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  ..500-1000 ml functions is to protect.fl.c   **amnion.membrane inside embryo ** amn.


periodic pattern of ovulation and temp. and menstruation. AVA.÷ .   c   ·harton͛s jelly-clear jelly like substance to prevent 1.control. maintains equilibrium as uterus increase pressure **Ovulation-discharge ovum while labor. 50ml average blood loss 5. **Menstruation-periodic shedding.÷ Umbilical cord. allows embryo to move freely.30-90cm long 2cm diameter..

corpus Note: Ovum is X. high estrogen.÷ "# $!"(day 1-5)-slough off of blood due to  $$   -!. sperm is either X or Y: if fertilization luteum from ovary causes low estro.identical twins (fetuses share ion one 2.÷ "! $!"(day 27-28)-if (-) fertilization.chromosomes-nucleus of cells. 44 homologous (22 3.pair of gene. Alleles.÷ L-completes follicular maturation(day 15-22) placenta) !""  "#  1. phenotype.÷  $!"(day14-26)-high estrogen. and low proges.fraternal twins (fetuses have separated      placenta) 1. AKA luteal 22 autosome + Y chromosome in male phase 22 autosome + X chromosome in female 4. genotype-individual actual gene phase *** normal is 46 chromosome (23 pairs). it is Male. !" "  % .. Genes. uterine vascularity occurs.strogen-hormone of femaleness blood compression in AVA 2.÷  $!"(day 6-14)-rapid thickness of segment of DNA.÷ ^ -develops ovarian follicle(day 1-14) constant.÷ Dizygote.÷ Monozygote. low estrogen !".small 2. low pairs) progesterone.÷ Prostaglandin-hormone of reproductive process 1.individual endometrium. AKA postmenstrual physical appearance.÷ Progesterone-hormone of pregnancy #$ $. and if zygote is XY then then arterial constriction prepares blood loss.(/ ruptured endometrial capillaries. comes the zygote as XX then it is ^emale." 3.

÷ .heterozygous(e. dwarfism) 1. c  þ÷ Autosomal dominant.

muscle tension þ÷ X-linked recessive. loss of involuntary þ÷ pinnbarkeit test. & þ÷ ·omen.pre orgasmic emission.strong vaginal & uterine cervical mucus with sperm ability to survive contraction. vaginal constrict. viscosity.rapid loss of erection. rickets) affected (e.women affected (e. cystic fibrosis) þ÷ Men. nipple þ÷ X-linked dominant.done @ midmenstrual cycle þ÷ Men. flush þ÷ ‘‘T 4. volume.lubrication. Test. emophilia.erection. thick scrotum. erect nipple. color þ÷ ·omen.citement þ÷ Autosomal recessive.÷ Plateu (  c %  þ÷ Men.blood test during luteal phase þ÷ Men. rela muscle þ÷ .done after 48-72 hrs of abstinence. high V/ check for sperm count.check estro level control þ÷ im͛s-huhner test. To testes. elevated þ÷ emen analysis.÷ Resolution þ÷ erum proges.or post coital test to eamine þ÷ ·omen. high V/ þ÷ pervical mucus test 3. presence of infection flushing. muscle blind) tension 2.homozygous(e.epel semen. motility.clitoris retract.÷ Orgasmic þ÷ ^ern test.

by soundwaves & . rela muscle into cervi & uterus to check patency and pathology þ÷ UTZ.with radiopaque dye injected protrudes.histology of endometrium þ÷ ·omen-vaginal vasodilatation.ndometrial biopsy. clitoris þ÷ ysterosalpingography.

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2.c  þ÷ ysteroscopy.÷ Pre embryonic stage. 3 layers: ectoderm.÷ ^ertilization.  &.8-10 days after implanted now to deciduas termed embryo.union of ovum + spermatozoan = zygote þ÷ perm vitro if has antibody sperm implanted @ ampulla formation.check adhesion in uterus 1.

mesoderm.÷ .inability to conceive after 1 year of coitus 4  a week. . endoderm ^emale causes 3.

AOG Male causes 2.÷ Decidua. & proges.mbryonic stage.3-8 weeks AOG þ÷ Anatomic abnormalities 4.÷ ^etal stage-8 weeks onwards þ÷ igh acidic vaginal environment þ÷ igh alkalinity in cervical os *   "#$$ "##" + þ÷ Due to diethylstilbestrol therapy st estro. During 1 þ÷ Myomas.÷ porpus luteum. leiomyomas. 2mos. etc.nourish &protect developing embryo and þ÷ .

low count.membrane outside embryo þ÷ TDs.interferes spermatogenesis (e. motility 3.jaculation retrograde fetus þ÷ perm abnormalities. hormonal. þ÷ Testicular condition-MMR.÷ Placenta. methotreate) 4. cryptorchiditis transmission & filtration of nutrients. þ÷ Drugs.÷ Membrane and Amniotic fluids **chorion. orchiditis. nicotine .functions starts @ 14 week AOG.

   c&  &.



.alkaline douche 30 min before coitus.hypertrophy. given PO 50 mg/day for 5 days.c c&   Reproductive system . clomiphene citrate þ÷ Uterus. @ level of umbilicus by 20wAOG.

.-multiple gestation. pergonal given IM daily. bleeding. check for @ level of ipoid by 36wAOG.

adb͛l þ÷ pervi. perclage-suturing around cervical streaks in abdomen þ÷ Linea negra.tender. check for ovarian enlargement þ÷ Ovaries.-multiple gestation. nurse acts as a Integumentary system ovulation during pregnancy #..dark line from umbilicus down to  c. 0# !$. large.corrects defect. nd þ÷ ‘reast.goodles sign pain.use proper communication. check for vaginismus and dyspareunia þ÷ triae gravidarum. pigmented with clostrum@ 2 microsurgery in fallopian obstruction tri.

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5 L retention ( c()  1 þ÷ Protein met͛sm 1. 3 tri-8-12lbs þ÷ þ÷ ·ater met͛sm-6.mask of pregnancy þ÷ upport decision making þ÷ Pigmentation.melanocyte-stimulating hormone @ þ÷ Guidance 8wAOG þ÷ Accurate information Metabolic changes þ÷ Keep resolve feeling of infertility st nd þ÷ ·t gain.due to spared glucose 2.average is 11-13 kg. 1 tri.iron supplements 20-40 mg daily catheter .sperm instill into cervical os þ÷ parb.÷ In vitro fertilization.2-4lbs. 2 tri-12- þ÷ ponfidentiality rd 14lbs.high plasma lipids @ 2 tri (petri dish) then instill in uterus using small elastic þ÷ Iron met͛sm.÷ Artificial insemination. met͛sm. symphisis þ÷ Regain self contol þ÷ phloasma.egg & sperm instill microscopically nd þ÷ ^at met͛sm.

^ ..ndocrine system 3. & fibrinogen ***Note: women in labor should positioned in semi/high fowlers with both legs fleed.glycosuria c .÷ Zygote intrafallopian transfer.high pO. leukocyte. with legislation and law process.. nd rd 6.donate egg + sperm þ÷ eart.. PL sperm þ÷ Pituitary.÷ urrogate mother. Tidal vol.high estro & proges.displaced upward by diaphragm implanted into infertile mother þ÷ pirculation. pG.dilated & elongated @ pregnancy Q-uickening (18-20w) þ÷ G^R.high RR. high PR. 4. mild respiratory p-hanges in the breast alkalosis ^-atigue þ÷ Diaphragm. avoid LITOTOMY $# because of sudden increased venous blood return @the right side of heart when legs raised above level of atria ) M-orning sickness Respiratory system A-menorrhea þ÷ Ventilation.elevated with epanded thora L-assitude Urinary system U-rinary frequency þ÷ Ureter. þ÷ igh R‘p.ovum fertilizes oytoin eternally pardiovascular system 5.produces surgery ovum retrieve from ovary then instill into ampulla with þ÷ Placenta.donate sperm + surrogate egg low ‘P @ 2 & 3 tri implanted into surrogate mother then newborn give to ematologic system infertile couple.÷ urrogate embryo transfer. proges.÷ Gamete intrafallopian transfer. suppressed L. (+) physiologic anemia.

 c c& .

D‘.÷ Grandly-dick͛s read method.(  ( c p-hadwicks(blue vulva) 1.

÷ Lamaze.÷ ‘radley. mouthing of P-ositive PT songs ‘-allotment 3. rela.delayed cord cutting c) & ..÷ Leboyer.pyschoprophylactic method.current childbirth delivery G-oodles(soft cervi) 5.with male partner acts as a coach O-utline fetal body 4.psychoseual -ouffle & ‘raton hick͛s 6. pushing -egar(soft lower uterus) techniques U-terine enlarge 2.÷ ·right.÷ Kitzinger.



10weeks-by dopler alpha-fetoprotein 16weeks-by fetoscope 2. bilirubin.@ semi fowlers then ^R in monitored for 20 min .aspiration of A.÷ ‘iophysical profile-APGAR highest is 10 18-20weeks-stetoscope 3.    ^etal heartbeat. skeleton check for color.÷ Rhythm strip testing.÷ Amniocentesis.^luid @ 14-16wAOG to movement. 1. L/ ratio. chromosomes.

percutaneous umbilical blood sampling Regular contraction Irregular contraction to check karyotyping.÷ ^etoscopy.÷ check for meconium staining .÷ Amnioscopy.÷ MRI. 4.÷ pontraction stress testing.@nipple stimulation while contracn # * &" * 8.÷ Maternal serum alpha-fetoprotein.done @ 16-17wAOG to check fetal spine 6.@ 15wAOG to to abdomen check for down͛s syndrome tressed tressed may lessen by rest to d ectopic preg & trophoblast dse.biopsy @ 10-12wAOG 5.     7. Pain radiates from lower back Pain at abdomen 9.÷ phrionic villi sampling.

power. passenger.÷ UTZ. location of placenta. gross abnormalities & to determine se & position. placental factors.ffaced pervi does not change yet 11. psyche ANT. NM: should have full bladder. amniotic fluid. Passageway. placed towel under right 2" ^ApTOR IN LA‘OR buttocks for to prevent supine d pregnancy @ early as 6wAOG to check for size.

PARTUM-starts of conception to onset of labor st INTRAPARTUM-beginning of contraction to 1 four hrs after (c  3 'c  .

# of past pregnancy that reached viability T. c placental delivery PO TPARTUM-period of puerperium D-escent of fetus(lightening.never been pregnant labor) PARITY.primi @ 2 w prior. multi @ onset of NULLIGRAVIDA.

refers to 38 w AOG O-pening of cervical os     -oft cervi Assessment þ÷ þ÷ purrent pregnancy h  of previous pregnancy p-ontraction are progressive þ÷ þ÷ Gynaecologic h purrent med͛l h R-upture of membrane Previous med͛l h þ÷ þ÷ ^amily med͛l h .RM.

-ffacement Occupational h þ÷ þ÷  of baby͛s father A-pprehension þ÷ Personal info þ÷ Assess risk factor M-ucus plug-bloody show þ÷ P.

papaniculao smear)   c& .. þ÷ Lab works (UA. p‘p.

c þ÷ Psychological &" ".4 to 7 cm 3.3 to 4 cm pregnancy 2.7 to 10 cm  ". þ÷ pommon minor discomfort during 1.÷ Transition.÷ Latent.(.÷ Active.

D ^IR.



) %( (  c& (.

 (placental delivery and separation) 1. .) (( ! ".÷ Naegeles rule (-3+7+1) ecept jan. lengthening of cord. 13 cotyledons LMP(last menses period) **signs of separation.globular uterus.feb & march **shiny chultz͛s and dirty Duncan.

then .. LMP is 9/10/09.

DD is __ sudden gush of blood 9-3=6 10+7=17 09+1=10 .

DD is June 17. 2010 .

@umbilicus ʹ 20wAOG .^requency.if above symphisis-12-14wAOG. *  (5 2..ontraction.beginning of one to beginning of net . 3 4" .÷ ^undal ht.

smooth & hard.palpate then observe Duration.indefinite.what is fetal attitude? (good or poor) I Duration I I ^requency I .what is at pelvic inlet? (engaged or not engaged) th 4 . Knee/elbows- angular nodulation palpated) Intensity Increment Decrement rd 3 . moves dependently) nd 2 . abdomen are relaed) st 1 .where is fetal back? (‘ack.strength of contraction (empty bladder @ supine with knee fleed.beginning to end of one contraction Intensity. moves independently.firm. Acme ‘reech.what is presentation? (ead.$/" #.


moderate fleion ͞military attitude͟ ‘row.relationship of fetal parts to each other Verte. mentum ‘reech(buttocks or feet). LOA.-ie.verte.right sacrum anterior -tation ^etal head _ -3 X _ -2 X ʹ iliac crest _ -1 --------------------.part of fetus that enters maternal pelvis pephalic(95%).ischial spine(important in I.transverse the shoulder @ acromion process -osition.full fleion inciput.right occiput anterior ROP. face.relationship of fetal spine to maternal spine Longitudinal Transverse Oblique ^etal spine maternal spine -ttitude.complete. footling houlder.left sacrum anterior R A.right occiput posterior L A.partial etension ^ace.relationship of the presenting part to a specific quadrant of maternal͛s pelvis. frank.poor fleion. full etention . brow.resentation.left occiput anterior LOP.O -------------------.left occiput posterior ROA.

) _+1 _+2 X _+3 X ʹ Ischial tuberosity Vagina .