Lecture Notes Menu Gestation and Parturition


  1. MECHANISM THAT PREVENTS LOSS OF THE UTERINE WALL

    1. EMBRYONIC CELLS SECRETE HCG
    2. HCG CAUSES CORPUS LUTEUM TO BE MAINTAINED
    3. CORPUS LUTEUM CONTINUES TO SECRETE ESTROGEN AND PROGESTERONE
    4. ESTROGEN PROMOTE GROWTH AND DEVELOPMENT OF UTERINE WALL

  2. HORMONAL CHANGES DURING PREGNANCY

    1. AFTER IMPLANTATION, EMBRYO SECRETES HCG
    2. HCG MAINTAINS CORPUS LUTEUM
    3. DEVELOPING PLACENTA SECRETES LARGE AMOUNTS OF ESTROGEN AND PROGESTERONE
    4. PLACENTAL ESTROGEN AND PROGESTERONE ACCOMPLISH THE FOLLOWING:

      1. ENDOMETRIUM DEVELOPMENT
      2. MAINTENANCE OF LINING
      3. INHIBIT FSH AND LH
      4. STIMULATE MAMMARY GLANDS
      5. PROGESTERONE INHIBITS UTERINE CONTRACTIONS
      6. ESTROGEN CAUSES ENLARGEMENT OF REPRODUCTIVE ORGANS

    5. RELAXIN FROM CORPUS LUTEUM INHIBITS UTERINE CONTRACTIONS
    6. PLACENTA SECRETES PLACENTAL LACTOGEN
    7. ALDOSTERONE FROM ADRENAL CORTEX PROMOTES Na REABSORPTION
    8. PARATHYROID HORMONE FROM PARATHYROID GLAND ALLOWS INCREASED ABSORPTION OF CALCIUM

  3. PROBLEMS DURING PREGNANCY

    1. DIAGNOSIS OF PREGNANCY

      1. NAUSEA AND VOMITING CAUSED BY HCG
      2. BLOOD TITER OF HCG
      3. SLIDE AGGLUTINATION TEST HCG POSITIVE (URINE)
      4. MISSED PERIOD
      5. CERVIX SOFTER (AFTER MISSED PERIOD)
      6. AT 12 WKS UTERUS ENLARGES OUT OF PELVIC AREA

    2. CALCULATION OF GESTATION

      1. NORMAL GESTATION IS 266 DAYS
      2. FIGURED 280 DAYS FROM LAST MENSES
      3. NAEGELES RULE:

        1. SUBTRACT 3 MONTHS FROM LAST PERIOD AND ADD 7 DAYS
        2. 10 % OR FEWER WILL DELIVER ON THIS DATE
        3. 50% WILL DELIVER +/- I WEEK
        4. 75 - 88 % WILL DELIVER +/- 2 WK.
        5. +/- 2 WEEKS IS CONSIDERED NORMAL

    3. COMPLICATIONS DURING PREGNANCY

      1. SPONTANEOUS ABORTION
      2. ECTOPIC PREGNANCY
      3. PREECLAMPSIA AND ECLAMPSIA
      4. ABRUPTO PLACENTAE ( PREMATURE SEPERATION)
      5. PLACENTA PREVIA ( IMPLANTATION NEAR CERVIX)
      6. PREMATURE LABOR (BEFORE 37 WKS)
      7. POSTDATISM ( AFTER 42 WEEKS )
      8. ABNORMAL PRESENTATION

  4. PARTURITION ( PRESENTATION OF OFFSPRING )

    1. AFTER 7 MONTHS THE LEVEL OF PROGESTERONE COMPARED TO ESTROGEN DECREASES
    2. STRETCHING UTERINE TISSUES STIMULATES HYPOTHALMUS TO SECRETE OXYTOCIN
    3. CHANGES IN PROGESTERONE AND ESTROGEN LEVELS STIMULATE PRODUCTIONS OF PROSTAGLANDINS WHICH MAY START THE BIRTH PROCESS
    4. OTHER THEORIES

  5. Lactation

    1. Progesterone and estrogen stimulate breast development
    2. Progesterone and estrogen prevent actual milk letdown
    3. Prolactin promotes secretion of milk; prolactin released from mothers anterior pituitary
    4. Concentration rises steadily from 5th week pregnancy
    5. Placenta releases human chorionic somatomammotropin which has a mild lactogenic affect
    6. At birth progesterone and estrogen greatly decrease
    7. Milk produced in 2 - 3 days
    8. Colostrum produced first ( Protein, lactose, antibodies, no fat )

  6. Milk Letdown and Ejection

    1. Prolactin returns to non pregnant level
    2. Each feeding stimulates nipple and neuronal signal sent to hypothalamus of mother.
    3. Stimulates release of prolactin and oxytocin
    4. Prolactin level increases 10 - 20 fold and lasts about one hour ( produces milk for next feeding )
    5. Oxytocin released from posterior pituitary gland
    6. In about 30 sec milk letdown occurs and milk flows into ducts