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Fetal Growth And Development Flashcards

0
Q

Define the embryonic period.

A

Week 3 - week 8

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1
Q

Define the pre-embryonic period.

A

Fertilisation - week 3

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2
Q

Define the fetal period.

A

Week 8 - week 38

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3
Q

Describe, briefly, the pattern of fetal growth.

A
  • CRL increases rapidly in the pre-embryonic, embryonic, and early fetal periods
  • Weight gain is slow at first and rapidly increases in mid/late fetal periods
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4
Q

When is placental growth most significant?

A

Pre-embryonic/ Embryonic periods

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5
Q

When does protein deposition occur?

A

During early fetal growth

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6
Q

When does adipose deposition occur?

A

During late fetal growth

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7
Q

When is the head approximately half of CRL?

A

Week 9

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8
Q

When is the bronchopulmonary tree created?

A

Embryonic period

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9
Q

What happens in the pseudo glandular stage of lung development?

A

Ducts begin to form in pulmonary segments

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10
Q

When is the pseudoglandular stage of lung development?

A

Weeks 8-16

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11
Q

What happens in the canalicular stage of lung development?

A
  • Formation of respiratory bronchioles

- Lung become more vascular

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12
Q

When is the canalicular stage?

A

Weeks 16-26

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13
Q

What happens in the terminal sac stage of lung development?

A
  • Terminal sacs begin to bud from respiratory bronchioles
  • A few primitive alveoli appear
  • Differentiation of pneumocytes
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14
Q

When does the terminal sac stage of lung development occur?

A

Weeks 26 - Term

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15
Q

What is the function of a type I pneumocyte?

A

Gas exchange

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16
Q

What is the function of a type II pneumocyte?

A

Surfactant production

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17
Q

What are the three stages of lung development that occur in utero?

A
  • Pseudoglandular stage
  • Canalicular stage
  • Terminal sac stage
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18
Q

When are alveoli formed?

A
  • Post-natally

- Starts from late fetal period until age eight

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19
Q

What stage of lung development occurs from weeks 8-16?

A

Pseudoglandular stage

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20
Q

What stage of lung development occurs from weeks 16-26?

A

Canalicular stage

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21
Q

What stage of lung development occurs from week 26 - term?

A

Terminal sac stage

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22
Q

What stage of lung development occurs mostly after birth?

A

Alveolar period

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23
Q

Which pneumocyte is used for gas exchange?

A

Type I

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24
Q

Which pneumocyte is used for surfactant production?

A

Type II

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25
Q

When is the definitive heart rate achieved?

A

Week 15

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26
Q

What is fetal bradycardia associated with?

A

Fetal demise

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27
Q

What is required for coordinated movement?

A

Corticospinal tracts

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28
Q

When do coordinated movements begin?

A

4 months

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29
Q

What movements develop after week 8?

A

Suckling and breathing

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30
Q

What matures first? Hearing and taste, or vision?

A

Hearing and taste

31
Q

When can fetal movements be seen by USS?

32
Q

When does the mother become aware of fetal movements?

33
Q

When is the ascent of the kidneys complete?

34
Q

When does the fetal kidney begin to function?

35
Q

When are renal pelvis and calyces present?

36
Q

What does fetal urine contribute to?

A

Amniotic fluid volume

37
Q

Where does the bladder lie in the fetus/infant?

A

Abdominal cavity

38
Q

After how many minutes is the fetal bladder emptied?

A

40-60 mins

39
Q

What tests are done to assess fetal development?

A
  • Fetal movement
  • Fetal breathing movement
  • Fetal tone
  • Amniotic fluid volume
  • Non-stress test
40
Q

Which systems are assessed in a fetal movement test?

A
  • MSK

- Nervous system

41
Q

Which systems are assessed in a fetal breathing movement test?

A
  • Respiratory
  • MSK
  • Nervous system
42
Q

Which systems are assessed in a fetal tone test?

A
  • MSK

- Nervous system

43
Q

Which systems are assessed in an amniotic fluid volume test?

A
  • Urinary
  • GI
  • Utero-placental
44
Q

Which systems are assessed in a non-stress test?

A
  • CVS

- Autonomic nervous system

45
Q

What techniques are used to assess fetal development?

A
  • USS
  • Doppler ultrasound
  • Non-stress test
  • Fetal movements kick chart
46
Q

What is the criteria for fetal growth restriction?

A

Fetal weight is below 10th percentile for gestational age

47
Q

What are the two types of growth restriction?

A
  • Symmetrical growth restriction

- Asymmetrical growth restriction

48
Q

What are the features of symmetrical growth restriction?

A

Generalised and proportional

49
Q

What are the features of asymmetrical growth restriction?

A
  • Abdominal growth lags

- Relative sparing of head growth

50
Q

What is the cause of asymmetrical growth restriction?

A

Deprivation of nutritional and oxygen supply

51
Q

How can fetal age be assessed?

A
  • Duration of pregnancy
  • Developmental criteria
  • Symphysis-fundal height
52
Q

How can duration of pregnancy assess fetal age?

A
  • Fertilisation age

- Last menstrual period

53
Q

How can developmental criteria be used to assess fetal age?

A
  • CRL in T1
  • Biparietal diameter in T2&3
  • Foot length
  • Weight and appearance after delivery
54
Q

What can poor nutrition in early pregnancy lead to?

A

Neural tube defects ➡️ DiGeorge syndrome

55
Q

What can poor nutrition in late pregnancy lead to?

A
  • Asymmetrical growth restriction

- Subsequent oligohydroaminos

56
Q

What is the threshold of viability?

A

Viability of pre-term neonate is only possible once lungs have entered terminal sac stage. Week 26.

57
Q

What is respiratory distress syndrome?

A
  • Affects infants born prematurely, as they are unable to produce sufficient surfactant
  • Usually occurs where pre-term delivery is unavoidable or inevitable
58
Q

How do you treat respiratory distress syndrome?

A

Glucocorticoid treatment of the mother will increase surfactant production in the fetus.

59
Q

What is oligohydraminos a sign of?

A
  • Placental insufficiency
  • Fetal venal impairment
  • Pre-eclampsia
60
Q

What is polyhydraminos a sign of?

A

Fetal abnormality e.g. Inability to swallow

  • Blind ended oesophagus
  • Unable to coordinate swallowing movements
61
Q

What is the purpose of amniotic fluid?

A
  • Provides mechanical protection

- Provides a moist environment

62
Q

What is the volume of amniotic fluid at 8 weeks?

63
Q

What is the volume of amniotic fluid at 38 weeks?

64
Q

What does the volume of amniotic fluid fall to at 42 weeks?

65
Q

What is amniotic fluid formed from in early pregnancy?

A

Maternal fluids

66
Q

How much urine does the metanephros produce at 25 weeks?

A

100 ml per day

67
Q

How much urine does the metanephros produce at term?

A

500 ml per day

68
Q

How is fetal bilirubin excreted?

A

Crosses the placenta to be conjugated and excreted by the mother

69
Q

Why do neonates develop jaundice sometimes?

A

Conjugation of bilirubin is not quickly established after birth

70
Q

What can help neonates to establish conjugation of bilirubin?

A

Phototherapy

71
Q

What changes occur only a few minutes after birth?

A
  • First breath reduces vascular resistance of lungs
  • Greater venous return to left atrium
  • Foramen ovale flap valve shuts
72
Q

What changes occur in the few hours after birth?

A

Increased pO2 and decreased concentration of prostaglandins leads to constriction of ductus arteriosus and umbilical arteries

73
Q

What changes occur in the next few days after birth?

A

Stasis of blood in the umbilical vein and ductus venosus leads to clotting of blood and closure due to subsequent fibrosis

74
Q

What is a good indicator of fetal O2 saturation?

75
Q

What value is fetal pO2?

Reproductive System (12 decks)

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