A reference hand-book for nursesBeck, Amanda K. (Amanda Kathryn)
Science
A reference hand-book for nurses
Beck, Amanda K. (Amanda Kathryn)
Nursing
=Placenta.=—The “after-birth” is a spongy cavernous organ and has a
circumference of from 20 to 24 inches. It is made up of two elements,
fetal and maternal, chiefly the former. The fetal surface, to which
the umbilical cord is attached, is formed by the amnion. External to
the latter is the chorionic tissue, consisting mainly of finger-like
processes of villi, many of which extend to the decidua. These villi
are mostly vascularized. The vascular villus is made of a capillary
loop, lying embedded in a connective tissue, the blood-vessels being
derived from the umbilical vessels. The villi are surrounded by
maternal blood, which circulates in the intervillous spaces. The
maternal part is represented by the decidua serotina. Its surface is
rough and irregular, being broken up into segments or cotyledons. It
is made of two layers: (_a_) The deep or spongy layer, and (_b_) the
compact, or layer to which the villi are attached. The decidua serotina
contains large cavities or sinuses, which are formed by a dilation
of the blood-vessels in the wall of the uterus. They communicate
with the intervillous spaces of the placenta, and it is through the
maternal blood circulating in them that nutriment is conveyed to the
fetus through the medium of the villi. An interchange takes place
between the fetal and maternal bloodstreams, though, of course, there
is no direct continuity between them. The placenta thus has a two-fold
function in acting both as an organ of circulation and of respiration.
It is through the walls of the villi that this interchange of gases
and fluids takes place; nourishment and oxygen passing through them to
the fetus, and carbonic-acid gas and waste materials passing through
them to the mother. There is no direct communication between the fetal
and the maternal blood. The placenta, normally, is attached to the
contractile part of the uterus, and on its separation the blood-vessels
are closed by the contractions of the uterine wall. The placenta may
be divided into two or more portions, or one or more of its cotyledons
may be detached from the rest of the organ and have their own vascular
supply. The importance of this lies in the fact that after the placenta
is expelled these isolated masses may be left and give rise to
hemorrhage or blood-poisoning.
SYMPTOMS OF PREGNANCY.
=Suppression of the Menses.=—The cessation of the periods may be due
to other causes, but it is usually the first indication of pregnancy.
Conception may take place and menstruation yet continue. It usually
occurs but once or twice, and then only where conception took place
immediately before an expected period.
=Morning Sickness.=—Nausea and vomiting continued for any length of
time is almost a certain sign of pregnancy. It may begin as soon as
conception takes place and last for many months; sometimes it may occur
toward the end of pregnancy, or occasionally not at all.
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