Chapter 3 Flashcards
3 periods of prenatal development
germinal
embryo
fetus
how long is the germinal period?
2 weeks; most people do not know they are pregnant during this time
implantation
the blastocyst burrows deep into the uterine lining
occurs during the 7th and 9th days
amnion
membrane that encloses the zygote in amniotic fluid
chorion
surrounds the amnion to make blood vessels
placenta
provides:
- nutrients
- oxygen
- antibodies
takes away:
- waste products
umbilical cord
connected to the placenta and organism, one large vein that delivers blood w/ nutrients and two arteries to remove waste
embryo
from weeks 3-8
most rapid prenatal changes take place, groundwork laid out for all body structures and internal organs
3 layers of cells formed during the embryo stage
ectoderm (nervous system and skin)
mesoderm (muscles, skeleton, circulatory system)
endoderm (digestive system, lungs, urinary tract, glands)
what can the organism do at the end of the embryo period?
sense its world/respond to touch!
fetus
from week 9-end of pregnancy
longest prenatal period, known as the “growth and furnishing” phase the organism increases rapidly in size
vernix
protecting the skin from chapping during the months in fluid
lanugo
white, downy hair helps the vernix stick to the skin
age of viability
the point at which the baby can first survive outside the womb
around 22-26 weeks
fetuses in the third trimester can
remember for a brief period of time
teratogen
any environmental agent that causes damage during the prenatal periods
factors that impact teratogens
dose
heredity
other negative influences
age
relationship with teratogens and prenatal stages
germinal = rarely any impact
embryo = where serious deficits are most likely to occur
fetus = minor damage
thalidomide during pregnancy
sedative offered during the 1960s that resulted in deformities of limbs
diethylstilbestrol (DES) during pregnancy
prescribed to prevent miscarriages but fetuses were at a high risk of vaginal cancers, malformations of uterus and infertility later in life
isotretinoin during pregnancy
prescribed to treat acne but if pregnant caused eye, ear, skull and brain damage to fetus
aspirin during pregnancy
when taken during pregnancy, can lead to brain damage and impaired motor skills
caffeine during pregnancy
high doses when pregnant can lead to low birth weight
what happens if women use drugs (cocaine, heroin) when pregnant?
lead to low birth weight, brain abnormalities, premature birth and, when born, are addicted to these substances
smoking while pregnant
restricts veins so nutrients cannot flow fully to organism
causes low birth weight or sometimes other abnormalities
fetal alcohol syndrome (FAS)
slow physical growth
pattern of three facial abnormalities (short eyelid openings, thin upper lip, indentation from nose to upper lip)
brain injury (evident in small head size and impairment in three areas of function)
partial fetal alcohol syndrome (p-FAS)
2/3 facial abnormalities
brain injury, evident in three areas of function
alcohol-related neurodevelopmental disorder (ARND)
at least three areas of mental functioning are impaired
FASD characteristics in early adulthood
attention deficits
poor school performance
trouble w/ law
inappropriate behaviors
mental health issues
what nationality has a higher rate of children with FASD
native americans
what acid is recommended that pregnant women take 0.4 milligrams a day?
folic
Rh factor incompatibility
if the mother is Rh- and the father is Rh+, the baby may inherit the + blood type. If any of the fetus’s blood crosses over the placenta to the mother, the mother’s body will start to produce antibodies against the fetus. If the antibodies come in contact with fetus, it can lead to reduction of oxygen supply to organs and tissues
preeclampsia
when bp increases sharply, causing swelling in the mother as well as risk for fetal death
stages of childbirth
dilation and effacement of the cervix
- longest stage, contractions occur
delivery of the baby
- shorter, push with strong contractions
delivery of the placenta
- shortest
what scale is used to quickly assess a newborns physical condition?
the Apgar scale
Apgar scale
a - appearance (pink is ideal)
p - pulse (100-140 bpm)
g - grimace/reflexes (strong)
a - activity/muscle tone (very active)
r - respiration (strong breathing and crying)
scoring of Apgar
7: best
4-6: needs assistance
3 or lower: infant needs immediate attention
natural/prepared childbirth
techniques aimed at reducing pain and medical intervention and making childbirth a rewarding experience
3 activities in natural childbirth program
classes
relaxation and breathing techniques
labor coach
anoxia
inadequate oxygen supply
breech position
butt or feet would be delivered first instead of the fetus’s head
analgesics vs. anesthetics
ana - less strong to relieve mother’s pain
ane - stronger, block pain
cesarean delivery
surgical birth
incision is made in mother’s abdomen and pulls baby out
what is the rule with cesareans?
once a cesarean, always a cesarean
once you have a c-section, all of the following pregnancies will be c-sections to protect the safety of mother and child
do preterm infants or small-to-date infants usually have more problems down the line?
small-to-date
appearance and behavior of preterm babies can lead parents to be…
less sensitive in caring for them
isolette
special plexiglas-enclosed bed to care for preterm babies
reflex
inborn, automatic response to a particular form of stimulation
rooting
when infant turns toward cheek stimulation
helps infant find nipple
moro
hold infant horizontally and make noise to see infant reach for parent
palmar grasp
place finger in infant palm and they will grasp it
tonic neck
turn infants head to the side while laying awake on back, displaying “fencing position”
babinski
stroke foot from heel to toe, infant will curl toes if healthy, fan if there is an underlying problem
which country (1-39) has the lowest infant mortality rates per 1000 live births?
Japan
which country (1-39) has the highest infant mortality rates per 1000 live births?
US
states of arousal
degrees of sleep and wakefulness
REM vs. non-REM sleep
REM - similar brain waves when compared to awake state, active body movements, more time spent here, vital for growth
non-REM - motionless body, slow brain waves
SIDS
sudden infant death syndrome
unexpected death of an infant under the age of 1
visual acuity
fineness of discrimination in the eyes
infants cannot focus their eyes well and have limited visual acuity
Neonatal Behavioral Assessment Scale (NBAS)
evaluates newborn’s reflexes, muscle tone, state changes, and responsiveness to physical and social stimuli
questions to ask when having a baby
- who can be with me during birth?
- what happens during a normal birth?
- how do you allow cultures/beliefs?
- can I walk during labor/positions?
- normal labor?
- how to stay comfy?
- what happens if baby arrives early?
- position on circumcision?
- how do you help breastfeeding?
- how to help things go smoothly?
ob/gyn
any risk level
hospital
high intervention rate
family practitioner
low-moderate risk
hospital
Traditional midwife
low risk
person-centered
home births
low intervention rate
CNM (certified nurse midwife)
low risk
birthing center/home
person-centered
low intervention rate
issues surrounding birth
safety
control
intervention
- drugs
- surgical intervention
- episiotomy
- c-section
midwife model of care
based on how pregnancy and birth are normal life events
doula
provide support, don’t catch baby but instead support mother!! (get water, housekeeping, information, etc.)
triple screen or quad screen
- noninvasive
- 15-22 weeks
- looks for AFP, HCG, uE3 and inhibin-A
- take blood from mother’s arm and look at chemicals
CVS
- invasive
- needle put through abdomen, remove cells from membrane surrounding fetus, really active in mitosis so quick results
- looking for chromosomal conditions
- higher risk in spontaneous abortion than amniocentesis
Amniocentesis
- invasive
- needle through abdomen, harvest amniotic fluid, not as active in mitosis so slower test results
PUBS
- umbilical cord sample
- rarer: take sample from umbilical cord to look at blood going into fetus
fetascopy
- tiny hammer through cervix, look @ developing fetus
- administered when ultrasound shows problem
PGD/embryo screening
give someone medication to produce more eggs, extract eggs and fertilize to then genetic screening
used for Tay-Sachs: if zygote has it, they discard but if they don’t have it they reimplant it back into mother
ultrasound
11-14 weeks
see if there is increased fluid around fetus’s neck, if so indicate DS
the risk of DS _____ with maternal age
increases
cell-free fetal DNA test
can detect 99% of DS pregnancies
noninvasive
used in high-risk pregnancies
expensive so not used often
____% of pregnancies with DS are terminated in the US while ____% of pregnancies with DS are terminated in Iceland
67; 100
fragile X is a genetic condition that is _____ inherited, and tends to be an issue more for ____.
dominantly; males
