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Description
Flashcards by Elizabeth Then, updated more than 1 year ago
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Created by Elizabeth Then
over 6 years ago
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| Question | Answer |
| Oogenesis and spermatogenesis | Oogenesis - sequence of events by which the oogonia are transforms into mature oocytes oocytes - are the female sex cell produced in the ovaries spermatogenesis - sequence of events by which spermocytes are transformed into sprematozoa which are capable of fertilising a mature ooctye |
| Uterine and ovarian fimbriae | - small fingerlike projections at end of fallopin tube through which oocytes move from ovarie to fallopian tube produce peritoneal fluid During ovulation - the sex hormones activate the fimbriae to swell with blood ooctye moves into peritoneal fluid fertilisation can occur with male spermatozoa |
| What happens at conception? | Begins at fertilisation when male sperm (spermatozoon) unites with a female oocyte (ovum) to form a single cell - a zygote usually occurs in the ampulla of the fallopian tube DNA of the offspring now determined through union |
| Fertilisation | occurs within fallopian tube |
| Germinal period | first two weeks after fertilisation zygote - fertilised ovum morula - call divides to form a solid mass (3 days) moves along fallopian tube towards the uterus (4-5 days) blastocyst - cavity forms within the mass of cells and attaches to the lining of the uterus -implantation (10-14 days) |
| embryonic period | from implantation until 8 weeks |
| Foetal stage | from 8 weeks until the birth of the baby - usually 40 weeks |
| Foetal development | foetal grwoth - from 8 - 40 weeks |
| Amniotic sac | amnion (inner layer) and chorion (outer layer) together form the amniotic sac the fetus grow within this sac surrounded by amniotic fluid amniotic fluid is generated to cushion the foetus villi project from the chorion to embed into the uterine wall and form the placenta |
| placenta and membranes | chorionic villi invade the endometrium and allow transfer of nutrients and other products from mother to foetus fetus is attached to placenta by umbilical cord |
| The placenta | provides: nutrition, blood supply, respiration, protection, produces hormones that maintain pregnancy |
| Trimesters of pregnancy | pregnancy is divided into 3 equal trimesters: 1st - profound growth in first 8 weeks rudimentary organs and tissues form 2nd - growth, maturation, functioning of organ systems 3rd - final maturation and growth - weight gain |
| Pregnancy changes are | physiological, psychological, social |
| Reproductive | uterus 20 x larger uterine lining and muscle growth increased blood supply to uterus anovulation of the ovaries and tubes vagina and vulva increased blood supply and bluish colour breasts - increase in size and cells/milk cervix - mucous plug (barrier) |
| Respiratory | breathing rate unchanged increased lung capacity and blood supply to lungs increased base and metabolic rate |
| Cardiovascular | RBC volume increases by 30% blood volume expands 40-50% increased CO by 30% WBC increases Clotting factors increase heart enlarges blood vessels dilate (progesterone) increased heart rate (10-15bpm) increased venous pressure |
| Urinary | Increased blood volume increased filtration rate uteters dilate urinary stasis in bladder urinary frequency sugar and protein may spill over in urine |
| Gastro intestinal | smooth muscle relaxation constipation haemorrhoids heartburn gall bladder slowet emptying time gallstones |
| Musculoskeletal | posture changes - lordosis increased mobility of joints - relaxin rectus muscle separation |
| Integumentary | hyperpigmentation - lineanigra, melasma, areola oedema - retained fluid striae - stretch marks acne pruritis - itchiness |
| endocrine | ovarian hormone production ceases prolactin increases (breast growth) insulin production increases thyroid-reduced iodine level oestrogen levels increase growth breasts, uterus, etc sodium and water retention progesterone levels increase -facilitate implantation -decreases uterine contractility -reduces smooth muscle tone relaxin increases allow muscles for labour to relax |
| Immunologicial | resistance to infection is decreased wcc increased cellular immune response is decreased maternal antibodies decreased due to cross placental transfer near term other immunoglobulins unchanged |
| psychological changes | developmental tasks tasks relate to pregnancy timetable of trimesters more clearly identified in some women compared to other |
| First trimester | pregnancy validation accepting the pregnancy behaviour sometimes become introverted as women questions her identity partner may also be concerned about responsibility of being father |
| Second trimester | Foetal embodiment accepting the baby woman attempts to incorporate the foetus into her body image re-adjusts roles, gains, inner strength foetal movements, helps woman to the foetus is distinct from herself father may feel left out |
| Third trimester | role transition preparing the parenthood woman psychologically seperates the foetus from herself makes concretes plans for the baby may be irritable as she may want the pregnancy to end coping mechanisms may flater father may feel apprehensive |
| Social changes - 4 phases | disruptive phase adaption phase centering phase anticipation and preparation phase |
| Antenatal Care - what and why | integral part of total childbearing experience takes place as a medical model prescribed set of act around monitoring and screening pregnancy seen as an illness midwives move towards wellness relationships with care provider are formed roles and relationships are established choices are made wellness and normality are promoted |
| Principles of ANC | antenatal - prenatal - antepartum principles: open and regular communication involve significant others accurate history assessment and screening of mother and baby information about pregnancy changes health promotion advice and education |
| Maternal and foetal assessment | weight and height gestation blood pressure abdominal palpation fetal movements (16-20 weeks) fetal HR (less than 12 weeks) anti-D prophylaxis (rh -ve 28 + 34) antenatal screening tests |
| Nutrition during pregnancy | good nutrition supports growth and development of foetus and maternal tissue demands weight gain - appetite governs intake 11-16kgs risk GDM and hypertension if overweight pre-pregnancy risk m/c and LBW baby if underweight pre-pregancy balanced diet with all food groups |
| Antenatal screening | way of detecting predisposition (risk) for a condition or disease not a diagnosis should be safe, valid, reliable may include: CBP, blood group, Rh status, Vit D, presence of anaemia, infections, urinalysis, matermal serum screening, US |
| antenatal screening | written information should be provided pre-screening counselling full information and consequences of tests choice of screening or not notification of results honesty and openess |
| Maternal serum screening | screening tool for chromosomal abnormality blood test in first trimester limitations - false results consequences: further screening + assisted risk of miscarriage termination versis increased health |
| Harmony prenatal test | non-invasive prenatal assessing risk of chromosomal abnormalitites maternal blood smaple taken at 10 weeks gestation blood contains fragments of DNA tests for trisomy 21 (down's syndrome), Trisomy 18 (edwards syndrome), result in 10 days expensive but accurate |
| Advantages and disadvantageof 1st trimester screening | benefits - less false positive and negative less normal foetal loss, higher detection, personal benefits to women diagnosis Disadvantages - cost of nuchal translucency scan, logistically more difficult to manage |
| Pregnancy ultrasound abdominal and vagina | abdominal - dating scan 10-13 weeks, nuchal transluencency scan, 1st trimester to identify any chromosomal abnormalities, identifies by pocket of fluid at back of baby's neck, anomaly scan 18-20 weeks, position of placenta, umbilical cord, amniotic fluid around foetus Vaginal - can be uncomfortable, less than 8 weeks, maternal obesity |
| Antenatal screening 18-20 week USS | 18-20 week USS morphology and placental site screening for abnormality does not detect all abnormality |
| Antenatal screening 26-28 weeks | OGCT, CBP, ab screen 50gm glucose load (non-fasting) random BSL versus fasting BGL screening tool for GDM with potential to avoid adverse outcomes does not detect all GDM if raised, requires lifestyle change, medication |
| Antenatal screening | 35-37 weeks GBS (strep) status implications: GBS largest cause of early onset neonatal sepsis GBS is transient so may not detect all materal colonisation treatment - antibiotic prophylaxis in labour prevents transmission of GBS |
| Cultural beliefs | pregnancy is a natural process - major life event pregnancy is a medical condition combination of both |
| cultural influences | gender and social expectatoins females attends health concerns parental roles shared or not women are quite in some cultures |
| Beware ethnocentrism | when we think out values and practices are superior and are greater worth than an alternative culture recognise prejudices, determine what client knows/believes, work with client |
| Summary | germinal period 2 weeks embryonic period -2-8 weeks foetal stage 8-40 weeks physiological changes psychological adjustments social adjustments antenatal screening/assessment |
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