Lecture Mosby's paramedic textbook (4th ed) - Chapter 46: Obstetrics

9/11/2012 1 Chapter 46 Obstetrics 2 Learning Objectives • Describe the basic anatomy and physiology of the female reproductive system. • Outline fetal development from ovulation through birth. • Explain normal maternal physiological changes that occur during pregnancy and how they influence prehospital patient care and transportation. 3 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 1 9/11/2012 Learning Objectives • Describe appropriate information to be elicited during the obstetrical patient’s history. • Describe specific techniques for assessment of the pregnant patient. • Describe the general prehospital care of the pregnant patient. • Discuss the special implications of trauma in pregnancy. 4 Learning Objectives • Outline principles of care for a pregnant patient in cardiac arrest or peri‐arrest. • Recognize and begin treatment for complications of pregnancy such as hyperemesis gravidarum, Rh sensitization, diabetes mellitus, and infection. • Describe the assessment and management of patients with preeclampsia and eclampsia. 5 Learning Objectives • Explain the pathophysiology, signs and symptoms, and management of vaginal bleeding in pregnancy. • Outline the physiological changes that occur during the stages of labor. • Describe the role of the paramedic during normal labor and delivery. 6 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 2 9/11/2012 Learning Objectives • Compute an Apgar score. • Describe assessment and management of postpartum hemorrhage. • Discuss the identification, implications, and prehospital management of complicated deliveries. 7 Female Reproductive Anatomy • Comprised of external and internal anatomic structures – Allow for pregnancy • External genitalia – Labium minora – Labium majora – Vagina – Clitoris 8 Female Reproductive Anatomy • Internal organs; lie within pelvis – Uterus – Ovaries – Uterine (or fallopian) tubes – Cervix • Under control of endocrine system and hormones 9 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 3 9/11/2012 Female Reproductive Anatomy • For women of childbearing age – Cycle usually a monthly event • Begins with menstruation (shedding of the endometrium or uterine lining) • Ends with pregnancy OR • Absence of fertilization, another menstrual cycle 10 11 Normal Events in Pregnancy • Fertilization normally occurs in fallopian tube – Head of sperm penetrates mature ovum – Nuclei of sperm and ovum fuse – Newly fertilized ovum becomes zygote – Zygote undergoes repeated cell divisions as it passes down tube 12 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 4 9/11/2012 Normal Events in Pregnancy • Fertilization normally occurs in fallopian tube – After few days of cell division, ball of cells called morula formed • Cell differentiation between inner layer cells (blastocyst cells) and outer layer cells (trophoblast cells) – Trophoblast cells attach to endometrium lining of uterus – Implantation begins within 7 days after fertilization • Completed when trophoblast make contact with maternal circulation • About day 12 13 Normal Events in Pregnancy • Fertilization normally occurs in fallopian tube – Trophoblast go on to make various life support systems for embryo • Placenta • Amniotic sac • Umbilical cord – Blastocyst cells develop into embryo itself 14 15 Copyright © 2013 by Jones & Bartlett Learning, LLC, an Ascend Learning Company 5 ... - tailieumienphi.vn