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Parturition
Parturition
Parturition
Parturition
Parturition
Parturition
Parturition
Parturition
Parturition
Parturition
Parturition
Parturition
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Parturition

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  • 1. Parturition Dr. Sadaf Mumtaz 15/02/11
  • 2.
    • Dilatation of cervix
      • Relaxin (corpus luteum & placenta)
        • Softens cervix
        • Relaxes birth canal by loosening the connective tissue between pelvic bone
      • Prostaglandins
    • Contraction of Uterine myometrium
      • Role of high estrogen levels/ Increases ratio of estrogen to progesterone
        • Gap Junctions
        • Increased number of oxytocin receptors
        • Cervical ripening local prostaglandins cervical enzymes collagen fibers
      • Role of oxytocin
        • Increased receptors
        • Rate of secretion at the time of labour
      • Effect of fetal hormones
        • Oxytocin
        • Cortisol
        • Prostaglandins
  • 3. Role of Inflammation
    • Nuclear factor- ĸ β
      • IL-8
      • Prostaglandins
    • Increase sensitivity of uterus to contraction
    • inducing chemical messengers
    • Help soften the cervix
    • Factors leading to activation of NF-ĸ β
    • Stretching of uterine cervix
    • Presence of pulmonary surfactant protein SP-A in the amniotic fluid
    • SP-A promotes migration of fetal macrophages to uterus which produce IL-1 β that activates NF-ĸ β
  • 4. Mechanical Factors
    • Stretch of the uterine musculature
      • Fetal movements
      • Twins
    • Stretch or irritation of cervix
    BRAXTON-HICKS CONTRACTIONS
  • 5. Mechanism of Parturition
    • Cervical dilatation
      • 24 hrs
    • Delivery of the baby
      • 30-90mins
    • Delivery of the placenta
      • 15-30mins
      • 350 ml of blood lost
      • SMC
      • Prostaglandins
    Involution of uterus
  • 6. Lactation
    • Role of estrogen and progesterone
    • Role of hCS
    • Colostrum (Fluid secreted during the last few days before and the first few days after parturition)
    • Role of growth hormone, cortisol, parathyroid hormone & insulin
  • 7.  
  • 8. Changes in rates of secretion of estrogens, progesterone and prolactin
  • 9. Advantages of breast feeding
    • Immune cells such as B and T lymphocytes, macrophages, neutrophills,
    • Secretory IgA --- Ecoli
    • Mucus
    • Lactoferrin – decreases availability of iron from bacteria
    • Bifidus Factor---promotes growth of non-pathogenic micro-organism lactobacillus bifidus. Growth of this bacteria helps crowd out potentially harmful bacteria
  • 10. Advantages of breast feeding for the mother
    • Oxytocin released triggered by nursing hastens uterine involution
    • Subsequent effect of increased prolactin
      • Inhibit GnRH and thereby stopping release of LH and FSH
  • 11. Assignments
    • Preeclampsia and Eclampsia
      • Effects on the mother, fetus and placenta
      • Treatment
      • Wednesday 23 rd of february
  • 12. Thankyou

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