

-during labour, increase infection risk

masters and johnson found that sexual desire increases most in what trimester

2nd trimester (declines in 1 and 3)

examples of pain management during birth being pharmacological or not

pharmacological: epidurals (injection into space of spine) tranquilizers/narcotics, spinal blocks (injection into spinal fluid), general anesthesia only for C-section

non-pharmacological: water immersion, birthing balls

what is “engagement” in pregnancy

few weeks b4 labour, fetus turns so widest part of head is against mothers pelvic bones

what is effacement? why it occur

thinning of cervix

-to prepare for dilation (dilation may cause mucous plug/capillaries to release = blood/mucus flow out vagina)

in what percent of people does amniotic sac rupture (water breaks)

12%

-must begin labour 24 hours later (prevent infection)

how many hours does average labour last

8.6 hours (average is half that for following pregnancies)

what do contractions help with

dilate cervix

stage 1 of vaginal birth has 3 phases, what are they and dilation levels

Early phase : 4cm (contraction every 15-20 min)

Active phase: 8cm (more intense/frequent contractions)

Transition: 10 cm (abt 30 min)

Stage 2 of vaginal birth? when begin? how long last

-begin when cervix fully dialated, head begin to move into vagina

-last average 80 minutes

-end with birth

whats stage 3 of vaginal birth? what is it also called and how long it last

-aka placental phase (placenta detach from uterine walls and expelled w/ other stuff called afterbirth)

-may last few min to hours

-contractions help uterus go back to smaller size

-tears sewed up

in C-section, incision made through ____ and wall of ____

through abdomen and wall of uterus

4 reasons for c-section

-baby too big

-pelvis too narrow

-baby in breech/transverse position

-umbilical cord will pass thru cervix b4 baby

-what happens right after baby born

-umbilical cord cut (2-3cm left on baby)

-skin-to-skin for bonding

-antibiotic drops in baby eyes

-vitamin K injection in baby (so blood clot normally, no hemorrhage death)

3 major categories of postpartum emotional conditions (which is most common, and briefly describe)

1. Postpartum BLUES (most common, 80% women)

-mild depression (only few days)

2. Postpartum DEPRESSION (10-20%)

-EXTREME depression (last months/years, appetite/sleep change, insecure)

3. Postpartum psychosis (0.2%)

traditionally women were advised to wait minum of how long postpartum to have sex? what abt now

traditionally wait 6 weeks

-now whenever couple ready

how many days after delivery does milk production start? what do breats produce in the meantime

2-3 days

-meantime, breasts make COLOSTRUM (nutrients/antibodies)

what hormone stimulates breastmilk production? what hormone is released from breastfeeding?

Prolactin (think pro-milk) stimulates

Oxytocin release (cause milk flow/exit breast)

explain prolactin vs oxytocin in breastfeeding

prolactin stimulations the production

oxytocin release cause milk to flow out breast

what else does oxytocin do? (hint uterus)

cause uterine contractions (help uterus return to normal shape and size)

true or false period delayed by breastfeeding

true

Medical term for miscarriage

spontaneous abortion

what percent of pregnancies end in miscarriage

10-20%

most miscarriages occur within how many weeks of gestation

first 20 weeks

most common reason for miscarriage

defect in embryo or fetus

describe Rh incompatibility. is there higher risk of this in first or subsequent pregnancies

-when pregnant mom has Rh-negative blood & fetus has Rh-positive blood (antibodies from mom blood destroy red blood cells in fetus)

-higher risk after first pregnancy (antibodies would have formed by then) can lead to fetal amenia, disability, death

3 types of hypertension (high blood pressure) related to pregnancy

1. Pregnancy-Induced hypertension (simple)

2. Pre-eclampsia (high blood pressure, ALSO edema & proteinuria

-increased risk fetal death

3. Exlampsia (seizures/coma) may result FROM pre-eclampsia and lead to death

list 3 ways congenital anomalies (birth defects) may result from

-genetics (like down syndrome)

-maternal illness/infection (diabetes, STI)

-use drugs/alc (fetal alcohol syndrome)

what supplements 3 months b4 conception + first trimester can reduce risk of congenital abnormalities from neural defects

folic acid

list some ways of detection of congenital anomalies (in hospital/lab)

-screening of Alpha-fetoprotein (AFP) (ADP produced by fetus but may leak if defect in fetal wall. if high AFP detected in maternal blood, Sonographic examination rule out 3 causes of AFP elevation: underestimation of gestational age, multifetal gestation, fetal death)

-more invasive methods: Amniocentesis (extract amniotic fluid from sac) & Chorionic villus sampling (chorionic villi - finger like projections from placenta)

-NON INVASIVE: NIPT Testing analyze fetal DNA in mom blood

what is AFP? 3 common causes of elevation of it? what exam to find cause

AFP is alpha-feto-protein

-produced by fetus, but might leak into mom blood if fetal wall defect

-sonographic exam:

-AFP elevation in maternal blood common causes: fetal death, multifetal gestation, underestimation of gestational age

invasive vs non invasive testing of congenital anomalies

invasive: Amnio centesis and chronic villus sampling

non-invasive: NIPT testing (non-invasive prenatal testing)

what is baby called if a baby is born before 37 weeks of gestation

preterm baby

preterm birth cause health problems, whats one of them

-low birth weight (because most weight gains happen last few weeks gestation)

what percent of infant deaths (without congenital anomalies) are DUE to preterm birth

60-80% (preterm means born before 37 weeks)

what is anoxia

oxygen deprivation

how may anoxia occur during birth?

umbilical cord compressed as baby pass birth canal (esp if baby born in breech position)

-doctor may order C-section (or else baby may die, brain damage, disability, cerebral palsy)

what occues if baby born dead any time after 28 weeks gestation and weighs atleast 500 gramss

stillbirth

around how many women die everyday from pregnancy/childbirth

830

what is infertility

biological inability to get pregnant

true or false: infertility cases mostly by infertility in men

FALSE. about 40% by men and 40% by women (20% from both partners or unknown)

primary vs secondary infertility

primary infertility: couple has NEVER been able to concieve

secondary infertility: couple cant concieve rn but HAS IN THE PAST (think secondary=2nd try)

list some factos of each gender affecting primary infertility. whats the most common issue of each gender

women: older than 40, endometriosis, painful periods,

MOST COMMON IS irregular periods

men: small/swollen testes, history

MOST COMMON IS low sperm count

-both: had cancer treament

whats often the first step in fertility treatments

fertility drugs (medication stimulate egg development/release) can result in more than 40 eggs in single cycle

likelihood of an assisted reproductive technology (ART) procefure resulting in pregnancy/birth

30%

list 5 diff treatments of infertility

-Artificial insemination (Al) -catheter put sperm in vagina (reduce distance sperm travel)

-In vitro fertilization (IVF) -if femal reproductive tract blocked, surgery (eggs removed) → LAB egg fertilized →egg injected back into uterus (intra-uterine insemination) or cervix (intra-cervical insemination)

-Gamete Intrafallopian transfer (GIFT) -egg/sperm collected + depositied into fallopian tubes

-Zygote intrafallopian transfer (ZIFT) -fertilized egg transferred into fallopian tube (natural implantation)

-Surrogacy -female OUTSIDE of couple become pregnant thru any of above methods and deliver baby

biggest risk with assisted reproduction?

TWINS (more than 1 fetus in uterus at once)

-70% twins result from these (ex. for IVF sometimes transfer multiple eggs in 1 cycle)

what percent of ART users are SGD (sexually and gender diverse ppl)

30%