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2 To do this: the body must be able to recognize the its own antigens as self and all other anti

gens as non-self . 3 the foreign antigens of the developing fetus and the placenta come into direct c ontact with cells of the maternal immune system, but do not trigger the typical tissue rejection response seen with organ transplants. > Overall regulation of then immune system is altered during pregnancy: autoimmu ne disease rheumatoid arthritis becomes less severe when pregnant 4 Medawar & Billingham, Nature, 1953 SEARCH ABOUT THIS WHETHER STILL BELIEVED OR N OT 5 Five possible mechanisms could explain why the fetus isn t attacked by the mother s immune system: 7 Delivery of the baby and placenta are brought about by a series of strong, rhyth mic uterine contractions 8 Explain the 5 P's of labor EXPLAIN AT LATER SLIDES 9 Cardinal Movements: SEARCH ABOUT THIS Also called the mechanisms of labor . A series of adaptations the fetus makes as it moves through the maternal bony pe lvis during the process of labor & birth. Influenced by the size and position of the fetus, the powers of labor, the size and shape of the maternal pelvis, and the mother s position. > How do you know a child's estimated birth date? 10 Premonitory signs of labor: SEARCH ABOUT THIS 11 Explain positive feedback in labor 13 Explain Dilation of Cervix 14 Prior to the beginning of labor, the thick cartilage walls of the cervix begin t o thin out and lengthen. This process is called effacement. The cervix must be completely effaced in order to fully dilate. 15 Dilation is said to be complete when the cervix has dilated to 10cm. 16 Explain Expulsion or delivery of baby 17 In the second stage of parturition, the baby is expelled from the womb through t he vagina by both the uterine contractions and by the additional maternal effort s of pushing or "bearing down". When the head is first visible, it is called cro wning . 18 The "sutures" or anatomical lines where the bony plates of the skull join togeth er can be easily felt in the newborn infant. The diamond shaped spaces on the to p, top back, and sides of the skull are often referred to as the "soft spot" in young infants correctly known as fontanels (fontanels). 19 The fontanels actually allow the skull to change to a new shape, so it can emer ge through the small cervical opening. This is called molding of the head. This ch ange in the shape of the skull will go back to it s original appearance in a few h ours up to a few days. 20

Explain Delivery of the Placenta 22 Happened in "Three Idiots" 24-30 (Give prizes no?) Contractions are irregular. False because Contractions are at regular intervals. Intervals between contractions gradually shorten. True Contractions increase in duration and intensity. True Discomfort is usually in abdomen. False because Discomfort begins in back and ra diates around to abdomen. Intensity usually increases with change in activity. True Cervical dilation and effacement are progressive. True Rest and warm tub lessen contractions. False because Contractions do not decreas e with rest or warm tub bath. 31 Psyche (maternal psychological status) uterine contraction pain evokes a generalised neuroendocrine stress response prod ucing widespread physiological effects during the first stage of labour. They in clude increased oxygen consumption, hyperventilation and respiratory alkalosis; increased cardiac output, systemic peripheral resistance and blood pressure; del ayed gastric emptying; impaired uterine contractility and diminished uterine per fusion; and metabolic academia. While other factors (such as anxiety, starvation and physical exertion) are also partly responsible for inducing some of these e ffects, pain appears to be the most potent source because they are all obtund by effective epidural analgesia. 32 The hormone oxytocin that started the process of childbirth has several other ef fects on the body. 33 Stimulus: When a baby suckles at the breast nerve stimuli are sent from the spec ial receptor cells in the breast to the hypothalamus 34 Why is lactation important?