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Questions and Answers

What function does the bulbourethral gland serve in the male reproductive system?

  • Lubricates the urethra and neutralizes acidity (correct)
  • Transport sperm from the testicles
  • Produces energy-rich fluid for sperm cells
  • Forms the majority of semen
  • Which structure is primarily responsible for the production of semen?

  • Seminal vesicle
  • Prostate gland (correct)
  • Bulbourethral gland
  • Epididymis
  • What is the primary source of energy for sperm cells?

  • Fluid from the seminal vesicle (correct)
  • Semen
  • Prostate fluid
  • Fluid from the bulbourethral gland
  • Which part of the female pelvis does the ischium contribute to?

    <p>Inferior portion (C)</p> Signup and view all the answers

    What is the role of the sacrum in the female pelvis?

    <p>Forms the upper posterior portion of the pelvic ring (A)</p> Signup and view all the answers

    Which components make up the true pelvis?

    <p>Innominate bones and sacrum (B)</p> Signup and view all the answers

    What percentage of semen is derived from the seminal vesicles?

    <p>30% (C)</p> Signup and view all the answers

    Which structure marks the midpoint of the pelvis?

    <p>Ischial spines (C)</p> Signup and view all the answers

    What is the primary function of the scrotum in the male reproductive system?

    <p>To support the testes and regulate sperm temperature (A)</p> Signup and view all the answers

    Which structures in the penis are primarily responsible for engorgement during sexual excitement?

    <p>Corpus cavernosa and corpus spongiosum (B)</p> Signup and view all the answers

    Where do the testes develop before descending into the scrotal sac?

    <p>In the pelvic cavity (D)</p> Signup and view all the answers

    What is the role of Leydig's cells in the male reproductive system?

    <p>To produce testosterone (D)</p> Signup and view all the answers

    What is the function of the epididymis in the male reproductive system?

    <p>To act as a maturation and storage area for sperm (D)</p> Signup and view all the answers

    What triggers the engorgement of the penis during sexual arousal?

    <p>Increased nitric oxide released from blood vessels (C)</p> Signup and view all the answers

    Which accessory gland provides fluids that nourish sperm cells?

    <p>Bulbourethral (Cowper's) gland (D)</p> Signup and view all the answers

    What anatomical feature covers and protects the glans of the penis?

    <p>Prepuce (B)</p> Signup and view all the answers

    What is the definition of live birth?

    <p>An infant that breathes spontaneously or shows signs of life after birth. (B)</p> Signup and view all the answers

    What does the fetal death rate measure?

    <p>The number of fetal deaths per 1000 live births. (B)</p> Signup and view all the answers

    Which of the following factors can affect fetal death rates?

    <p>Fetal disease and chromosomal abnormalities. (D)</p> Signup and view all the answers

    What describes neonatal death?

    <p>Death of a live-born infant during the first 7 days after birth. (A)</p> Signup and view all the answers

    What does the fertility rate represent?

    <p>The number of pregnancies per 1000 women of childbearing age. (A)</p> Signup and view all the answers

    What is considered a stillbirth?

    <p>No signs of life being present at or after birth. (B)</p> Signup and view all the answers

    During which period does the perinatal period end?

    <p>At 28 completed days after birth. (A)</p> Signup and view all the answers

    Which of the following is a purpose for nurses to use statistical data?

    <p>To assess at-risk populations. (A)</p> Signup and view all the answers

    What is the diploid number of chromosomes in a human zygote?

    <p>44 autosomes &amp; 2 sex chromosomes (A)</p> Signup and view all the answers

    What role does the trophoblast play after implantation?

    <p>It develops into the placenta and membranes. (B)</p> Signup and view all the answers

    What occurs during the first 24 hours after fertilization?

    <p>Mitotic cell division, or cleavage, begins. (A)</p> Signup and view all the answers

    What is the fluid space left inside the blastocyst called?

    <p>Blastocoel (D)</p> Signup and view all the answers

    After fertilization, where does the zygote migrate?

    <p>Towards the uterus (A)</p> Signup and view all the answers

    What is the name given to the endometrium after implantation occurs?

    <p>Decidua (A)</p> Signup and view all the answers

    What happens to the sperm's tail after it penetrates the ovum?

    <p>It degenerates. (D)</p> Signup and view all the answers

    What is a possible result of abnormal implantation?

    <p>Ectopic pregnancy (A)</p> Signup and view all the answers

    What is the maternal mortality rate defined as?

    <p>Number of maternal deaths per 100,000 live births (B)</p> Signup and view all the answers

    Which of the following is NOT included in the 'Big 5' of direct maternal deaths?

    <p>Cardiovascular issues (B)</p> Signup and view all the answers

    What is the leading cause of death in children aged 1 to 14 years?

    <p>Motor vehicle crashes (C)</p> Signup and view all the answers

    What is the average length of a menstrual cycle?

    <p>28 days (B)</p> Signup and view all the answers

    During which phase of the menstrual cycle does vaginal bleeding occur?

    <p>Menstrual Phase (A)</p> Signup and view all the answers

    What triggers the release of hormones that influence the menstrual cycle?

    <p>Hypothalamus (D)</p> Signup and view all the answers

    What is the term used for the first menstruation in a female?

    <p>Menarche (B)</p> Signup and view all the answers

    How much blood is typically shed during a menstrual cycle?

    <p>25-60 mL (D)</p> Signup and view all the answers

    What is the purpose of amniocentesis during pregnancy?

    <p>To analyze amniotic fluid for genetic and biochemical markers (D)</p> Signup and view all the answers

    What must be done before performing amniocentesis?

    <p>The abdomen must be washed aseptically (C)</p> Signup and view all the answers

    Which substance is produced by the fetal liver and analyzed in amniotic fluid?

    <p>Alpha-Fetoprotein (A)</p> Signup and view all the answers

    What does a Lecithin/Sphingomyelin (L/S) ratio of 2:1 indicate?

    <p>Lung maturation of the fetus (C)</p> Signup and view all the answers

    What is the primary purpose of percutaneous umbilical blood sampling (PUBS)?

    <p>To analyze blood from the umbilical vein for genetic and blood issues (B)</p> Signup and view all the answers

    What might a strong yellow amniotic fluid indicate?

    <p>Presence of meconium (A)</p> Signup and view all the answers

    What is the expected color of amniotic fluid late in pregnancy?

    <p>Colorless with a slight yellow tinge (D)</p> Signup and view all the answers

    Which test is used for visual inspection of amniotic fluid?

    <p>Amnioscopy (A)</p> Signup and view all the answers

    Flashcards

    Scrotum function

    The scrotum supports the testes and regulates sperm temperature.

    Testes location

    Two ovoid glands located within the scrotum, producing spermatozoa and testosterone.

    Penis structure

    Three erectile tissues (two corpus cavernosa, one corpus spongiosum) enabling an erection.

    Erection mechanism

    Nitric oxide release, blood vessel dilation, increased blood flow to the penis, contraction of ischiocavernosus muscle leading to trapping of arterial and venous blood.

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    Epididymis function

    A coiled tube that matures and stores sperm before transport.

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    Vas Deferens function

    Thin tube that carries the mature sperm.

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    Accessory Glands function

    Secrete fluids that nourish and lubricate sperm.

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    Penis roles

    Serves as outlet for both urinary and reproductive tracts.

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    Bulbourethral gland function

    Produces fluid that lubricates the urethra and neutralizes acidity.

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    Seminal vesicle function

    Produces a yellowish fluid that provides energy to sperm cells and aids motility.

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    Prostate gland role

    Produces fluid that forms part of semen, a mixture of sperm and other fluids.

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    Semen composition

    Derived from prostate (60%), seminal vesicles (30%), epididymis (5%), and bulbourethral glands (5%).

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    Urethra function

    Hollow tube that carries semen from the bladder to the outside of the body.

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    Female pelvis function

    Supports and protects the female reproductive organs.

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    Ilium bone definition

    Upper and lateral portion of the innominate bone, crucial for hip structure.

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    Pubis

    Anterior part of the innominate hip bone. Point of fusion for both pelvic bone sides.

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    Perinatal Period

    All births weighing 500g or more, ending 28 days after birth.

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    Birth

    Complete removal of a fetus from the mother, regardless of cord or placenta.

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    Birthweight

    Weight of a newborn baby immediately after birth, rounded to the nearest gram.

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    Fertility Rate

    Number of pregnancies per 1000 women of childbearing age.

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    Live Birth

    Birth where the infant breathes spontaneously or shows signs of life (heartbeat, movement).

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    Stillbirth

    No signs of life present at or after birth.

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    Neonatal Death (Early)

    Death of a live-born infant within the first 7 days of life.

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    Neonatal Death (Late)

    Death of a live-born infant after 7 days, but before 29 days of life.

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    Maternal Mortality Rate

    The number of maternal deaths per 100,000 live births directly related to pregnancy or childbirth.

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    Direct Maternal Deaths

    Deaths that occur as a direct result of complications during pregnancy, childbirth, or the postpartum period.

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    Childhood Mortality Rate

    The number of deaths per 1000 children aged 1 to 14 years.

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    Menstrual Cycle Purpose

    To bring an ovum to maturity for fertilization and prepare the uterine lining for implantation.

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    Menstrual Cycle Length

    Typically 28 days from the beginning of one menstrual flow to the next.

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    Menstrual Cycle Stages

    The cycle phases are: Menstrual Phase, Follicular Phase, Ovulatory Phase, Luteal Phase.

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    Menstrual Bleeding

    Occurs during the Menstrual Phase as the unfertilized egg and uterine lining are shed.

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    Menstrual Period

    The period of absolute infertility during the Menstrual Phase.

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    Zygote Migration

    After fertilization, the zygote travels from the fallopian tube towards the uterus, a journey that takes about 3 to 4 days.

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    Cleavage

    The rapid mitotic cell division of the zygote, starting within 24 hours of fertilization, leading to the formation of blastomeres.

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    Morula vs. Blastocyst

    A morula is a solid ball of cells resulting from cleavage. A blastocyst is a hollow ball with an inner cell mass and an outer layer called the trophoblast.

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    Blastocyst Attachment

    The blastocyst reaches the uterus, attaching itself to the endometrium, the inner lining of the uterus.

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    Trophoblast Role

    The outer layer of the blastocyst, the trophoblast, will develop into the placenta and membranes.

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    Embryoblast Role

    The inner cell mass of the blastocyst, the embryoblast, will form the embryo.

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    Implantation (Nidation)

    The attachment and embedding of the blastocyst into the endometrium, typically occurring 8-10 days after fertilization.

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    Decidua

    The endometrium after implantation is called the decidua.

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    What is amniocentesis?

    A procedure where amniotic fluid is withdrawn from the pregnant uterus for analysis, typically performed between the 14th and 16th week of pregnancy.

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    Why is amniotic fluid analyzed?

    Amniotic fluid is analyzed for various factors like Alpha-Fetoprotein (AFP) levels, bilirubin levels, chromosome analysis, color, fetal fibronectin, lecithin/sphingomyelin ratio (L/S ratio), and presence of surfactant components like phosphatidyl glycerol and desaturated phosphatidylcholine.

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    What does a high AFP level suggest?

    A high Alpha-Fetoprotein (AFP) level in amniotic fluid might indicate potential birth defects such as anencephaly or spina bifida.

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    What does a green amniotic fluid indicate?

    Green amniotic fluid usually signifies meconium staining, which could be a sign of fetal distress.

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    What does the L/S ratio measure?

    The Lecithin/Sphingomyelin ratio (L/S ratio) in amniotic fluid reflects lung maturity. A ratio of 2:1 indicates mature lungs, while a lower ratio suggests premature lung development.

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    What is percutaneous umbilical blood sampling?

    Percutaneous umbilical blood sampling, also known as cordocentesis or funicentesis, involves extracting blood from the umbilical vein for testing.

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    What is amnioscopy?

    Amnioscopy is a procedure where an amnioscope, a small fetoscope, is used to visually inspect the amniotic fluid through the cervix and membranes.

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    What are the potential benefits of percutaneous umbilical blood sampling?

    Percutaneous umbilical blood sampling provides a direct way to diagnose fetal blood disorders, chromosomal abnormalities, and infections, enabling timely intervention.

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    Study Notes

    Care of Mother, Child & Adolescent Well Clients (NSG 107)

    • Course focused on the care of mothers, children, and adolescents.

    Reproductive Development

    • Gonads: Body organs producing reproductive cells (ovaries in females, testes in males).
    • Week 12: External genitalia develop. In males, testosterone affects penile tissue elongation and the urogenital fold closes, forming the urethra. In females, without testosterone, the urogenital fold forms labia minora; scrotal tissue becomes labia majora.
    • Five Weeks: Shows an indifferent stage of the external genitalia. Shows the urethral fold, labioscrotal swelling, and genital tubercle (before differentiation into male or female).
    • Ten Weeks: Demonstrates differentiation. Shows the penis, scrotum, and clitoris.
    • Near Term: Clearer differentiation. Shows the glans penis, scrotum, clitoris, labia majora, and labia minora.

    Pubertal Development

    • Puberty: The stage of life marking the start of secondary sex changes.
    • Hypothalamus: Releases gonadotropin-releasing hormone (GnRH), activating the anterior pituitary to produce follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
    • FSH & LH: Initiate androgen and estrogen production, leading to secondary sex characteristics (visible signs of maturity). Girls mature earlier (9-12 years).

    Role of Androgen

    • Androgenic Hormones: Responsible for muscle development, physical growth, sebaceous gland secretions (acne).
    • Males: Produce androgen hormones in the adrenal cortex and testes.
    • Females: Produce androgen hormones in the adrenal cortex and ovaries.
    • Age 12-14: Testosterone levels rise further developing testes, scrotum, penis, prostate, seminal vesicles; visible pubic, axillary, and facial hair; and laryngeal enlargement (voice change); spermotozoa maturation.
    • Girls: Testosterone influences labia majora and clitoris enlargement and axillary/pubic hair formation (adrenarche).

    Role of Estrogen

    • Puberty: FSH triggers ovarian follicles to release high levels of estrogen.
    • Development: Influences uterus, fallopian tubes, vagina development, typical female fat distribution & hair patterns, breast development (thelarche).

    Secondary Sex Characteristics

    • Girls:

    • Growth spurt.

    • Increase in transverse pelvis diameter.

    • Breast development (thelarche).

    • Growth of pubic hair.

    • Onset of menstruation (menarche).

    • Growth of axillary hair.

    • Vaginal secretions.

    • Boys:

    • Increased weight.

    • Growth of testes.

    • Growth of face, axillary, and pubic hair.

    • Voice changes.

    • Penile growth.

    • Increased height.

    • Spermatogenesis (sperm production).

    Anatomy & Physiology of the Reproductive System

    • Gynecology: Study of the female reproductive organs.
    • Andrology: Study of male reproductive organs.
    • Vulva: The term for female external genitalia (Latin for "covering").
    • Mons Veneris: Pad of adipose tissue above the symphysis pubis, a protective layer for the pubic joint from trauma, covered with coarse, curly hairs.
    • Clitoris: A small, rounded organ of erectile tissue at the forward junction of the labia minora, highly sensitive to touch and temperature.
    • Labia Minora: Soft, thin tissue folds located between the labia majora, rich in sebaceous glands, but without hair follicles.
    • Labia Majora: Long, pigmented folds of skin extending from the mons pubis to the perineum with fatty tissue underneath.
    • Vestibule: Smooth, flattened surface inside the labia major, where openings for urethra & vagina appear.
    • Skene's glands: Paraurethral glands located laterally to the urinary meatus; their ducts open into the urethra.
    • Bartholin's glands: Vulvovaginal glands located laterally to the vaginal opening, helpful in lubrication during coitus.
    • Fourchette: Ridge of tissue formed by the posterior joining of the two labia minora and majora; site of an episiotomy (surgical cut, to enlarge vaginal opening) during child birth.
    • Perineum: Muscular tissue lying between the anus and vagina; easily stretched during childbirth.
    • Hymen: A semicircle of tough, elastic tissue covering the vaginal opening in childhood.

    Female Internal Structures

    • Ovaries: Almond-shaped glands; produce, mature, and discharge ova (eggs); produce estrogen & progesterone (regulate menstrual cycle); prevent osteoporosis & lower cholesterol levels.
    • Fallopian Tubes: Located at the upper corners of the uterus; Transport the ovum to the uterus and are the site of fertilization. Divided into interstitial, isthmus, ampulla, and infundibular regions.
    • Fimbria: Small hairs in the infundibular region to help guide the ovum into the fallopian tube.
    • Uterus: Hollow pear-shaped muscular organ; located in the lower pelvis; receives the ovum from the fallopian tube, provides a place for implantation, and nourishment and protection of the fetus, expels fetus after maturation.
    • Body or Corpus: Uppermost part of the uterus; expands during pregnancy.
    • Fundus: Portion of the uterus situated between the points of fallopian tube attachment; palpable abdominally.
    • Isthmus: Short segment between the body and the cervix; often cut (episiotomy) during C-section.
    • Cervix: Lowest portion of the uterus, extending into vagina; internal cervical os is the distal opening to the vagina, external cervical os is at the ischial spine.
    • Three Layers:
    • Endometrium: Inner mucous membrane; shed during menstruation.
    • Myometrium: Three interwoven smooth muscle layers; uterus's strength; holds internal cervical os closed in pregnancy; contracts after delivery to prevent hemorrhage.
    • Perimetrium: Outermost layer; provides strength and support.

    Male Reproductive System

    • External Genitalia: Testes (encased in scrotum) and penis.

    • Scrotum: Rugated, skin-covered pouch; Supports testes and helps regulate sperm temperature.

    • Testes: Two ovoid glands in scrotum- produce spermatozoa and testosterone. Fetus form in pelvic cavity and descend to scrotal sac (34th-38th week).

    • Penis: Composed of 3 cylindrical masses of erectile tissue (corpus cavernosa and corpus spongiosum). Serves as outlet for urinary and reproductive tracts.

    • Glans: Distal end of penis (bulge/sensitive)

    • Prepuce: Retractible skin casing protecting the glans.

    • Internal Structures:

    • Epididymis: Coiled tube where sperm mature and stored before entering vas deferens.

    • Vas Deferens: A thin tube carrying mature sperm.

    • Accessory Glands: Provide fluids for sperm lubrication and nourishment. The bulbourethral glands and seminal vesicles.

    • Prostate Gland: Responsible for producing part of the semen and fluid mixture of sperm, prostate and seminal fluid.

    • Urethra: Hollow tube that carries semen and urine out of the body through the shaft and glans of the penis.

    • Semen: Combined fluid from various glands.

    Male/Female Pelvis

    • Female Pelvis: Bony ring formed by four united bones (ilium, ischium, pubis, and sacrum); supports and protects reproductive organs; divided into false and true pelvis. The linea terminlais (imaginary line) separates the false and true pelvis.
    • Ilium: Upper and lateral; flaring superior border forms hip prominence.
    • Ischium: Inferior portion; ischial tuberosities are two projections at the lowest portion. The ischial spines are two small projections that make up the midpoint of the pelvis.
    • Pubis: Anterior portion of the innominate bone.
    • Sacrum: Posterior aspect, forming the upper posterior portion of the pelvic ring. Sacral prominence is the marked anterior projection.
    • Coccyx: Below the sacrum; comprised of very fine fused small bones.
    • Pelvic Inlet: Entrance to the true pelvis, its transverse diameter is wider than its antero-posterior diameter (13cm transverse, 11cm antero-posterior, and 12cm right and left oblique). The pelvic cavity (space between the inlet & outlet from pelvic brim to pelvic outlet) curves slowing & controlling the passage of the fetus, and the snugness compresses the fetal chest.
    • Pelvic Outlet: Inferior portion of the pelvis. A fetus to be delivered vaginally must be passing through the pelvic ring, and the opening must be sufficient.
    • Classification of Pelvis: Gynecoid, Anthropoid, Platypelloid, Android.

    Statistics on Maternal & Child Health

    • Definition of Statistics: Collection and interpretation of numerical data related to maternal and child health.
    • Nurses Use: Tracking reproductive trends, identifying at-risk populations, evaluating prenatal care, and comparing data with other regions.
    • Perinatal Period: All births weighing 500g or more, ending 28 days after birth.
    • Birth: Complete expulsion of a fetus from the mother, regardless of whether the umbilical cord or placenta is detached.
    • Birthweight: Weight of a newborn immediately after birth, measured in grams.
    • Fertility Rate: Number of pregnancies per 1000 women of childbearing age.
    • Live Birth: Infant breathes spontaneously or shows other signs of life (heartbeat or movement) after birth.
    • Stillbirth (Fetal Death): Infant shows no signs of life at or after birth.
    • Neonatal Death: Death of a live-born infant during the first 7 days (early ND) or between the 7th and 29th days (late ND).
    • Infant Death: Death of a live-born infant from birth through 12 months of age.
    • Fetal Death Rate: Number of fetal deaths (weighing more than 500g) per 1000 live births.
    • Neonatal Death Rate: Number of neonatal deaths per 1000 live births. Causes of Neonatal Death, 2010: Prematurity, Asphyxia, Infections (sepsis + pneumonia), Neonatal tetanus, Diarrhea.
    • Preventive Interventions: Breastfeeding (13%), insecticide-treated materials (7%), supplementary feeding (6%), clean delivery (4%), Hib vaccine (4%), water sanitation/hygiene (3%).

    Female Reproductive Cycle

    • Menstrual Cycle: Episodic uterine bleeding due to cyclic hormonal changes. Purpose is to bring ovum to maturity (for fertilization) and to renew uterine tissue bed (implantation).
    • Menarche: First menstruation. Average cycle length is ~28 days; Menses lasts 4-6 days. Initiated by GnRH from the hypothalamus, stimulating the anterior pituitary to produce FSH & LH.
    • Stages:
    • Menstrual Phase/Bleeding Phase: Uterine endometrium shedding.
    • Proliferative (Follicular) Phase: Estrogen increases, stimulating endometrium regrowth/thickening. Ovulation (release of mature ovum) occurs on approx. day 14.
    • Ovulation Signs: Breast tenderness, BBT rise, positive Spinnbarkeit test (stretchiness), mittelschmerz (pain on one side in the lower abdomen related to follicle rupture), positive Ferning test.
    • Secretory (Luteal) Phase: Corpus luteum forms under LH influence. Estrogen and progesterone increase, and the endometrium prepares for implantation.

    Human Development of Normal Pregnancy

    • Fertilization: Fusion of spermatozoon and ovum in the fallopian tube ampulla; zygote forms; sex determined by sperm chromosome (male with Y. female with X).
    • Implantation: Trophoblast implants itself in the endometrium of the uterus anterior or posterior fundal region 8-10 days after fertilization. Endometrium is called the decidua after implantation.
    • Stages of Fetal Development:
    • Preembryonic period (zygote): Begins with fertilization, lasts 4 weeks (zygote-morula-blastocyst).
    • Embryonic period (embryo): 5th-8th week. High vulnerability to injury from drugs/infections.
    • Fetal period (fetus): 8th week to birth; maturation, growth, and increased weight; head is larger at term than other parts. Umbilical cord.
    • Chorionic Villi: Projections into the uterine endometrium leading to placenta formation; contain connective tissue and fetal capillaries; covered by syncytiotrophoblast and cytotrophoblast layers.
    • Fetal Membranes: Protect and support the developing embryo (chorion and amnion).

    Assessing Fetal Well-Being

    • Fetal Movement: Quickening (fetal movement felt by the mother) occurs during the 8-20th week and peaks in intensity (28-38 weeks). Methods include Sandovsky and Cardiff methods; count number of movements in a specific time frame.
    • Fetal Heart Rate:
    • Nonstress testing: Assess the fetal heart rate's response to fetal movements (10-20 mins).
    • Contraction stress testing: Analyze fetal heart rate in conjunction with contractions (nipple stimulation).
    • Ultrasonography: Used throughout to diagnose pregnancy, confirm presence of placenta and amniotic fluid (AF), confirm anomalies if present, establish fetal sex, determine fetal presentation and position, and predict fetal maturity (biparietal diameter). Before/during UTZ explain the procedure (SAFE: no x-rays) to the client; ensure full bladder, drape appropriately and place a towel beneath the right buttock; use room-temperature gel.
    • Amniotic Fluid Volume Assessment: Fetal health assessment; estimate of fetal kidney output, using the Amniotic volume index (AFI); average index is 12-15cm (28-40 weeks). Values above/below this can indicate possible problems.
    • Chorionic Villi Sampling: Biopsy and chromosomal analysis of chorionic villi to assess genetic conditions; done at 10-12 weeks.
    • Amniocentesis: Aspiration of amniotic fluid from the uterus used to assess fetal well-being by examining the fluid analyzing alpha-fetoprotein (AFP), bilirubin, suspected blood incompatibilities, chromosomal abnormalities. Check fetal heart tones and uterine contractions after amniocentesis.
    • Amnioscopy: Visual inspection of amniotic fluid.
    • Fetoscopy: Examination with a fetoscope.
    • Biophysical Profile: (Nonstress test & AFI); combines five parameters to assess fetal well-being: fetal reactivity, fetal breathing movements, fetal body movements, fetal tone, and amniotic fluid volume.

    Health History

    • Specific Inquiries: Nutritional intake, personal habits, experienced accidents/abuse.
    • Obstetrical History: 5-point system. Gravida, Para (GTPAL)—G: Total pregnancies; T: Term births; P: Premature births; A: Abortions; L: Currently living children.

    Developmental Tasks of Pregnancy

    • Tasks: Acceptance of pregnancy/body image; develop personal values; adjust to adult identity; internalize sexual roles & identity; acceptance of pregnancy's termination or childbirth concerns.
    • Trimester Divisions:
    • 1st Trimester (Accept the pregnancy).
    • 2nd Trimester (Accept the baby).
    • 3rd Trimester (Prepare for parenthood).

    Emotional/Psychosocial Adaptations in Pregnancy

    • 1st Trimester: Normal denial, ambivalence, mood swings, and emotional lability; focusing on self.
    • 2nd Trimester: Acceptance of the baby and their own distinct personhood; Introspective analysis of marriage, career, and in-laws. Comfortable stage.
    • 3rd Trimester: Fear/anxiety/mutilation concerns about childbirth; preparation for birth, and anxieties regarding maternal roles are common.

    Physiological Changes During Pregnancy

    • Reproductive System (Uterus): Increased size (length, width, depth, weight (6.5-32cm, 2.5-22cm, 4-24cm & 50-1000g)); fundic height changes throughout pregnancy (12 weeks to 36th week, palpable in lower pelvis to reaching xiphoid process ). Increased vascularity (Chadwick's sign, bluish/purplish discoloration of the vaginal mucosa; Goodell's sign, cervix softening; Hegar's sign, softening of the lower uterine segment or isthmus). Braxton Hicks contractions, intermittent, irregular, painless abdominal contractions. Secondary amenorrhea (due to corpus luteum persistence).
    • Reproductive System (Cervix): Shorter, thicker, elastic; increased edema and hyperplasia, increased mucus production (mucus plug) preventing bacterial contamination.
    • Reproductive System (Vagina): Increased hypertrophy and hyperplasia, vaginal mucosa thickening; leukorrhea (whiteness, mucoid secretions).
    • Reproductive System (Perineum): Hypertrophy, edema, increase in size; increased vascularization resulting in deeper color.
    • Reproductive System (Ovaries): Ovum production ceases. Corpus luteum takes over hormonal functions. Placenta is the major endocrine organ in pregnancy.
    • Endocrine system:
    • Hormone production changes: HCG (important for pregnancy maintenance), estrogen, progesterone.
    • Pituitary gland (Anterior and Posterior) and endocrine changes affect various bodily functions.
    • Thyroid and parathyroid gland changes influence metabolism.
    • Pancreas insulin secretion increase to meet metabolic needs.
    • Adrenal cortex increased aldosterone influences sodium & water retention).
    • Respiratory System: Increased vascularity (nasal congestion), respiratory rate up, resulting in shortness of breath during late stages, relieved by lightening, and hyperventilation.
    • Cardiovascular System: Increased heart rate; blood circulation changes (supine hypotension risk, potentially due to vena cava compression; increased cardiac output; and leg varicosities).
    • Urological System: Glomerular filtration rates (GFR) ↑ by 50%; Glycosuria (glucose in urine) due to lowered renal threshold for glucose; relaxation of bladder & ureter smooth muscles (uterine pressure); frequent urination (bladder crowding).
    • Integumentary System: Chloasma (mask of pregnancy); linea nigra; striae gravidarum; palmar erythema (reddened palms); spider nevi (facial); diaphoresis (increased sweating).

    Signs of Pregnancy (Presumptive, Probable, and Positive)

    • Presumptive findings: Possible signs based on patient reports; subjective findings.
    • Probable findings: More definitive signs; typically observed by healthcare professional; objective findings.
    • Positive findings: Absolutely definitive signs of pregnancy; typically observed by healthcare professional; objective findings. Use of blood tests and ultrasound methods usually confirms these signs. Times from implantation (weeks).
    • Examples of signs of different confirmation levels.

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