Before Conception
Menstrual Cycle
1)the hypothalamus releases gonadotropin- releasing hormone (GNRH)
2)GNRH causes the pituitary to make follicl-e Stimulating hormone (FSH) + Luteinizing hormone (LH)
3)FSH+ It tell the ovaries to make a mature egg by increasing the production of estrogen
4)the empty follicle (corpus Interm) increases estrogen + progesterone production , which help to thicken the lining of the uterus
5)if embryo implants, it makes human chorionic gonadotropin (hCG)
6)If embryo doesn't implant negative hCG causes estrogen + progesterone to decrease + bleeding (period)
Barrier Conception
- male condoms are generally less effective as contraception but are the best protection against STIS
~ 18% failure rate over 1 year
embryonic Stage (weeks 2-8) :
· Implantation occurs by the end of the week2
· neural tube fuses at the center + tubular heart begins to beat in week 3
pregnancy occurring outside the uterus often the fallopian tube, pregnancy occurring
- life-threatening for mom, must not be continued
- signs include severe pelvic pain that may refer to one shoulder + bleeding
What is Ectopic Pregnancy?
genomics
addresses all genes + their interrelationships to identify their combined influence on the organism
Confirming Pregnancy
-presumptive pregnancy symptoms include breast tenderness , amenorrhea, + nausea
-probable pregnancy signs are braxton hicks contractions, positive pregnancy test , softening of the cervix (goodell sign), + a blueish discoloration of the female genitalia (chadwick sign)
- lack of pregnancy after 12 months of well-timed intercourse(6months if pt is over 35yld)
- can be related to male or female factors
· immature sperm, endometriosis fibroids
What is Infertility?
dark line from pubic Symphysis to fundus
What is linea nigra?
Preterm Premature Rupture of Membranes (PPROM)
- preterm rupture of membranes (PROM) is the rupture of membranes prior to the start of contractions at or after 37wKs
· water breaks but no contractions
increases the risk of prolapsed cord, placental abruption, chorioamnionitis, cord compression
Teratogens
- toxic to growth + development of baby
- include drugs alcohol TORCH infections STIS
- first 8 wks of gestation are when the fetus is most vulnerable to the effects of teratogens since major organs are forming
GP
G: number of pregnancies someone has had
P: number of pregnancies carried to viable gestational age (-20-24 weeks)
- 1 living child (39 uks) + twins + 1 abortion (21lks)= G3P3
artificial reproductive technology (ART)
helps treat male,female, mixed, or unknown infertility
· intrauterine insemination washes sperm + inserts it in to upper uterine cavity
· in vitro fertilization (IVF) stimulates ovaries to retrieve eggs , which get mixed with cleaned sperm
- temporary organ acting as circulatory interface between mom + embryo/fetus
- forms at site of blastocyst implantation
- attaches with projections called chorionic villi
What is Placenta?
Hyperemesis Gravidarum
- HG is characterized by unusually acute nausea + vomiting
- may lead to weight loss malnutrition dehydration, Ketonuria electrolyte imbalances
- treated with antiemetics IV rehydration parenteral electrolytes
- risk factors are multiple pregnancy hyperthyroidism, GI disease, depression + anxiety, female fetus
allows for early detection of genetic disorders (ex: down syndrome)
What is prenatal testing?
GTPAL
- G: gravida, the number of pregnancies a person has had · includes live + not live births (all pregnancie)
- T: number of pregnancies ended at term (37+weeks)
- P: number of pregnancies ended preterm (20-37 weeks)
- A: number of pregnancies ended by spontaneous or elective abortion before 20 weeks
- L: number of living children (born alive
- 1 living child (39wKS)+ 1 miscarriage (9wKs)= G2T1POA1L1
- 1 living child (38wKs)+ twins (24 wKs) = G2T1P1AOL3
Natural Family Planning
- relies on predictability of fertility in menstrual cycle
- ex : cervical secretions , symptothermal, symptohormonal
Fetal Stages weeks 13-16
-oogenesis established in females, blood vessels visible under skin, ridges that will form in the finger, hand, foot, +toe prints present
Polyhydramnios
- excessive amniotic fluid
- cause is unknown , r/t diabetes, or twin transfusion - associated with poor outcome for fetus + mom including preterm labor birth defects hemorrhage
- diagnosed by ultrasound of 4 largest pockets of fluid + they get added together to get amniotic fluid
index (AFI) + values = 24 cm are abnormal
naegele's rule
estimated due date
last menstrual period (day1)+ 7 days-3mos + 1yr
Gametogenesis
- creation of gametes through meiosis
- number of chromosomes in melosis is reduced from diploid (46) to haploid (23 chromosomes, one set) - females are born with 1-2 million oocytes
- male spermatogenesis starts at puberty
progesterone
only pills (POPs) only have progestin
· given to pts when estrogen is contraindicated
-> migraine with aura HTN smokers
· take within a 3-hour window to be effective
Endocrine Changes
- at 12 weeks fetus makes its own thyroid hormones
- thyroid hormones are critical for neurologic development
when fetal blood vessels (umbilical cord) overlie
Cervical OS
What is Vasa Previa?
Bonus points if you can name the 3 types!!
used to detect genetic changes in embryos created using assistive reproduction technology (IVF)
What is Preimplantation Testing?