9. foetal growth and development 3 (workbook)

Question 1

which is the fastest developing organ in the foetus and infant?

Answer 1

brain

Question 2

how much of the body weight does the brain account for?

Answer 2

12% at birth

falling to around 2% in adults

Question 3

what are the important changes that occur during foetal period to the brain structurally and functionally?

Answer 3

1. cerebral hemisphere becomes largest part of brain
2. histological differentiation of cortex in cerebrum and cerebellum
3. formation and myelination of nuclei and tracts
4. relative growth of the spinal cord and vetebral column

Question 4

what happens to allow for cerebral hemisphere to become largest part of the brain?

Answer 4

gyri and sulci form after 5 months as the brain grows faster than the head

Question 5

when do hearing and taste mature?

Answer 5

before vision

Question 6

when are the organ of corti and retina developed?

Answer 6

organ of corti (inner ear): at 5 months

retina: immature at birth

Question 7

when are foetal movements seen and felt?

Answer 7

seen at 8 weeks (ultrasound)

felt at 17 weeks

Question 8

what are the 4 features of foetal development of clinical importance?

Answer 8

1. foetal movements (quickening)
2. viability
3. SENSory awareness e.g. pain, sound
4. maternal / neonatal nutrition and cortical development

Question 9

what are foetal movements known as?

Answer 9

quickening

Question 10

what is viability?

Answer 10

is the brain sufficiently mature to control body functions e.g. breathing

Question 11

what is foetal waste excreted ultimately by?

Answer 11

the placenta

Question 12

what us the functional foetal kidney?

Answer 12

metanephros

Question 13

what happens to the metanephros at around 10 weeks?

Answer 13

ascent is complete and function begins

kidneys have lobulated form, until 4-5 years

Question 14

what is present at 10 weeks of the kidneys?

Answer 14

glomeruli and some tubules

Question 15

what is present at 23 weeks of the kidneys?

Answer 15

renal pelvis

renal calyces

Question 16

what happens by 8 months to the kidneys?

Answer 16

histological differentiation of cortex and medulla is almost complete

Question 17

where does the bladder lie in foetus and infants?

Answer 17

in abdominal cavity

Question 18

where does urine entering the bladder empty into in foetus?

Answer 18

urine enters the bladder and is emptied into the amniotic fluid, to be swallowed by the foetus

Question 19

what is the rate at which foetal bladder empties?

Answer 19

every 40-60mins

can be seen on ultrasound scans

Question 20

what is the rate of foetal bladder emptying used for?

Answer 20

used clinically to assess foetal urinary function

Question 21

what is the foetal circulation adapted to do?

Answer 21

to bring oxygenated blood from the placenta to the foetus via umbilical vessels

Question 22

what do the foetal lungs receive in terms of CVS?

Answer 22

the foetal lungs receive only the blood needed to sustain their own growth and development

Question 23

what changes at birth to the CVS?

Answer 23

rapid and profound changes take place in the circulation at birth, related to the onset of air breathing

Question 24

how can foetal growth and development be assessed?

Answer 24

via a range of tests that monitor changes in anatomical and physiological parameters

Question 25

what are the tests that can be done to assess foetal growth and development?

Answer 25

1. ultrasound
2. doppler ultrasound
3. non-stress test (NST)
4. biophysical profiles (BPP)
5. vibroacoustic stimulation
6. contraction stress tests
7. foetal movements kick-chart

Question 26

what do non-stress tests (NST) monitor?

Answer 26

monitors heart rate changes associated with foetal movement

Question 27

what do vibroacoustic stimulations monitor?

Answer 27

foetal heart rate change

Question 28

what do biophysical profiles (BPP) consist of>

Answer 28

5 variables to be measured

Question 29

what do the tests done in utero indicate?

Answer 29

foetal organ system development and functionality

Question 30

how does foetal weight change during the embryonic and foetal period?

Answer 30

slow weight gain in embryonic period

increases rapidly in foetal period

Question 31

initially, what accounts for most of the weight gain in the foetal period?

Answer 31

protein

Question 32

when does foetal weight gain change?

Answer 32

after 28 weeks, foetal adipose tissue is laid down in subcutaneous and abdominal stores
(from protein prior to 28 weeks of foetal period)

Question 33

when is a foetus regarded as having ‘growth restriction’?

Answer 33

if his / her estimated weight is below the 10th percentile for his gestational age

Question 34

depending on the cause a foetus with growth restriction may be compromised in what?

Answer 34

the uterine environment and require closer monitoring in order to allow the continuation of the pregnancy to term

Question 35

what are the 2 main types of growth restriction?

Answer 35

1. symmetrical

2. asymmetrical

Question 36

what is symmetrical growth restriction?

Answer 36

growth restriction is generalised and proportional

Question 37

what is asymmetrical growth restriction?

Answer 37

abdominal growth lags

there is relative sparing of head growth

Question 38

when does asymmetrical growth restriction tend to occur?

Answer 38

in the last part of pregnancy when maternal, foetal or utero-placental factors cause some deprivation of nutritional and oxygen supply to the foetus