4. PREGNANCY
DEFINITION
The period from conception to birth.
After the egg is fertilized by a sperm
& then implanted in the lining of the
uterus,it develops into the placenta &
embryo, and later into a fetus.
5. • First 3 months
• 1 week to 12 Weeks
First
Trimester
• 3 to 6 months
• 13Weeks to 27 Weeks
Second
Trimester
• 6 months to birth of baby
• 28 Weeks to the birth of
baby
Third
Trimester
TRIMESTER
8. 1. Presumptive signs
Amenorrhea at 4th week
Morning sickness at 14th
week
Unexplained fatigue
Frequent urination at 6th to
12th week
Breast tenderness and
changes
Excessive salivation
(ptyalism)
Skin changes
Quickening at 18th to 20th
week.
9. 2. Probable signs
Positive pregnancy test (presence of HCG
detected, by blood or urine test)
Enlargement of Uterus
Braxton-Hicks contractions
Softening of cervix at six to eight weeks
(Goodell's sign)
10. 2. Probable signs
Bluish coloration of cervix, vagina and vulva at six to
eight weeks (Chadwick's sign/Jacquemier’s sign)
Pulsation in the lateral fornices (Osiander’s
sign)
Softening & compressibility of the
Isthmus(Hegar’s sign)
Passive movement of the fetus during an exam
(ballottement)
11. 3. Positive signs
Fetal heart
sounds heard
by Doppler
Fetus
visible on
ultrasound
Fetal
movements
felt by
caregiver
Fetus
visible
on X-
ray,
MRI
15. MANAGMENT
• Dietary changes
• Symptomatic Treatment
Avoid
• Disagreeable odors, spicy, or Oily foods
Medication
• When indicated and prescribed.
16. 2. CONSTIPATION:
due to the effect of progesterone, it
diminished physical activity and
pressure of the gravid uterus on the
pelvic colon.
Iron supplements also can
contribute to constipation.
17. MANAGAMENT
• Eating high fiber foods.
• Regular do Exercise.
• Drink at least six glasses of water
per day.
18. 3. ACIDITYAND HEARTBURN
Due to the growing
uterus pressing on the
stomach, rising
progesterone levels,
and decreased gastric
motility.
19. Eating Slowly
Eat frequent, small meals.
Drinking milk between meals.
To avoid over eating and not to go to bed
immediately after the meal.
Avoid fatty & gas forming foods.
MANAGEMENT:
20. 4. ABDOMINAL DISCOMFORT
Due to Pressure, pelvic heaviness, is
caused by the weight of the uterus on
the abdominal wall.
Flatulence and distention can be due
to large meals, gas-forming foods, and
chilled drink.
22. 5. PICA
When the mother eating
abnormal food or unnatural
substances such as coal, chalk,
ashes.
Due to unknown but may be
hormones changes
To take medical advice.
24. Due to altered posture and extra
weight carried.
MANAGEMENT:
Frequent rest periods are
recommended.
Anemia must be Find out.
Take necessary treatment.
Obtaining regular exercise.
1. Fatigue
25. Common in pregnancy(50%)
Due to weight gain,
hyperlordosis, high heel
shoes, urinary infection or
constipation.
2. BACKACHE
26. Encourage Rest.
Avoided Excessive weight gain.
Sleeping on a firm mattress.
To wear appropriate, well-fitting
shoes, Avoid High-heeled shoes.
Apply local heat and light
massage.
Avoid
MANAGMENT
28. Take the prescribed vitamins B & D per
doctor’s instructions.
Eat a diet with adequate calcium or
prescribed calcium.
Getting regular exercise, especially walking.
Patient lie on her back.
MANAGMENT
30. Veins that have
become enlarged and
twisted(later months)
Due to weakness of the
vascular walls.
1. VARICOSE VEINS
31. Wearing support shoes.
Elevating the feet when sitting.
Lying with the feet & hips
elevated.
Get adequate rest.
Perform moderate exercise.
Avoiding leg crossing, long time
standing or sitting, constrictive
clothing.
Avoid obesity.
MANAGMENT
32. A swollen vein or group of veins in the
region of the anus.
MANAGEMENT:
Soaking in a warm sit’z bath.
Sitting on a soft pillow.
Eating high fiber food & avoiding
constipation.
Drinking sufficient fluids.
Increasing exercise such as walking.
Applying ointment, drugs taken if needed.
2. HEMORRHOIDS(PILES)
33. The woman presents with
dizziness or light headache.
Other causes may be
dehydration, hypoglycemia,
prolonged standing, standing
upright suddenly.
3. FAINTING
34. Sitting with the feet
elevated.
Avoid prolonged
standing.
Changing the position to
the left lateral recumbent to
relieve the pressure of the
uterus.
MANAGMENT
35. Due to weight or evidences of
preeclampsia.
Generalized edema, always
serious, must be investigated.
4. ANKLE EDEMA
36. Edema subsides on rest with slight
elevation of the limbs.
Maintain good posture.
Restrict excessive salt intake.
Avoiding prolonged standing & sitting.
MANAGMENT
37. 1. BREATHLESSNESS
Due to progesterone, allergic
problems, (12th week)
MANAGEMENT
Take a Proper Rest.
RESPIRATORY SYSTEM
39. Discomfort caused by
the fetal movements,
frequency of micturition,
some anxiety or fear.(late
pregnancy)
1. INSOMNIA
40. MANAGMENT
Take rest in
the
afternoon.
Drink a
glass of
warm milk
at bed time.
Tuck a
pillow
under the
abdomen
when lying
in a left
lateral
position
Talk about
her fear
and anxiety
so that she
can have a
sense of
normality
and
lightness.
41. Common and usually due to tension.
Severe, persistent headache due to
preeclampsia, eclampsia. (third trimester)
MANAGEMENT
Changing position slowly.
Regularly Check Blood Pressure.
Eating small snack.
Use PCM only if prescribed by physician.
2. HEADACHE
43. It is a white or yellowish mucous
discharge from the vagina.
MANAGEMENT:
Proper cleansing hygiene.
Wear cotton underwear.
To cleanse the vulva at least once
a day with soap & water & to dry
thoroughly.
1. VAGINAL DISCHARGE(LEUKORRHEA)
44. Urinary frequency and stress incontinence
in multiparas are common, especially in
advanced pregnancy.
Due to increased intra abdominal pressure
and reduced bladder capacity.
Suspect urinary tract disease if dysuria or
hematuria is present.
2. URINARY SYMPTOMPS
46. 1.SKIN
Scarring of the skin of abdominal area is
called Pregnancy stretch marks or Striae
gravidarum.
Dark vertical line that appearance from
navel to pubis is called Linea Nigra.
Chloasma or Mask of Pregnancy means
Brown patches of pigmentation on
forehead, cheek,neck.
INTEGUMENTARY SYSTEM