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A. Fertilization B.

Stages of Fetal Growth and Development 3-4 days travel of zygote – mitotic cell division begins *Pre-embryonic Stage a. Zygote- fertilized ovum. Lifespan of zygote – from fertilization to 2 months b. Morula – mulberry-like ball with 16 – 50 cells, 4 days free floating & multiplication c. Blastocyst – enlarging cells that forms a cavity that later becomes the embryo. Blastocyst – covering of blastocys that later becomes placenta & trophoblast d. Implantation/ Nidation- occurs after fertilization 7 – 10 days. Fetus- 2 months to birth. placenta previa – implantation at low side of uterus Signs of implantation: 1. slight pain 2. slight vaginal spotting - if with fertilization – corpus luteum continues to function & become source of estrogen & progesterone while placenta is not developed. 3 processes of Implantation 1. Apposition 2. Adhesion 3. Invasion C. Dicidua – thickened endometrium ( Latin – falling off) * Basalis (base) part of endometrium located under fetus where placenta is delivered * Capsularies – encapsulate the fetus * Vera – remaining portion of endometrium. C. Chorionic Villi- 10 – 11th day, finger life projections 3 vessels= A – unoxygenated blood V – O2 blood A – unoxygenated blood Wharton’s jelly – protects cord Chorionic villi sampling (CVS) – removal of tissue sample from the fetal portion of the developing placenta for genetic screening. Done early in pregnancy. Common complication fetal limb defect. Ex missing digits/toes. E. Cytotrophoblast – inner layer or langhans layer – protects fetus against syphilis 24 wks/6 months – life span of langhans layer increase. Before 24 weeks critical, might get infected syphilis F. Synsitiotrophoblast – synsitial layer – responsible production of hormone 1. Amnion – inner most layer a. Umbilical Cord- FUNIS, whitish grey, 15 – 55cm, 20 – 21”. Short cord: abruptio placenta or inverted uterus. Long cord:cord coil or cord prolapse b. Amniotic Fluid – bag of H2O, clear, odor mousy/musty, with crystallized forming pattern, slightly alkaline. *Function of Amniotic Fluid: 1. cushions fetus against sudden blows or trauma 2. facilitates musculo-skeletal development 3. maintains temp 4. prevent cord compression 5. help in delivery process Normal amt of amniotic fluid – 500 to 1000cc polyhydramnios, hydramnios- GIT malformation TEF/TEA, increased amt of fluid oligohydramnios- decrease amt of fluid – kidney disease

artery . Genetic screening. 5.determine if amniotic fluid has ruptured or not (blue paper turns green/grey . fluid is tested for: 1. 2. Liver of mom detoxifies fetus. diffusion more rapid from higher to lower. Paper turns blue green/gray-(+) rupture of amn fluid. 4. If mom hypoglycemic.2:1 signifies fetal lung maturity not capable for RDS Shake test – amniotic + saline & shake Foam test Phosphatiglyceroli: PG+ definitive test to determine fetal lung maturity Placenta – (Secundines) Greek – pancake.pre term labor Important factor to consider for amniocentesis. Simple diffusion GIT – transport center. Amnioscopy – direct visualization or exam to an intact fetal membrane. Size: 500g or ½ kg -1 inch thick & 8” diameter Functions of Placenta: a.Diagnostic Tests for Amniotic Fluid A. Paper turns yellow. Nitrazine Paper Test – diff amniotic fluid & urine. Amniocentesis empty bladder before performing the procedure. Respiratory System – beginning of lung function after birth of baby. Has a diabetogenic effect – serves as insulin antagonist Relaxin Hormone.+ ruptured amniotic fluid) C.maternal serum alpha feto-protein test (MSAFP) – 1st trimester 2. Purpose – obtain a sample of amniotic fluid by inserting a needle through the abdomen into the amniotic sac.urine. Fern Test. Human Chorionic Gonadrophin – maintains corpus luteum alive. Determination of fetal maturity primarily by evaluating factors indicative of lung maturity – 3rd trimester Testing time – 36 weeks decreased MSAFP= down syndrome increase MSAFP = spina bifida or open neural tube defect Common complication of amniocenthesis – infection Dangerous complications – spontaneous abortion 3rd trimester.needle insertion site Aspiration of yellowish amniotic fluid – jaundice baby Greenish – meconium A. B. Human placental Lactogen or sommamommamotropin Hormone – for mammary gland development. Chorion – where placenta is developed Lecithin Sphingomyelin L/S Ratio. 1.HBV Fetal Stage “ Fetal Growth and Development” Entire pregnancy days – 266 – 280 days 37 – 42 weeks . glucose transport is facilitated. fetus hypoglycemic Excretory System.carries waste products. 1. combination of chorionic villi + deciduas basalis. Circulating system – achieved by selective osmosis Endocrine System – produces hormones      6. It serves as a protective barrier against some microorganisms – HIV.causes softening joints & bones estrogen progestin 3.

1st fetal movement. 3.for calcium Thymus – development of immunity Liver – lining of upper RT & GIT * Mesoderm – development of heart. Fetal heart tone begins – heart is the oldest part of the body 2. 18. Sex is distinguishable Second Trimester: FOCUS – length of fetus Fourth Month lanugo begins to appear fetal heart tone heard fetoscope. 2. 1. 2. 3. musculoskeletal system. All vital organs formed. 3. 16. FOCUS: weight of fetus Seventh Month – development of surfactant – lecithin Eighth Month lanugo begin to disappear sub Q fats deposit Nails extend to fingers Ninth Month lanugo & vernix caseosa completely disappear Amniotic fluid decreases Tenth Month – bone ossification of fetal skull 1. 2. . Third trimester: Period of most rapid growth. 5. 3.18 wks – multi fetal heart tone heard with or without instrument Sixth Month eyelids open wrinkled skin vernix caseosa present 1. 18 – 20 weeks buds of permanent teeth appear Fifth Month lanugo covers body actively swallows amniotic fluid 19 – 25 cm fetus. skin and senses. 2. 1. Meconium is formed Third Month 1. Corpus luteum – source of estrogen & progesterone of infant – life span – end of 2nd month 3. Fetal heart tone heard – Doppler – 10 – 12 weeks 4. 1. nails. Buds of milk teeth appear 3. placenta developed 2. hair. kidneys and repro organ * Ectoderm – development of brain.Brain & heart development GIT& resp Tract – remains as single tube 1. Quickening. mucus membrane or anus & mouth First trimester: 1st month . 4. CNS develops – dizziness of mom due to hypoglycemic effect Food of brain – glucose complex CHO – pregnant womans food (potato) Second Month 1. Sex organ formed 4. Kidneys functional 2.Differentiation of Primary Germ layers * Endoderm 1st week endoderm – primary germ layer Thyroid – for basal metabolism Parathyroid .20 weeks primi. 2.

Cardiovascular System – increase blood volume of mom (plasma blood) 30 – 50% = 1500 cc of blood . It affects toughly 20% of pregnant women. Vaccine is terratogenic C – cytomegalo virus H – herpes simplex virus II. the exposure to such may cause damage to the fetus A.any drug. epistaxis – due to hyperemia of nasal membrane palpitation.. Don’t get pregnant for 3 months.iron deficiency anemia is the most common hematological disorder. Herpes simples virus. C. rashes and lesions.pathologic anemia if lower HCT should not be 33%. Cytomegalo virus.Terratogens. enlarged lymph nodes. mom will be given rubella vaccine. increase heart workload. TORCH: Toxoplasmosis. virus or irradiation. fetal alcohol withdrawal syndrome char by microcephaly Smoking – low birth rate Caffeine – low birth rate Cocaine – low birth rate.5 – 14g/dL Criteria 1st and 3rd trimester. hyperbilirubenia or jaundice Iodides – enlargement of thyroid or goiter Thalidomides – Amelia or pocomelia. Drugs: Streptomycin – anti TB & or Quinine (anti malaria) – damage to 8th cranial nerve – poor hearing & deafness Tetracycline – staining tooth enamel. D. inhibit growth of long bone Vitamin K – hemolysis (destr of RBC). influenza like findings. Hgb should not be < 11g/dL 2nd trimester – Hct should not <32% Hgb Shdn't < 10. In some chases the infection may go unnoticed in the pregnant woman yet have devastating effects on the fetus. These infections are often characterized by vague. after delivery.5% pathologic anemia if lower Pathogenic Anemia .easy fatigability. . HIV – blood & body fluids Syphilis R – rubella – German measles – congenital heart disease (1st month) normal rubella titer 1:10 <1:10 – less immunity to rubella. Hepa A or infectious heap – oral/ fecal (hand washing) Hepa B. Other. Feces of cat go to raw vegetables or meat O – others. Systemic Changes 1. and jaundice (hepatic involvement). TORCH (Terratogenic) Infections – viruses CHARACTERISTICS: group of infections caused by organisms that can cross the placenta or ascend through birth canal and adversely affect fetal growth and development. Physiological Adaptation of the Mother to Pregnancy A. T – toxoplasmosis – mom takes care of cats. absence of extremities Steroids – cleft lip or palate Lithium – congenital malformation Alcohol – lowered weight (vasoconstriction on mom). slight hypertrophy of ventricles. abruption placenta B. E. Physiologic Anemia – pseudo anemia of pregnant women Normal Values Hct 32 – 42% Hgb 10. Rubella.

increase clotting factor . 3 times a day) empty stomach 1 hr before meals or 2 hrs after.use support stockings.position – side lying with pillow under hips or modified knee chest position Thrombophlebitis – presence of thrombus at inflamed blood vessel . Nausea afternoon .) Bed rest Never massage Assess + Homan sign once only might dislodge thrombus Give anticoagulant to prevent additional clotting (thrombolytics will dilute) Monitor APTT antidote for Heparin toxicity.small freq feeding.Assessment reveals:  Pallor. constipation  Monitor for hemorrhage Alert:    Iron from red meats is better absorbed iron form other sources Iron is better absorbed when taken with foods high in Vit C such as orange juice Higher iron intake is recommended since circulating blood volume is increased and heme is required from production of RBCs Edema – lower extremities due venous return is constricted due to large belly.increase fibrinogen .) 4. pressure on gravid uterus. Z tract.pregnant mom hyperfibrinogenemia .. protamine sulfate Avoid aspirin! Might aggravate bleeding. Vomiting in preg – emesisgravida. elevate legs above hip level. horseradish. F&E imbalance – primary med mgt – replace fluids.) 3. black stool. Monitor I&O .) 5.) 6. Eat dry crackers or dry CHO diet 30 minutes before arising bed.3 g.if improperly administered. Metabolic alkalosis.use elastic bandage – lower to upper Vulbar varicosities. hematoma. liver due to ferridin content. 2.  Oral Iron supplements (ferrous sulfate 0. to relieve.thrombus formation candidate outstanding sign – (+) Homan's sign – pain on cuff during dorsiflexion milk leg – skinny white legs due to stretching of skin caused by inflammation or phlagmasia albadolens Mgt: 1. avoid wearing knee high socks . give IM.saluyot. ampalaya  Parenteral Iron ( Imferon) – severe anemia. green leafy vegetable-alugbati.) 2. Varicosities – pressure of uterus .lateral expansion of lungs or side lying position.  Gastrointestinal – 1st trimester change Morning Sickness – nausea & vomiting due to increase HCG. malunggay. Respiratory system – common problem SOB due to enlarged uterus & increase O2 demand Position.painful. constipation  Slowed capillary refill  Concave fingernails (late sign of progressive anemia) due to chronic physio hypoxia Nursing Care:  Nutritional instruction – kangkong. 3.

. seafood-tahong (mussels). Urinary System – frequency during 1st & 3rd trimester lateral expansion of lungs or side lying pos – mgt for nocturia Acetyace test – albumin in urine Benedicts test – sugar in urine Musculoskeletal 5. mousy odor discharge ESTROGEN – hormone. Mgt. lobster. PROGESTERONE – hormone responsible for operculum PREGNANT – acidic to alkaline change to protect bacterial growth (vaginitis) . crab. watermelon. Increase fluid intake. suha. increase fiber diet .exercise -mineral oil – excretion of fat soluble vitamins * Flatulence – avoid gas forming food – cabbage * Heartburn – or pyrosis – reflux of stomach content to esophagus . Cheese. Except guava – has pectin that’s constipating – veg – petchy. sardines with bones. pressure of gravid uterus (labor cramps) at lumbo sacral nerve plexus Mgt: Increase Ca diet-milk(Inc Ca & Inc phosphorus)-1pint/day or 3-4 servings/day. pineapple. over fatigue. avoid 3 full meals. apple with skin. resp for leucorrhea OPERCULUM – mucus plug to seal out bacteria. Vit D for increased Ca absorption dorsiflexion B. Dilis. mango. avoid fatty & spicy food. proper body mechanical increase salivation – ptyalsim – mgt mouthwash *Hemorrhoids – pressure of gravid uterus. oversex. hot sitz bath for comfort 4. brocolli.small frequent feeding.fruits – papaya. yogurt. sips of milk.constipation – progesterone resp for constipation. chills. Ca & phosphorous imbalance(#1 cause while pregnant). cantaloupe. malungay. head of fish. Local Changes Local change: Vagina: V – Chadwick’s sign – blue violet discoloration of vagina C – Goodel's sign – change of consistency of cervix I – Hegar's – change of consistency of isthmus (lower uterine segment) LEUKORRHEA – whitish gray. Lordosis – pride of pregnancy Waddling Gait – awkward walking due to relaxation – causes softening of joints & bones Prone to accidental falls – wear low heeled shoes Leg Cramps – causes: prolonged standing.

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