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ANTEPARTUMANTEPARTUMMICHELLE D. ROSARIO RM,RN,MAN
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ObjectivesObjectives
y Recall Human Anatomy and Physiology ofthe Reproductive system (Male & Female)
y
Understand the physiology of the menstrualcycle, process of conception and milestonesof fetal development
y Know the importance of understanding themechanism of menstrual cycle, process ofconception and fetal development in relationto dealing with maternal issues and concernse.g contraception and pregnancy
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ANATOMY AND PHYSIOLOGYANATOMY AND PHYSIOLOGY
REPRODUCTIVE
SYSTEM
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MALE REPRODUCTIVE ORGANMALE REPRODUCTIVE ORGAN
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y
Testicles
After puberty, a mans testicles,located at the base of the penis, producemale sex cells called sperm. Also starting atpuberty, testicles produce testosterone, themale sex hormone
y Scrotum The testicles are covered by apouch of skin called the scrotum.
y Epididymis and vas deferensThe
epididymis stores the sperm after thetesticles produce them, and the vas deferenstransports the sperm from the epididymis tothe urethra
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y
Urethra
The urethra is a duct, ortube, that transports fluids from the inside
of the body to the outside.
y Penis The penis is perhaps the most
visible part of the male sexual anatomy. In
its reproductive capacity, the urethral
opening at the tip of the penis delivers
sperm into the vagina. Urine also flowsout of the body through the urethral
opening.
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Accessory glandsAccessory glands
Sperm can live inside the female
reproductive system for up to 48 hours,
and seminal fluid helps the sperm move
around and stay nourished.
The seminal vesicle produces a fluid that
provides energy to the sperm as they
seek out the female sex cell, or the egg.
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Accessory glandsAccessory glands
y The prostate glandmakes a different
fluid that helps the sperm move more
quickly through the female reproductive
system
y Bulbourethral orCowper's glands,
makes a small quantity of fluid that helps
protect the sperm on its way through theurethra by neutralizing any leftover traces
of acidic urine.
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FEMALE REPRODUCTIVE ORGANFEMALE REPRODUCTIVE ORGAN
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TERMSANDDEFINITIONSTERMSANDDEFINITIONS
y a.Broad Ligaments. Two wing-likestructures that extend from the lateralmargins of the uterus to the pelvic walls anddivide the pelvic cavity into an anterior and a
posterior compartment.y b.Corpus Luteum. The yellow mass found
in the graafian follicle after the ovum hasbeen expelled.
y c. Estrogen. The generic term for thefemale sex hormones. It is a steroidhormone produced primarily by the ovariesbut also by the adrenal cortex.
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y d.Fimbriae. Fringes; especially the finger-like ends of the fallopian tube.
y e. Follicle. A pouch like depression or
cavity.y f.Follicle Stimulating Hormone. The
follicle stimulating hormone (FSH) is ahormone produced by the anteriorpituitary during the first half of themenstrual cycle. It stimulatesdevelopment of the graafian follicle.
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y g.Graafian Follicle. A mature, fullydeveloped ovarian cyst containing the ripeovum.
y
h. Hormone. A chemical substanceproduced in an organ, which, being carried toan associated organ by the bloodstreamexcites in the latter organ, a functional
activity.y i. Lactation. The production of milk by the
mammary glands.
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yj. Luteinizing Hormone. A hormoneproduced by the anterior pituitary that
stimulates ovulation and the development
of the corpus luteum.y k.Oocyte. A developing egg in one of
two stages.
y
l.Ovum. The female reproductive cell.
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y m.Progesterone. The pure hormone
contained in the corpora lutea whose
function is to prepare the endometrium
for the reception and development of thefertilized ovum.
y n.Reproduction. The process by which
an offspring is formed.
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Fetal CirculationFetal Circulation
Blood from the mother enters the
fetus through the vein in the
umbilical cord. It goes to the liverand splits into three branches. The
blood then reaches the inferior vena
cava, a major vein connected to the
heart.
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FETAL CIRCULATIONFETAL CIRCULATION
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Note:Note:
y The placenta does the work of
exchanging oxygen (O2) and carbon
dioxide (CO2) through the mother's
circulation, the fetal lungs are not used forbreathing.
y In the fetus, blood is shunted from the
pulmonary artery to the aorta through aconnecting blood vessel called the ductus
arteriosus.
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COMMONTERATOGENSCOMMONTERATOGENS
ANDTHEIREFFECTSANDTHEIREFFECTS
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HEALTH HISTORYHEALTH HISTORY
y Pasty Presenty Potentialy
Biographical datay Menstrual hxy Current pregnancy (EDC,AOG,GRAVID)y Previous pregnancies and outcomey
Gynecological hxy Medical hx.y Nutritional status
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MENSTRUAL HISTORYMENSTRUAL HISTORY
y Menarche
y Duration of menses
y Interval between menses
y Characteristics of menstrual flow
y Presence of mittelschmerz
y Date of onset of last menstrual period
y Date of past/previous menstrual period
y Menstrual abnormalities or problems
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Determining Gravidity and ParityDetermining Gravidity and Parity
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ESTIMATINGTHEEDCESTIMATINGTHEEDC
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NORMAL CHANGESNORMAL CHANGES
DURINGPREGNANCYDURINGPREGNANCY
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UTERUS
CERVIX
VAGINA
BREASTS
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CardiovascularCardiovascular
1.Cardiac output 40-40% increase
Pulse rate 10-15 beats
2. Pulmonary and Peripheral vascular
resistance decreases 40-50%
3rd tri- prepregnant level
3. Vena cava syndrome
4. Blood Volume
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RESPIRATORYRESPIRATORY
1.Volume of air
breathed2. Intrathoracic volume
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NEUROLIGICNEUROLIGIC
NO KNOWN
CHANGES
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MUSCULOSKELETALMUSCULOSKELETAL
1. Waddling gait2. Physiologic lordosis
3. Diastasis recti
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GASTROINTESTINALGASTROINTESTINAL
1. Nausea and Vomiting
2. Bloating, reflux of gastric
secretions, constipation, GIproblems
3. Hemorrhoids
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RENALRENAL
1. Urinary frequency
2. Glomerular filtration
increase
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INTEGUMENTARYINTEGUMENTARY
CHLOASMA
LINEA NIGRA
STRIAE GRAVIDARUM
SWEAT AND SEBACEOUS GLAND
ACTIVITY INCREASES
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ENDOCRINEENDOCRINE
METABOLISM
HORMONE ( hcg,hPL, estrogen,
progesterone)
RELAXIN
PROSTAGLANDIN
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NUTRITIONAL REQUIREMENTSNUTRITIONAL REQUIREMENTS
Factors affecting nutritional needs
1. Pre-pregnancy nutritional status
2. Maternal Age
3. Maternal Parity
Maternal Nutrition
Additional 300 calories per day
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Appropriate pregnancy wt gain ave. 25-35
lbs. for women with a normal pre-
pregnant wt.
a. 10-13 lbs. in the 1st 20 wks
b. About 1lb per wk after 20th wk.
Maternal wt. gain is distributed to a variety
of structures
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PSYCHOSOCIAL CHANGESPSYCHOSOCIAL CHANGES
y Role changes
y Anxieties
y Family strength in coping with the
psychosocial changes of pregnancy
y Priority nursing diagnosis
y Planning and Implementation
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(Pls.refer to attached table)
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DIAGNOSTIC ANDDIAGNOSTIC AND
LABORATORYLABORATORY
URINE TEST
BLOOD TEST (cbc)
ULTRASOUND
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