ABOUT PREGNANCY

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ABOUT PREGNANCY

Ques. 1 What is Normal labour in case of pregnancy?

Ans.          NORMAL LABOUR – It is the process of the expulsion of the mature foetus at term presented by anterior position (L.O.A. or R.O.A.) where the process is spontaneous, uncomplicated and unduly prolonged (within 24 hours), with (episiotomy) or without minimum surgical aid.

Ques. 2 What is Abnormal labour?

Ans.          Abnormal labour or Dystocia – This is one in which 1. The fetus is presented by vertex but there is some complication either of maternal or of fetal origin. 2. The fetus is presented by some part other than vertex.

Labour – It is process of expulsion of the foetus after the stage of viability via per naturalis.

  1. Position – It is the relation of denominator to the different quadrants of the pelvis, i.e. L.O.A., R.O.A. etc.
  2. Engagement – Engagement of the presentation occurs when the maximum transverse diameter of it passes the pelvic brim. Normally vertex engages about three weeks before onset of labour in primigravida while in multigravida, engagement may occur even in labour.
  3. Sign of true labor – Show. 2. Dilatation of the os. 3. Formation of bag of water. 4. Painful, rhythmic uterine contraction.
  4. Presentation – It means any foetal pole which presents before the pelvic brim, i.e. Cephalic, Podalic or Shoulder.
  5. Asynclitism – When the head flexes to the right or left, the sagittal suture approaches symphysis of the sacrum, the situation is referred to as asynclition. Depending upon direction of flexion towards or away from the sacrum.
  6. Show – This is a discharge of blood stained mucous per vagina, due to expulsion of cervical mucous plug and blood from separated membranes from the lower uterine segment.
  7. LIE – It is the relation of the long foetal axis to that of maternal spine, i.e. longitudinal, oblique or transverse.
  8. Synclitism – It means when the sagittal suture lies about midway between symphysis pubis and sacrum.
  9. Lightening – This is the sensation of decreased abdominal distension produced by the descent of uterus into the pelvic cavity, 2 to 3 weeks before labor begins. As the fundus of uterus no longer presses upon the lungs and heart. Breathing is easier & relief of pressure experienced by the woman is known as lightening.
  10. Attitude – This is the relation of different parts of the foetus to each other, normally parts of foetus lie in “attitude” of flexion as they tend to occupy small space inside the uterus. The attitude of flexion, extension of foetal head is possible.
  11. Denominator - It is the fixed part for any presentation which the leading part during the progress of presentation in labour, e.g., is Occiput for vertex presentation. Mentum for face presentation.
  12. Presenting Part – It is the particular part of a presentation which engages first such as vertex, face, and brow.
  13. Infant – The foetus with onset of pulmonary respiration at birth becomes an infant.
  14. Embryo – From 3rd week upto 8th week of intra-uterine life.
  15. Grande Multipara – A woman who has had 5 or more viable deliveries is called a grande multipara.
  16. Gravida – Means the state of a pregnant woman before the stage of viability (28 weeks or 7 months).
  17. Fertilization – The union between a mature spermatozoon and a mature ovum is know as fertilization. This results in evolution of a anew individual known as zygote.
  18. Primigravida – A woman in her first pregnancy coming to labour is termed Primigravida, in later confinements is termed Multipara.
  19. Ovum – Form the moment of fertilization upto 3rd week of intrauterine life.
  20. Parity – Means the state of a pregnant woman after the stage of viability or the state of a woman who has given birth to child after the stage of viability.
  21. Contracted pelvis – It is difficult to However, it is taken as a pelvis in which any of its essential diameters is so shortened as to alter the normal mechanism of labour. This is the obstetrical definition. It is a pelvis in which any diameter of inlet or outlet is shortened by more than 0.5 cm. This is  anatomical definition. Disproportion – The clinical term ‘disproportion’ means state in which baby is disproportionately big for the pelvis, and this may be due to (i) large baby and (ii) combination of both factors. (iii) contracted pelvis ;
  22. Foetus – From 8th week upto birth at term.

 

Ques. 3 Explain the mortality or death rate in pregnancy?

Ans.          The mortality or death rate in pregnancy are-

  1. Maternal mortality rate – It means number of such maternal deaths per 100 viable births for the year.
  2. Maternal mortality – It means death of any women dying of any cause while pregnant of within 42 days of termination of pregnancy irrespective of duration and site of pregnancy.
  3. Perinatal Mortality – It mean number of still births plus first week deaths of babies weighting 1000 grams or more at birth.
  4. Still birth – It means the condition of the newborn at birth (weight 1000 gram or more) which after its complete birth does not show any sign of life. {Still birth rate – It is the number of still birth per 1000 total births}.
  5. Neonatal Death – It mean death of babies within first 4 weeks of life.
  6. Neonatal Period – First 4 week of extra uterine life of the infant during which anatomical and physiological re-adjustments take place.
  7. Total calories required during pregnancy & labor – During pregnancy : 2,500 Kcal/day and during lactation : 3,000 keal/day.
  8. Viable foetus – A foetus called viable when it is able to lead a separate existence after its birth. Age of viability – and 28th By this time a foetus measures 14” in length and 3 Ibs by weight.
  9. Perinatal mortality rate – It means total number of still births and first week deaths per 1000 total births.

Ques. 4 What should be the diet in pregnancy?

Ans.          Diet in pregnancy – Cow’s milk –Pint, fish or meat – 60 g. at least, egg- one, orange/mousumbe, apple, banana, green leafy vegetables along with usual carbohydrate plus vitamins and minerals.

Ques. 5 What is colostrum? What are its functions?

Ans.          Colostrum, and its composition– It is a yellowith fluid secretion which appears in breasts during pregnancy and after labour, persists for 2 to 3 days after delivery. Composition – Protein, fat, carbohydrate, minerals and colostrums corpuscles.

Functions – (1) help to pass meconium for the first and second days thus acting like a purgative. (2) Gives immunity to the baby :

Ques. 6 What is the importance of Balanced diet in pregnancy?

Ans.          Importance of a well Balanced Diet during pregnancy –

  1. To maintain the maternal health.
  2. To provide physical strength and vitality during labor.
  • To initiate lactation successfully.
  1. To reduce the incidence of abortion, stillbirths and neonatal deaths.
  2. To meet the need of the growing fetus.

Rooming in plan – This is a system of keeping the baby in its cot at the bed side of the mother for the greater part of 24 hours.

Umbilical cord – This is the structure connecting the body of the fetus with the placenta and carries fetal blood to and from placenta. Umbilical cord is about 50 cm. long and is usually eccentrically attached to fetal surface of the placenta. It consists of a large vein and two thick muscular walled arteries. The vein carries oxygenated blood from the placenta to fetus, white two umbilical arteries which originate from the hypogastric arteries of fetus carry deoxygenated blood from fetus to placenta.

Ques. 7 What is obstructed labour?

Ans.          Obstructed labour – This means difficult labor due to insuperable mechanism obstructed in the process of delivery of fetus through passage. There are various conditions in which this obstruction occurs.

Causes –

  1. Faults passage – Bony passage (brim contraction in generally contracted, flat or osteomalacic pelvis etc.) Soft tissue – cervical fibroid, impacted ovarian cyst, cervical stenosis.
  2. Fault in passenger (fetal cause), such as – Brow presentation, face presentation with backward rotation of the chin, breech presentation with extended leg, locked twins etc. Fetal anomalies, e.g., hydrocephalus, abdominal tumour, double monsters, large baby etc.
  3. Faults in power; constriction ring.
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