Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her BabyVan Blarcom, Carolyn Conant
Science
Obstetrical Nursing: A Text-Book on the Nursing Care of the Expectant Mother, the Woman in Labor, the Young Mother and Her Baby
Van Blarcom, Carolyn Conant
Infants -- Care; Maternity nursing; Pregnancy
As the ductus venosus and hypogastric arteries terminate in blind ends
and become useless as soon as the umbilical cord is cut, they soon begin
to atrophy and are obliterated within a few days after birth. This means
that less blood is poured into the right auricle, which naturally
results in relatively less tension in the right heart and an increased
pressure in the left, which tends to close the foramen ovale. The
foramen ovale does not entirely disappear at once, however, but closes
gradually, sometimes remaining open for months. Occasionally it remains
open permanently, and though some people have gone through life
comfortably with a patent foramen ovale, its ultimate failure to close
usually results in serious circulatory trouble. This is also true of the
ductus arteriosus, which sometimes, but not often, fails to close.
The rule is that as the lungs expand and an increased amount of blood is
carried to them for aëration, the ductus arteriosus deflects a steadily
diminishing stream from the right ventricle to the arch of the aorta.
Thus it gradually ceases functioning in most cases and disappears in the
course of a few weeks. The abandoned vessels may degenerate and
disappear in time or they may persist in the form of small fibrous
cords. (Fig. 29.)
Although the circulatory system shows the most elaborate adjustments to
the protection afforded by intra-uterine life, there are also other
adaptations made by the fetal organism.
The baby acquires about 90 per cent of its weight during the latter half
of pregnancy, as well as a steadily increasing proportion of solids and
a decrease of fluids in its tissues, for in its early days the embryo
consists largely of water. But for all of that, its existence and growth
in utero, and the functioning of its heat producing centre require
surprisingly little oxygen and nourishment. The amniotic fluid keeps the
fetus at an equable temperature, about 1° above that of the mother, and
as space within the uterine cavity permits of only limited movement,
there is very little combustion for the liberation of heat and energy.
=The kidneys= assume functional form at a very early fetal age, probably
about the seventh week, and the presence of albumen and urea in the
amniotic fluid suggest that small amounts of urine may be voided,
particularly during the latter part of pregnancy.
=The bowels=, on the other hand, are normally inactive, this is in spite
of the fact that the baby evidently obtains fluid, and possibly some
nutriment by swallowing amniotic fluid. But a discharge of meconium may
be caused by pressure on the cord or by any condition which interferes
with the umbilical circulation. For this reason, meconium stained fluid
escaping during labor in a head presentation may be taken as an evidence
of imminent asphyxiation, due to an interruption of the umbilical
circulation.
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