Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
8. Weight five to eight pounds. 8. Weight less than five
pounds.
9. Cartilage in ear well
developed.
10. Navel in middle of body.
11. Testes have descended in the
male, and the labia majora in
the female usually cover the
labia minora.
12. Moves and cries vigorously when
born.
=The Fœtal Circulation.=—The placenta is an organ of nutrition as well
as respiration, and through the umbilical vessels the food materials are
brought to the fœtus and the waste products removed.
Surrounded by the jelly of Wharton that fills out the cord, and running
in and out between the two arteries, the umbilical vein passes into the
fœtal abdomen and divides into two branches, one, the larger,
short-circuits directly into the inferior vena cava. This branch is
called the ductus venosus. The other joins the portal vein and passes
through the liver, after which it also enters the vena cava.
Thus the heart is fed with a mixed blood, part coming fresh from the
placenta and part coming up from the lower half of the fœtus. This blood
is poured into the right auricle, where it becomes mixed again with the
blood coming down from the upper pole of the fœtus through the superior
vena cava.
[Illustration: Fig. 23.—The fœtal circulation. (Edgar.)]
Now a small part goes down into the right ventricle and is forced into
the pulmonary arteries to supply the lungs. But the lungs are not
functionating, hence the greater part is again short-circuited through
the ductus arteriosus into the arch of the aorta, where it meets with
the great volume of blood which passed over into the left auricle
through the hole in the septum between the right and left auricles,
called the _foramen ovale_, thence down into the left ventricle and out
through the aorta to supply the rest of the fœtal body.
With the exception of the ductus venosus and the ductus arteriosus and
the foramen ovale, the circulation is the same as in the adult.
The blood in the descending aorta again divides and part goes on to
supply the lower extremities while the greater part leaves the internal
iliac arteries by means of the hypogastric vessels and returns through
the umbilical arteries to the placenta for oxygenation.
As soon as the child is born, the fœtal structures are altered. The
child breathes, the pulmonary circulation is established and the ductus
arteriosus is closed. The placental circulation is abolished, and the
ductus venosus and the hypogastric arteries are converted into solid
fibrous cords. Owing to the immediate change of pressure in the
auricles, the foramen ovale closes and the circulation assumes the adult
type.
CHAPTER III
NORMAL PREGNANCY
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