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Reproductive System > Fetal Growth + Development > Flashcards

Fetal Growth + Development Flashcards

1
Q

What is the fetal period?
What occurs during this time?

A
  • From 9 weeks to term
  • physiological maturation of structures created in the embryonic period
  • period of preparation for transition to independent life after birth
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2
Q

Outline the patterns of growth during development of the fetus

A

Embryonic period:
- absolute growth is very small, except the placenta
- characterised by intense activity

Fetal period:
- growth + weight gain accelerate

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3
Q

What is the crown rump length?

A

Length of the fetus

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4
Q

Body proportions in the fetal period

A
  • at week 9, the half is 50% of the crown rumplength
  • after, the body length + lower limb growth accelerates
  • head makes up 25% of the length at term
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5
Q

How can fetal well-being be assessed?

A
  • last menstrual period (age of fetus + estimate due date)
  • ask the mothers (fetal movements)
  • symphysis fundal height
  • ultrasound scan
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6
Q

When do fetal movements start to happen?

A

~ 20 weeks

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7
Q

How is symphysis fundal height used to assess fetal wellbeing?

A

Normal SFH = number of week +/- 2cm

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8
Q

Why may symphysis-fungal height be larger?

A
  • polyhydramnios: if there is a lot of amniotic fluid
  • accumulation can happen due to swallowing difficulties or excessive urine production
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9
Q

Why may symphysis fundal height be low?

A
  • intrauterine growth restriction
  • oligohydramnios: lack of amniotic fluid production
  • normal near term as fetal head engages in the pelvis
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10
Q

What is the 20 week scan used for?

A

anomaly scan
- screen for fetal anomalies
- determine placental location
- sex of baby

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11
Q

What is the 12 week scan used for?

A
  • dating scan
  • determine gestational age
  • detect multiple pregnancy
  • screening for chromosomal abnormalities
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12
Q

What 2 scans are used in antenatal care?

A

12 week scan (dating scan)
20 week scan (anomaly scan)

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13
Q

When is the crown rump length used?

A

Measured between 7 -13 weeks to date pregnancy
In 12 week dating scan

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14
Q

What measurements are used to determine fetal size?

A

Crown rump length
Biparietal diameter
Abdominal circumference
Femur length

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15
Q

What is the biparitetal diameter measurement?
When is it used?

A
  • Distance between the parietal bones of the fetus
  • In 2nd + 3rd trimester
  • Used in combination with abdominal circumference
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16
Q

What is the abdominal circumference measurement?
When is it used?

A
  • measures widest part of the abdomen
  • in 2nd + 3rd trimesters
  • in combination with biparietal diameter + femur length
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17
Q

What measurement is used in the first trimester to help date pregnancy?

A

Crown rump length

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18
Q

What is the average normal brith weight at term?

A

~ 3.5 kg

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19
Q

What is macrosomia?

A

Large baby
>4kg

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20
Q

Birth weight ranges for babies at term

A
  • extremely low birth weight: <1kg
  • very low birth weight: 1-1.5kg
  • low birth weight: <2.5kg
  • average normal: ~3.5kg
  • macrosomia: >4kg
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21
Q

Why can babies have a low birth weight?

A
  • premature
  • constiutionally small
  • suffered growth restriction (associated with neonatal morbidity)
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22
Q

Types of fetal growth restrictions

A

Symmetrical
Asymmetrical

23
Q

What is symmetrical intrauterine growth restriction?
What is it due to?

A
  • occurs early on in pregnancy <20 weeks
  • abdominal circumference, biparietal diameter + fetal length all proportionally reduced
  • due to genetic disorders or TORCH infections
24
Q

Changes to fetal measurements in symmetrical intrauterine growth restrictions

A

Abdominal circumference, biparietal diameter + fetal length ALL proportionally reduced

25
Q

What is asymmetrical intrauterine growth restriction?
What is it due to?

A
  • occurs later on >20 weeks
  • abdominal circumference decreased
  • biparietal diameter + femur length normal
  • due to placental insufficiency e.g. pre-eclampsia
26
Q

Changes to fetal measurements in asymmetrical intrauterine growth restrictions

A
  • abdominal circumference decreased
  • biparietal diameter + femur length normal
27
Q

Development of the respiratory system in the embryonic + fetal period

A
  • lungs develop relatively late
  • embryonic period: only bronchopulmonary tree
  • fetal period: functional specialisation
28
Q

What are the lung development stages?

A

Every Penguin Can Swim Anywhere

Embryonic
Pseudoglandular
Canalicular
Saccular
Alveolar

29
Q

What is made in the embryonic stage of lung development?

A

Only bronchopulmonary tree

30
Q

What is made in the psuedoglandular stage of lung development?

A

Terminal bronchioles
- duct system begins to form within the bronchopulmonary segments

31
Q

What is made in the canalicular stage of lung development?

A

Respiratory bronchioles
- budding from bronchioles formed in psuedoglandular stage
- start of differentiation of cuboidal cells to type 1 + 2 pneumocytes

32
Q

What is made in the saccular stage of lung development?

A
  • terminal sac begin to bud from respiratory bronchioles
  • differentiation of type I + II pneumocytes > surfactant made
33
Q

What is made in the alveolar stage of lung development?

A
  • mature alveoli formation
  • proliferation + expansion of capillaries, nerves + gas exchange areas
34
Q

What is fetal viability?

A

The ability of a fetus to survive outside the uterus

35
Q

What is respiratory distress syndrome due to?

A

Insufficient surfactant production

36
Q

When is the first heat beat of a fetus?
When is definitive fetal heart rate achieved?

A

5-6 weeks
15 weeks

37
Q

What is definitive fetal heart rate?

A

110-160bpm

38
Q

What is fetal bradycardia a sign of?

A

Fetal distress

39
Q

When does fetal kidney function begin?

A

Week 10

40
Q

What is oligohydramnios?
What can it be due to?
What could indicate this?

A
  • Low volume of amniotic fluid
  • due to placental insufficiency or poor renal function in fetus (poor blood supply)
  • Low symphysis-fundal height
41
Q

What is polyhydramnios?
What can it be due to?
What could indicate this?

A
  • high volume of amniotic fluid
  • due to fetal abnormalities (oesophageal atresia), gestation diabetes, fetal anaemia or multiple pregnancies
  • high symphysis-fundal height
42
Q

When does myelination of the brain begin?

A

9th month

43
Q

Role of magnesium sulphate during pregnancy

A
  • given to women at high risk of imminent spontaneous preterm brith between 24-29 weeks gestation
  • given for fetal neuroprotection e.g. reduces risk of cerebral palsy
44
Q

Why is the nervous system the most vulnerable to injury during development?

A

First to start development
Last to finish

45
Q

What do co-ordinated movements require?
When does this form?

A

Corticospinal tract
Begins to form in the 4th month

46
Q

Why are new born babies unable to walk or perform coordinated movements until ~ 1 year?

A

Myelination of the corticospinal tract is incomplete at birth

47
Q

When is fetal viability a possibility?

A

Once the lungs have entered the terminal sac stage of development
>24 weeks

48
Q

Antenatal managment of respiratory distress syndrome

A

Glucocorticoid treatment
Boosts lung development > surfactant produced

49
Q

Neonatal management of respiratory distress syndrome

A
  • nCPAP (nasal continuous positive airway pressure)
  • surfactant replacement therapy
  • mechanical ventilation
50
Q

What does a lack of fetal kidney function cause?

A

Oligohydramnios

51
Q

What cells produce surfactant?

A

Type II pneumocytes

52
Q

What glucocorticoid treatment used for during pregnancy?
How does it work?

A
  • Treatment of respiratory distress syndrome before baby is born
  • Boosts lung development > surfactant produced
53
Q

What are the stages of respiratory development + what develops in each?

A

Every Penguin Can Swim Anywhere
- embryonic: bronchopulmonary tree
- pseudoglanudlar: terminal bronchioles
- canalicular: respiratory bronchioles + pneumocytes
- saccule: terminal sacs + surfactant produced
- alveolar: alveoli

Reproductive System (20 decks)

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