Conception and Fetal Development Flashcards

1
Q

Fertilization occurs when and where?

A

It occurs when there is a union of the nuclei of the sperm and ovum.
Location is in the outer third or ampulla of the fallopian tubes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How long is the ovum fertile for?

How long can sperm survive? Fertile time phrame?

A

24 hours

Sperm can survive for 48-72 hrs.
Sperm are only fertile tho for 24 hrs as well.

(Sperm information contradicts her previous notes from family planning????)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

So when the egg is released from the ovary & taken up into the fallopian tube - how does it move, again?

A

Ciliary movement and current pushes it along

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does the sperm move in order to meet the ovum?

A

Sperm have a tail that helps them move.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How many sperm should penetrate an ovum?

Which is bigger - ovum or sperm?

A

One sperm per ovum typically

The ovum is much bigger.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How is it that only one sperm can enter the ovum?

A

Zonal reaction or ability of the membrane to block other sperm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is conception?

What do the chromosomes do?

A

Formation of the zygote

The chromosomes then pair up. XX or XY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What does the zygote form into officially? And where does this formation burrow?

What is this process called? How many days should this take?

A

The zygote will form into the blastocyst.
And then the blastocyst will burrow into the endometrium - which is the inner lining of the uterus.

Process is known as implantation. Takes between 6-10 days.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the best site for implantation?

What name change occurs of the endometrium after implantation?

A

The side or posterior wall. NOT the front.

The endometrium or inner lining will have its name changed to decidua.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the site of implantation of the decidua (new name for endometrium)? What is it?

A

Decidua capsularis

It is a bubble structure that covers the blastocyst

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is is the maternal side of the placenta?

A

Decidua basalis. It serves as the base for the placenta.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Decidua vera?

A

Remaining uterine lining of the decidua/endometrium that really isn’t all that affected by pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why are twins becoming more common?

A

Due to delayed child bearing and artificial reproductive treatments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Two types of twins?

A

Dizygotic

Monozygotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Dizygotic twins
How many ovum and sperm needed?

How many placentas, chorians, amnions?

A

Two of everything because they are totally separate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Will dizygotic twins always be the same gender?

A

No, these twins can be separate genders bc they’re separate in general.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What increases chances of having Dizygotic twins?

A

These twins are pretty much separate fyi…

Older pregnancy
Familial genes - twins tend to run in families
Going off the pill & having multiple ovum released.
Obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Monozygotic twins
Will have how many ovum and sperm?

How many placentas?

Will these be identical twins? Gender?

A

Will have one single fertilized ovum (so one sperm).

One shared placenta.

Yes - they are identical. Same gender as well.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Risk of monozygotic or identical twins?

What type of treatment could increase this?

A

Can become conjoined or have Siamese twinning where they are fused.

ART or artificial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which types of twins will do better?

A

The Dizygotic twins will do better since they have their own stuff.
Monozygotic babies share placenta and possibly their chorion. Baby A gets the nutrients and Baby B is second.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Will blood ever be shared/mixed between mom and baby?

A

No - two separate circulatory systems going on. Unless there’s trauma and a vessel ruptures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What do babies do to amniotic fluid that surrounds them?

A

They recycle it by drinking and peeing in it.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Cotyledons of placenta

A

Beefy red sub-sections of placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Fetal side of placenta

A

Where cord comes off of and attaches to the fetus.

Shiny, gray color

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
How big is the placenta at 20 weeks How big is it by term
Covers 1/2 of uterine surface By term it is 6-9 inch diameter and about 1 Ib
26
What if a mom is Rh-?
There could be mixing of blood due to maternal antibodies if baby is positive (it's a blood type)
27
While there shouldn't really be any mixing of blood unless there is something rare or abnormal - can the mother's circulation affect the baby in any way?
Yes. Maternal circulation can increase or decrease uterine blood flow. Same thing can happen with mother's blood pressure. Ex: hypertension can decrease the CO and thus uterus &. placenta aren't perfused doesn't get enough
28
Uterine souffle
Listening over to maternal blood vessels which is the pulse of the mother. Whoosh noise.
29
Funic souffle
To listen to HR over umbilical cord that equals FHR - but you don't want to necessarily listen to this. Do it over the baby's back.
30
What does the placenta transport? How does the placenta act as the lungs?
Nutrients Waste Antibodies the last month of pregnancy/mother's gift/passive immunity Takes care of gas exchange components like O2 and CO2
31
Major hormones from placenta
hCG - basis of pregnancy testing; found in blood & urine hPL - metabolism & growth in pregnancy Estrogen - growth hormone of breast, uterus, blood Progesterone - keeps uterus quiet and calm
32
Dirty duncan presentation
When placenta presents maternal side up with the Cotyledons
33
Where should the cord be on the placenta
In the center - unless there is an abnormality
34
Umbilical cord contains how many arteries and veins acronym?
2 arteriers 1 vein AVA - arteries on side and vein in center
35
Umbilical artery Umbilical vein
Takes deoxygenated blood to placenta Takes oxygenated blood to to the fetus so reverse of your circulation
36
Percent of umbilical cords that only have 1 artery and 1 vein?
1% The baby will still be healthy - but want to take a closer look to make sure there aren't any other issues.
37
Does it hurt the baby when you cut the cord?
No - there's no pain receptors.
38
How long is the cord? | Why does the length matter?
Same length of baby so 20-22 inches | If the cord is too short then it can get too tight and seperate
39
Protein around the umbilical cord? What does the high blood volume help with?
Wharton's Jelly - gelatin substance and water. Cushions the vessels. Will fall off after delivery It can keep the cord from tangling up around baby neck or having a nuchal cord. Can kill the baby
40
Ultrasound and doppler blood flow study helps with what?
Complications of pregnancy. Can check for blood flow through the vessels
41
Amniotic sac or Bag of water layers (2) Are they fused together?
Amnion or inner layer that develops from the blastocyst. It is thin, Chorion or outer membrane of the sac. Develops from the trophoblast and is thick. No, they are not fused together.
42
Amniotic fluid amount at 39 weeks? Amount at 41 weeks? Main point?
700-900 mL 500 mL So - this is why we never want a pregnancy to go past 40 weeks bc the amniotic fluid decreases.
43
Polyhydraminos
Excessive amount of amniotic fluid greater than 2L
44
Why would a baby have too much amniotic fluid (polyhydraminos)?
Gi issue like esophageal problem where baby can't swallow their own amniotic fluid and so the fluid never gets recycled. It just accumulates in the sac. Other reason is there could be more than one fetus and so more fluid is needed. Diabetes - glucose can transfer to baby and the baby enlarges but also pees out everything so the fluid accumultes
45
Oligohydramnios
Not enough amniotic fluid so like less than 300 mL Fluid will be super concentrated half of the normal amount too
46
Why would a baby have Oligohydraminos or not enough fluid in their amniotic sac?
Since the fluid is recycled - baby may not be excreting fluids due to kidney issues Maternal drug use can cause no kidney in child Or Reduced blood volume so less fluid Or post date PG so 41 weeks
47
Amniotic fluid ph ?
Alkaline or high ph
48
What will amniotic fluid look like
full of cellular debris so cloudy but may come out clear
49
What if amniotic fluid is red? What if fluid is green?
Means there could be bleeding Green could be stool or meconium
50
Three sources of amniotic fluid?
Amnion cells fetal urine fetal lungs
51
How to diagnose amount of amniotic fluid?
Fundal height . After 20 weeks - the weeks represent height. So 21 weeks = 21 cms. Sonogram by measuring AFI - amniotic fluid index or measurement of parts of placenta (5-18 is normal .. 26 is high) subjective data - does the mother think her pregnancy is weird? Especially compared to other pregnancies?
52
Amniosythesis
Analyze amniotic fluid by drawing out fluid from sac. | Can determine gender, chromosomal info.. etc. Maturity.
53
How does amniotic fluid help with pressure?
It surrounds the fetus equally and keeps the pressure equal to develop normally
54
How does amniotic fluid help with movement?
It creates a gravity free environment for the baby to move and float around - which also helps muscles.
55
What does amniotic fluid help prevent?
Prevents fetus from sticking to the amnion sac.
56
How does amniotic fluid control temp?
Well the baby will feel your temp so regulates constant body temp. If you're cold - your baby will be cold. If hot - they will be too.
57
Do babies swallow amniotic fluid?
Yes - it their source of oral fluid. | And they excrete their urine. It is sterile tho.
58
Why do the placenta and amniotic fluid have to manage fluids and electrolytes?
A fetus doesn't have adequate kidneys and so the placenta and amniotic fluid take care of it.
59
How does amniotic fluid affect lungs
Baby has to have amniotic fluid bc it helps with practice breathing in utero. Without it, baby can die when it's birthed. Chest wall movement practice
60
The amniotic fluid pushes against the cord. | If there isn't enough - symptoms of oligohydramnios occur. What is this evidenced by?
Variable decelerations in HR
61
How does amniotic fluid act as an intact bag?
Dilating wedge against the cervix in labor However, often they'll rupture the membrane of placenta to allow baby's head to be the dilating wedge since its much harder.
62
Order of fetal progression
zygote> blastocyst > embryo> fetus
63
Embryo weeks What develops in this time frame?
2-8 weeks Organs
64
After 9 weeks ?
Fetus
65
Fetal development week 4 of the heart
Heart is beating at 28 days & circulating blood
66
What does a week 5 embryo look like in shape?
a C shape
67
Fetus at week 9?
Every organ system and external structure is present
68
Fetus at week 12 What does the HR do as pregnancy ensues?
Resembles a human Fetal heart tones can be heard , 120-160 usually The HR will slow
69
Fetus at week 16 development
The sonogram can now try to pick up whether a fetus is a boy or girl
70
Fetus at week 20
Activity such as quickening is felt by the mom Vernix (cheesy coating) Lanugo (peach fuzz like growths on body) FHR is heard by a fetoscope
71
Fetus at week 24
Skin is now COVERED by vernix Alveolar ducts and sacs are present with no surfactant Lethicin begins showing up by 27 weeks! (can survive outside of uterus)
72
Fetus at week 28
Lungs can now do mature gas exchange | Eyelids open
73
Fetus at 36-40 weeks weight Lanugo and Vernix? Genitals? immunnity?
More weight gain due to subcutaneous fat Lanugo and vernix begin to disappear Testes descend to scrotum Labia majora becomes more full to cover up other parts of vagina due to fat deposits from weight gain Mother's anitbody gift transfer complete
74
Teratogen
Agent that can cause an abnormality in fetus structure drugs virus radiation
75
First system to function in embryo?
Circulatory system
76
What determines a baby's blood type
Parent genes
77
How is that babies carry more O2 than adults
due to larger fHGB - which protects against hypoxia
78
Will a baby or mother have more fHGB?
Baby
79
If a baby's FHR is higher than a humans, does that increase or decrease CO?
Will increase CO!
80
Will an adult or baby have a higher pulmonary bp?
Baby bc of pulmonary vessel constriction & thus blood is diverted from lungs all together?
81
How is that blood is able to flow back to the placenta in a fetus?
Fetal systemic pressure is just lower
82
Ductus venosus
Shunt that helps bypass the liver in fetus since it is underdeveloped
83
Ductus arteriosis
A different shunt which is between the Pulmonary and artery in order to drive blood from lungs to systemic circulation
84
Foramen ovale ASD?
Shunts blood from right atrium to left atrium via a small hole in heart Eventually this will be covered again by a flap but if not, then you have an atrial septal defect
85
At 24 weeks can the aveoli produce surfactant?
no. But the alveioli are present
86
Then when can surfactant be produced? important surfactant ratio?
28-32 weeks to ease breathing so alveoli dont stick together Lecithin : Spinogomyelin 2:1 means mature lungs for breathing and this finally occurs around 35 weeks
87
Conditions that accelerate lung development
``` Fetal stress Maternal hypertension Infections Steriods (might be giving these for pre-term labors 24-34 weeks) Placental dysfunction ```
88
Conditions that delay lung development
Maternal diabetes Maternal renal problems These issues can cause a baby to be bigger than what the maternal week development shows. So, size does not determine maturity whatsoever.
89
How can Oligohydramnios inhibit lung development?
It can cause there to be less fluid for the baby to able to practice breathing and so lungs don't develop as well.
90
Why would a C-section baby have more fluid in lungs upon birth?
A vaginal birth squeezes the fluid out of the baby as to facilitate its first breathe. A c-section baby doesn't experience that squeezing and so the fluid remains. Will have resp. distress until fluid is suctioned out or absorbed maybe 24 hrs.
91
How do babies develop first ?
Proximal -distal | Head to toe
92
How does oligohydramnios affect the musculture?
Inhibits normal development contractures deformities
93
If you feel the baby move is this good or bad?
Good. Once you start to feel the quickening, you'll want to feel this almost every day thereafter
94
How often do babies sleep in the womb?
Every 20 min. It is a sleep wake cycle
95
Will the vernix caseosa or cheesy coating increase or decrease as fetus gets closer to term? What about lanugo?
Decrease for both of them. | So if the baby is cheesy upon birth, that means it was an earlier labor than 40 weeks. Same with lanugo.
96
Will fingernails or toenails develop first?
Fingernails first Toenails second Cephalocaudal development
97
Can babies suck and swallow in PG? | When will a baby develop a gag reflex?
Yes! | 8 months for protection
98
Meconium What if there is a passage that occurs in utero? Why can this be bad?
Tarry black green stool in NB. Will transition to yellow brown & stay yellow. Could indicate maturity or means they're hypoxic. If they become hypoxic to the point of apoxic - they can have anal sphincter relaxation which causes the utero poop. Need to consider if maturity or stress.
99
What is a meconium breech presentation?
meconium stained liquid on butt. Should be head down for labor.
100
How soon should a baby have meconium passage after birth? What if they don't?
48 hrs Could indicate an imperforated anus that is not patent. Will need surgery or could be from meconium illeus due to cystic fibrosis due to it being in the family
101
What week if urine formation started?
12 weeks - but it'll be a small, clear amount, no smell
102
How can a fetus have acid base balance issues very quickly?
Kidneys aren't doing the excretion in this case.
103
How soon should a baby urinate after birth?
Within 24 hrs
104
Main function of the liver during PG?
Glycogen stores | Iron stores - if you're anemic, after 5-6 months infant can develop anemia since theirs will be depleted
105
Can a baby break down bilirubin ?
Not very well due to immature liver. They may develop jaundice - and we assess during first week of life.
106
What does a baby's sterile gut contribute to?
Cannot produce vit k and so all newborns receive an IM injection within 2 hrs of delivery Vit k = keeps them from bleeding
107
How should a mom control fetal metabolism?
Avoid hot environments that may make her hot or over heat ; hyperthermia If not controlled can lead to dna synthesis issues.
108
Brown fat
Fat the baby is born with | We metabolize it to produce heat
109
White fat
Layer of insulation between skin and blood vessels - laid down last month of pregnancy. Keeps them warm and adds pink color to skin.
110
How can some babies develop congenital hypothydroism? Is this more common than hyper?
They don't produce thyroxine. Can be either but hypo more often. But babies need to be screened for thyroid function.
111
When is the pancreas able to produce insulin? What does Macrosomnia mean?
20 weeks Big bodied baby Glucose can cross the placenta and now the baby can store it - and they end up huge. Latter part of pregnancy . common in hyperglycemic moms
112
What is passive immunity?
Gift to baby from mother in IGG | Keeps baby healthy for about 6 months
113
Largest group of antibodies that crosses the placenta?
IGG | the gift antibody
114
Antibodies from breatfreeding? | What systems does it help?
IGA | GI, GU and respiratory system from infection
115
What antibodies are produced by the fetus?
IGM will test this if they suspect sepsis