ante part um slides 2011-2012

8/6/2019 Ante Part Um Slides 2011-2012

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ANTEPARTUMANTEPARTUMMICHELLE D. ROSARIO RM,RN,MAN


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ObjectivesObjectives

y Recall Human Anatomy and Physiology ofthe Reproductive system (Male & Female)

y

Understand the physiology of the menstrualcycle, process of conception and milestonesof fetal development

y Know the importance of understanding themechanism of menstrual cycle, process ofconception and fetal development in relationto dealing with maternal issues and concernse.g contraception and pregnancy


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ANATOMY AND PHYSIOLOGYANATOMY AND PHYSIOLOGY

REPRODUCTIVE

SYSTEM


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MALE REPRODUCTIVE ORGANMALE REPRODUCTIVE ORGAN

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y

Testicles

After puberty, a mans testicles,located at the base of the penis, producemale sex cells called sperm. Also starting atpuberty, testicles produce testosterone, themale sex hormone

y Scrotum The testicles are covered by apouch of skin called the scrotum.

y Epididymis and vas deferensThe

epididymis stores the sperm after thetesticles produce them, and the vas deferenstransports the sperm from the epididymis tothe urethra


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y

Urethra

The urethra is a duct, ortube, that transports fluids from the inside

of the body to the outside.

y Penis The penis is perhaps the most

visible part of the male sexual anatomy. In

its reproductive capacity, the urethral

opening at the tip of the penis delivers

sperm into the vagina. Urine also flowsout of the body through the urethral

opening.


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Accessory glandsAccessory glands

Sperm can live inside the female

reproductive system for up to 48 hours,

and seminal fluid helps the sperm move

around and stay nourished.

The seminal vesicle produces a fluid that

provides energy to the sperm as they

seek out the female sex cell, or the egg.


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Accessory glandsAccessory glands

y The prostate glandmakes a different

fluid that helps the sperm move more

quickly through the female reproductive

system

y Bulbourethral orCowper's glands,

makes a small quantity of fluid that helps

protect the sperm on its way through theurethra by neutralizing any leftover traces

of acidic urine.


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FEMALE REPRODUCTIVE ORGANFEMALE REPRODUCTIVE ORGAN


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TERMSANDDEFINITIONSTERMSANDDEFINITIONS

y a.Broad Ligaments. Two wing-likestructures that extend from the lateralmargins of the uterus to the pelvic walls anddivide the pelvic cavity into an anterior and a

posterior compartment.y b.Corpus Luteum. The yellow mass found

in the graafian follicle after the ovum hasbeen expelled.

y c. Estrogen. The generic term for thefemale sex hormones. It is a steroidhormone produced primarily by the ovariesbut also by the adrenal cortex.


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y d.Fimbriae. Fringes; especially the finger-like ends of the fallopian tube.

y e. Follicle. A pouch like depression or

cavity.y f.Follicle Stimulating Hormone. The

follicle stimulating hormone (FSH) is ahormone produced by the anteriorpituitary during the first half of themenstrual cycle. It stimulatesdevelopment of the graafian follicle.


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y g.Graafian Follicle. A mature, fullydeveloped ovarian cyst containing the ripeovum.

y

h. Hormone. A chemical substanceproduced in an organ, which, being carried toan associated organ by the bloodstreamexcites in the latter organ, a functional

activity.y i. Lactation. The production of milk by the

mammary glands.


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yj. Luteinizing Hormone. A hormoneproduced by the anterior pituitary that

stimulates ovulation and the development

of the corpus luteum.y k.Oocyte. A developing egg in one of

two stages.

y

l.Ovum. The female reproductive cell.


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y m.Progesterone. The pure hormone

contained in the corpora lutea whose

function is to prepare the endometrium

for the reception and development of thefertilized ovum.

y n.Reproduction. The process by which

an offspring is formed.


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Fetal CirculationFetal Circulation

Blood from the mother enters the

fetus through the vein in the

umbilical cord. It goes to the liverand splits into three branches. The

blood then reaches the inferior vena

cava, a major vein connected to the

heart.


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FETAL CIRCULATIONFETAL CIRCULATION


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Note:Note:

y The placenta does the work of

exchanging oxygen (O2) and carbon

dioxide (CO2) through the mother's

circulation, the fetal lungs are not used forbreathing.

y In the fetus, blood is shunted from the

pulmonary artery to the aorta through aconnecting blood vessel called the ductus

arteriosus.


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COMMONTERATOGENSCOMMONTERATOGENS

ANDTHEIREFFECTSANDTHEIREFFECTS


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HEALTH HISTORYHEALTH HISTORY

y Pasty Presenty Potentialy

Biographical datay Menstrual hxy Current pregnancy (EDC,AOG,GRAVID)y Previous pregnancies and outcomey

Gynecological hxy Medical hx.y Nutritional status


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MENSTRUAL HISTORYMENSTRUAL HISTORY

y Menarche

y Duration of menses

y Interval between menses

y Characteristics of menstrual flow

y Presence of mittelschmerz

y Date of onset of last menstrual period

y Date of past/previous menstrual period

y Menstrual abnormalities or problems


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Determining Gravidity and ParityDetermining Gravidity and Parity


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ESTIMATINGTHEEDCESTIMATINGTHEEDC


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NORMAL CHANGESNORMAL CHANGES

DURINGPREGNANCYDURINGPREGNANCY


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UTERUS

CERVIX

VAGINA

BREASTS


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CardiovascularCardiovascular

1.Cardiac output 40-40% increase

Pulse rate 10-15 beats

2. Pulmonary and Peripheral vascular

resistance decreases 40-50%

3rd tri- prepregnant level

3. Vena cava syndrome

4. Blood Volume


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RESPIRATORYRESPIRATORY

1.Volume of air

breathed2. Intrathoracic volume


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NEUROLIGICNEUROLIGIC

NO KNOWN

CHANGES


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MUSCULOSKELETALMUSCULOSKELETAL

1. Waddling gait2. Physiologic lordosis

3. Diastasis recti


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GASTROINTESTINALGASTROINTESTINAL

1. Nausea and Vomiting

2. Bloating, reflux of gastric

secretions, constipation, GIproblems

3. Hemorrhoids


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RENALRENAL

1. Urinary frequency

2. Glomerular filtration

increase


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INTEGUMENTARYINTEGUMENTARY

CHLOASMA

LINEA NIGRA

STRIAE GRAVIDARUM

SWEAT AND SEBACEOUS GLAND

ACTIVITY INCREASES


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ENDOCRINEENDOCRINE

METABOLISM

HORMONE ( hcg,hPL, estrogen,

progesterone)

RELAXIN

PROSTAGLANDIN


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NUTRITIONAL REQUIREMENTSNUTRITIONAL REQUIREMENTS

Factors affecting nutritional needs

1. Pre-pregnancy nutritional status

2. Maternal Age

3. Maternal Parity

Maternal Nutrition

Additional 300 calories per day


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Appropriate pregnancy wt gain ave. 25-35

lbs. for women with a normal pre-

pregnant wt.

a. 10-13 lbs. in the 1st 20 wks

b. About 1lb per wk after 20th wk.

Maternal wt. gain is distributed to a variety

of structures


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PSYCHOSOCIAL CHANGESPSYCHOSOCIAL CHANGES

y Role changes

y Anxieties

y Family strength in coping with the

psychosocial changes of pregnancy

y Priority nursing diagnosis

y Planning and Implementation


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(Pls.refer to attached table)


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DIAGNOSTIC ANDDIAGNOSTIC AND

LABORATORYLABORATORY

URINE TEST

BLOOD TEST (cbc)

ULTRASOUND


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ante part um slides 2011-2012

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