Changes of the Reproductive System during Pregnancy (Nursing)

by Jacquelyn McMillian-Bohler

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    00:01 Hello, welcome to a conversation about pregnancy.

    00:05 Today, we're going to talk about the physiological changes of pregnancy.

    00:09 This lays the foundation for everything, we're going to talk about in this course.

    00:13 So, spend some time in this lecture and use it for a reference point, if you ever feel like you're struggling with any of the content.

    00:20 Are you ready? Here we go! We're going to talk about: The reproductive system, we're going to talk about the cardiovascular system, the hematologic system, the endocrine system, the renal system, the gastrointestinal system, the musculoskeletal system, the respiratory system and finally, the integumentary system.

    00:43 So, beginning with reproductive system changes, so, these are the things that go on in the reproductive system, that are going to change as a result of pregnancy.

    00:53 When we think about changes in the breast, the estrogen, also causes changes in the milk ducts.

    00:59 So, let's look at this in detail.

    01:01 As we have an increase in blood supply, we're going to have growth and proliferation of the milk ducts.

    01:07 This is where the milk is going to be produced later on, so, we have to start early.

    01:12 Progesterone causes, specifically the development of the mammary lobes, so, remember estrogen causes growth and proliferation of the milk ducts and progesterone causes development of the mammary lobes.

    01:25 When we think about the areola, that's the dark area around the nipple, this area is going to become enlarged and the pigment is going to change, it's going to be much darker than it is normally.

    01:37 Sometimes, this is a cause for a concern for clients, make sure they know that this is expected.

    01:43 We also may notice something that looks like little pimples, around the nipple.

    01:47 These are called the, “Tubercles of Montgomery.” The function of these tubercles is to supply, sort of, a lubrication for the breast.

    01:54 Remember, the function of the breast is to feed the new-born, so, we want to make sure that area doesn't get dry, so, the tubercles of Montgomery will help with that process.

    02:04 Also, in terms of how the breasts look, they're going to change, so, they may look more transparent, they may have more vessels that are visible superficially.

    02:14 Again, these are things we want to reassure the client about, let them know, these are normal changes.

    02:21 There may be stretch marks that form on the breast as they enlarge and again, this may not be the most fun, but it is normal.

    02:30 This process of milk production starts during the pregnancy.

    02:34 So, not just when the baby arrives.

    02:36 We start the production of colostrum during Lactogenesis I, this happens during the pregnancy.

    02:43 It's important that you know that the lobes are formed, that the alveolar cells start to grow and we also have formation of the milk ducts.

    02:52 Fatty tissue will also help to support breast function.

    02:56 The areola as we mentioned previously, will become dark, the nipple will become more sensitive and often larger as well.

    03:04 It's important that you remind clients, that, although colostrum is produced during pregnancy, it's normal for it to leak out before delivery.

    03:15 Let them know that, and also let them know they will not run out.

    03:19 This is all a part of lactogenesis I.

    03:22 Lactogenesis II, we'll talk about in a later lecture, because that occurs after delivery.

    03:28 Now, let's talk about the uterus.

    03:30 Now, the uterus is prime time, when we talk about reproductive changes.

    03:34 Under the influence of estrogen, the cells proliferate and the uterus grows.

    03:39 Now, because estrogen is present, whether the pregnancy is in the uterus or as in the case of an ectopic outside the uterus, no matter what, the uterus is going to grow and stretch.

    03:49 So, understanding that the uterus grows from the beginning, all the way until the end of pregnancy to create a home for the baby.

    03:58 Let's talk about some other changes that also happen.

    04:01 Because of the increase of blood flow to the uterus, we have softening of the uterus.

    04:06 So, specifically when we speak of the isthmus, which is right above the cervix, that area becomes soft and it has a name it's called “Hegar’s sign.” So, softening of the isthmus is, “Hegar.” So, “High up on the cervix,” is how I remember.

    04:24 “Chadwicks,” is also another sign of pregnancy, but specifically, what's going on, is all that extra blood flow, into the cervix, makes it take on, kind of a bluish color.

    04:35 So, if you place the speculum into the vagina and you open up the blades and you see the cervix, you may notice that it looks a little cyanotic, that seems bad, but it's actually good, it means we have great blood flow, to the cervix, “C for color C for Chadwicks.” Softening of the cervix itself is called, “Goodell’s sign.” So, I remember it by thinking of something being good and soft, you know like a doughnut, right? Get it? Cervix, doughnut? Anyway, so a Goodell sign is when we can feel, how soft the uterus is, under the influence of all of those hormones, as it proliferates and blood flow comes in, it's going to be softer.

    05:18 Within the cervical canal, we have the formation of a mucus plug, also called, “Operculum.” I actually just love saying that, operculum operculum, operculum, it makes me feel really smart.

    05:31 But what it actually is, is a wad of mucus and when it comes out later in pregnancy, it looks like a wad of, well, mucus or snot, which is not really that nice looking, but it is important, because functionally, what it does, is to protect cletus the fetus as they're inside, from all the bacteria they may form, inside the vagina.

    05:50 That's the operculum or mucus plug.

    About the Lecture

    The lecture Changes of the Reproductive System during Pregnancy (Nursing) by Jacquelyn McMillian-Bohler is from the course Physiological Changes in Pregnancy (Nursing).

    Included Quiz Questions

    1. Estrogen
    2. Oxytocin
    3. Human chorionic gonadotropin
    4. Cortisol
    1. Progesterone
    2. Oxytocin
    3. Estrogen
    4. Testosterone
    1. Softening of the isthmus of the uterus
    2. The darkening of the aerolas
    3. The production of colostrum before birth
    4. The blueish tinge of the cervix

    Author of lecture Changes of the Reproductive System during Pregnancy (Nursing)

     Jacquelyn McMillian-Bohler

    Jacquelyn McMillian-Bohler

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