Ovum released into fallopian tube- viable for 24 hours
Sperm deposited into vagina- viable for 48-72 hours
Chromosome pairs split up to produce diploid zygote
23+23=46
Zygote contains new combination of genetic material
Sex of zygote determined at moment of fertilization
Nageles rule
1st day of LMP subtract 3 months and add seven days
Can be difficult as periods are irregular and can affect ovulation
Prenatal considerations
Adaptations- weight gain, additional hormones, changes in personal relationship
Prenatal classes and education resources
Creation of birth plan- communication between healthcare providers. Keep in mind labor does not always go according to plan
Follow up visits- every 4 weeks for first 28 weeks gestation, every 2 weeks from 28 weeks until 36 weeks gestation, after 36 week- every week until childbirth
Gestational hypertension+diabetes= extra screening/care
1st Trimester ultrasound- important for:
Premature babies and knowing exact dates
Adjust dates(miscarage then get pregnant right away
Prenatal assessments- vitals and weight, uterine size and fetal heartbeat, Tests: urinalysis, blood tests, group b strep test, re-evaluation/prenatal history-questions will change
Gravida + TPAL
G- any pregnancy, regardless of duration, including present pregnancy
T- number of term infants born(37/0 and after)
P- number of preterm infant born(20/0, 36/6)
A-number of pregnancies ending in either spontaneous or therapeutic abortion
L- number of living children
Abortion- a birth that occurs before the end of 20 weeks gestation
Spontaneous: naturally occurring from a multitude of causes, cause not always known
Therapeutic: medically induced
Stillbirth: a birth of an infant whom is dead< occurring after 20 weeks gestation
Umbilical cord: develops from amnion
Contains two arteries and one vein; surrounded by Wharton's jelly to protect vessels
Wharton's jelly: specialized connective tissue that protect blood vessels, less wharton's jelly puts baby at risk
Placenta: developed at site where embryo attaches to uterine wall at 3rd week after conception
Metabolic and nutrient exchange between embryonic and maternal circulation
Maternal portion- surface appears red and flesh-like
Fetal portion- appears shiny and gray
4 weeks: the fetal heart begins to beat
8 weeks: all body organs are formed(if something happens to mom during this stage, it can effect babies organ development)
8-12 weeks: fetal heart rate can be detected
16 weeks: the sex of the baby can be detected, looks like a baby on an ultrasound image
20 weeks: heart beat can be detected, mother experiences quickening, baby develops a regular schedule, vernix and lanugo is present, head hair, eyebrows, and eyelashes present
28 weeks: eyes open/close, baby can breath, surfactant is developed
32 weeks: fingernails and toenails from, subcutaneous fat is developing less red and wrinkled
38+ weeks: baby fills entire uterus, reciving antibiotics from mother
Multiple gestation
Therapeutic management: serial ultrasounds, close monitoring during labor, operative delivery
Nurse assess- uterus larger than expected for EDB
Monochorionic-monoamniotic is most dangerous- cords can wrap around each other and twins can fuse together
A)
Dichorionic-Diamniotic
A)
Monochromic-monoamniotic
Monochorinic-diamniotic
A)
Dichorionic-diamniotic
A)
Presumptive
Subjective changes experienced by a women
Cannot be used to diagnose pregnancy
Amenorrhea, nausea and vomiting, excessive fatigue, urinary frequency, breast changes, quickening, weight changes
Probable
Objective changes can be observed by the women or an examiner
These changes alone cannot confirm pregnancies
Pelvic organ changes, enlargement of the abdomen with amenorrhea, braxton hicks contractions, changes in skin pigmentation, fetal outline, pregnancy tests
Positive
Objective changes that cannot be confused with a pathologic state and can be measured conclusively
Fetal heartbeat, fetal movement, visualization of the fetus via ultrasound
Body aches, stretch marks, darkening of the skin around the nipples, linea nigra, darker patches on the face, carpal tunnel syndrome, insomnia, itchiness, swelling of ankles, fingers and face