Developmental Milestones Flashcards
What are the 3 periods in prenatal development?
Ovular Period or Germinal Period- first 2 weeks following ovulation
Embryonic Period – 3rd week following ovulation and extends up to 10 weeks of gestation
Fetal Period – begins after 8th week following conception and ends with delivery
Describe the fetal period.
Ranging from 8-9 weeks to delivery
Brain grows the fastest (sensitive period up until this point)
Limb buds form
Sex organs form
Bones and muscles
Hair
Eyes form
TONS OF DEVELOPMENT
What two ways can you determine gestational age?
LMP- age since Last Menstrual Cycle
- Technically off by about 2 weeks (over estimates the age)
- With this technique, it lasts 40 weeks
- Issues with memory
Post Conception (fertilization) Age
- From exact time of conception
- Lasts 38 weeks
What is placental abruption?
Placental abruption (abruptio placentae) is an uncommon yet serious complication of pregnancy.
Placental abruption occurs when the placenta partly or completely separates from the inner wall of the uterus before delivery. This can decrease or block the baby’s supply of oxygen and nutrients and cause heavy bleeding in the mother.
Placental abruption often happens suddenly. Left untreated, it endangers both the mother and the baby.
Symptoms include vaginal bleeding, belly pain, and back pain in the last 12 weeks of pregnancy.
What is placenta previa?
In most pregnancies, the placenta attaches at the top or on the side of the uterus. In placenta previa, the placenta attaches low in the uterus. The placenta might partially or completely covers the cervix. Placenta previa can cause severe bleeding in the mother before, during or after delivery.
Placenta previa risk factors include a previous delivery, age older than 35, and a history of previous surgeries, such as a cesarean section (C-section) or uterine fibroid removal.
The main symptom is bright red vaginal bleeding without pain during the second half of pregnancy. The condition can also cause severe bleeding before or during delivery.
Bed rest is recommended. A cesarean section is often needed.
What are teratogens?
A teratogen isanything a person is exposed to or ingests during pregnancy that’s known to cause fetal abnormalities.
Period of risk (4-8 weeks critical periods)
What are the categories of teratogens?
Medications/Drugs
Maternal Infections (Torches)
Chemicals
Maternal disorders
Reproductive Traits
Exposure to teratogens during pregnancy can cause…
Low birth weight
Developmental delays
Loss of pregnancy
Cognitive delays
Growth delays
What are TORCHes infections?
T - toxoplasma gondii
O - other
R - rubella
C - cytomegalovirus
He - herpes
S - syphillis
Describe the first few weeks of
Everything is developing
4 weeks-heart tube forms
- Neural system begins (neural Defects)
- Intestines, lungs, liver and kidneys
- Sex organs
- Buds to be limbs
Week 8- goes from embryo to fetus
What are the body functions in a fetus?
Mental Function
Based on fetal behavior and movement
Correlation to brain function after birth
KANET test
What are fetal behavioral states?
F1: quiescent state (quiet sleep)
F2: frequent gross body movements
F3: continuous eye movement. This state was disputed.
F4: Vigorous body movements and FHR accelerations.
Describe sensory function and pain during development.
8 weeks gestation
- respond to touch by crying, grimacing, retracting
24 weeks gestation
- respond to sound
25 weeks gestation
- vestibular system allows them to right themselves in the womb
Describe the cardiopulmonary system during development.
Heart is one of the first systems to start functioning (21 days)
In utero-works from the placenta
Within seconds of birth
- Breathing on their own
- Shift from maternal to infant circulation requires closure of the ductus arteriosus
Describe the shift in circulation that occurs within seconds of birth.
Ductus arteriosus
Pulmonary trunk and aorta
Usually closes within hours of birth
35 weeks and younger sometimes trouble
Describe the neuromuscular system during development.
Development occurs
- Cephalocaudal
- Proximodistal
Fetal movements are well documented
- Startles, stretches
- Hiccups
- Paradoxical breathing
- Twitches
- Head movement
- Periods of rest and movement
- Slowing of movement as they get too big
* See this in preemies as the approach 36 weeks
What happens at 9 weeks?
Now a fetus
What happens at 12 weeks?
Able to tell sex based on visual appearance
Spontaneous movement begins
Gut starts to work- begin to swallow amniotic fluid
What happens at 16 weeks?
Hands and feet (fingernails)
Reflexes begin
What happens at 20 weeks?
Tiny person- all parts are there and size ratio
Hair
Lanugo
Vernix caseosa
First flutters by mom
What happens at 22 weeks?
Viability in US
What happens at 24 weeks?
Eyes are formed and open
What happens at 25 weeks?
Viable baby
What happens at 28 weeks?
Most reflexes are present (not suck)
May cry, breath, swallow and suck thumb
Viable lungs
What happens from 28-33 weeks?
Fat!
Issues with temperature regulation
What happens at 32 weeks?
Can live without support
Suck reflex
Describe a full term infant.
Weigh about 3.4 KG or 7.5 #
FAT
Thermoregulation is working
Can sustain feeding
Can poop (eliminate waste)
Breath when separated from placenta
Describe VLBW and/or very preterm.
weight <1,500mg or gestational age <32 weeks
Continue feeding with expressed breast milk
Give vitamin K
Kangaroo Mother Care
Describe LBW and/or preterm.
weight 1,500-2,000g or gestational age 32-37 weeks
KMC
Counsel on optimal breastfeeding and infection prevention
Give vitamin K
Follow up visits every week for 6 weeks
Describe normal birthweight and/or term.
weight >2,500g or gestational age >37 weeks
Counsel on optimal breastfeeding and infection prevention
Give vitamin K
3 follow up visits
What are 2 main causes of LBW?
Early delivery
Poor fetal growth
What can cause early delivery?
Carrying more than one baby such as twins or triplets
Previous preterm birth
Previous abortions
Smoking or exposure to second hand smoke
Stress and lack of support
Infection- some infections in pregnant women, such as bladder or vaginal infections, can cause labor to start early
Stress
Exposure to harmful substances
Oligohydramnios-lack of amniotic fluid
What can cause poor fetal growth?
Use of alcohol, drugs and smoking
Exposure to second hand smoke
Poor nutrition - women who do not gain at least 22lb (10 kg) are 2-3 times more likely to have a LBW baby
Being under weight before becoming pregnant
Mothers age at time of pregnancy - women under 20 and over 45 are more likely to have a LBW baby.
Stress, exhaustion or lack of rest
Abuse and /or family violence
Living in poverty
What are the types of spina bifida?
spina bifida occulta
myelomeningocele
meningocele
What is spina bifida occulta?
It’s the mildest and most common type. Results in a small separation or gap in one or more of the bones of the spine (vertebrae). Many people who have spina bifida occulta don’t even know it, unless the condition is discovered during an imaging test done for unrelated reasons.
What is spina bifida myelomeningocele?
Myelomeningocele is a severe type of spina bifida in which the membranes and the spinal nerves protrude at birth, forming a sac on the baby’s back. The exposed nervous system may become infected, so prompt surgery is needed after birth.
What is spina bifida meningocele?
This rare type of spina bifida is characterized by a sac of spinal fluid bulging through an opening in the spine. No nerves are affected in this type, and the spinal cord isn’t in the fluid sac. Babies with meningocele may have some minor problems with functioning, including those affecting the bladder and bowels.
What is anencephaly?
A baby born with an underdeveloped brain and an incomplete skull.
Anencephaly is a defect in the formation of a baby’s neural tube during development. A baby born with anencephaly might be stillborn or survive only a few hours to a few days after birth.
The main symptom is unconsciousness.
There is no cure for anencephaly. Treatment aims at making the baby as comfortable as possible.
When is cleft palate and lip still a risk?
Weeks 5-6 you have a risk of developing cleft palate and lip.
Ossification starts at 6-7 weeks
What do we know about prenatal developmet?
- When does life begin?
- Biological life-matter for science - When are obligated to protect life?
- Physiological and ethical issue - How do we as health professionals respond to disagreements between 1 and 2?
- Remain informed and understand what you are talking about
What is the controversy surrounding stem cells?
Can be maintained in cultures for years.
They come from aborted fetus
Can also come from
- Cord blood
- Amniotic fluid
- Possibility of taking adult living cells and reverting them
