lOMoARcPSD|26582732
Maternity Readings 1
Chapter 26 - reproductive system
1. Female reproductive structures
Ovaries form and expel ova, secrete estrogen and progesterone
Fallopian tubes muscular tubes lying near the ovaries and connected to the uterus, tubes that propel the
ova from the ovaries to the uterus
Uterus muscular pear shaped cavity in which the fetus develops, cavity from which menstruation occurs
Cervix the internal os of the cervix opens into the body of the uterine cavity, located between the internal
os and the external os which opens into the vagina
Vagina muscular tube that extends from the cervix to the vaginal opening in the perineum, known as the
birth canal, passageway for menstrual blood flow, for penis for intercourse, and for the fetus
2. Male reproductive structures
Penis structures include the body, shaft, glans penis, and urethra – primary functions include pathway for
urination and is the organ for intercourse
Scrotum structures include the testes, epididymis, and van deferens – normal temperature is slightly
cooler than body temperature
Prostate gland secretes a milky alkaline fluid – enhances sperm movement and neutralizes acidic vaginal
secretions
3. Menstrual cycle
Ovarian hormones released by the anterior pituitary gland, include follicle-stimulating hormone (fsh) and
luteinizing hormone (lh) – hormones produce changes in the ovaries and in the endometrium – menstrual
cycle, the regularly recurring physiological changes in the endometrium that culminate in its shedding,
may vary in length, with the average length being about 28 days
4. Female pelvis and measurements
True pelvis lies below the pelvic brim, consists of the pelvic inlet, midpelvis, and pelvis outlet
False pelvis shallow portion above the pelvic brim, supports the abdominal viscera
Types of pelvis
- Gynecoid: normal female pelvis, transversely rounded or blunt
- Anthropoid: oval shape, adequate outlet with narrow public arch
- Android: heart-shaped/angulated, resembles a male pelvis, not favourable for labour & birth,
narrow pelvic planes can cause slow descent and mid-pelvic arrest
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Maternity Readings 2
- Platypelloid: flat with an oval inlet, wide transverse diameter, but short antero-posterior
diameter, making labour and birth difficult
5. Fertilization and implantation
Fertilization occurs in the ampulla of the fallopian tube when sperm and ovum unite, when fertilized, the
membrane of the ovum undergoes changes that prevent entry of other sperm, each reproductive cell
carriers 23 chromosomes – sperm catty an x or a y (xy male, xx female)
Implantation the zygote is propelled toward the uterus and implants 6-8 days after ovulation
6. Fetal development
Preembryonic period first 2 weeks after conception
Embryonic period beginning on day 15 through approximetly the 8th week after conception
Fetal period beginning at the 9th week after conception and ending with birth
Weeks 2 – 3 Lung buds appear – blood circulation begins, heart is tubular and begins to beat
Week 5 Double heart chambers appear, heart is beating
Week 8 Eyelids begin to form – every organ is present
Week 12 Face is well formed – limbs are long – kidneys begin to produce urine – spontaneous
movement – heartbeat by doppler 10-12 weeks – can see gender
Week 16 Active movements, fetal skin is transparent – hair develops
Week 20 Nails develops – muscles develops – heartbeat by fetoscope
Week 24 Skin is reddish – reflex hand grasp functions – fetus can hear
Week 28 Limbs are well flexed – brain is developing rapidly – lungs developed
Week 32 Bones fully develop
Week 36 Skin is pink and body is round/less wrinkled
Week 40
7. Fetal environment
Amnion encloses the amniotic cavity – the inner membrane that forms about the 2 nd week of embryonic
development – forms during second week
Chorion outer membrane enclosing the amniotic cavity – becomes vascularized and forms the fetal part
of the placenta
Amniotic fluid consists of 800-1200ml by the end of pregnancy – surrounds, cushions, and protects the
fetus and allows for the fetal movement – maintains the body temp – contains fetal urine and is a measure
of fetal kidney function – fetus modifies fluid through processes for swallowing, urinating, and
movement of fluid through the resp tract
Placenta provides for exchange of nutrients and waste products between the fetus and mother – begins to
form at implantation – the structure is complete by week 12 – produce hormones to maintain pregnancy
and assumes full responsibility for the production of these hormones by the 12 th week
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Maternity Readings 3
8 . Fetal circulation
Umbilical cord contains 2 arteries and 1 vein (arteries carry deoxygenated blood and waste products
from the fetus)(vein carry oxygenation blood and provides oxygen and nutrients to the fetus)
Fetal heart rate depends on gestational age
- 160-170bpm in 1st trimester but slows with fetal growth to 110-160 beats/minute at full term
Fetal circulation bypass fetal circulation bypass is present because of non-functioning lungs – bypass
must close after birth to allow blood to flow through the lungs and the liver
9 . Family planning
Description involves choosing when to have children – includes contraception, prevention to pregnancy,
and methods to achieve pregnancy
Birth control the focus of counselling on contraception must meet the needs and feelings of the women
and her partner – if planning goals have already been met, sterilization of the male or female may be
considered
Infertility involuntary inability to conceive when desired – infertility in males (abnormalities of the
sperm, erections, ejaculations or seminal fluids) - infertility in females (disorders of ovulation or
abnormalities of the fallopian tubes or cervix)
- Infertility options may include medication, surgical procedures, therapeutic insemination,
vitrofertilization, surrogate mothers, and embryo hosts
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Maternity Readings 4
Chapter 28 – prenatal period
Gestation: time from fertilization of ovum to the estimated date of delivery (about 280 days)
Nägele’s rule: tool for estimating date of delivery (requires woman to have regular 28-day menstrual
cycle) o subtract 3 months and add 7 days to the first day of the last menstrual period, then add a
year. O or add 7 days to the last menstrual period and count forward 9 months
Gravida: refers to a pregnant woman
Gravidity: refers to the number of pregnancies
Nulligravida: a woman who has never been pregnant
Primigravida: a woman who is pregnant for the first time
Multigravida: a woman in at least her second pregnancy
Parity: the number of births (not fetuses) carried past 20 weeks gestations regardless of being born alive
Nullipara: a woman who has not had a birth at more than 20 weeks of gestation
Primipara: a woman who has had 1 birth that occurred after 20 weeks of gestation
Multipara: a woman who has had 2 or more pregnancies to the stage of fetal viability
Gtpal
o G: is gravidity, the number of pregnancies including the current one o t: is term births, the
number of births after 37 weeks o p: is preterm births, number born before 27 weeks o a:
abortions or miscarriages (intended/unintended) o l: current living children
(gtpa – all have to do w pregnancies, doesn’t matter how many babies)
Presumptive pregnancy signs
o amenorrhea
o Nausea and vomiting
o Increased size and feeling of fullness in breasts
o Pronounced nipples o urinary frequency
o Quickening (first perception of fetal movement by mother which may occur at 16 th-20th week) o
fatigue
o Discoloration of the vaginal mucosa
Probable pregnancy signs
o uterine enlargement
o Hegar’s sign (compressibility and softening of the lower uterine segment that occurs around
week
6) o goodell’s sign (softening of the cervix that occurs at the beginning of the second
month) o chadwicks signs (violet coloration of the mucous membranes of the cervix, vagina and
vulva around week 6)
o Ballottement (rebounding of the fetus against the examiners fingers on palpation) o braxton
hicks contractions o positive pregnancy test for determination of the presence of human
chorionic gonadotropin
Positive pregnancy signs o fetal heart rate detected by device at 10-12 weeks and non-
electronic around 20 weeks
Downloaded by NELSON KIIRU ()
Maternity Readings 1
Chapter 26 - reproductive system
1. Female reproductive structures
Ovaries form and expel ova, secrete estrogen and progesterone
Fallopian tubes muscular tubes lying near the ovaries and connected to the uterus, tubes that propel the
ova from the ovaries to the uterus
Uterus muscular pear shaped cavity in which the fetus develops, cavity from which menstruation occurs
Cervix the internal os of the cervix opens into the body of the uterine cavity, located between the internal
os and the external os which opens into the vagina
Vagina muscular tube that extends from the cervix to the vaginal opening in the perineum, known as the
birth canal, passageway for menstrual blood flow, for penis for intercourse, and for the fetus
2. Male reproductive structures
Penis structures include the body, shaft, glans penis, and urethra – primary functions include pathway for
urination and is the organ for intercourse
Scrotum structures include the testes, epididymis, and van deferens – normal temperature is slightly
cooler than body temperature
Prostate gland secretes a milky alkaline fluid – enhances sperm movement and neutralizes acidic vaginal
secretions
3. Menstrual cycle
Ovarian hormones released by the anterior pituitary gland, include follicle-stimulating hormone (fsh) and
luteinizing hormone (lh) – hormones produce changes in the ovaries and in the endometrium – menstrual
cycle, the regularly recurring physiological changes in the endometrium that culminate in its shedding,
may vary in length, with the average length being about 28 days
4. Female pelvis and measurements
True pelvis lies below the pelvic brim, consists of the pelvic inlet, midpelvis, and pelvis outlet
False pelvis shallow portion above the pelvic brim, supports the abdominal viscera
Types of pelvis
- Gynecoid: normal female pelvis, transversely rounded or blunt
- Anthropoid: oval shape, adequate outlet with narrow public arch
- Android: heart-shaped/angulated, resembles a male pelvis, not favourable for labour & birth,
narrow pelvic planes can cause slow descent and mid-pelvic arrest
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Maternity Readings 2
- Platypelloid: flat with an oval inlet, wide transverse diameter, but short antero-posterior
diameter, making labour and birth difficult
5. Fertilization and implantation
Fertilization occurs in the ampulla of the fallopian tube when sperm and ovum unite, when fertilized, the
membrane of the ovum undergoes changes that prevent entry of other sperm, each reproductive cell
carriers 23 chromosomes – sperm catty an x or a y (xy male, xx female)
Implantation the zygote is propelled toward the uterus and implants 6-8 days after ovulation
6. Fetal development
Preembryonic period first 2 weeks after conception
Embryonic period beginning on day 15 through approximetly the 8th week after conception
Fetal period beginning at the 9th week after conception and ending with birth
Weeks 2 – 3 Lung buds appear – blood circulation begins, heart is tubular and begins to beat
Week 5 Double heart chambers appear, heart is beating
Week 8 Eyelids begin to form – every organ is present
Week 12 Face is well formed – limbs are long – kidneys begin to produce urine – spontaneous
movement – heartbeat by doppler 10-12 weeks – can see gender
Week 16 Active movements, fetal skin is transparent – hair develops
Week 20 Nails develops – muscles develops – heartbeat by fetoscope
Week 24 Skin is reddish – reflex hand grasp functions – fetus can hear
Week 28 Limbs are well flexed – brain is developing rapidly – lungs developed
Week 32 Bones fully develop
Week 36 Skin is pink and body is round/less wrinkled
Week 40
7. Fetal environment
Amnion encloses the amniotic cavity – the inner membrane that forms about the 2 nd week of embryonic
development – forms during second week
Chorion outer membrane enclosing the amniotic cavity – becomes vascularized and forms the fetal part
of the placenta
Amniotic fluid consists of 800-1200ml by the end of pregnancy – surrounds, cushions, and protects the
fetus and allows for the fetal movement – maintains the body temp – contains fetal urine and is a measure
of fetal kidney function – fetus modifies fluid through processes for swallowing, urinating, and
movement of fluid through the resp tract
Placenta provides for exchange of nutrients and waste products between the fetus and mother – begins to
form at implantation – the structure is complete by week 12 – produce hormones to maintain pregnancy
and assumes full responsibility for the production of these hormones by the 12 th week
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Maternity Readings 3
8 . Fetal circulation
Umbilical cord contains 2 arteries and 1 vein (arteries carry deoxygenated blood and waste products
from the fetus)(vein carry oxygenation blood and provides oxygen and nutrients to the fetus)
Fetal heart rate depends on gestational age
- 160-170bpm in 1st trimester but slows with fetal growth to 110-160 beats/minute at full term
Fetal circulation bypass fetal circulation bypass is present because of non-functioning lungs – bypass
must close after birth to allow blood to flow through the lungs and the liver
9 . Family planning
Description involves choosing when to have children – includes contraception, prevention to pregnancy,
and methods to achieve pregnancy
Birth control the focus of counselling on contraception must meet the needs and feelings of the women
and her partner – if planning goals have already been met, sterilization of the male or female may be
considered
Infertility involuntary inability to conceive when desired – infertility in males (abnormalities of the
sperm, erections, ejaculations or seminal fluids) - infertility in females (disorders of ovulation or
abnormalities of the fallopian tubes or cervix)
- Infertility options may include medication, surgical procedures, therapeutic insemination,
vitrofertilization, surrogate mothers, and embryo hosts
Downloaded by NELSON KIIRU ()
, lOMoARcPSD|26582732
Maternity Readings 4
Chapter 28 – prenatal period
Gestation: time from fertilization of ovum to the estimated date of delivery (about 280 days)
Nägele’s rule: tool for estimating date of delivery (requires woman to have regular 28-day menstrual
cycle) o subtract 3 months and add 7 days to the first day of the last menstrual period, then add a
year. O or add 7 days to the last menstrual period and count forward 9 months
Gravida: refers to a pregnant woman
Gravidity: refers to the number of pregnancies
Nulligravida: a woman who has never been pregnant
Primigravida: a woman who is pregnant for the first time
Multigravida: a woman in at least her second pregnancy
Parity: the number of births (not fetuses) carried past 20 weeks gestations regardless of being born alive
Nullipara: a woman who has not had a birth at more than 20 weeks of gestation
Primipara: a woman who has had 1 birth that occurred after 20 weeks of gestation
Multipara: a woman who has had 2 or more pregnancies to the stage of fetal viability
Gtpal
o G: is gravidity, the number of pregnancies including the current one o t: is term births, the
number of births after 37 weeks o p: is preterm births, number born before 27 weeks o a:
abortions or miscarriages (intended/unintended) o l: current living children
(gtpa – all have to do w pregnancies, doesn’t matter how many babies)
Presumptive pregnancy signs
o amenorrhea
o Nausea and vomiting
o Increased size and feeling of fullness in breasts
o Pronounced nipples o urinary frequency
o Quickening (first perception of fetal movement by mother which may occur at 16 th-20th week) o
fatigue
o Discoloration of the vaginal mucosa
Probable pregnancy signs
o uterine enlargement
o Hegar’s sign (compressibility and softening of the lower uterine segment that occurs around
week
6) o goodell’s sign (softening of the cervix that occurs at the beginning of the second
month) o chadwicks signs (violet coloration of the mucous membranes of the cervix, vagina and
vulva around week 6)
o Ballottement (rebounding of the fetus against the examiners fingers on palpation) o braxton
hicks contractions o positive pregnancy test for determination of the presence of human
chorionic gonadotropin
Positive pregnancy signs o fetal heart rate detected by device at 10-12 weeks and non-
electronic around 20 weeks
Downloaded by NELSON KIIRU ()
