Professional Documents
Culture Documents
PREGNANCY
BY
TIYAS K
Definition of pregnancy
The
wordnet.princeton.edu/perl/webwn )
Pregnancy
Conception
Fertilization
of an ovum by a spermatozoon
Cell division
Chromosome
exchange
Normal Pregnancy
Spans
40 weeks
without any complication in either mother
& fetus
Trimesters:
First: weeks 1 through 13
Second: weeks 14 through 26
Third: weeks 27 through 40
Fetal Growth
Probable indicators
Uterine enlargement
Braxton Hicks contractions
Uterine souffle
Ballotement
Positive pregnancy test
Positive indicators
Presence of fetal heartbeat distinct from
mothers
Fetal movement felt by someone other than
mother
Visualization (e.g., ultrasound examination)
Diagnosis of Pregnancy
USG
Doppler Examination
Estimated date of birth (EDB)
Ngeles rule
Determine first day of LMP(Last
Menstrual Period), subtract 3 months,
add 7 days plus 1 year
Alternatively, add 7 days to LMP and
count forward
9 months
Adaptation of Pregnancy
Psychosocial adaptation:
Maternal adaptation
Accepting pregnancy
Identifying with mother role
Reordering personal relationships
Establishing relationship with fetus
Emotional attachment
Preparing for childbirth
Adaptation of Pregnancy
Psychosocial adaptation:
Paternal adaptation
Accepting pregnancy
Identifying with father role
Reordering personal relationships
Establishing relationship with fetus
Emotional attachment
Preparing for childbirth
Sibling adaptation
Grandparent adaptation
Physical Changes
Hormones
Endocrine
system
Reproduction system
Hematology system
Respiratory system
Urinary system
Gastrointestinal system
Bone and integument system
Pregnancy Hormones
a.
b.
c.
d.
e.
Pregnancy Hormones
a.
b.
c.
d.
Pregnancy Hormones
a.
b.
c.
Oestrogen
3 kinds of estrogen: Oestriol , Beta-Oestradiol,
Oestrone
Stimulate tissue growth, uterus enlarging,
produce milk duct in mother breast
Tissue softens, >> extra cell matrix water
water retention edema
Pregnancy Hormones
a.
b.
c.
d.
e.
Progesterone
Produce by syntiotrophoblast
Lowering excitability of white muscle
(myometrium, ureter, usus)
Increasing sensitivity of chemoreceptor on CO2
Increasing temperature 0,51,0C
induce varicose & hemorrhoids cause by
dilatation of vein on lower extremity & rectal
Endocrine system
>>
sekresi ACTH
>> Beta endorfin on 3rd trimester >> oxytocin
sekretion
<< FSH & LH
>> corticosteroid @cortisol higher level in
morning , induce striae
>> T3 & T4 intestine calcium absorbtion
>>, excretion by the renal <<
Reproduction system
a.
b.
UTERUS
increasing size & uterus volume from 10mL
preconception to 5L on 3rd trimester
>> contraction frequency (5% per week) especially
nocturnal
. CERVIX
a.
b.
. VAGINA
a.
b.
UTERUS
Hematology system
Hemodilution
Increased
734
Hemoglobin, immunoglobulin, platelet &
protein <<
Respiratory system
High
metabolismeOxygen consumption
20% increase
Chemoreceptor Sensitivity >>hyperventilation
Snoring especially women with preeclampsia
(Izci etal,2005)
Urinary system
Increased
Gastrointestinal system
Slow
gastric emptying
Nausea, vomiting
constipation
weight : 28%
Plasenta : 5,7%
amnion : 4,1%
uterus : 8%
breast : 6,5%
Blood volume : 13,1%
Body fat : 33,6%
(Neil, 1995)
Healthy (19.826)
11.516
Overweight (<26)
7.011.5
AUS National Research Council, 1990
Striae
Linea nigra
Care Management
Purpose
Assessment
Follow-up visits
Interview
Physical examination
Fetal assessment
Fundal height
Gestational age
Health status
Laboratory tests
Multiple-marker or triple-screen blood test
Other blood tests (RPR/VDRL, CBC, anti-Rh)
Other tests
Ultrasonography
Amniocentesis
Obstetric History
Terminology
Physical Examination
Pelvic
examination
Abdomen
Leopolds
maneuvers
Auscultation
Normal
Follow-up Visits
Visit
schedule:
Intervention
Education on:
Nutrition
Personal hygiene
Prevention of urinary tract infections
Kegel exercises
Preparation for breastfeeding newborn
Dental health
Physical activity
Posture and body mechanics
Rest and relaxation
Employment and travel
Clothing
Medications
Immunizations
Alcohol, cigarettes, and other substances
Normal discomforts
Recognizing potential complications
Sexual
counseling
Permission
Countering misinformation
Suggesting alternative behaviors
Psychosocial
support
Cultural influences
Emotional response
Clothing
Physical activity and rest
Sexual activity
Diet
Pain
management
Key Points