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Reasons the birth rate has declined: Contraceptive methods, Women delaying reproductive, Costof children , Covid us birth decline
•For Age 40 +: Birth rate INC
•What are some significant changes in the approach to labor & birth: Advances in
technology,medicine, nursing, Individual desires of couples
● Home birth → hospital (1900 5% hospital, 1930’s 75% hospital, 1980’s hospital
birthing suits)
● Induction of labor ↑
● Cesarean deliveries
○ (ideal rate for C-section births between 10% to 15%...reports > 31% of all
deliveries (US) were C-section 2018)
○ (CDC and Prevention provisional data from 2019 show that 31.7% of all
births were by cesarean and 25.6% of the NTSV ("low-risk") population
had cesarean births.)
○ Hospital is considered an independent risk factor for a cesarean birth
● Maternal morbidity and mortality
● Age of mother
•Infant mortality – definition
● The Birth rate has INC
•INC in preterm births →what gestational age has increased in numbers
•Most important predictors of an infant’s health & survival at birth is gestational age and birth
weight at delivery.
What organization sets forth the standards & guidelines for Perinatal Nursing Practice
• Fetus is most vulnerable to teratogens…
● First 8 weeks during period of organogenesis
● Timing: when does an embryo become a fetus? Week 9 (organ systems grow)
•Anatomy & physiology of Umbilical Cord: AVA: Umbilical vein 1(oxygenated) & Umbilical
arteries 2 (deoxygenated)
Fetal Circulation
● Ductus venosus: connects umbilical vein to inferior vena cava (allows highly oxygenated
blood into right atrium)
● Foramen ovale:opening between right and left atria. Blood high in oxygen is shunted into
left atrium to be distributed to body /BYPASSES LUNGS
, ● Ductus arteriosus: connects pulmonary artery with descending aorta
● Blood enters the right atrium, the chamber on the upper right side of the heart. When the
blood enters the right atrium, most of it flows through the foramen ovale into the left
atrium.
● Blood then passes into the left ventricle (lower chamber of the heart) and then to the
aorta, (the large artery coming from the heart).
● From the aorta, blood is sent to the heart muscle itself in addition to the brain.
●
●
● After circulating there, the blood returns to the right atrium of the heart through the
superior vena cava. About two thirds of the blood will pass through the foramen ovale as
described above, but the remaining one third will pass into the right ventricle, toward the
lungs.
● In the fetus, the placenta does the work of breathing instead of the lungs. As a result, only
a small amount of the blood continues on to the lungs. Most of this blood is bypassed or
shunted away from the lungs through the ductus arteriosus to the aorta. Most of the
circulation to the lower body is supplied by blood passing through the ductus arteriosus
● The decrease in pulmonary vascular resistance causes an increase in pulmonary blood
flow, and the increase in systemic vascular resistance influences the cardiovascular
changes.
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