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
=The abdomen= as a whole changes in contour as it steadily enlarges, and
the skin and underlying muscles are somewhat affected as a result. The
tension upon the skin is so great that it may rupture the underlying
elastic layers which later atrophy and thus produce the familiar _striæ_
of pregnancy, known variously as the _striæ gravidarium_ and the _linea
albicantes_. Fresh striæ are pale pink or bluish in color, but after
delivery they take on the silvery, glistening appearance of scar tissue,
which they really are.
In a woman who has borne children, therefore, we find both new and old
striæ; those resulting from former pregnancies being silvery and
shining, while the fresh tears are pink or blue. Striæ may be found also
on the breasts, hips and upper part of the thighs, and as they are of
purely mechanical origin, are not necessarily associated with pregnancy
alone. They may result from a stretching of the skin by ascites, a
marked increase in fat or an abdominal tumor.
The same distension that causes striæ sometimes causes a separation of
the _recti muscles_. This separation, known as _diastasis_, is sometimes
slight but frequently very marked, the space between the muscles being
easily felt through the thinned abdominal wall.
The =umbilicus= is deeply indented during about the first three months
of pregnancy. But during the fourth, fifth and sixth months the pit
grows steadily shallower, and by the seventh month it is level with the
surface. After this it may protrude, in which state it is described as a
“pouting umbilicus.”
The increased pigmentation at the umbilicus and in the median line is
scarcely to be classified among the abdominal changes, as the skin
elsewhere presents the same discolored appearance. The degree of
pigmentation varies with the complexion of the individual, as blondes
may be but slightly tinted while the discolored areas on a brunette may
be dark brown, sometimes almost black.
The changes in the =breasts= during pregnancy were practically all
included in the enumerated signs and symptoms of pregnancy. They
increase in size and firmness and become nodular; the nipple is more
prominent and together with the surrounding areolæ, grows much darker;
the glands of Montgomery are enlarged; the superficial veins grow more
prominent, and after the third month a thin, yellowish fluid can be
expressed from the nipples. This fluid, called _colostrum_, consists
largely of fat, epithelial cells and colostrum corpuscles and differs
from milk, in its yellowish color, and in the fact that it coagulates
like the white of an egg when boiled. The previously quiescent mammary
glands develop very early in pregnancy an ability to select from the
blood stream the necessary materials to produce a secretion. Colostrum
is the product of their activity until about the third day after
delivery, when milk appears.
Public-domain text, read in full here on John Shaqi.
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