Ovulation and Twin Formation

Ovulation

• Ovulation happens around day 14 in a 28-day cycle
• It lasts about 24 hours
• Symptoms:
  • Slight rise in basal body temperature
  • Thicker discharge with the texture of egg whites

Luteal Phase

• The follicle transforms into the corpus luteum after releasing its egg
• The corpus luteum releases hormones, mainly progesterone and some estrogen
• The rise in hormones keeps the uterine lining thick and ready for implantation
• If pregnant, the body produces human chorionic gonadotropin (HCG), maintaining the corpus luteum and uterine lining
• If not pregnant, the corpus luteum shrinks, leading to decreased estrogen and progesterone, initiating menstruation

Twins

• Two babies born at the same time
• Can be identical (monozygotic) or fraternal (dizygotic)

Identical Twins

• Formed when a single fertilized egg splits into two embryos
• Genetically identical
• Always the same sex (boy-boy or girl-girl)
• Relatively rare, occurring in about 1 in 250 births
• Higher risk of certain genetic disorders

Fraternal Twins

• Formed when two separate eggs are fertilized by two separate sperm
• Genetically different, like any other siblings
• Can be the same sex or different sexes

Challenges of Raising Twins

• Double the work
• Lack of sleep
• Financial strain
• Social isolation

Fertilization

• Sperm cells travel through the vagina, cervix, and uterus to reach the egg in the Fallopian tube
• One sperm cell penetrates the egg and fertilizes it
• The fertilized egg (zygote) divides and develops into a blastocyst
• The blastocyst implants in the uterine wall and develops into an embryo
• Genetic material from sperm and egg combine to form a single diploid nucleus with 46 chromosomes
• The zygote undergoes mitosis, dividing into two identical daughter cells

2nd Trimester

• Weeks 13-28
• Fetal movements
• Skin darkening
• Swelling in extremities
• Breast/belly growth
• Braxton-Hicks

3rd Trimester

• Weeks 29-40
• Dyspnea (hard breathing)
• Difficulty sleeping
• Colostrum leaks
• Lochia (blood: body fluid)
• Fatigue
• Breast soreness/leaking
• Postpartum depression risk

False Labor Symptoms

• Discomfort over the lower abdomen and groin areas, not associated with dilation
• Typically shorter in duration
• Less intense
• Relieved by sedatives or ambulation

True Labor Symptoms

• Discomfort over the fundus with radiation to the back and low abdomen
• Associated with effacement and dilation
• Increasingly intense and frequent
• Regular and effective

Medical Intervention for Ectopic Pregnancy

• Methotrexate: Injections that stop the growth of ectopic tissue allowing the body to reabsorb it, most effective when diagnosed early
• Laparoscopy: A minimally invasive procedure using small incisions and a laparoscope to remove the ectopic tissue or the affected fallopian tube
• Laparotomy: A more invasive surgery with a larger incision, used for severe internal bleeding, significant damage, or when laparoscopy isn’t feasible
• Expectant Management: Watchful waiting by monitoring with blood tests and ultrasounds for small, asymptomatic ectopic pregnancies

Psychological Changes of Pregnancy

• The woman’s attitude toward pregnancy depends on the environment she’s raised in
• Social influences: Pregnancy is not an illness, the family is included
• Increased use of birthing centers
• Demedicalize childbirth

Factors Affecting Labor (5 P’s)

• Passenger (the fetus): The fetus’s relationship to the passageway is the major factor in the birthing process

Complete Blood Count (CBC)

• Measures the number of red blood cells, white blood cells, and platelets in the blood

Hemoglobin Levels

• Measures the amount of hemoglobin in the blood

Serum Iron Levels

• Measures the amount of iron in the blood

Ferritin Levels

• Measures the amount of iron stored in the body

Iron Deficiency Anemia Treatment

• Address underlying cause and replenish iron stores
• Oral iron supplements
• Intravenous (IV) iron
• Consuming vitamin C-rich foods

Antepartum Hemorrhage and Placenta Previa

• Associated with IUGR

Intrauterine Growth Retardation (IUGR)

• Structural abnormalities in the fetus can impede growth
• Twins or higher-order multiples can experience restricted growth due to competition for resources
• Uterine abnormalities like fibroids can impact fetal growth
• IUGR Symptoms:
  • Small for Gestational Age (SGA)
  • Reduced Fetal Movements
  • Low Amniotic Fluid
  • Abnormal Doppler Ultrasound Findings

IUGR Medical Intervention

• Monitoring and diagnosis through ultrasounds and Doppler studies

Gestational Diabetes

• Can increase the risk of having a cesarean section because the baby may be large
• A cesarean section is a major surgery

Pregnancy Food Recommendations

• Choose high-protein or carbohydrate foods like crackers, bread, pretzels, nuts, and low-fat yogurt
• Avoid spicy, greasy, or acidic foods
• Drink cold, clear fluids like sports drinks or ginger ale, and avoid coffee
• Drink between meals instead of with them
• Suck on popsicles or ginger-flavored lollipops
• Brush your teeth right after eating
• Avoid lying down right after eating
• Take your vitamins at bedtime with a snack, not in the morning
• Stay away from things that upset your stomach like stuffy rooms, strong smells, hot places, or loud noises
• Have someone else prepare your meals
• Wear acupressure bands on your wrists to help with nausea

Hyperemesis Gravidarum Treatment

• Treatment focuses on managing symptoms and preventing dehydration
• Intravenous fluids
• Anti-nausea medications
• Diet modifications
• Rest and relaxation

Family Planning Objectives (WHO)

• Avoid unwanted birth
• Bring about wanted birth
• Produce a change in the number of children born
• Regulate the intervals between pregnancies
• Control the time at which birth occurs

Scope of Family Planning

• Proper spacing and limitation of births
• Advice on sterility
• Education for parenthood
• Sex education
• Screening for pathological conditions related to the reproductive system
• Genetic counseling

Types of Family Planning Methods

• Natural Family Planning Method (Fertility Awareness Method)

Advantages of Natural Family Planning

• Free from side effects of artificial substances