Obstetrics - is the branch of medicine that deals • Unang Akap or First Embrace practice.
with the management of pregnancy, parturition • KMC or Kangaroo mother care
(labor and delivery) and puerperium (the sixth • Breast feeding practice intensified.
weeks following childbirth)
• Biochemical, Physiological and Anatomic
PRIMITIVE PERIOD changes
• Woman in labor gives birth in squatting
position or sit in special birth stool A. Organic Changes
• Killing of baby is practiced Uterus – hypertrophy and dilatation
• Child is not considered a person with soul 1. Non-pregnant uterus – almost solid with
until he receives a name and presented to 10ml cavity
spirit ▪ Pregnant uterus - becomes thin- walled
and enlarged to accommodate fetus,
ANCIENT TIME (ANCIENT EGYPT) placenta, amniotic fluid
• Egyptians are considered to be the 2. Total volume of uterine contents at term
founders of medicine averages about 5 liters to as much as 10
• Children were valued highly, and infanticide liters or more which is 500-1000 times its
was not allowed by the law during this time non- pregnant capacity
• Practice of medicine was more 3. Non-pregnant uterus weights about 70
sophisticated – Forceps, cs, podalic version grams
was already practiced during this period. ▪ Term Pregnancy – 1100 gram
4. Pregnancy- hypertrophy/enlargement of
ANCIENT INDIA muscle fibers and to a limited degree and
• Hippocrates was considered the “father of due to estrogen and progesterone.
medicine” 5. Uterine walls become thicker during few
• Soranus of Ephesus was considered the months then become thin as 1.5 cm at term
“father of Obstetric” this allows movement of the fetal
extremities and facilitate palpation of fetal
MIDDLE AGE parts abdominally by Leopold’s manuever.
• Lying- in hospital are already available
• Midwives are considered attendants of
normal delivery
• Doctors attend complicated deliveries
SIZE
• Wet nursing or breast feeding was
1. By the end of the 12th week gestation, the
practiced
uterus has grown too large to remain in the
pelvis, so it rises up to the abdomine cavity
PRESENT TRENDS
• Prenatal care are practice
SHAPE
• Husband and wife are encouraged to share
• Pear shape-globular to ovoid from 1 weeks
in child-bearing experience
until term
• Rooming-in and mother-baby friendly
Note: increase of fundic height is an
hospital starts
1
, Important sign of fetal growth and wellbeing. 6. Blood pressure may drop slightly in
• 12 weeks - fundus can already be palpated second trimester
as it rises out of the pelvic cavity 7. Supine hypotension syndrome: in
supine position weight of enlarged
• At the level of symphysis pubis uterus obstructs vena cava, which
▪ 1 weeks - halfway between symphisis decreases blood return to heart
pubis and umbilicus. therefore decreasing cardiac output
▪ 20 weeks - at the level of umbilicus. resulting to hypotension,
▪ 2 weeks - two fingers above umbilicus. lightheadedness, faintness and
▪ 2-3 weeks - midway between umbilicus palpitations.
and xyphoid process. 8. White blood cells, fibrinogen and other
▪ 32-3 weeks - two finger below the clotting factors increases.
xiphoid process. 9. PHYSIOLOGIC ANEMIA
▪ Weeks - two fingers below umbilicus, a. occurs as a result of hemodilution
drops at 3 weeks level of the blood.
▪ Weeks- two fingers below umbilicus, b. There is 45-50% increase in blood
drops at 3 weeks level because of volume expansion, of which about
lightening. 75% is plasma and 25% is RBC.
▪ Isthmus – narrow portion of the uterus c. Normal values in pregnancy
that joins the connective tissue of the ✓ Hct. 32 – 42%
cervix to the muscle fibers of the body ✓ Hgb. : 10.5 – 14 g/L
of the uterus. 10. PATHOLOGIC ANEMIA
▪ Hegar’s sign – refers to the softening of a. Iron deficiency anemia – most
the lower uterine segment the begins common hematologic disorder
as early as 5 weeks gestation. affects roughly 20% of pregnant
▪ Cervix color women
b. Assessment reveals: pallor, slowed
capillary refill, concave fingernails
(late sign of progressive anemia)
caused by chronic tissue hypoxia
A. CARDIOVASCULAR SYSTEM and constipation
1. At 3rd months, there is an increase in
blood volume of 30-50% (around 1500
ml) which contributes to increased
✓ Nutritional instruction- increased iron in the
cardiac workload. Blood volume is
diet
increased to meet the development
✓ Parenteral iron thru z- tract method if not
needs of the fetus. This increase
given properly hematoma formation may
further with multiple pregnancies.
occur
2. Mother feels fatigue (lassitude)
✓ Oral iron supplements (ferrous sulfate 0.3g,
3. Slightly hypertrophy of ventricles
3x a day) best given 1 hour before meals or
4. Heart rate increases 10-15 beats per
with empty stomach for better absorption,
minute in the letter half of pregnancy
however can lead to git irritation, hence,
5. Palpitation is also common due to
given on full stomach but with vitamin c to
stimulation of the sympathetic nervous
enhance absorption.
system
2
with the management of pregnancy, parturition • KMC or Kangaroo mother care
(labor and delivery) and puerperium (the sixth • Breast feeding practice intensified.
weeks following childbirth)
• Biochemical, Physiological and Anatomic
PRIMITIVE PERIOD changes
• Woman in labor gives birth in squatting
position or sit in special birth stool A. Organic Changes
• Killing of baby is practiced Uterus – hypertrophy and dilatation
• Child is not considered a person with soul 1. Non-pregnant uterus – almost solid with
until he receives a name and presented to 10ml cavity
spirit ▪ Pregnant uterus - becomes thin- walled
and enlarged to accommodate fetus,
ANCIENT TIME (ANCIENT EGYPT) placenta, amniotic fluid
• Egyptians are considered to be the 2. Total volume of uterine contents at term
founders of medicine averages about 5 liters to as much as 10
• Children were valued highly, and infanticide liters or more which is 500-1000 times its
was not allowed by the law during this time non- pregnant capacity
• Practice of medicine was more 3. Non-pregnant uterus weights about 70
sophisticated – Forceps, cs, podalic version grams
was already practiced during this period. ▪ Term Pregnancy – 1100 gram
4. Pregnancy- hypertrophy/enlargement of
ANCIENT INDIA muscle fibers and to a limited degree and
• Hippocrates was considered the “father of due to estrogen and progesterone.
medicine” 5. Uterine walls become thicker during few
• Soranus of Ephesus was considered the months then become thin as 1.5 cm at term
“father of Obstetric” this allows movement of the fetal
extremities and facilitate palpation of fetal
MIDDLE AGE parts abdominally by Leopold’s manuever.
• Lying- in hospital are already available
• Midwives are considered attendants of
normal delivery
• Doctors attend complicated deliveries
SIZE
• Wet nursing or breast feeding was
1. By the end of the 12th week gestation, the
practiced
uterus has grown too large to remain in the
pelvis, so it rises up to the abdomine cavity
PRESENT TRENDS
• Prenatal care are practice
SHAPE
• Husband and wife are encouraged to share
• Pear shape-globular to ovoid from 1 weeks
in child-bearing experience
until term
• Rooming-in and mother-baby friendly
Note: increase of fundic height is an
hospital starts
1
, Important sign of fetal growth and wellbeing. 6. Blood pressure may drop slightly in
• 12 weeks - fundus can already be palpated second trimester
as it rises out of the pelvic cavity 7. Supine hypotension syndrome: in
supine position weight of enlarged
• At the level of symphysis pubis uterus obstructs vena cava, which
▪ 1 weeks - halfway between symphisis decreases blood return to heart
pubis and umbilicus. therefore decreasing cardiac output
▪ 20 weeks - at the level of umbilicus. resulting to hypotension,
▪ 2 weeks - two fingers above umbilicus. lightheadedness, faintness and
▪ 2-3 weeks - midway between umbilicus palpitations.
and xyphoid process. 8. White blood cells, fibrinogen and other
▪ 32-3 weeks - two finger below the clotting factors increases.
xiphoid process. 9. PHYSIOLOGIC ANEMIA
▪ Weeks - two fingers below umbilicus, a. occurs as a result of hemodilution
drops at 3 weeks level of the blood.
▪ Weeks- two fingers below umbilicus, b. There is 45-50% increase in blood
drops at 3 weeks level because of volume expansion, of which about
lightening. 75% is plasma and 25% is RBC.
▪ Isthmus – narrow portion of the uterus c. Normal values in pregnancy
that joins the connective tissue of the ✓ Hct. 32 – 42%
cervix to the muscle fibers of the body ✓ Hgb. : 10.5 – 14 g/L
of the uterus. 10. PATHOLOGIC ANEMIA
▪ Hegar’s sign – refers to the softening of a. Iron deficiency anemia – most
the lower uterine segment the begins common hematologic disorder
as early as 5 weeks gestation. affects roughly 20% of pregnant
▪ Cervix color women
b. Assessment reveals: pallor, slowed
capillary refill, concave fingernails
(late sign of progressive anemia)
caused by chronic tissue hypoxia
A. CARDIOVASCULAR SYSTEM and constipation
1. At 3rd months, there is an increase in
blood volume of 30-50% (around 1500
ml) which contributes to increased
✓ Nutritional instruction- increased iron in the
cardiac workload. Blood volume is
diet
increased to meet the development
✓ Parenteral iron thru z- tract method if not
needs of the fetus. This increase
given properly hematoma formation may
further with multiple pregnancies.
occur
2. Mother feels fatigue (lassitude)
✓ Oral iron supplements (ferrous sulfate 0.3g,
3. Slightly hypertrophy of ventricles
3x a day) best given 1 hour before meals or
4. Heart rate increases 10-15 beats per
with empty stomach for better absorption,
minute in the letter half of pregnancy
however can lead to git irritation, hence,
5. Palpitation is also common due to
given on full stomach but with vitamin c to
stimulation of the sympathetic nervous
enhance absorption.
system
2
