Local changes during pregnancies- pg.

49-51 Ovaries- Inactive since ovulation does not take place during pregnancy Abdominal wall Striae Gravidarum- due to rupture and atrophy connective tissue layers on the growing abdomen. Linae nigra Umbilicus is pushed out Malasma or chloasma- increased pigmentation due to melanocyte by the pituitary Unduly activated sweat glands Danger signs of pregnancies Vaginal bleeding any amount Swelling of face or fingers Severe continuous headache Dimness or blurring vision Pain in the abdomen Persistent vomiting Chills and fever Sudden escape of fluids from the vagina Absence of FHT Labor and delivery Theories of labor onset- pg. 86 A Four Ps of labor- pg. 86 B Fontanels- pg. 87 Presentation: Cephalic Breech Shoulder Movement flexion Descent Internat rotation Extension External rotation Obstetrical conjugate- pg. 89 Conjugate vera- pg. 89 Tuberlischial diameter- pg. 89 Preliminary signs of labor- pg. 90 False labor: remain irregular Confined to abdomen No increased in duration

Disappear in ambulation No cervical changes True labor: becomes regular and predictable Radiates in girdle liked fashion Increased in duration, frequency, intensity Continue regardless of activity Signs of true labor: effacement, dilation Stages of labor True labor- complete cervical dilation. Primigravida- 3.3- 19.7 hrs: Multgravida- 0.1-14.3 hrs Second stage- complete dilation- birth of the new born Third stage- delivery of newborn- delivery of placenta Fourth stage- 1st hr. after delivery- woman physically develop Promoting healing and involution during post-partum- pg. 134-143