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October 13, 2014

October 13, 2014. NURS 330 Human Reproductive Health. Reading Assignments Updated Check course website for updated info. Review. 10/6/14 Lecture Male & Female Physiology and Anatomy Menstrual Cycle Links Lecture Notes-Addendum. Group Activity. Scenarios. Fertilization.

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October 13, 2014

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  1. October 13, 2014 NURS 330 Human Reproductive Health

  2. Reading Assignments Updated • Check course website for updated info

  3. Review • 10/6/14 Lecture • Male & Female Physiology and Anatomy • Menstrual Cycle • Links • Lecture Notes-Addendum

  4. Group Activity Scenarios

  5. Fertilization • Also referred to as conception • Occurs in the Fallopian tube • Oocyte = mature ovum is viable for 12-24 hours • Sperm are viable 2 to 3 days in woman’s body

  6. The zygote • Once fertilized, the egg is called a zygote. • Zygote travels four days to the uterus • Divides rapidly • Identical (Monozygotic) Twins • One egg fertilized by one sperm but divides into two separate masses • Fraternal (Dizygotic) Twins • Two separate eggs fertilized by two separate sperm

  7. Implantation • The zygote reaches the uterine cavity about 3 days after fertilization • Implantation • occurs 7 days after fertilization • Zygote now becomes a blastocyst

  8. Sex of a Child • Determined at the time of fertilization • Differences are genetically determined by the chromosomes that each possesses in the nuclei of the cells

  9. Development of Reproductive Organs • Undifferentiated Stage • First eight weeks • At 12 Weeks • Female • Male • At 36 Weeks • Female • Male

  10. Pregnancy • 266 days – 270 • About nine months

  11. Embyronic Period • From implantation until the 8th week of pregnancy (gestation), the blastocyst is now known as an Embryo • Embryo • Prenatal organism from implantation on uterine wall to 8th week of pregnancy • During this period, internal and external structures begin to form • No external indication of sex of embryo

  12. The Embyronic Period (cont) • Yolk sac • first element seen in the gestational sac during pregnancy, usually at 5 weeks gestation • Placenta • Develops at the site of implantation • Secretes human chorionic gonadotropin (hCG) • Effect on ovaries • Effect on corpus luteum • Nourishment, oxygen, elimination of waste products • Umbilical cord • Connects the developing embryo to the placenta • Waste products are removed from the fetus and nutrients are transported from the mother through the placenta

  13. The Embyronic Period (cont) • Amniotic sac • Protective membrane around the fetus • Amniotic fluid • watery liquid surrounding and cushioning a growing embryo within the amnion. • allows the fetus to move freely without the walls of the uterus being too tight against its body.

  14. Fetal Period • From the 8th week of gestation to delivery, at about 40 weeks. • The embryo is now known as a fetus • When internal and external structures (organs that developed during the embryo period) grow and mature

  15. Prenatal Sex Differentiation (cont) • Nature is predisposed toward female development. Female development requires no added hormones. • For a male to develop, the testes must produce large amounts of testosterone between the 6th and the 12th week of the prenatal period. • For the vast majority, sex differentiation occurs flawlessly and normal genitalia develop. However, in rare instances, problems may occur.

  16. Prenatal Care • Health care during pregnancy before the baby is born • Good prenatal care • Protects the mother’s health • Nutrition, diet, exercise • Enhance probability of having a healthy baby

  17. Pregnancy Tests • All pregnancy tests look for a special hormone in the urine or blood that is only present when a woman is pregnant. • This hormone, human chorionic gonadotropin (hCG), is also called the pregnancy hormone. • HCG levels increase significantly following implantation • Blood test detects HCG sooner than Urine tests • 7 days vs. 2 weeks

  18. Trimesters • First: 0 – 13 Weeks • Second: 14 – 26 Weeks • Third: 27 – 40 Weeks

  19. Early Pregnancy Signs and Symptoms • Symptoms: missed period, breast tenderness, etc • Hegar’s Sign: • softening of the uterus just above the cervix, purplish hue of labia minora, vagina and cervix

  20. Pregnancy Symptoms • First trimester • 2/3rds of pregnant women experience nausea, vomiting, fatigue and painful swelling of the breasts • Second trimester • Most nausea and vomiting subside, fetal movements = quickening • Braxton Hicks - False Labor

  21. Pregnancy Symptoms • During the third trimester • pressure on the internal organs causes heartburn, acid reflux and frequent urination. • Edema causes swelling of ankles, face, hands and feet. • Normal weight gain • 20 – 25 lbs

  22. Diagnostic Tests during Pregnancy • Amniocentesis • Genetic test - examination of chromosomes in amniotic fluid • Done during the 2nd trimester (16th week) • Chorionic Villus Sampling • Genetic test – sample of villi from the chorion • Done during the 1st trimester (weeks 8 and 12)

  23. Diagnostic Tests during Pregnancy • Ultrasound (Sonogram) • Picture of the internal structure of the fetus • Commonly used to estimate gestational age of the fetus. • Also used as a guide during amniocentesis and CVS • Alpha-fetoprotein (AFP): • Blood test - examination of the mother’s blood can detect spinal cord defects (spina bifida; also used to screen for Down’s Syndrome) • Done during weeks 16 and 18

  24. Postpartum Period • The period consisting of the months or weeks immediately after childbirth. • It is a time when the woman adjusts, both physically and psychologically, to the process of childbearing • Marker events • Postpartum Blues • Postpartum Depression • Postpartum Psychosis • Breastfeeding

  25. Postpartum blues or baby blues • Common – 50 – 70% women after pregnancy • State of short-term dysphoria that my accompany the feelings of happiness and excitement that follow the baby’s birth • Only lasts a few days • Symptoms include: Bouts of crying Mild Confusion Irritability Memory Lapses Mood swings Fatigue

  26. Postpartum Depression (PPD) • Not so common: 8% – 20% of women after pregnancy • More severe than baby blues. • Extreme sadness and feelings of worthlessness and inadequacy as a mother • May become suicidal • Most women improve on their own in 3 - 6 months • Others may require psychological intervention • Symptoms include: • Insomnia • Digestive problems • Unusual weight loss

  27. Postpartum Psychosis • Rare • Serious disorder that probably has underlying psychological causes • Requires psychological evaluation and treatment • Marked by extreme highs and lows • Symptoms • Extremely agitated • Paranoid • Delusions & hallucinations

  28. Breastfeeding • Facilitates uterine contractions • Colostrum • Produced in late pregnancy and for about 48 hours after birth • Contains no “milk” • Contains many nutrients and antibodies that are valuable for the newborn

  29. Spontaneous Abortion or Miscarriage Ectopic Pregnancy Preeclampsia/Eclampsia Gestational Diabetes Placenta problems Abruption, previa Pregnancy Conditions/Complications

  30. Pregnancy Conditions/Complications • High Risk Pregnancies: • Mother's health • Mother’s Age • Teenage mothers (17 and younger) • Mothers over 35 years of age • Health of the fetus (baby) • Complications unique to pregnancy

  31. Teratogens • Substances that can be dangerous to the health of the baby • Cause defects because they cross the placenta • Greatest teratogenic effect during the first trimester

  32. Active Teratogens • Passive Teratogens

  33. Active or Passive Teratogen? • Second hand smoke • Cigarette smoking • Alcohol consumption • Air pollution • Marijuana use • Fumes from parking garage • Use of Over the Counter meds • Fumes from cleaning supplies • Caffeine

  34. Labor & DeliveryPreparing for Labor • Woman may experience burst of energy • Lightening and engagement of fetus • descent of fetus into pelvic region • Cessation of weight gain • Dilation and effacement (thinning) of cervix • bloody show (due to bursting capillaries) • mucus plug expelled • Rupture of amniotic sac (the water breaking)

  35. Stage I • Early phase • mild-moderate contractions dilate cervix 0–3 cm • Active phase • moderate contractions dilate cervix 3–7 cm • Transition • intense contractions dilate cervix 7–10 cm

  36. Stage II • Early or Rest phase • brief lull with no urge to push • Active or Decent phase • pushing during contractions • Moves baby down the birth canal • Transition or Crowning and Birth phase • head and body delivered

  37. Stage III & Stage IV • Stage III • Placental phase • Placenta is delivered • Stage IV • Recovery phase • Mother and baby checked for complications

  38. Episiotomy • The cutting of the perineum that allows more room for the baby to be delivered

  39. Drugs During Labor • Analgesics • Tranquilizers or narcotics • Help a woman relax and give some pain relief • Anesthesia • Lumbar epidural • Eliminates sensation from the belly down • May sometimes prolong or even stop labor • Risks associated with drugs • Can cross the placental barrier to the baby • Temporary side effects • Irregular or slowed heart beats • Higher rates of jaundice • Breathing problems

  40. Cesarean Section • Most common when • fetus in the breech position • labor difficult or abnormal • fetus is distressed • woman had a previous c-section

  41. Breech Positions • By 36 weeks of pregnancy, most fetuses turn into a head-down, or vertex position. This is the normal and safest fetal position for birth. • A fetus with the feet, buttocks, or legs pointing down toward the cervix is said to be in breech position • Types • Complete • The buttocks are down near the birth canal • Frank • buttocks are in place to come out first during delivery • Footling • One leg (single footling) or both legs (double footling) are stretched out below the buttocks. The leg(s) are in place to come out first during delivery.

  42. Video: Having a Healthy Baby

  43. Menopause • Permanent cessation of menstruation. • Results from a loss of ovarian function • Represents the end of a woman’s reproductive life • Estrogen production decreased by 80% or more • Average age of menopause: 45 - 55 • As early as 40 years • As late as late 50s.

  44. Menopause • Natural • Occurs naturally after the woman’s supply of follicles has been depleted and menstruation ends completely • Surgical • Can be induced if the ovaries are surgically removed or destroyed by x-rays.

  45. Estrogen depletion can lead to: • Osteoporosis • Loss of bone mass • Increased risk of heart disease

  46. Symptoms of Menopause • An array of symptoms, including: -Hot flashes -Headaches -Changes in mood -Dizziness -Depression -Lack well-being -Nervousness -Breast atrophy -Vaginal Dryness -Psychological • Can last from six months to more than five years after the onset of menopause

  47. Remedies: Over-the-counter • Painkillers such as aspirin, ibuprofen (Advil, Motrin) • Relief of menopausal symptoms • Lubricants • Vaginal dryness • Vitamin E • Helps with hot flashes

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