trimester- might not go for fear of miscarriagesa. Physical and Psychological changesb. Body imagec. Fetal growth and developmentd. Symptoms of preterm labore. Things to avoid2. 2ndand 3rdtrimestersa. Focus on preparationb. Medicine for pain reliefc. Stages of Labord. Infant care and safety (including CPR for babies)e. Holding/diaper changingf. Prepared childbirth- where to go, where to park, etc3. Sibling classes- 3 to 8 years old4. Grandparent classes- ways to be helpful5. Adolescent Parenting Classesa. Safe parentingb. Involvementc. Health Dangersd. Healthy Nutrition6. C-Section classes7. Prepared Childbirth classes- Lamaze, Bradley, READPhysical and Psychological Changes of PregnancyI. PhysicalA. Reproductive system1. Uterus: 2 oz to 2 lbs (estrogen)Capacity from 10 mL to 5LFalse contractions- “Braxton-Hicks” as early as 20 wks (painless, irregular)2. Cervix: bluish discoloration (Chadwick’s sign) d/t increased vascularityMucous plug-protect baby from infection (dislodges 38-39 wks)OB Notes20
Seals the endocervical canal and prevents the ascent of bacteria or other substances into the uterus Goodell’s sign: increased vascularization causes both the softening of the cervixChadwick’s sign: increased vascularization is a result of hypertrophy and engorgement of the vessels below the growing uterus Softening of cervix3. Ovaries: No more release of eggsProgesterone (smooth muscle relaxant) released by ovaries until placenta is fully functional.4. Vagina: Chadwick’s sign (upper area)Loosened connective tissue5. Breasts: tissue increasesProduces colostrum (leaky from 20 wks on)Areola and nipple darken (melanin) d/t increased MSHB. Respiratory System1. Progesterone- relaxes smooth muscle in lungs (decrease airway resistance = increased oxygenation)2. Diaphragm is being pushed by babywoman sounds out of breath3. Breathing changes from abdominal to thoracicC. Cardiovascular System1. increased blood flow to uterus and kidneys = increased pulse rate (+10-15 bpm above baseline)2. Progesterone- relaxes muscle in arterioles so bp will not increase despite increase in blood volume3. During first 2 trimesters, bp should decrease slightly and return to normal in third.4. Vena Caval Syndrome- decreases blood flow to heart following compression of vena cava by baby. If laying down, turn to left side.5. Edema (dependent in legs) due to decreased blood flow return to heart6. Blood volume increases by 30-50% (18-20% RBCs)7. Pseudoanemia- extra plasma makes it look like anemia D. GI System1. Increased HcG + carbohydrate metabolismN&V (88% have nausea), 3rdto 13th/14thweekcontribute: empty stomachEat: carbs and protein 2. bleeding of gums d/t softening3. Ptylism- increased saliva (sometimes bitter)4. Relaxation of cardiac sphincter causes acid reflux,heartburn(Pyrosis)5. Decreased peristalsis (progesterone) lets woman absorb moreconstipationIron may contribute alsoLifestyle becomes more sedentary Prenatal vitamin 6. Slowed emptying of gall bladdergall stones.
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- Fall '12
- Nursing, progesterone, A., Late pregnancy, OB Notes