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Agent

-H.T. 29 years old,



female

-pre-ecclamptic

-familyhx. of HPN
-inadequate pre-

natal chack-up














Host

Environment

Fertilization
(Union of sperm and ovum at the fallopian tube)

Zygote- Unicellular
(Intermingling of haploid paternal 23 X or Y and maternal 23 X chromosomes

Series of Mitotic Cell division- Cleavage


(In 24 hrs. becomes two cell organism)
In 72 hrs.it becomes 16 cell organism called Morula

Morula enters the uterus on the 3rd day through peristaltic movement

Separate into 2 parts by fluid from the uterus on the 4th day

The outer layer gave rise to the placenta (Trophoblast)


Release hCG (responsible for positive result in pregnancy test

The inner layer gave rise to the embryo (embryoblast)

(Blastocytes) attaches to endometrium on the 4th day of free floating

Implantation

Increase the levels of Estrogen and


Progesterone

Top layer becomes the embryo

Lower cell becomes the yolk sac

Formation of blood and blood vessels

Production of hematopoietic or non-nucleated blood cells

Formation of blood and blood

Embryonic development begins during the second week continues through the 8th week

Presumptive
Breast changes
Nausea &vomiting
Amenorrhea
Frequent Urination
Fatigue
Uterine
enlargement
Quickening
Linea nigra
Melasma
Striaegravidarum
Darkening of
underarms

Signs of Pregnancy
Probable
Serum lab tests
Chadwicks sign
Goodells sign
Hegars sign
Sonographic
Ballottement
Braxton hicks sign
Fetal outline felt by
examiner

Positive
Sonographic
evidence of fetal
outline
Fetal heart audible
Fetal movement felt
by examiner

The placenta begins to produce hPL

Rapid cell growth

Development of the 3 germ layers (Ectoderm, mesoderm and endoderm)

End of 12 Gestation Week: Bone Ossification centers are forming, nail bed formation, some reflex (Babinski reflex),
fetal heart beat is audible through Doppler technology

End of 16 Gestation Week: Fetal heart sounds are audible with a stethoscope, Lanugo well formed, liver & pancreas functioning, sex can be determined by ultrasound

End of 20 Gestation Week: Spontaneous fetal movement, antibody production, brown fat formation, vernixcaseosa formation, meconium present in the upper
intestine

End of 24 Gestation Week: Meconium present as far as rectum, active production of lung surfactant begins, hearing possible

End of 28 Gestation Week: Lung alveoli begin to mature & Surfactant can be demonstrated in amniotic fluid. Testes begun to descend into scrotal sac

End of 32 Gestation Week: Fetus is aware of sounds outside the mothers body, Active moro reflex birth position assumed (vertex or breech) fingernail growth reach end
of fingertips

By 33 weeks of gestation: baby is around 3-4lbs in weight and around 44cm long, might already have a head of hair, and will have perhaps shifted
position and gone head down in your womb, with their little legs folded up to the chest, the baby's bones are also continuing to harden at this stage
except for those in their skull, which stay soft and pliable to enable baby's head to be born safely and the immune system will now also be fully developed
with the antibodies the baby needs for the outside world and the levels of Amniotic fluid is now at its lowest as your baby continues to grow and take up
space.

Possible etiology
Stress
Pre-ecclampsia

Preterm Labor

Signs & Symptoms:


Cramping pain at pelvic area 8/10 pain score
6-7 cm dilated

Uterine Contractions

1ST Stage of Labor


Dilatation and Effacement (Latent Phase, Active Phase, Transition Phase)

2nd Stage of Labor


Expulsion Phase or Fetal Stage

Mechanism of Labor

4th Stage of Labor

3rd Stage of Labor

Immediate Post Partum Care

Placental Stage

Retained
Placental
Fragments

Signs of Placental Stage:


Globular shaped uterus
Rise of fundus to abdomen
Sudden gush of blood
Lengthening of the cord

Lack of Sufficient uterine


contraction due to blockage by
retained placental fragments

Uterine Atony
Signs and Symptoms:
Vaginal bleeding
noted for 3 days 6/23,
6/24 and 6/25)

Medication:
Ferrous Sulfate
(Sorbifer) durule, 1
durule , BID, PO, AC

Possible etiology:
precipitous labor (labor
lasting less than 3 hours)

Profuse bleeding


HGB

Lab Results:

6/23
6/24
10.4
11.5

HCT
RBC

29.8
3.37

32.5
3.73

RDW

9.85

10.2

Hemorrhage

May lead to
Hypovolemic shock if
not treated

Death

36-49%
4.10-5.30
10e6/uL
11.6-18%


A decreased in HGB, HCT,RBC and RDW for 2 days

Procedure performed:
Blood transfusion of 1 packed RBC last 6/24/15

N.V
12-16 g/dL