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Overview of Pregnancy
- 1. Copyright © 2014 by Mosby, an imprint of Elsevier Inc.Copyright © 2014 by Mosby, an imprint of Elsevier Inc. OVERVIEW OF PREGNANCY 1
- 2. Full term= 9 solar/10 lunar months 40 weeks 3 trimesters Estimated date of delivery Nägele's rule • Last menstrual period (LMP) + 7 days – 3 months Duration of Pregnancy 2Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
- 3. Fertilization Union of egg + sperm = zygote Factors • Mature sperm and egg in fallopian tubes @ 5 hours • Sperm: Uniform size, normally formed, highly mobile, secrete enzymes to dissolve egg membrane • Female: Basal body temperature; no adhesions Implantation Endometrium: Supplies nutrition for first 5 days Progesterone: Stimulates decidua, which supplies nutrition for embryo for up to 8 weeks Fertilization and Implantation 3Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
- 4. Zygote → embryo → fetus Congenital vs. genetic defect Placental development Integration of embryonic and decidual cells Formation of chorionic and amniotic membranes • Amniotic fluid protects fetus Allows maternal-fetal blood exchange to nourish fetus Selective exchange of nutrients without mixing maternal-fetal blood Fetal Growth and Development 4Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
- 5. Presumptive signs Nausea/vomiting Change in breast sensations/size Increased urinary frequency Missed menstrual period Probable signs Enlargement of the uterus Softening of the uterine isthmus (Hegar sign) Bluish or cyanotic color of cervix and upper vagina (Chadwick sign) Softening of the cervix (Goodell sign) Asymmetrical, softened enlargement of the uterine corner caused by placental development (Piskacek sign) Positive test for HCG in the maternal urine or blood Changes in skin pigmentation (chloasma and linea nigra) Signs of Pregnancy 5Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
- 6. Positive signs Detection of fetal heart tones by auscultation, ultrasonography, or Doppler Palpation of fetal body parts Objective detection of fetal movements Radiological or ultrasonographic demonstration of fetal parts Signs of Pregnancy (Cont.) 6Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
- 7. Urinary system 80% increase in urinary output Cardiovascular system 50% increase cardiac output 10 beats/min heart rate increase Respiratory system 30%-40% increase tidal volume Diaphragm displaced upward Musculoskeletal system Relaxation of joints Increased lumbar/dorsal spinal curves Gastrointestinal system Slowing peristalsis/stomach emptying time Constipation Heartburn Adaptive Changes of Other Systems 7Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
- 8. Changes in size Affects uterus, breasts, vagina, vulva, ovaries Uterus Increases from “fist” size to capacity of 3.2-4.5 kg infant and placenta Fundus moves higher in abdomen Breasts Enlarge in early pregnancy Reproductive System 8Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
Editor's Notes
- 9 solar/10 lunar months 40 weeks 3 trimesters
- Fertilization occurs when a sperm cell penetrates an egg in the fallopian tube= zygote Several important factors must take place this to occur: Both sperm and egg must be mature and in the fallopian tube for approx. 5 hours process of conception Sperm must be uniform in size, normally formed, mobile, and the ability to secrete enzymes that dissolve the membrane surrounding the egg Female- must have certain basal body temperate and no adhesions or obstructions in the fallopian tubes Transplantation of the fertilized egg to the uterine cavity takes about 6 days Once the zygote reaches the uterus it stays there for 5 days receiving nutrients from the endometrium (lining of the uterus) Large amounts of the hormone progesterone are produce with stimulates the formation of endometrial cells known as the decidua, which is what then supplies the embryo with nutrients.
- Progression of fetal growth and development is from the zygote to embryo to fetus. Appropriate fetal development depends on these events occurring in a specified period and order during each trimester of pregnancy If this does not occur, and abnormality, aka congenital defect may occur Congenital vs genetic defect Congenital- occurs during development 1 in 33 infants affected and estimated 270,000 newborns die during the first 28 days of life from congenital anomalies What do you think are some of the causes of these congenital defects? About 50% unknown causes. Prevention is KEY Genetic- abnormality during conception What do you think is the most common genetic defect? Down syndrome Most genetic defects are going to be related to chromosome abnormalities- extra, deleted or translocations. Some genetic defects can be surgically corrected early in life Placental development Development of the placenta occurs with the integration of embryonic and decidual cells The chorionic and amniotic membranes surround the fetus and the amniotic fluid which surrounds the fetus and protects it from injury. Maternal blood exchange takes place the nourish the fetus The unique structure of the placenta permits the exchange of certain molecules but prevents fetal and maternal blood supplies from mixing for most of the pregnancy. The fetus continues to gain strength and maturity The rupture of the membranes cause the loss of amniotic fluid and strong uterine contractions which is the start of the labor process
- Breathing is normal, resting breathing; the tidal volume is the volume of air that is inhaled or exhaled in only a single such breath.e: What adaptations to treatment might this mean to a dental appointment