Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OB > fetal growth & development > Flashcards

fetal growth & development Flashcards

1
Q

gestational age is dated from ?

A

the first day of the LMP

precedes conception, which occurs approx. 2 wks later

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

gestation takes approximately how many days? months? weeks?

A

280 days
10 “lunar” months
40 weeks

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

Nagle’s rule

A

LMP+ 7 days - 3 months= EDD

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

what takes place the 1st 2 weeks of pregnancy?

A

ovulation
fertilization- formation of zygote
formation of blastocyst- hCG production
implantation

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

what happens during implantation?

A

embryonic laminar develop
2 flat layers of cells
the first of 3 germ layers

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

when does the embryonic period begin?

A

beginning of 3rd week

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

trilaminar disc in embryonic period 3rd wk) is what?

A

3 germ layers

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

ectoderm

A

skin of genitalia
part of anal canal
nervous system

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

mesoderm

A

gonads
ureters
uterus, part of vagina

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

endoderm

A

GIT, epithelium
urinary bladder, anorectal canal
male urethra, prostate gland
female urethra, vaginal epithelium, vestibule

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

disc becomes cylindrical in the 4th week, what does it look like/ form

A

“salamander look”

buds of arms, ears, legs & facial/neck structures

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

development during week five?

A

brain development
head looks big
eyes begin

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

development during week six?

A

nose
mouth
palate

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

development during week seven

A

neck established

distinctly human form

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

development during week eight

A

end of embryonic period
fetus begins
has male/female characteristics

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

by the end of 1st trimester, fetus can do what?

A 
make respiratory movements
urinate
swallow
move limbs
squint
frown
open mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

folate acid deficiency can result in what?

A

neural tube defects- spina bifida, cleft lip

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

what can fetus do beginning week 14

A

sucking motion

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

when do you generally begin to feel the baby move?

A

18 weeks

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

quickening

A

first fetal movements

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

3rd trimester, weeks 28-40

A

this is where the baby grows in size & fine tunes the organ systems- nervous system has control over organ function

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

non-stress test

A

look at a baby’s heart rate that corresponds to the babies movement…fetal well being in utero

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

normal growth reflects what?

A

the interaction of the fetus’ genetically predetermined growth potential & it’s modulation by the health of the fetus, placenta & mother

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

3 phases of growth & development

A 
cellular hyperplasia (1st 16 weeks)
concomitant hyperplasia & hypertrophy (wks 16-32)
cellular hypertrophy (32 weeks- term)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

evaluating fetal growth

A

establish GA as early as possible- using hx, LMP, early ULS
monitor wt gain
measure fundal ht at each visit
serial ULS PRN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

fundus rises….by_______weeks it is still a pelvic organ

A

12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

size>date discrepancy

A 
inaccurate dating
LGA
multiple gestation
polyhydramnios
molar pregnancy (1st tri)
uterine anomaly (fibroid)
congenital anomaly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

size < dating discrepancy

A 
inaccurate dating
intrauterine growth restriction (IUGR)
oligohydramnios (having little fluid)
congenital anomaly
chronic maternal dz
viral infxn
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

large for gestational age (LGA)

A

birth wt>95th percentile

usually >4000g (8lbs 13 oz)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

risk factors for LGA

A

large mother
GDM
post-date
h/o large babies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

complications of LGA

A

cephalopelvic disproportion
postpartum hemorrhage
stillbirth
neonatal complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

cephalopelvic disproportion (CPA)-

A
  • labor dystocia/prolonged labor
  • shoulder dystocia
  • maternal soft tissue damage
  • increased c/s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

shoulder dystocia

A

head is pushed out of but shoulder is impinged & all the blood rushes to the babies head
have ~ 4min to get baby out before it dies from hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

neonatal complications d/t LGA

A

low apgar
hypoglycemia
hematologic abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

hypoglycemia can cause?

A

seizures

inability to regulate body temp

36
Q

mngt of LGA

A
  • screen for GDM
  • ULS to r/o polyhydramnios, molar -pregnancy, fibroids
  • serial ULS to monitor growth
  • anticipate cephalopelvic disproportion (CPD) & sequelae, shoulder dystocia, postpartum hemorrhage
  • offer delivery @ 39 wks if possible macrosomia
  • offer elective c/s
  • alert peds at delivery
37
Q

prognosis of LGA

A
  • risk of subsequent LGA baby
  • increased risk of DM eventually in CH
  • neonatal complications & sequelae
  • increased risk of neoplasia in CH
38
Q

IUGR

A

-impaired/restricted intrauterine growth
-significant b/c there is an inverse relationship bet. fetal/neonatal wt % & perinatal mortality
not be confused w/ SGA

39
Q

SGA

A

neonatal dx of size below the 10th %

usualy genetic or d/t inadequate nutrition

40
Q

risk factors of IUGR

A 
poor nutrition/wt gain
vascular dz/HTN
renal dz
infxn
genetic abnormality
multiple gestation
placental problems
pregestational diabetic (Type I)
drug use/smoking/EtOH
hypoxemia/ anemia
late onset prenatal care
low socioeconomic status
prothrombic d/o's
ART
41
Q

symmetrical IUGR

A

the whole baby is smaller

compromised growth in length, head circumference & wt

42
Q

asymmetrical IUGR

A

decreased length & wt, but nml head circumference

aka head sparing

43
Q

complications of IUGR

A

increased risk of fetal distress
meconium staining
increased perinatal morbidity & mortality

44
Q

Dx of IUGR

A

careful menstrual/medical/OB hx
accurate dating/ early sono
monitor for adequate wt gain
carefully eval fundal ht changes (watch for “progressive” growth, <2cm in 4wks suspicious)
2 sonos 4 wks apart to confirm (esp head & abdominal circumference, AFI check to r/o oligohydramnios)

45
Q

management of IUGR

A 
limit activity/ bedrest
nutrition
cessation of smoking
fetal surveillance (repeat sonos q 4-6 wks, NST's weekly, BPP's prn, amniocentesis for lung maturity
delivery of compromised fetus
46
Q

birth defects

A

a major birth defect is one of medical, surgical or cosmetic significance

47
Q

some causes of birth defects

A 
genetic/ environmental factors
maternal age
illness
drug use
physical features of uterine environment
48
Q

genetic causes of birth defects

A 
single gene d/or (15-20%)
chromosomal abnormalities (5%)
49
Q

environmental exposures & birth defects

A 
maternal illness
substance use
infxn
drugs
chemicals
radiation
hyperthermia
mechanical/physical constraints
50
Q

genetic d/o’s general info

A

> 90% do not survive to term
multiple organ systems tend to be involved
longevity & fertility of these individuals tend to be reduced
chromosomal abnormalities
single gene d/o’s
non-mendellian patterns of inheritance

51
Q

chromosomal abnormalities

A

affect 1:200 newborn infants

nondisjunction, unequal recombination, inversions, deletions/suplications, translocations

52
Q

single gene d/o’s

A

autosomal dominant/recessive

x-linked

53
Q

non-mendellian patterns of inheritance

A 
unstable DNA
fragile X syndrome
imprinting
mitochondrial inheritance
etc
54
Q

maternal illness

A

pregestational DM
phenylketonuria
androgen producing tumors
autoimmune dz’s

55
Q

pregestational diabetes

A

2-3 fold increase in congenital anomalies (esp heart dz, spina bifida)
abnormal fetal growth
newborn hypoglycemia
stillbirth

56
Q

newborn hypoglycemia

A

cyanosis
poor eating
seizures
damage to brain cells

57
Q

phenylketonuria

A

can be minimized by dietary ctrl
microcephaly
MR
congenital heart dz

58
Q

androgen producing tumors

A

virilization of female fetuses

59
Q

autoimmune dz’s

A

same or different toxicity to fetus

tx of mother does not always reduce effects on fetus

60
Q

teratogenic infections

A

CMV (cytomegalovirus)- can cause seizure, MR, etc
Parvovirus (aka 5th dz)
rubella (eye lesion, heart, CNS, etc)
toxoplasmosis (uncooked meat, cat feces)
varicella (13-20 wks= highest risk; last 10 days)
herpes
syphilis

61
Q

teratogens

A

radiation
meds
EtoH, tobacco, recreational drugs

62
Q

meds that are teratogenic

A 
ACE inhibitors, chloramphenicol
warfarin/coumadin/anticoags
DES, toluene, iodides, lithium
accutane/isoretinoin, tetracycline
thalidomide, valproate, lead, rubella vaccine, anticonvulsants, antineoplastics, SSRIs
63
Q

Avoid what in pregnancy

A

ibuprofen
ASA
sulfa drugs @ term
trimethoprim

64
Q

alcohol in pregnancy

A

no amt considered safe
binge drinking worse than spread out
-no exact dose-response relationship bet amt & damage caused

65
Q

alcoho + other factors that may effect outcome

A

maternal age
hih parity
being AA or Native American
genetics

66
Q

exposure risk factors

A 
low economic status
smoking
unmarried
unemployed
illicit drug use
h/o sexual/physical abuse
h/o incarceration
family member who drinks heavily
socially transient
psychologic stress/mental health d/o
67
Q

fetal alcohol spectrum d/o (FASD)

A

describes the broad range of adverse sequelae

  • no effect, nml
  • fetal alcohol effects (FAE)
  • alcohol related birth defects (ARBD)
  • fetal alcohol syndrome (FAS)
68
Q

Fetal alcohol syndrome (FAS)

A

most severe
affects 1-2 ounces daily
chronic alcohol consumption

69
Q

what is the most important modifiable risk factor in pregnancy?

A

tobacco use

70
Q

pathophys of tobacco use in pregnancy

A

impaired fetal oxygen delivery
CO exposure
direct damage to fetal genetic material
direct toxicity from >2500 subst. in cigs
directly impair LU develop.
sympathetic activation leading to accelerated HR & reduction in fetal breathing mvnt
genetics

71
Q

impaired fetal ozygen delivery

A

placentas of smokers show structural changes that may contribute to abnormal gas exchange

72
Q

carbon monoxide exposure

A

carboxyhemoglobin clears slowly from fetal circulation & diminshes tissue oxygenation

73
Q

adverse effects of tobacco

A 
infertility (maternal)
low birth wt
miscarriage
stillbirth
preterm premature rupture of membranes
placental abruption/previa
preterm delivery
congenital malformations
postnatal morbidity
preeclampsia
74
Q

opiate exposure risks that are the same for pregnant & nonpregnant women

A

infxn
psychological stress
violence

75
Q

S&S of high-risk chemical abuse

A 
late prenatal care
multiple missed appts
impaired school/work performance
past OB h/o SAB, IUGR, premature birth, placental abruption, stillbirth, precipitous delivery
CH w/ neuro-developmental problems
h/o drug/EtoH problems
76
Q

OB complications w/ opiate use

A 
preeclampsia
3rd trimester bleeding
malpresentation
nonreassuring fetal status
meconium passage
low birth wt
perinatal mortality
puerperal morbidity
77
Q

neonatal outcomes in opiate use

A 
premature birth
neonatal opiate withdrawal
postnatal growth deficiency
microcephaly
neurobehavioral deficits
SIDS
78
Q

cocaine use in pregnancy

A

related to dose:stage of pregnancy
dcreased birth wt, length, HC
increased risk prematurity, placental abruption, SAB, fetal death
readily crosses placenta

79
Q

what is the major mechanism of fetal & placental damage is?

A

vasoconstriction

80
Q

possible teratogenic effects of cocain

A

intestinal atresia
brain anomalies
cognitive development
*possibilities!

81
Q

how long is cocaine detectable in neonatal urine, meconium, & hair

A

urine: tests + w/in 2 days of delivery, excreted w/in 12-24 hrs
meconium: + for 3 days
hair: + for months

82
Q

what is the MC illicit substance taken during pregnancy?

A

marijuana

83
Q

impact of marijuana?

A

unknown
not significantly related to growth measures, prematurity, congenital anomalies
*CH of heavy users had smaller HC at all ages

84
Q

methamphetamine

A

neurotoxic agent that damages ending of brain cells containing dopamine
3.5x’s more likely to be SGA

85
Q

mgnt of pregnant substance users

A 
screen all for EtOH & substance use
counsel regarding risks
behavioral/pharmacotherapy for addiction
multidisciplinary approach
test for STIs & tx
frequent visits to monitor status of both
ULS to get GA, baseline for growth
fetal surveillance if complications evident
inform peds of possible neonatal w/d
86
Q

discourage what in women who continue to take illicit drugs?

A

breastfeeding

OB (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions