NCM 101 LECTURE (Maternal and Child Health Nursing

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FallopianTube- 2-3 inches long that serves as a passageway of the sperm from the uterus to the ampulla or thepassageway of the mature ovum or fertilized ovum from the amplla to the uterus4 significant segments * infundibulum – most distal, part trumpet shape, has fimbrae * ampulla – outer 3rd or 2nd half, site of fertilization, common site for ectopic pregnancy * isthmus – site for sterilization, site for BTL * interstitial – most dangerous site for ectopic pregnancy Fertilization: 1.Union of the ovum and spermatozoon 2.Other terms: conception, impregnation or fecundation 3.Normal amount of semen/ejaculation= 3-5 cc = 1 tsp. 4.Number of sperms: 120-150 million/cc/ejaculation 5.Mature ovum may be fertilized for 12 –24 hrs after ovulation 6.Sperms are capable of fertilizing even for 3 – 4 days after ejaculation (life span of sperms 72 hrs) 7. Normal life span of sperm is 7 days Implantation- nidation - takes 1 week after fertilization General Considerations: o Once implantation has taken place, the uterine endometrium is now termed deciduao Occasionally, a small amount of vaginal bleeding occurs with implantation due to breakage of capillaries. Immediately after fertilization, the fertilized ovum or zygote stays in the fallopian tube for 3 days, during which time rapid cell division (mitosis) is taking place. The developing cells now called blast omere and when about to have 16 blastomere called morula. Morula travels to uterus for another 3 – 4 day so When there is already a cavity in the morula called blasto cyto finger like projections called trophoblast form around the blastocyst, which implant onthe uterus Implantation is also called nidation, takes place about a week after fertilization -morula-16 blastomere -morula-cavity in the morula -trophoblast-fingerlike projections

heart beat heard by fetoscope 5th month : Vernix appears. buds of permanent teeth form. Buds of milk teeth form .12th wk.cartilage.bladder and urethra2.meconium formed (5th – 8th wk) 3rd mont h: Kidneys function .endosderm – gives rise to lining of GIT. placental fully developed.urine formed .20-35 y/o Average menstrual cycle.15-44y/o Childbearing. heart. tonsils.28 daysAverage menstrual period. FHR audible withstethoscope 6th month : Attains proportions of full term but has wrinkled skin 7th month : 28 weeks – lower limit of prematurity. establishment of feto-placental exchange 4th month : Lanugo appears. allows amniotic fluid . Ectoderm – responsible for the formation of the nervous system.5 daysNormal blood loss50cc/1/4 cup accompanied by FIBRINOLYSIS – prevents clot formation Fetal Growth and DevelopmentFirst Lunar Month –first four weeks-germ layers differentiate by the 2nd week 1. lanugo over entire body. blood cells. muscles and tendons). skin. thymus gland (for development of immunity). begin boneossification . thyroid (for basalmetabolism). 4th week – heart beats 2nd month: All vital organs and sex organs formed. Respiratory Tract.Age of reproductivity.parathy roid (for calcium metabolism).kidneys and ureters. circulatory system. hair and nails and themucous membrane of the anus and mouth 1 month : 2nd week – fetal membranes16th day – heart forms .Mesoderm – forms into the supporting structures of the body (connective tissues. reproductive system. quickening.3. alveoli begins to form 8th month .

V.Central insertion.Wharton’s jelly. Short Cord results to: 1. subcutaneous fat deposition begins 9th month : Lanugo continue to disappear. A (2 arteries. begins to form at 11 – 15th week of gestation. 1 Vein)Cord Abnormalities: BASA PRAVIA .Battledoor Insertion – at the edge Diagnosis of Basa Pravia . vernix complete.Amniotic fluid: clear albuminous fluid. T r u e K n o t s C o r d a.Lateral insertion.cord inserted at the center of the placentab. containing little white specks of vernix caseosa. S u d d e n f e t a l b r a d y c a r d i a 3.Amnion – gives rise to umbilical cord/funis – with 2 arteries and 1 vein supported by 2. lanugo disappears.cord inserted away from the center of the placenta2. colorless.long term variability consist of 5-15 bpm every 3-5mins4.protects the umbilical cord 3.Sudden gosh bright red blood at the tip of the rapture of membrane2 .the umbilical cord loses the protection of the wharton’s jellySigns and Symptoms:1. rapid increase inlength Third Trimester – period of most rapid growth and development because of the depositionof subcutaneous fat Fetal Membranes 1.Villatentous insertion – membranes of cord is inserted to the membrane to the placenta3.: 32 weeks – fetus viable. amniotic volume decrease Focus of Fetal DevelopmentFirst Trimester – period of organogenesis Second Trimester – period of continued fetal growth and development.Intrapartum hemorrhage (during delivery) 2. near term is clear.Sinusoidal fetal heart rate pattern. Known as BOW or Bag of Water U m b i l i c a l C o r d / f u n i s w h i t i s h g r a y -connects the fet us to the placenta-carry oxygen and nutrients from the placenta to the fetus and return un oxygenated blood and fetal waste product to the placentaliver functions for the detoxification-A. chiefly derived from maternal serum and fetal urine. produced at rate of 500 ml/day. urine is added by the 4th lunar month. I n v e r s i o n o f t h e u t e r u s Long Cord results to: 1 .Delayed descend of the fetus during labor 3 .

vesicular formation on the cord *true cord cyst . Torsion of the corddeficiency of Wharton’s jelly number Hematoma of the cord .Wharton’s jelly containing a loop of umbilical vessels Loops of the cordcord coil around the fetal body and neck.each cotyledon is a collection of villi which terminatein one main stem.Transvaginal sonography at 16 weeks of gestation2.commonly seen in the dead fetus Single Umbilical Arteryrenal associated with other renal anomalies 2 sides of placenta 1.large and derived from Wharton’s jelly.1.Maternal (rami.derived from remnants of the umbilical vesicles *false cord cyst . Edema of the cord . Amniotic FluidPurposes of Amniotic FluidProtection . when the cord coil is the neck it iscalled nuccal cord. Caesarean Section is the best remedy Knots of the cordfetal movement may cause knots in the cord *true knotsfetus passes through a loop of cord * false knots . the lobes are separated by grooves called septic.results from the rapture of the vessels with a fusion of blood into thecord Cord Cyst .collection of villi).

develops 15 – 20 cotyledons •Purpose of Placenta: respiratory.com/doc/36300683/NCM-103-RESPI .scribd. exchange of nutrients and oxygen •Renal system •Gastrointestinal system •Circulatory system Endocrine system: produces hormones (before 8th week-corpus luteum produces thesehormones) hCG keeps corpus luteum to continue producing estrogen and progesterone •HPL or human chorionic somatomammotropin which promotes growth of mammary glands forlactation •Protective barrier: inhibits passage of some bacteria and large molecules http://www. start to form at 8thweek of gestation.– shield against pressure and temperature changesCan be used to diagnose congenital abnormalities intrauterine– amniocentesisAid in the descent of fetus during active labor Implication:Polyhydramios = more than >1500 ml due to inability of the fetus to swallow the fluidas intrachoesophageal fistula. Oligohydramnios = less than <500 ml due to the inability of the kidneys to add urineas incongenital renal anomaly Fetal Membranes •Chorion .together with the deciduas basalis gives rise to the placenta.

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