Pregnancy Health Education. Section 19.1 Development Before Birth Uterus Implantation Zygote Blastocyst Fallopian tube Cell division Fertilization Ovary

PregnancyPregnancy

Health Education

Section 19.1 Development Before Birth

Uterus

Implantation

Zygote

Blastocyst

Fallopian tube

Cell division

Fertilization

Ovary

Physical Physical DiscomfortDiscomfort

s of s of pregnancypregnancy

Section 19.2 A Healthy Pregnancy

Section 19.2 A Healthy Pregnancy

Prenatal Tests Cont..

• Ultrasound– Sound waves are used to

create a picture of the fetus to detect age, the presence of multiples , major birth defects, and other serious complications

– Accuracy: Depending on what you’re screening for it anywhere between 50%-90%

Ultrasound

Transducer

Prenatal Tests Cont…• Amniocentesis Test (“Amnio” Test)

– In this test, done at 15 to 18 weeks, amniotic fluid is extracted via the abdomen and analyzed for chromosomal defects and genetic defects

– Accuracy: 99% for chromosomal disorders, 98%-99% for neural-tube defects

– Downside: It has a 0.5% – 1% risk of miscarriage

Amniocentesis

Amniocentesis

Amniocentesis• The doctor then

extracts about four teaspoons of amniotic fluid.

• This fluid contains fetal cells that a technician grows in a lab and analyzes.

• Test results are generally available in two to three weeks.

Amniocentesis• Amniocentesis detects or

rules out Down's syndrome, which causes mental retardation, congenital heart defects, and physical characteristics such as skin folds near the eyes.

• Amniocentesis also detects spina bifida. Can lead to leg paralysis, bladder and kidney defects, brain swelling (hydrocephalus), and mental retardation

Pregnancy Notes

• The fetus is connected to the Placenta

• The placenta is connected by the Umbilical Cord

• How does a pregnancy test work?– Test for HCG


Wall of uterus

Amniotic fluid

Cervix

Vagina

PlacentaThis structure lines part of the wall of the uterus during pregnancy and nourishes the embryo with substances from the mother’s blood.

Amniotic sacThe amniotic fluid contained in this sac cushions the embryo from shock and helps keep the embryo’s temperature constant.

Umbilical cordAn umbilical cord carries nutrients and oxygen from the placenta to the embryo, and carries wastes away.

What is SIDS?What is SIDS?• Sudden Infant Death Syndrome (SIDS):

– SIDS is the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including performance of a complete autopsy, examination of the death scene, and review of the clinical history. (Willinger et al, 1991).

• Prevention:– 1. Get medical care early in pregnancy, preferably within the first three

months, followed by regular checkups at the doctor's office or health clinic. Make every effort to assure good nutrition. These measures can reduce the risk of premature birth, a major risk factor for SIDS.

– 2. Do not smoke, use cocaine, or use heroin. Tobacco, cocaine, or heroin use during pregnancy increases the infant's risk for SIDS.

– 3. Take care to prevent becoming pregnant during the teenage years. If you are a teen and already have one infant, take extreme caution not to become pregnant again. The SIDS rate decreases for babies born to older mothers. It is highest for babies born to teenage mothers. The more babies a teen mother has, the greater at risk they are.

– 4. Wait at least one year between the birth of a child and the next pregnancy. The shorter the interval between pregnancies, the higher the SIDS rate.

Sudden Infant Death SyndromeSudden Infant Death Syndrome

• U.S. Annual SIDS Rate per 1000 Live Births

ChromosomesChromosomes• A person needs to have 46 chromosomes.

Each is made up of:– Egg Cell is 22 chromosomes + 1 sex chromosome

(X)– Sperm Cell is 22 chromosomes + 1 sex

chromosome (X or Y)• Sperm will ALWAYS determine the gender of the

baby– Girl Sperm (X) will swim slower, but will live

longer than boy sperm– Boy Sperm (Y) will swim faster, but die sooner– When sperm cell meets egg cells (XY) is a boy

(XX) is a girl

Stages of BirthStages of Birth

• 1st Stage– Contractions will start and are about

30-90 seconds long and 5-20 minutes apart

– Contractions can start a few hours, days, or (in rare cases) weeks before birth is complete

– Cervix usually dilated to 10cm, cervix becomes soft and wide enough for fetus to pass through.

Stages of Birth Cont..

• 2nd Stage – Active Labor– Average 1 to 3 ½ hours– Contractions are 40-60 seconds long and

are about 3-4 minutes apart– Epidural is administered if wanted– Episiotomy (80-90% of first births)– Caesarean births (usually in cases of known

STD’s, previous caesareans, breech, or too large babies)

Stages of Birth Cont…• 3rd Stage - Afterbirth

– Placenta is expelled– Cord of baby is cut and clamped– APGAR test is performed

• Rates: – Respiration– Crying– Reflexes – Irritability– Pulse– Heart Rate– Skin color of body and extremities– Muscle tone

Preclampsia• Pre-eclampsia is a form

of high blood pressure brought on by pregnancy.

• It is also known as pregnancy-induced hypertension (PIH) or toxemia.

• Eclampsia is seizures or convulsions caused by a severe form of pre-eclampsia.

Vaginal Birth

Vaginal Birth

Vaginal Birth / Pain Relief

Section 19.3 Childbirth

The Birth Process

Vaginal Birth

Vaginal Birth


The Birth Process

Vaginal Birth

Vaginal Birth


The Birth Process

Vaginal Birth

Breech Delivery• Fetal presentation

refers to the part of your baby's body that is closest to the birth canal. In most full-term pregnancies, the baby is positioned head down in the uterus.

Breech Delivery• There are three types of

breech presentation: complete, incomplete, and frank.

• Complete breech is when one or both of the baby's knees are bent and his feet and bottom are closest to the birth canal.

• Frank breech is when the baby's legs are folded flat up against his head and his bottom is closest to the birth canal.

Breech Delivery• A prolapsed umbilical cord

is common in breech deliveries. This happens when part of the umbilical cord slips down through the cervix before the baby does. The cord is then compressed during contractions, which cuts down on blood flow to the baby. An emergency cesarean section is usually needed.

Breech Delivery• If you're near term and your

baby is breech, your doctor may try to manually move him into a head-down position for delivery. There are two ways to do this: During an external version, the doctor moves your baby by pressing on the outside of your belly. During an internal version, the doctor inserts his hand through your vagina and cervix and moves the baby from the inside.

Breech Delivery• If your baby is in a posterior

position, his face is turned up toward your belly. This can make labor longer and more difficult, since the widest part of his head has to fit through the birth canal.

• If your baby is transverse, he is lying horizontally in your uterus. Your doctor may try to manually flip him into a head-down position, but a cesarean section is usually needed.

APGAR TEST

Circumcision

• Oddly shaped head from force of birth process and skull is not completely formed yet

• Vernix Caseosa is the cheesy substance found on the baby to help protect the skin from the amniotic fluid… the more premature the baby is the more they will have on their body

• Lanugo is a very fine hair that covers the shoulders, back, forehead and temples. It will eventually fall off as the baby grows

• Puffy eyes from the drops that they use to clear out bacteria the infant may have gotten from the birth canal

• Meconium can happen a few moments after birth (it is the first stool which is thick, tarry, and dark greenish/black

What the baby may look like or have:

Common concerns/issues with newborns (left is erythema toxicum-a common rash and right is abundance of hormone may enlarge breasts or genitals of newborns

Skin Characteristics after Birth

Problems after Birth

Jaundice in Newborn

“Stork Bites” or vascular lesions after birth

usually last about 18 months

Child Options• Adoption• In Vitro (egg fertilized outside of the

body)• Surrogate (another female will carry

the egg and sperm of a women who can’t or doesn’t want to carry)

• Sperm Banks• Foster Care

• Miscarriage– The death of an embryo or fetus in the first 20

weeks of pregnancy. – Miscarriage most often occurs during the first

trimester, sometimes before a woman knows she is pregnant.

– Miscarriage ends over 20 % of all pregnancies– Usually caused by a genetic defect, but is

sometimes due to illness or a drug that mother has taken.

• In other cases, there is NO apparent reason for a miscarriage

• Stillbirth– Occurs when a fetus dies and is expelled

from the body after the twentieth week of pregnancy

Complications

• Cesarean Section (C-Section) – The surgical method of birth.– Take about 1 hour to complete the operation

• Mother may be awake or asleep– Doctor makes an incision in the lower abdomen into the

uterus, then removes the baby & placenta.– About 25 % of all babies born in the US are delivered

by C-Section• Reasons for C-Section Deliveries

– Baby too large (delivery through vagina & cervix not possible

– Mother has an STD– Baby in breech position– Mother has had a previous C-Section and

could be dangerous to deliver vaginally.

Complications at Birth

Stool and Urination Patterns of newborns

• Baby Stool PatternsType Characteristics Time Frame

Meconium Thick, tarry, dark green Birth – 2 days

Normal Loose, green-brown, to yellow-brown, seedy

2-5 days

Breastfed Mushy, golden yellow, often after each feeding, odor similar to sour milk

After 5 days

Formula-Fed

Firm, pasty, yellow-brown, strong odor

After 5 days

Stool and Urination Patterns of Newborns cont…

• Urination– Babies wet (urinate) three to four

time per day in the first few days of life. By the end of the first week, the baby should wet six to 10 times per day if adequately hydrated

– Urine is almost colorless

Fetal Development

•Picture of six week old fetal tissue

Fetal Development•Stages of hand and feet development

Fetus at 7 weeks• Facial features are

visible, The eyes have a retina and lens. The major muscle system is developed, and the unborn child practices moving. The child has its own blood type, distinct from the mother's.

Fetus at 8 weeks• The unborn child,

called a fetus at this stage

• ½ inch long. • Fingers can be seen• The toes will

develop in the next few days

• Brain waves can be measured

16 week old fetus

18 week old fetus• the unborn child is

covered with a very fine hair called Lanugo. Its tender skin is protected by a waxy substance called Vernix

• The child practices breathing by inhaling amniotic fluid into developing lungs.

Pregnancy NotesPregnancy Notes• Pregnancy Month by Month• Month 1

– Tiny limb buds, which will grow into arms and legs, appear.

– The embryo looks like a tadpole– The heart and lungs begin to form. By the

25th day, the heart starts to beat– The neutral tube, which becomes the brain

and spinal cord, begins to form– At the end of the first month, the embryo is

about ½ inch long and weighs less than 1 ounce

1st month of pregnancy (4 weeks)

Month 2• All major body organs and systems are

formed but not completely developed• The early stages of the placenta, which

exchanges nutrients from your body from waste products produced by the baby, are visible and working.

• The ears, ankles, and wrists form. The eyelids form and grow but are sealed shut

• Fingers and toes develop• By the end of the second month, the fetus

looks more like a person than like a tadpole, is about 1 inch long and still weighs less than 1 ounce.

2nd month of pregnancy (8 weeks)

Month 3• After 8 weeks as an embryo, the baby now is

called a “fetus”.• The fingers and toes have soft nails.• The mouth has 20 buds that will become “baby

teeth”• You can hear your baby’s heartbeat for the first

time (10 to 12 weeks) using a special instrument called al Doptone

• For the rest of the pregnancy, the body organs will mature, and the fetus will gain weight

• By the end of this month, the fetus is 2 ½ inches long and weighs a little over 1 ounce.

3rd month of pregnancy

Month 4Month 4• The fetus moves, kicks, and swallows• The skin is pink and transparent• The umbilical cord continues to grow

and thicken to carry enough nourishment from mother to fetus

• The Placenta is fully formed• By the end of the fourth month, the

fetus is 6 to 7 inches long and weighs 5 ounces

4th month of pregnancy

Month 5• The fetus becomes more active, turning from

side to side and sometimes head over heals• The fingernails have grown to the tips of the

fingers• The fetus sleeps and wakes at regular

intervals• The fetus has a month of rapid growth. At

the end of the fifth month, the fetus is 8 to 12 inches long and weighs 1/2 to 1 pound.

• By the end of the 5th month (20-21 weeks), fetal activity can be felt by the mother


Month 6• The skin is red and wrinkled and covered

with fine, soft hair.• The eyelids begin to part and the eyes

open.• The finger and toe prints can be seen• The fetus continues its rapid growth. At the

end of the sixth month, the fetus is 11 to 14 inches long and weighs 1 to 1 ½ pounds.

• If born at 24 weeks or more, the fetus might survive with intensive care


Month 7

• The fetus can open and close its eyes and suck its thumb

• The fetus exercises by kicking and stretching

• The fetus responds to light and sound• If born now, the fetus has a good chance

for survival• The fetus is now about 15 inches long

and weighs about 3 pounds


Month 8• Rapid brain growth continues• The fetus is too big to move around much but

can kick strongly and roll around• You may notice the shape of an elbow or heel

against your belly• The bones of the head are soft and flexible to

make it easier for the baby to fit through the birth canal

• The lungs may still be immature. If born now, before 37 weeks, the fetus is premature but has an excellent chance for survival.

• The fetus is now about 18 inches long and weighs about 5 pounds.



Month 9• At 37-40 weeks, your baby is full term• The baby’s lungs are mature and ready to

work on their own.• During this month the baby gains about ¼

to ½ pound a week.• The baby moves into position to be born,

usually dropping into a head-down position and resting lower in the mother’s pelvis

• By the end of the 9th month, the baby weighs 6 to 9 pounds and is 19 – 20 inches long


The Postpartum Period• After the birth, a period of adjustment for the parents & their

newborns begins.• Postpartum Period: The first 6 weeks after the birth of the baby• While the organs adjust to life outside the uterus, the newborn is

learning to get what it needs by forming a strong bond with its mother and father

• For the MotherFor the Mother– Changing hormone levels signal the breasts to produce

milk and causes uterus to gradually shrink back to normal size.

– Hormonal changes & fatigue may cause the mother to feel overwhelmed, or even very sad (“baby blues”)

• If the sadness lasts longer or causes the mother to withdraw from the baby and other people, she should seek prompt medical attention.

• She may need to be treated for postpartum depression.

The Costs of Having a The Costs of Having a BabyBaby

•SEE OVERHEADSEE OVERHEAD

The EndThe End

Documents

Pregnancy Health Education. Section 19.1 Development Before Birth Uterus Implantation Zygote Blastocyst Fallopian tube Cell division Fertilization Ovary