NUR 166 week 2

Female Reproductive System Overview

• The female reproductive system comprises several key organs:
  • Uterus:
    • Fundus: The dome-shaped top of the uterus.
    • Body: The main part of the uterus.
  • Fallopian Tubes:
    • Located on either side of the fundus, they are delicate structures that transport the egg after it's ovulated.
  • Ovaries:
    • Positioned below the fallopian tubes, they release an egg during the menstrual cycle.

Menstrual Cycle and Ovulation

• The cycle lasts about 28 days, divided into phases:
  • First Two Weeks (Follicular Phase):
    • The uterus's lining thickens, preparing for potential fertilization.
    • An egg is released from the ovary around day 14.
  • Post-Ovulation (Luteal Phase):
    • If fertilized, the egg moves towards the uterus; if not, it will be expelled during menstruation.
• Fertilization Window:
  • The egg is viable for fertilization for approximately 10 days after ovulation.

Menstruation

• If fertilization does not occur:
  • Hormone levels (progesterone and estrogen) drop.
  • The uterine lining sheds, resulting in menstruation, which is about 2 tablespoons of blood along with tissue breakdown.

Bleeding Disorders in Pregnancy

• The disruption of pregnancy processes can lead to complications such as:
  • Spontaneous Abortion (Miscarriage): Termination of pregnancy before 20 weeks.
  • Blighted Ovum: Fertilized egg fails to develop leading to miscarriage.
  • Cervical Incompetence: A weak cervix can lead to miscarriage or preterm labor.
    • Cerclage: A stitch to hold the cervix closed can be placed in cases of incompetence.
  • Progesterone Injections: Given for women who have had frequent miscarriages to support the pregnancy.

Ectopic Pregnancy

• Occurs when the fertilized egg implants outside the uterus, often in the fallopian tube.
• Symptoms include:
  • Abdominal pain on one side
  • Abnormal bleeding
• Treatment options:
  • Methotrexate injections to stop the growth of the implanted egg.
  • Surgery if it ruptures.

Gestational Trophoblastic Disease (Molar Pregnancy)

• Caused by abnormal growth of trophoblastic tissue, leading to elevated hCG levels without a viable fetus.
• Common sign: a higher than expected fundal height measurement.
• Symptoms can include severe nausea and vomiting (hyperemesis gravidarum).

Late Pregnancy Bleeding

• Placenta Previa: Placenta is positioned low in the uterus, potentially covering the cervix, causing painless bleeding. Can lead to emergency cesarean delivery if severe.
• Placental Abruption: The placenta detaches from the uterus prematurely, causing severe pain and potential hemorrhage.

Hypertensive Disorders in Pregnancy

• Key conditions include:
  • Gestational Hypertension: High blood pressure after 20 weeks without protein in urine.
  • Preeclampsia: Defines by hypertension and proteinuria, can lead to severe complications.
  • HELLP Syndrome: Severe form of preeclampsia with hemolysis, elevated liver enzymes, and low platelets.
• Treatment often involves delivery and monitoring for complications.

Rh and ABO Incompatibility

• Rh Incompatibility: If a Rh- mother has Rh+ fetus, it can lead to hemolytic disease of the newborn. RhoGAM is administered during pregnancy and after delivery to prevent this.
• ABO Incompatibility: Occurs when a mother with type O blood has a baby with A or B blood type, leading to mild jaundice due to antibody response.

TORCH Infections in Pregnancy

• Toxoplasmosis: Avoid cat litter and gardening without gloves.
• Other: Includes Zika and hepatitis B.
• Rubella: Can cause serious defects, vaccination is recommended before pregnancy.
• Cytomegalovirus: Often asymptomatic in mothers but can cause severe issues in babies.
• Herpes: Pregnant women with active lesions should have a cesarean to prevent transmission during delivery.