egnancy-related Concern

and
Pre-natal Care
Ovulation
Hormones rises

Progesterone
Fertilization
Cells continue to divide
implantation
Pregnancy
Fetal Development
 Fetal Development
1. Pre-embryonic stage
zygote – fertilized ovum
 Fetal Development
2. Embryonic (3rd to 8th week)
Germ layers:
a. Ectoderm
b. Mesoderm
c. Endoderm
 Fetal Development
3. Fetal stage - fetus
Biopsychosoci
al
aspect of
pregnancy
3 signs of pregnancy
Presumptive
signs
Probable
signs
Positive
signs
 First trimester
Presumptive signs
Breast changes
Urinary frequency
Fatigue and discomfort
Amenorrhea
Morning sickness
Enlarged uterus
 First trimester
Probable signs
Goodells sign – softening of the cervix
Chadwick sign – bluish discoloration of
vagina
Hegar sign – softening of isthmus
Elevated body temperature
 First trimester
Positive sign
Ultrasound
Second trimester
Presumptive sign
Chloasma
Linea nigra
Striae
gravidarum
Quickening
Second trimester
Probable signs
Enlarged abdomen
Braxton-Hicks contraction
Second trimester
Positive sign
Fetal heart tone
Reproductive System
Changes
Chadwick - vagina
Goodells - cervix
Hegar - isthmus
Piskacek - uterus
Gastrointestinal System changes
Morning
sickness
Heart burn and
flatulence
Bloating and
constipation
Musculoskeletal System changes
Lordotic position
Waddling gait
Leg cramps
Health Teachings
Sexual activity
Privacy
Moderation
Comfortable position
No air during cunnilingus
Contraindicated:
Vaginal spotting
Preterm labor
Premature rupture of membrane
Health Teachings
Exercises
Squatting
Walking
Kegel’s exercise
Shoulder circling
Pelvic rocking
Complications
during
pregnancy
 Abortion
Induced
Therapeutic
Illegal
Spontaneous
Complete
Incomplete
Threatened
Missed
Inevitable
Habitual
 Abortion
Causes:
Certain viruses
Chromosomal abnormalities, luteal phase defects
Immunologic abnormalities
Major trauma
Uterine abnormalities (eg, fibroids)
Most often, the cause is unknown.
Risk factors include
Age > 35
History of spontaneous abortion
Cigarette smoking
Use of certain drugs (eg, cocaine, alcohol, high doses of caffeine)
A poorly controlled chronic disorder (eg, diabetes, hypertension) in
the mother
 Ectopic pregnancy
Implantation outside the uterine cavity
CAUSES - unknown
Damaged fallopian tube
Risk Factors:
Current use of an intrauterine device(IUD)
History of pelvic inflammatory disease (PID)
Sexually-transmitted diseases such
as chlamydia and gonorrhea
Congenital abnormality (problem present at
birth) of the fallopian tube
 Ectopic pregnancy
History of pelvic surgery (because
scarring may block the fertilized egg from
leaving the fallopian tube)
History of ectopic pregnancy
Unsuccessful tubal ligation (surgical
sterilization)
Use of fertility drugs
Ectopic pregnancy
Symptoms
Light vaginal bleeding
Nausea and vomiting with pain
Lower abdominal pain
Sharp abdominal cramps
Pain on one side of your body
Dizziness or weakness
Pain in your shoulder, neck, or rectum
If the fallopian tube ruptures, the pain and bleeding
could be severe enough to cause fainting
Hydatidiform mole
Hydatidiform mole, or molar
pregnancy, results from too much
production of the tissue that is
supposed to develop into the
placenta.
Signs and symptoms:
Hypertension
Swelling in the feet, ankles and legs in the first
trimester
Abnormal growth of the uterus, either bigger or
smaller than usual
Nausea and vomiting that may be severe enough to
require a hospital stay
Vaginal bleeding during the first 3 months of
pregnancy
Placenta previa
Placenta previa occurs
when a baby's placenta
partially or totally covers
the opening in the
mother's cervix
 Placenta previa
Placenta previa is also
more common among
women who:
Have delivered at least
one baby
Had placenta previa with
a previous pregnancy
Are carrying more than
one fetus
Smoke
Use cocaine
Placenta previa
Signs and
symptoms:
Painless bright
red vaginal
bleeding
 Effects
Bleeding. Severe, possibly
life-threatening vaginal
bleeding (hemorrhage) can
occur during labor, delivery or
the first few hours after
delivery.
Preterm birth. Severe
bleeding may prompt an
emergency C-section before
your baby is full term.
Gestational DM
Affects how your cells use sugar
(glucose)
Causes high blood sugar that can affect
your pregnancy and your baby's health.
san
Risk factors:
Diet
Overweight or obesity
Age greater than 25
Effects
Excessive birth weight. 
Early (preterm) birth and respiratory
distress syndrome. 
Low blood sugar (hypoglycemia)
Type 2 diabetes later in life. 
Untreated gestational diabetes can
result in a baby's death either before or
shortly after birth.
Effects
Gestational diabetes may also
increase the mother's risk of:
High blood pressure and
preeclampsia
Future diabetes
 s
during
labor and
delivery
Premature labor
20 weeks to 36 weeks
Signs and symptoms:
Regular or frequent contractions — a tightening
sensation in the abdomen
Constant low, dull backache
A sensation of pelvic or lower abdominal pressure
Mild abdominal cramps
Diarrhea
Vaginal spotting or bleeding
Watery vaginal discharge (water breaking) — in a gush
or a trickle
A change in vaginal discharge
Risk factors
Previous preterm labor or premature birth
Pregnancy with twins, triplets or other multiples
Certain problems with the uterus, cervix or
placenta
Smoking cigarettes or using illicit drugs
Certain infections, particularly of the genital tract
Some chronic conditions, such as high blood
pressure and diabetes
Being underweight or overweight before
pregnancy, or gaining too little or too much weight
during pregnancy
Risk factors
Stressful life events
Red blood cell deficiency (anemia), particularly
during early pregnancy
Too much amniotic fluid (polyhydramnios)
Pregnancy complications, such as preeclampsia
Vaginal bleeding during pregnancy
Presence of a fetal birth defect
Little or no prenatal care
An interval of less than six months since the
last pregnancy
Fetal effects
Low birth weight
Breathing difficulties
Underdeveloped organs
Vision problems
Premature rupture of membrane
 water breaks before the 37th week of
pregnancy
Risk factors:
A history of preterm premature rupture
of membranes in a prior pregnancy
A genital tract infection
Vaginal bleeding during pregnancy
Smoking during pregnancy
A low body mass index
Effect
Potential complications
include:
maternal or fetal infection,
placental abruption
at risk of complications due to
premature birth
Prolapsed umbilical cord
The most common cause of an umbilical cord
prolapse is a premature rupture of the membranes
that contain the amniotic fluid.
Other causes include:
Premature delivery of the baby
Delivering more than one baby per pregnancy
(twins, triplets, etc.)
Excessive amniotic fluid
Breech delivery (the baby comes through the
birth canal feet first)
An umbilical cord that is longer than usual
Prolapsed umbilical cord
An umbilical cord prolapsed
presents a great danger to the
fetus. During the delivery, the
fetus can put stress on the cord.
This can result in a loss of oxygen
to the fetus, and may even result
in a stillbirth.
Cephalocaudal disproportion
occurs when a baby’s head or body is too large to fit
through the mother’s pelvis
Causes:
Large baby due to:
Hereditary factors
Diabetes

Postmaturity (still pregnant after due date has passed)

Multiparity (not the first pregnancy)

Abnormal fetal positions

Small pelvis
Abnormally shaped pelvis
 Life Lessons
Life isn’t fair, but it’s still good.
When in doubt, just take the next
small step.
Life is too short to waste time hating
anyone.
Don’t take yourself so seriously. No
one else does.
Pay off your credit cards every month.
 Life Lessons
You don’t have to win every argument. Agree to
disagree.
Cry with someone. It’s more healing than
crying alone.
Save for retirement, starting with your first
paycheck.
When it comes to chocolate, resistance is futile.
Make peace with your past so it won’t screw up
the present.
 Life Lessons
It’s OK to let your children see you cry.
Don’t compare your life to others’. You have
no idea what their journey is all about.
If a relationship has to be a secret, you
shouldn’t be in it.
Life is too short for long pity parties. Get
busy living, or get busy dying.
You can get through anything if you stay put
in today.
 Life Lessons
It’s never too late to have a happy
childhood. But the second one is up to you
and no one else.
When it comes to going after what you love
in life, don’t take no for an answer.
Burn the candles; use the nice sheets; wear
the fancy lingerie. Don’t save it for a special
occasion. Today is special.
Overprepare, then go with the flow.
 Life Lessons
Be eccentric now. Don’t wait for old age
to wear purple.
The most important sex organ is the
brain.
No one is in charge of your happiness
except you.
Frame every so-called disaster with
these words: “In five years, will this
matter?”
 Life Lessons
What other people think of you is none
of your business.
Time heals almost everything. Give
time time.
However good or bad a situation is, it
will change.
Your job won’t take care of you when
you are sick. Your friends will. Stay in
touch.
 Life Lessons
Whatever doesn’t kill you really does
make you stronger.
Your children get only one childhood.
Make it memorable.
Get outside every day. Miracles are
waiting everywhere.
If we all threw our problems in a pile
and saw everyone else’s, we’d grab ours
back.
 Life Lessons
Don’t audit life. Show up and make the
most of it now.
Get rid of anything that isn’t useful,
beautiful or joyful.
All that truly matters in the end is that
you loved.
Envy is a waste of time. You already
have all you need.
The best is yet to come.
 Life Lessons
No matter how you feel, get up,
dress up, and show up.
Take a deep breath. It calms the
mind.
If you don’t ask, you don’t get.
Yield.
Life isn’t tied with a bow, but it’s
still a gift.