Obstetrics for NursesReed, Charles B. (Charles Bert)
Science
Obstetrics for Nurses
Reed, Charles B. (Charles Bert)
Maternity nursing
The entire body participates in the changes brought about by pregnancy.
The hips and breasts become fuller, the back broadens, and the woman
puts on fat. She becomes mature in appearance, but, of course, the
phenomena connected with alterations in the breasts and genitals are
most important, and late in pregnancy, most conspicuous.
The uterus exhibits the most marked alteration. From an organ that
weighs two ounces, it becomes the largest in the body, and increases in
size from two and one-half or three inches to fifteen inches. The
typical pear-shape becomes spheroidal near the end of the third month,
becomes pyriform again at the fifth month, and continues thus until
term.
Up to the fourth month the walls become thicker, heavier and more
muscular, but as pregnancy advances, more and more tissue is demanded,
until at the end, a muscle wall of only moderate thickness protects the
ovum. Meanwhile the muscular functions of contractibility and
irritability are greatly increased.
At the fourth month the womb, which has occupied a position of
anteversion against the bladder, rises out of the pelvis. It is now an
abdominal organ and as it gets heavier and heavier, it rests a certain
amount of its bulk on the brim of the pelvis. About the sixth month, the
uppermost part of the uterus (fundus) is at the level of the umbilicus.
At the eighth month, the fundus is found a little more than midway
between the umbilicus and the ensiform cartilage. About two weeks before
term, it reaches its highest point, the ensiform cartilage, and then
sometimes sinks a little lower in the abdomen.
The ovum, or egg, does not completely fill the uterine cavity at first,
but grows from its side like a fungus until the third month. Then the
uterine cavity is entirely occupied and thereafter the egg and the
uterus develop at an equal rate. As the uterus rises in the abdomen, it
rotates to one side, usually the right, forward on its vertical axis.
[Illustration: Fig. 24.—Gravid uterus at the end of the eighth week.
(Braune.)]
The blood vessels and lymphatics also increase in size, number, and
tortuosity. Many of the veins become sinuses as large as the little
finger. This increased amount of fluid both within and without the
uterus has a marked effect upon its consistency. The walls of the
uterus, vagina, and cervix become softened, infiltrated and more
distensible. There is also an increase in size and in number of the
muscle cells.
During pregnancy the uterine muscle exhibits a definite functional
activity. Intermittent contractions occur, feeble at first, but growing
markedly stronger as pregnancy advances. These are the contractions of
Braxton Hicks. They are irregular and painless, but can be felt by the
examining hand. At term they merge into, and are lost in, the regular,
painful contractions of labor.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account