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Maternal/Neonatal > Fetal Development & Physiology of Pregnant > Flashcards

Fetal Development & Physiology of Pregnant Flashcards

1
Q

gravidity

A

Gravidity: number of pregnancies
* Nulligravida: never pregnant
* Primigravida: first pregnancy
* Multigravida: two or more pregnancies

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2
Q

parity

A

Parity: number of pregnancies that reach >20 weeks, regardless of the outcome
* Nullipara: no pregnancy beyond viability
* Primipara: one pregnancy beyond viability
* Multipara: two or more pregnancies beyond viability

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3
Q

viability

A

Viability: fetus has capacity to survive outside with uterus
* Grey area of 22-25 weeks

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4
Q

gestational age

A
  • Preterm: <37 weeks
  • Early Term: 37 - 38 6/7 weeks
  • Full Term: 39 - 40 6/7 weeks
  • Late Term: 41 - 41 6/7 weeks
  • Postterm: >42 weeks
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5
Q

Stages of Fetal Development

A

Preembryonic
*Fertilization through the second week

Embryonic
*End of the 2nd week through the 8th week

Fetal
*End of the 8th week through birth

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6
Q

Mitosis

A

Cell division that results in daughter cells that are
exact copies of the original cell
*Diploid # of chromosomes
(46)
*Somatic (body) cells

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7
Q

Meiosis

A

Cell division in which diploid cells produce gametes
*Sperm & ova
*Contain half the genetic
material of the parent cell
*Haploid # of chromosomes
(23)

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8
Q

Oogenesis

A

Production of ovum
* Present in the ovaries at birth
*Oocytes mature into ova at puberty

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9
Q

Spermatogenesis

A

Mature sperm is not produced until
puberty

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10
Q

Preembryonic Stage

A

Preparation for fertilization
*Ovum (12-24 hours)
* ↑ estrogen during ovulation
* Assists with mobility through the fallopian tube
* Thins cervical mucus
*Sperm (48-72 hours)
* Propel themselves through the female reproductive tract, where only ONE penetrates
the ovum

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11
Q

Preembryonic Stage: Cellular Multiplication

A

Zygote travels through
the fallopian tube to the
uterus
*Rapid cellular division via mitosis occurs

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12
Q

Preembryonic Stage: Implantation

A

Occurs 7-10 days after
fertilization
*Upper posterior uterine wall
*Causes uterine lining to thicken
*Cellular differentiation
*Embryonic membranes
*Primary germ layers
* Ectoderm
* Mesoderm
* Endoderm

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13
Q

Embryonic Stage

A

2-8 weeks
MOST VULNERABLE TO TERATOGENS
*“Essentials” are further
developed
*Embryonic membranes
*Amniotic fluid
*Umbilical cord
*Placenta
*Basic structures of all major
body organs are formed
*Main external features are
completed

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14
Q

Embryonic Stage: Embryonic Membranes

A

Protect & support the embryo as it
grows
*Chorion
* Chorionic villi which grow into fetal
portion of the placenta
* May be used in early genetic testing
*Amnion
* Thin membrane containing amniotic
fluid

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15
Q

Functions of Amniotic Fluid

A

Functions
*Cushions
*Temperature regulation
*Symmetrical growth & movement
*Infection barrier
*Aids in diagnosing fetal health &
maturity
*Approx. 1L at term
*Components
*98% water
*Fetus eventually contributes
through excretion of urine
*Alterations
*Oligohydramnios
*Hydramnios

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16
Q

Yolk Sac & Umbilical Cord

A

Yolk sac
*Functions only early in embryonic
development
*Forms primitive RBCs during 1st 6
weeks of development before the
liver takes over
*Umbilical Cord
*Formed from the amnion
*1 vein; 2 arteries
*Wharton’s jelly (connective tissue that covers cord vessels to prevent folding and compression)

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17
Q

Placenta

A

Interface between the mother &
the fetus
*Arises from trophoblasts
*Metabolic, respiratory,
endocrine, immunologic, &
protective functions

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18
Q

Placental Functions

A

*Metabolic (transfer energy)
*Respiratory (transfer oxygen and waste products)
*Immunologic/Protective (regulate bacteria)
*Endocrine/Hormonal
*Placental circulation
* Maternal & fetal blood NEVER mix
* Interchanged through active
transport, diffusion, etc

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19
Q

Placental Circulation

A

Maternal uterine arteries
Intervillous spaces of the placenta
Umbilical vein into fetal circulation
Returns via the umbilical arteries
Villous capillaries of the placenta
Maternal uterine veins into maternal circulation

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20
Q

3 weeks

A
  • Neural tube forms
  • Beginning brain, heart, & spinal cord
21
Q

4 weeks

A
  • Brain differentiates
  • Limb buds
22
Q

5 weeks

A

Heart beats!

23
Q

6 weeks

A
  • Fetal circulation established
  • Liver produces blood cells
  • Brain waves
24
Q

7 weeks

A
  • Palate formation nearly complete
  • Fetal heartbeat can be seen on
    US
25
Q

8 weeks

A
  • All body organs are formed
26
Q

12 weeks

A
  • Urine is produced & excreted
  • Sex recognizable
27
Q

6 weeks

A

Quickening (first movements)

28
Q

20 weeks

A
  • Quickening (baby should continue to still move)
  • Lanugo & vernix caseosa present
  • Primitive respiratory movements (baby “practicing breathing”)
29
Q

24 weeks

A
  • Alveoli
  • Surfactant
30
Q

28 weeks

A
  • Rapid brain development
  • Lecithin production BEGINS
31
Q

30-31 weeks

A
  • Rhythmic breathing movements
  • L/S ratio increasing
32
Q

36-40 weeks

A
  • More subcutaneous fat
  • Increased CNS control
33
Q

changes to uterus

A
  • increase in size, vascularity &
    thickness
  • 10mL to 5,000mL capacity
  • 600 mL/min at term
  • Changes
  • Hegar’s sign (uterus turns into abdominal organ, skins starts to soften)
  • Pelvic to abdominal organ
  • McDonald’s method
  • Lightening (baby drops, bladder pressure increases)
  • Ballottement (can move baby)
34
Q

changes to cervix

A
  • increased secretions
  • Mucus plug forms
    *Changes
  • Goodell’s & Chadwick’s sign
35
Q

changes to ovaries

A

ceases

36
Q

changes to vagina

A

increased thickness
increased acidity of secretion

37
Q

changes to breasts

A

*↑ size & tenderness
*Striae
*Pronounced nipples
*Areolae darken
*Colostrum might be manually
expressed by 12 weeks

38
Q

changes to CVS

A

Blood Volume
*increase a total of up to 50% or 1500 mL
* Plasma & RBCs
*Blood flow increase to uterus, placenta & breasts
*Provides a reserve for blood loss at birth
*Murmurs
Blood Pressure
*Slight decrease BP
* Lowest in 2nd trimester
* Returns to pre pregnancy levels
near term
Cardiac Output
* increase 30-50%
Heart Rate
*Pulse rate increase10-15 bpm by 32 weeks

39
Q

changes to blood components

A

RBCs
*increase 25%-35% depending on
available iron
*Necessary to transport
additional O2
*Physiologic Anemia of
Pregnancy
*Total plasma volume increase faster
than RBCs can keep up,
leading to hemodilution
(Decreased H&H)
WBCs
*Physiologic leukocytosis
Clotting factors
*Fibrin & fibrinogen increase
*increase in blood clotting factors

40
Q

changes to respiratory system

A

Mild hyperventilation or no change in respiratory rate
* Shortness of breath
*increased O2 consumption
*Diaphragm elevates d/t
enlarged uterus
*Diaphragmatic vs. abdominal
breathers
*Estrogen-induced edema &
vascular congestion
* increased nasal stuffiness & congestion
* Epistaxis

41
Q

changes to renal/urinary

A

Renal
* Renal pelvis dilates
* Kidneys enlarge
* Kidney function
* increased GFR 40-60%
* Must handle
* increased intravascular & extracellular volume
* increased metabolic waste products
* Excretion of fetal wastes

Urinary
* Urinary frequency (1st & 3rd trimester)
* Pressure of growing uterus & fetal presenting
part
* Renal activity increases while lying down
* Bladder becomes concave

42
Q

changes to integumentary system

A

Skin hyperpigmentation
*increased estrogen, progesterone & α-
melanocyte-stimulating
hormone
*Linea nigra
*Facial chloasma “mask of
pregnancy”
* Striae
*Varicosities
*Impaired venous return
*Pressure of gravid uterus
*Sweat & sebaceous glands

43
Q

changes to musculoskeletal system

A

*Hormonal changes (relaxin)
*Joints of the pelvis relax in later preg -> “waddle”
*Postural changes (lordosis)
*d/t relaxin, increased weight, & fetal position
*Low back pain common
*Change in center of gravity
*increased weight, & fetal position
*Pressure of enlarged uterus -> rectus abdominis muscle
can separate -> diastasis recti

44
Q

changes to neurologic system

A

Compression of pelvic nerves or vascular stasis
*Sensory changes in the legs
*Edema
*Carpal tunnel syndrome
*Stooped shoulder stance
*Numbness & tingling in hands
*Vasovagal instability or postural hypotension
*Light headedness

45
Q

changes to GI

A

Mouth
*Hyperemic gum tissue
*Ptyalism
*Changes in taste & smell
*Gingivitis
Upper GI
*N & V
*Pyrosis
*Prolonged emptying time of
gallbladder
* Pruritis
Lower GI
*Delayed gastric emptying time
*Decreased intestinal motility
*Bloating, constipation &
hemorrhoids

46
Q

changes to endocrine system

A

Thyroid
*increases in activity & size
*BMR increases
*Maternal thyroid hormone
*Crucial for fetal neurologic
development
Pancreas
*Production of insulin
*Does not cross placenta
Pituitary
*FSH & LH are inhibited
*Prolactin
*Promotes breast development
& lactation
*Inhibited by progesterone until
delivery
*Oxytocin
*Responsible for uterine
contractions near term
*Milk ejection during
breastfeeding

47
Q

Nutrient Metabolism during Pregnancy

A

*1st half of pregnancy
*Growing fetus needs SIGNIFICANT amounts of glucose,
amino acids, & lipids -> maternal glucose levels decrease
*2nd half of pregnancy
*hPL & other insulin antagonists increase
*Maternal insulin production must increase to overcome
resistance

48
Q

changes to immune system

A

*Enhancement of innate immunity
*Better inflammatory response
*Some chronic conditions stabilize
*Suppression of adaptive immunity
*Prevents rejection of the fetus as a foreign body
*More susceptible to certain infections

49
Q
A

Maternal/Neonatal (6 decks)

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