Std Pregnancy

Edgel May C. Bayag, M.D.



Ovulation

 Fertilization  Embryo  Birth

Formation and Development

of the Baby

 Urine

pregnancy test will often be positive at the time of the missed menstrual cycle

 Beta

HCG produced by the placenta rises to a peak of 100,000 mIU/mL by 10 weeks

 Confirmed

by Ultrasound:

 Gestational

Sac at 5 weeks or Beta HCG of 1500 to 2000 mIU/mL an  Fetal Heart at 6 weeks or Beta HCG of 5000 to 6000 mIU/mL

 Signs  Chadwick’s 

Bluish discoloration of vagina and cervix

 Goodell’s 

Sign

Softening and cyanosis of cervix at or after 4 weeks

 Ladin’s 

Sign

Sign

Softening of the uterus after 6 weeks

 Breast

swelling and tenderness  Development of the linea nigra from umbilicus to pubis  Telangiectasias  Palmar erythema

 Symptoms  Amenorrhea  Nausea 

and vomiting

“Morning Sickness” (12-16wks)

 Breast

Pain  Quickening – fetal movement

 Gestational

age

 In

wks and days measured from Last Menstrual Period, LMP

 Developmental

age

 In

wks and days since fertilization  GA 2 wks more than DA  Fertilization usually occurs ~14 days after first day of the prior menstrual period or LMP  Expected

Date of Confinement, EDC:

 Naegele’s

rule (-3m + 7d) from LMP

 Previable

(before 24 wks)  Preterm (24 to 37 wks)  Term (37 to 42 wks)  Postterm (beyond 42 wks)  OB

SCORE: (GnPn)  Gravidity (number of times pregnant)  Parity (number of pregnancies led to a birth beyond 20 wks GA or infant weighing >500g)

 Embryo

(time of fertilization until 8 wks or 10 wks gestational age, GA)  Fetus (8 wks until birth)  Infant (delivery until 1 year of age)  First

Trimester (until 14 wks GA)  Second Trimester (14 to 28 wks GA)  Third Trimester (28 wks to delivery)

 Back

pain  Constipation  Contractions  Dehydration  Edema  Gastroesophageal Reflux  Hemorrhoids  Urinary Frequency  Varicose Veins

 Medical  Preeclampsia,

GDM, Hyperthyroidism

 Surgical  Caesarian

Delivery 2’ CPD

 Bleeding  Ectopic,

Abortion, Placenta Previa

 Infectious  Urinary

Tract Infection, Chorioamnionitis

 Death  Amniotic

Fluid Embolism

 Early

Pregnancy Complications  Antepartum Hemorrhage  Complications of Labor and Delivery  Fetal Complications of Pregnancy  Hypertension in Pregnancy  Diabetes during Pregnancy  Other Medical Complications  Postpartum Care and Complications

 High

risk  Unwanted  Underdeveloped reproductive tract  Psychological Impact  When

is the ideal time then?

Edgel May C. Bayag, M.D.

 Sexually

Transmitted Diseases or Sexually Transmitted Infections  Are infections that can be transferred from one person to another through sexual contact  Adolescents and young adults are the age groups at the greatest risk for acquiring  Approximately 19M new infections/year  Half among ages 15 to 24

 Some

have severe consequences, especially in women, if not treated

 Lead

to pelvic inflammatory disease  Infertility

 May

even be fatal

 Abstinence

from sexual activity

 Monogamy  Use

of contraceptive devices, ie condoms (but only to a certain extent)

Human Papilloma Virus  Herpes Virus  Hepatitis B  HIV/AIDS  Syphilis  Trichomoniasis  Gonorrhea  Chlamydia  Public Lice  Rare Infections like Chancroid, Granuloma Inguinale, Molluscum Contagiosum, Lymphogranuloma Venereum 

 Genital

Warts (Condylomata acuminata)  Cervical Cancer in Females  2nd

leading cause of death in the Philippines  Video Clip  Penile

Cancer in Males  Preventable by Vaccination

 Transmission:  Sexually  Bloodborne  Vertical:

Mother to

Child  Preventable by Vaccination

 Females:

For you, when is the ideal time to get pregnant? Explain factors to be considered.  How can you prevent contracting STDs?  Males:

For you, when is ideal time to impregnate a woman? Explain factors to be considered.  How can you prevent contracting STDs?

 Submision

of your reaction paper

 Rosal

– Wed  Sampaguita – Friday  Champaca - Friday  Submission

of Quiz on Menstrual Cycle

 Sampaguita

 Joint

– Monday

classes on Monday

 Sampaguita

& Champaca

Edgel May C. Bayag, M.D.

 Contraception  Sterilization  Theoretical

Efficacy Rate  Actual Efficacy Rate

Natural Methods – least effective  Barrier Methods and Spermicides  Intrauterine Devices  Hormonal Methods  Surgical Sterilization 

 No

Contraceptive or Sterilization Method is 100% Effective (as seen on the Table for Failure Rates)

Method

No method Periodic Abstinence Calendar Ovulation method Symptothermal Postovulation Withdrawal

Percent of Women who Become Pregnant Theoretica Actual l Failure Failure Rate Rate 85.0 85.0 ___ 20.0 9.0 3.0 2.0 1.0 4.0

18.0

Condom Male condom Female condom Diaphragm with Spermicide Cervical cap Sponge Parous women Nulliparous women Spermicide alone IUD’s Progestasert Paraguard copper T

2.0 12.0 6.0 21.0-26.0 6.0 18.0 6.0

18.0

9.0 6.0 3.0

28.0 18.0 21.0

2.0 0.8

2.0 0.7

Combination pill Progestin only pill Norplant Depo-Provera

Tubal Ligation Vasectomy

0.1 0.5 0.09 0.3

0.2 0.1

3.0 3.0-6.0 0.09 0.3

0.4 0.15

 Submision

of your reaction paper

 Rosal

– Wed  Sampaguita – Friday  Champaca - Friday  Submission

of Quiz on Menstrual Cycle

 Sampaguita

 Joint

– Monday

classes on Monday

 Sampaguita

& Champaca