birth Flashcards

quiz one (64 cards)

1
Q

How do gametes differ from other normal human cells?

A

they only have one half of the total amount of human genetic information.

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2
Q

conception

A

Ovulation: An egg is released from the ovary into the fallopian tube.
Sperm Journey: During intercourse, sperm travel through the cervix and uterus to the fallopian tube to meet the egg.
Fertilization: One sperm enters the egg, combining their genetic material to form a zygote.
Cell Division: The zygote starts dividing and forms a blastocyst.
Implantation: The blastocyst attaches to the uterine lining, beginning pregnancy.

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3
Q

What determines the sex of the child?

A

Y chromosome

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4
Q

How are monzygotic and dizygotic twins formed? Describe each from a genetic standpoint.

A

Monzygotic = one egg + one sperm → one zygote splits = genetically identical twins.
Dizygotic = two eggs + two sperm → two separate zygotes = genetically different twins.

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5
Q

How are monzygotic and dizygotic twins formed? Describe each from a genetic standpoint.

A

Monzygotic = one egg + one sperm → one zygote splits = genetically identical twins.
Dizygotic = two eggs + two sperm → two separate zygotes = genetically different twins.

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6
Q

What factors related to the process of fertilization might impact its success?

A

Sperm Health:

Low sperm count
Poor sperm motility (movement)
Abnormal sperm shape
DNA damage in sperm
Egg Health:

Age (older eggs are less viable)
Poor egg maturation
Timing of Ovulation:

Must coincide with sperm presence (fertile window)
Ovulation problems (e.g., luteal phase deficiency)
Cervical Mucus:

Thin and fertile mucus helps sperm travel
Thick mucus can block sperm
Hormonal Imbalances:

In women (e.g., PCOS, thyroid issues)
In men (e.g., low testosterone affecting sperm production)
Fallopian Tube Health:

Blocked or damaged tubes prevent sperm from reaching egg
Uterine Health:

Fibroids, polyps, infections can affect implantation
Lifestyle Factors:

Smoking, alcohol, drugs reduce fertility
Poor diet and nutrition affect egg and sperm quality
High stress can disrupt ovulation
Environmental Factors:

Exposure to toxins (e.g., pesticides, plastics) harms reproductive health

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7
Q

Prenatal
Development

A

Is the process of rapid change and growth that occurs in the 40 weeks prior to the birth of a child
Follows three stages:
Preeembryonic
embryonic
fetal

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8
Q

Preembryonic

A

conception to implantation or end of week 2

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9
Q

Embryonic

A

implantation to end of week 8

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10
Q

Fetal

A

week 9 to birth

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11
Q

Gestation

A

Intrauterine development from conception through birth is called gestation
Length of human gestation
40 weeks after first day of last menstrual period, or 280 days
38 weeks after fertilization, or 266 days
Most born within 10 to 14 days of calculated date of birth
Gestation is also divided into 3 equal parts, but trimesters are different time frames then the periods of prenatal development

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12
Q

Age of Viability

A

The term for the first chance of survival to live outside the womb
Is reached at about 22 to 26 weeks
The fetus weighs up to 1.4 pounds
Hearing has developed, so the fetus can respond to sounds.
The internal organs, such as the lungs, heart, stomach, and intestines, have formed enough that a fetus born prematurely at this point has a chance to survive outside of the mother’s womb

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13
Q

Fetal circulation

A

Oxygenated blood is carried from the placenta to the fetus via the umbilical vein
Blood from the vena cava is mostly deflected through the foramen ovale – left atrium & ventrical – up ascending aorta – allows brain & heart to receive highest concentration of oxygenation
Deoxygenated blood travels from fetus to placenta through the 2 umbilical arteries

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14
Q

Teratogens

A

Teratogens are factors outside the fetus that can contribute to birth defects
About 10% of all birth defects are caused by teratogens
Can also increase the risk for miscarriage, preterm labor or stillbirth
The first 12 weeks of pregnancy are when most miscarriages occur
Examples include some STIs, maternal diseases, viruses, tobacco, drugs and alcohol, air pollution, poor maternal malnutrition, stress, and environmental and occupational exposures.
Some teratogen-caused birth defects are potentially preventable

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15
Q

Gravidity

A

Gravidity refers to the number of times a woman has been pregnant, regardless of the outcome (whether the pregnancies resulted in live births, stillbirths, or miscarriages).

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16
Q

Gravida

A

Definition: Refers to a woman who is pregnant or the number of times a woman has been pregnant.

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17
Q

Nulligravida

A

Nulli- means “none” or “zero,” and gravida refers to pregnancy, so a nulligravida is a woman with a gravid status of zero.

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18
Q

Primigravida

A

Primigravida refers to a woman who is pregnant for the first time.

Primi- means “first,” and gravida refers to pregnancy, so a primigravida is a woman who is experiencing her first pregnancy.

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19
Q

Multigravida

A

Multigravida refers to a woman who has been pregnant more than once.

Multi- means “many,” and gravida refers to pregnancy, so a multigravida is a woman who has had multiple pregnancies.

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20
Q

Viability

A

Viability refers to the ability of a fetus to survive outside the uterus, typically with medical support. This is often determined by the gestational age (how many weeks into the pregnancy the fetus is) and developmental maturity.

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21
Q

Parity

A

Parity refers to the number of pregnancies a woman has carried to a stage where the fetus has the potential to live outside the uterus, typically after 20 weeks of gestation. It is often used alongside gravidity (the total number of pregnancies) to describe a woman’s pregnancy history.

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22
Q

Nullipara

A

Nullipara refers to a woman who has never given birth to a viable fetus (i.e., a fetus that has reached at least 20 weeks of gestation).

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23
Q

Primipara

A

Primipara refers to a woman who has given birth once to a viable fetus (i.e., a fetus that has reached at least 20 weeks of gestation).

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24
Q

Multipara

A

Multipara refers to a woman who has given birth multiple times to viable fetuses (i.e., fetuses that have reached at least 20 weeks of gestation).

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25
Presumptive signs
Presumptive signs of pregnancy are symptoms or signs that suggest a woman might be pregnant, but they are not definitive. Breast changes, amenorrhea, N/V, urinary frequency, fatique, quickening
26
probable signs of pregnancy
Probable signs of pregnancy are those that are more likely to indicate pregnancy but are still not definitive. These signs are typically observed by a healthcare provider during a physical examination or through certain tests. Goodell sign, Chadwick sign, hegar sign, positive test serum and urine, braxton hicks, ballottment
27
Positive signs of pregnancy
Positive signs of pregnancy are definitive indicators that a woman is pregnant. These signs cannot be explained by any other condition and confirm the presence of a pregnancy. fetal heart tones, visualization of fetus, fetal movements
28
goodell sign
Goodell's sign refers to the softening of the cervix during pregnancy, which occurs due to increased blood flow and hormonal changes. It is one of the probable signs of pregnancy and is typically observed during a pelvic exam by a healthcare provider.
29
Chadwick sign
Chadwick’s sign is a probable sign of pregnancy characterized by the bluish or purple discoloration of the cervix, vagina, and vulva. This change occurs due to increased blood flow to these areas as a result of hormonal changes during pregnancy.
30
Hegar sign
Hegar's sign is a probable sign of pregnancy characterized by the softening of the lower segment of the uterus (the area near the cervix). This softening occurs as a result of hormonal changes, particularly increased blood flow and the effects of progesterone.
31
Ballottement
Ballottement is a probable sign of pregnancy that refers to the tapping or displacement of the fetus within the uterus, which can be felt by a healthcare provider during a pelvic exam.
32
Gestational age
“Due date” Estimated date of birth (EDB) or confinement (EDC) is determined by: Early ultrasound Nägele's rule 1st day of LMP, minus 3 months, add 7 days and 1 year Eg., Gestational Wheel; apps
33
Pregnancy, Insulin, and Glucose
In early pregnancy Maternal glucose levels decrease - why? Maternal insulin production and insulin levels decline In the first trimester, the body becomes more insulin-sensitive due to the influence of hormones like progesterone and estrogen. This insulin sensitivity allows glucose to move more efficiently into the cells, reducing maternal blood glucose levels, especially in the early stages of pregnancy. As a result, maternal glucose levels can be lower compared to pre-pregnancy levels.
34
Pregnancy, Insulin, and Glucose continued
As the pregnancy progresses, hPL from the placenta and steroids (cortisol) from the adrenal cortex act against insulin. How does the pancreas respond? In response to insulin resistance caused by hPL and cortisol, the pancreas increases its production of insulin to overcome the reduced effectiveness of insulin and maintain normal blood glucose levels. Maternal insulin does not cross the placenta, fetus must produce its own
35
Preconception Care
Smoking cessation programs Screening and counselling as needed Alcohol abstinence is strongly advised due to associations with miscarriage and FASD Medications and herbal preparations safety; see http://www.motherisk.org/women/index.jsp Adequate folic acid supplementation Ensuring vaccines are up to date Chronic diseases are under control
36
Prenatal care
Assessment and screening at regular and purposeful intervals Initial visit Follow up visits Monthly up to 28 weeks (7 months) Then every 2 weeks Around 36-37 weeks gestation, every week to birth Women with risk factors or high-risk pregnancies may require more visits
37
SUBJECTIVE DATA:
SUBJECTIVE DATA: Health History Pregnancy Obstetrical hx Current gestational age Fetal behaviour Cramping? Discharge? Bleeding? Issues in current &/or previous pregnancies Medical Review of systems Current medications Psycho-social & Cultural
38
OBJECTIVEDATA:
OBJECTIVEDATA: Routine Lab tests Diagnostics Physical exam Weight Head-to-toe (focused) Vital signs Fundal height Fetal heart tones Leopold’s maneuvers >36 weeks: Vaginal Exam
39
Para
Para - # of births after 20 weeks
40
TPAL 
T - Term = # of term pregnancies (at or more than 37 wks gestation) P – premature = # of premature pregnancies (>20 but <37 weeks) A - Abortion = # of therapeutic terminations or spontaneous losses (before 20 weeks gestation) L – Living = # of living children who the woman gave birth
41
Fundal
Done at each prenatal visit, beginning at 20 weeks Measures the distance in cm of the fundus (top of uterus) from the symphysis pubis Roughly corresponds to gestational week Monitors fetal growth
42
Fetal Movement Counting
A noninvasive method to screen fetal health status An active baby is usually a healthy baby A compromised fetus decreases its oxygen requirements by decreasing movements Moms are taught to self monitor fetal movement in the 3rd trimester (or sooner prn)
43
Teaching:Fetal Movement Counting
Get into a comfortable position – lying on your side or sitting. Place one or both of your hands on your abdomen. Count each time that you feel your baby move and write it down on the chart Count once a day. You should feel 6 or more movements in 2 hours If less than 6 movements are felt, go to the hospital for assessment
44
Leopold's maneuvers are a series of four palpation techniques used by healthcare providers, including nurses, to assess the fetal position and presentation during pregnancy. These maneuvers are typically performed in the third trimester (from about 28 weeks onward) to help determine the position of the fetus and assess for any potential complications.
Leopold's maneuvers are a series of four palpation techniques used by healthcare providers, including nurses, to assess the fetal position and presentation during pregnancy. These maneuvers are typically performed in the third trimester (from about 28 weeks onward) to help determine the position of the fetus and assess for any potential complications.
45
What circumstances might make performing Leopold’s maneuvers a challenge, and how can these be overcome?
Obesity: Challenge: Thick abdominal wall. Solution: Gentle palpation, ultrasound. Full Bladder: Challenge: Affects palpation. Solution: Empty bladder. PROM: Challenge: Infection risk. Solution: Avoid internal exams, use sterile technique. Fetal Position/Size: Challenge: Hard to palpate. Solution: Confirm with ultrasound. Fibroids: Challenge: Obstruct palpation. Solution: Gentle palpation, ultrasound. Discomfort: Challenge: Pain or tension. Solution: Comfortable position, gentle palpation. Inaccessible Fetus: Challenge: Fetus too high/low. Solution: Change position, ultrasound. Early Pregnancy: Challenge: Fetus too small. Solution: After 28 weeks, or use ultrasound. Multiple Fetuses: Challenge: Hard to distinguish. Solution: Ultrasound.
46
Fetal Heart Tones
Are positive sign of pregnancy Can be heard by Doppler at 8-10 weeks & fetoscope at 20 weeks Assess rate & rhythm (110-160 bpm & regular) Steps Locate fetal back with Leopold’s maneuvers Auscultate for a full minute ** Differentiate FHTs from other sounds (maternal pulse, uterine souffle, & funic souffle) Spontaneous accelerations indicate fetal well-being
47
the five ps
1. Passageway (birth canal) 2. Powers (contractions) 3. Passenger (fetus and placenta) 4. Position of mother 5. Psychological response
48
The birth canal is composed of the following:
The birth canal is composed of the following: * Bony pelvis * Soft tissue components * Other factors
49
Soft Tissue Factors
Soft Tissue Factors * Lower uterine segment * Pelvic floor muscles * Cervix * Vagina * Introitus
50
primary powers
Primary powers (Uterine contractions) * Involuntary * Effects: * Effaces and dilates the cervix * Decreases blood flow to uterus and placenta * Raises maternal blood pressure during contractions * Ferguson reflux * With bearing-down efforts, expels the fetus and placenta * Begins involution
51
Secondary Powers
Secondary Powers * Voluntary * The intra-abdominal force provided by the labouring woman * Aka “pushing” or bearing down * When to start pushing? * Technique?
52
Intrapartum Factors: Passenger
Intrapartum Factors: Passenger * Location of the placenta * Fetal head * Fetal position, components include: * Fetal lie * Fetal presentation * Fetal attitude * Fetal station and engagement * Fetal orientation in relation to maternal pelvis
53
station
Station - degree of descent
54
Engagement
Engagement - when widest diameter of presenting part has descended into pelvic inlet to the imagined plane at level of ischial spines.
55
signs of approaching labour
Signs of Approaching Labour * Lightening * Ripening of the cervix * Spurt of energy * Braxton-Hicks contractions * Backaches * Bloody show * Spontaneous rupture of membrane * Diarrhea * Weight loss
56
true labour
Contractions begin in the lower back & radiate to abdomen, become regular and increase in frequency, duration and intensity * Position changes ineffective * Progressive cervical changes
57
false labour
Contractions are irregular, may be more noticeable at night, pain is felt mainly in the abdomen * Relieved by change of position or activity * No cervical changes
58
first stage of labour latent phase
First Stage of Labour Latent Phase * 0-3 cm * Contractions mild and short (20-40 sec) * Low-back pain and abdominal discomfort * Cervix thins; some bloody show * Station – nullipara 0; multipara 2 to +1 * Time – nullipara 8-10 hr average; multipara 5-6 hr
59
First Stage of Labour Active Phase
First Stage of Labour Active Phase * 4-7 cm * Contractions stronger (40-60 sec); Q3-5 min * Average time; nullipara 2-4 hrs; multipara 1.5-2 hrs * Membranes may rupture now * Increased bloody show * Station -1 to 0
60
first stsge of labour active stage part 2
First Stage of Labour Active Phase * 8-10 cm * Contractions stronger & longer (60-90 sec; Q3-5 min) * Average time; nullipara 1-2 hrs; multipara 1 hr * Increased vaginal show; rectal pressure with beginning urge to bear down * Station: +1 to +2
61
second stage of labour
Second Stage of Labour * Begins with full cervical effacement and dilation and ends with baby's birth * Three phases: 1. Fully dilated with passive descent 2. Descent: active pushing and urges to bear down 3. Crowning: presenting part is on perineum, and bearing-down efforts are most effective for promoting birth
62
Second Stage of Labour * Mechanism
Second Stage of Labour * Mechanism of birth with a vertex presentation * Birth of head * Anteroposterior slit, oval opening, circular shape, crowning * Birth of anterior shoulder * Birth of posterior shoulder * Birth of body and extremities
63
3rd stage of labour
Third Stage of Labour * Includes placental separation, descent, and expulsion A: Placenta begins the separation process in central portion with retroplacental bleeding. Uterus changes from discoid to globular shape. B: Placenta completes separation and enters lower uterine segment. Uterus is globular in shape. C: Placenta enters vagina, cord is seen to lengthen, and there may be increased bleeding. D: Expulsion (birth) of placenta and completion of third stage.
64
4th stage of labour
Fourth Stage of Labour and Birth * Birth of the placenta to completion of involution * Psychological, emotional and social adaptations continue beyond 6 weeks * See PP unit