WEEK ONE
In the first week, you have just conceived your new bundle of joy. Whether you’ve been trying for some time to become pregnant or you’ve just stumbled into motherhood, this first week is when the egg and the sperm have finally finished their dance and united to be ready to make a baby.
The development of baby
The baby is called a blastocyst at this point
Is about 0.1- 0.2 millimeters in diameter
Starts dividing and replicating cells
The development of mom
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The body produces that EPF protein that works to protect the newlyforming baby from being attacked by others cells in your body
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Mom might have some implantation bleeding•
Mom might feel a little pain during the implantationWhat baby is feeling
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Baby is just a bundle of newly dividing cells right now and has notbegun to form any recognizable body systems
What mom is feeling
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Most moms aren’t feeling anything at this time.•
The hormones are beginning to increase, but there probably isn’t anoticeable difference in mood or behavior
Special needs for the week
If you are planning to become pregnant or think that you might have a chance at being pregnant, it’s a good idea to start taking folic acid supplement.
These supplements have been proven to prevent birth defects in babies Special concerns during this week If you’re planning on becoming pregnant, you will want to start eating more healthfully and getting daily exercise.
Special tip for mom
If you think that you might be pregnant, a home pregnancy test can confirm it as early as two weeks after conception.
INDICATED LABOR INDUCTION.
Induction is indicated when the benefits to either the mother or the fetus outweigh those of continuing the pregnancy. Indications include emergent conditions such as ruptured membranes withchorioamnionitis or severe preeclampsia. More common indications include membrane rupture without labor, hypertension,nonreassuring fetal status, and postterm.
Induction for
postterm or prolonged pregnancy is discussed in Chapter 37). Many clinicians consider this diagnosis especially at 41 weeks, to be within the normal range of term gestation and that induction of such women is considered elective. This belief is due in part to definitions and methods used to support this diagnosis. For example, in a randomized trial,Bennett and associates (2004) reported that
combined first and second-trimester ultrasound examination pregnancy dating,compared with a single second-trimester screening examination, reduced the number of women attaining 41 weeks to 6.7 from 16.3 percent. Savitz and colleagues (2002) described a systematic tendency to overstate gestational age from the last menstrual period compared with that from early ultrasound examination 12.1 percent versus 3.4 percent,
respectively
This overstatement most likely reflected delayed ovulation. Menticoglou and Hall (2002) present an elegant and compelling analysis to refute routine induction at 41 weeks as a "nonsensus consensus" and as a "rescue from normalcy."
Although induction is widely practiced for suspected fetal macrosomia, there is little evidence that it is of benefit. Sanchez- Ramos and colleagues (2002) conducted a meta-analysis of observational studies in which women with suspected fetal macrosomia were managed expectantly or underwent labor induction. Perinatal outcomes were similar, however, the cesarean delivery rate was significantly lower with expectant management compared with that of induction 8.4 versus 16.6 percent.
Women whose labor is induced have an increased incidence of chorioamnionitis and cesarean delivery compared with those in spontaneous labor. In many cases, it seems that the uterus is simply poorly prepared for labor. One example is an "unripe
It is also likely that the increase in cesarean deliveries associated with induction is influenced by the duration of the
induction attempt, especially in the circumstance of an unfavorable cervix (Rouse and colleagues, 2000). The duration for
either labor induction or augmentation and successful delivery has received too little attention. More precise data are needed
to understand the wide range of individual management. For example, Garcia and associates (2001), after adjustment for case mix, reported that cesarean births were significantly lower at academic medical centers (odds ratio 0.66) compared with those at community hospitals. Doyle and colleagues (2002) reported that cesarean deliveries in a community hospital were twice that of a county hospital. There are other factors too. For example, Bland and co-workers (2001) observed a significant decrease in elective induction with a change from
individual practitioner billing to revenue sharing.
Cesarean birth is associated with markedly increased common and uncommon maternal infectious morbidities (Goepfert and colleagues, 2001). These morbidities are further increased in women with overt chorioamnionitis. The need for emergent hysterectomy also is increased. Shellhaas and associates (2001), from the Maternal-Fetal Units Network, reported 146 emergent cesarean hysterectomies amongst 136,948 deliveries about 1 per 1000 vaginal deliveries versus 1 per ۲۰۰ cesarean deliveries. Importantly, 41 percent of
hysterectomies followed primary cesarean delivery. Uterine atony was the
indication for one third of all cesarean hysterectomies, and thisindication was more prevalent in women with induced or
augmented labor, or in those with chorioamnionitis. Kastner and colleagues (2002) reported similar findings.
