Fertility Rate

What proportion of women who could have babies are having them.

Fetal Death Rate

Neonatal death rate

Neonates

the first 28 days of life is known as the neonatal period.

Leading cause of death for neonates

prematurity, low birth weight, and congenital anomalies

Perinatal death rate

The number of deaths of fetus more than 500 g and in the first 28 days of life. sum of fetal and neonatal death rates.

infant mortality rate

death occuring at birth or in the first 12 months of life.

Obstetrics

medicine. concerned w/ the management of women during pregnancy, childbirth, and the puerperium.

Maternity Nursing

delivering professional quality health care while recognizing and focusing on the physical and psychosocial needs of the childbearing woman, family and newborn.

Parturition

The act or process of giving birth.

There are 3 stages.

1) Antepartum

The time period during pregnancy before onset of labor

2)Intrapartum

The time period during the process of labor and delivery

3) Postpartum

The first 6 weeks after childbirth

Puerperium

Gravida

the number of times a woman has been pregnant, including the present pregnancy, regardless of the duration or outcome of the pregnancy

Nulligravida

 Woman has never been pregnant

Primigravida

The woman is pregnant for the first time

Multigravida

the woman has been pregnant more than once

Para

number of pregnancies that reached viability (24 wks+) regardless of whether the infants were born alive or not.

*refers to the number of pregnancies not the number of fetuses. Ex. First pregnancy is twins: G1 P1

Nullipara

woman who has never completed a pregnancy beyond a spontaneous or elective abortion

Primipara

woman who has given birth once after a pregnancy of at least 20 wks. gestation.

Multipara

woman who has given birth two or more times at 20 or more wks. of gestation

High risk families

marital conflict and divorce, adolescent parenting, violence, substance abuse, children w/ special needs

Early discharge

focus on patient teaching so clients can take better care of themselves. careful assessment and reporting so they don't get discharged w/ a problem.

Rooming in

Infant stays in mom's room for most or all of day/night

Traditional hospital childbirth room setting

separate labor, delivery, recovery, postpartum room. safe setting, impersonal/uncomfortable.

LDR

labor, delivery, recovery all done in the same room w/ the same nurses. mom then moves into postpartum unit, infant to nursery or rooming in

LDRP

Mom and infant remain in same room until discharged. Nicely decorated, special beds/chairs. homelike.

Birth Centers

provide care to low risk women outside the hospital setting. less expensive. not prepared for emergencies

Positions of childbirth

Dorsal lithotomy for convenience of MD or midwife

Perineum

skin covered region between vagina and anus. during labor stretches and becomes very thin, sometimes tearing when baby is born.

2 ovaries

oocytes(immature egg), produces sex hormones estrogen and progesterone

2 oviducts or fallopian tubes

uterus

Cervix

opening of uterus. secretes mucus that facilitates sperm and blocks bacteria.

vagina

birth canal

Bony pelvis

structured to adapt to the demands of childbearing

Gynecoid

traditional female pelvis

breasts

function-lactation

androgens

males sex hormones

testosterone

secondary sexual characteristics

fertility

related to sperm number, size, shape and motility

Menstrual Cycle

2 cycles: Ovarian and Endometrial

Ovarian

Has 3 phases

1) Follicular

follicle develops in ovary

2) ovulation

egg released from follicle/ovary

3) Luteal

follicle becomes the corpus luteum

Gonadotropin-releasing hormone (GnRH)

Follicle Stimulating Hormone (FSH)

Leutenizing hormone (LH)

hypothalamus secretes GnRH that stimulates the pituatry to secrete FSH and LH

Ovarian Cycle

The follicle/ovulation

in response to elevated LH, the follicle bursts releasing the egg (ovulation) from the ovary into the fallopian tube

which hormone stimulates ovulation the most?

increased LH

after releasing the egg the follicle becomes..

 the corpus luteum.

corpus luteum

begins producing progesterone

Progesterone

prepares the uterus and endometrium for pregnancy. needed to maintain pregnancy.

If no pregnancy occurs.. 

the corpus luteum degenerates and stops producing progesterone.

If the egg is fertilized in the fallopian tube and successfully implants into the endometrium of the uterus..

the embryo begins producing Human Chorionic Gonadotripin(HCG)

HCG

maintains the corpus luteum, which results in the continued release of progesterone which maintains the uterus during pregnancy.

Spinnbarkheit

elasticity of cervical mucous

Ferning

crystallization of cervical mucus

Temperature

increased basal body temp. while ovulating

mittelschmerz

abdominal cramping during ovulation

endometrial cycle

the uterine endometrium responds to ovarian hormone stimulation

3 phases that mark endometrial changes

proliferative, secretory, menstrual

proliferative phase

takes place as ovum matures and is released during the first half of the ovarian cycle.

endometrial lining thickens.

new endometrial epithelium and endometrial glands stimulated by estrogen secreted by ovarian follicles.

as ovulation approaches, the endometrial glands secrete a thin, stringy mucus that aids entry of sperm into the uterus.

secretory phase

occurs during the 2nd half of the ovarian cycle as the uterus is prepared to receive a fertilized ovum.

endometrium cont. to thicken. max 5-6 mm.

blood vessels and endometrial glands become twisted and dilated.

progesterone from the corpus luteum causes the thick endometrium to secrete substances to secrete substances that nourish a fertilized ovum.

large quanities of glycogen, proteins, lipids, and minerals are stored with the endometrium (awaiting arrival of the fertilized ovum.)

Menstrual Phase

if fertilization does not occur, the corpus luteum regresses and production of estrogen and progesterone falls.

about 2 days before the onset of menses, vasospasm of the endometrial blood vessels cause the endometrium to become ischemic and necrotic.

the necrotic areas of the endometrium separate form the basal layers=menstrual flow.

climacteric phase

perimenopausal phase

Menopause

last menstrual period

postmenopausal phase

time after menopause, estrogen produced by the adrenal glands.