Genetics, Conception, Fetal Development & Reproductive Technology (1)

Question 1

Birth Rate

Answer 1

number of live births per 1000 people

Question 2

Infant Mortality

Answer 2

number of deaths of infants under 1 year of age per 1000 live births (before the first birthday)

Question 3

Neonatal Mortality

Answer 3

number of deaths of infants less than 28 days of age per 1000 live births

Question 4

Maternal Death or Mortality

Answer 4

number of deaths from any cause related to or aggravated by pregnancy or its management during the pregnancy cycle (includes 42 day PP period) per 100,000 live births

Question 5

Largest Concerns Impacting Health of Mothers and Infants Today:

Answer 5

Adolescent pregnancy
Tobacco use/ vaping
Substance abuse in pregnancy
Obesity
Health disparities (preventable differences in the burden of disease, injury, violence or opportunities to achieve optimal health)

Question 6

Tobacco Use in Pregnancy

Answer 6

Increase risk of growth restriction and low birth weight infants d/t impaired oxygenation.

Question 7

Obesity in Pregnancy (BMI >30)

Answer 7

Maternal risk of:
Gestational HTN and preeclampsia
Gestational diabetes
Thromboembolism

Increase fetal/infant risk of:
Birth injuries r/t macrosomia

Question 8

Health Disparities and Pregnancy

Answer 8

low income women are less likely to seek early and regular care d/t:
transportation, financial, and communication

they may have different attitudes about the importance of care

Question 9

Genes

Answer 9

DNA + protein
*each human cell contains 46 chromosomes w/ 22 autologous pairs of chromosomes and one pair of sex chromosomes (XX or XY)

Genome: organisms COMPLETE set of DNA
Genotype: person’s genetic makeup
Phenotype: person’s outward expression of those genes

Question 10

Abnormalities of Chromosome Number

Answer 10

Trisomies: the presence of an extra chromosome (three instead of the usual pair)

Question 11

Abnormalities of Chromosome Structure

Answer 11

Translocation: chromosome breaks and a portion of it reattaches to different chromosomes

Duplications: region of a chromosome is repeated

Deletions: area of the chromosome is deleted

Question 12

Prenatal (Antepartum) Testing

Answer 12

early genetic screening for genetic disorders like trisomy 21

Question 13

Who should be offered genetic testing and why?

Answer 13

couples at higher risk for conceiving a child w/ genetic disorder:
maternal age >35YO
prior pregnancy w/ genetic or newborn abnormality
personal hx of genetic disorder
family hx of genetic disorder

why? b/c it provides parents w/ options

Question 14

Uterus

Answer 14

3 layers:
outer = fundus, muscle fibers run up and down to help push baby out
middle = fibers run in chicken wire like formation so it can clamp down and prevent hemorrhage after birth
inner = cervix, fibers run horizontally so muscle can flatten out and dilate when baby is ready to be delivered

*fibers run in different directions

Question 15

Where does fertilization occur?

Answer 15

Fallopian tubes at the Ampulla

Question 16

Ovaries

Answer 16

Store and develop follicles (present from birth)

Follicles secrete hormones (primary source)

• estrogen: contribute to femaleness
• progesterone: hormone of pregnancy

Question 17

Ovarian Cycle

Answer 17

3 phases pertaining to oocyte development:

Follicular phase (days 1-14)
Ovulatory phase: begins when estrogen levels peak and ends w/ release of oocyte from follicle
Luteal phase (days 15-28)

Question 18

Endometrial Cycle

Answer 18

3 phases pertaining to changes in the endometrium based on hormonal changes from ovarian cycle:

Proliferative Phase: begins after menstruation and ends w/ ovulation
Secretory Phase: begins after ovulation and ends when menses begins
Menstrual phase: sloughing of the endometrial tissue

Question 19

Female Infertility Causes

Answer 19

Ovulatory dysfunction
Tubal & pelvic pathology
Cervical Mucus Factors

Question 20

Male Infertility Causes

Answer 20

Endocrine
Problems w/ spermatogenesis
Sperm antibodies
Sperm transport
Disorders of intercourse (ED)

Question 21

Gametogenesis

Answer 21

oogenesis
spermatogenesis
mitosis: cell divides forming two identical daughter cells
meiosis: two cell divisions producing half the number of chromosomes

Question 22

Fertilization

Answer 22

Fertilization occurs -> single cell Zygote
3 days after fertilization -> Morula (16 cell sphere)
5 days after fertilization -> Blastocyst (composed of embryoblast (will become embryo) and trophoblast (will become chorion)
Implantation: occurs 5-10 days after fertilization, blastocyst burrows into endometrium which is now called decidua (lining of uterus)

Question 23

Dizygotic Twins

Answer 23

fraternal twins

2 ova and 2 sperm
2 placentas, 2 chorions & 2 amnions

NOT genetically the same
*happens in family lines as women may be predisposed via genetics to release two eggs at once

Question 24

Monozygotic Twins

Answer 24

identical twins

single fertilized ovum
same gender, same genetic material

usually 1 placenta
# of amnions and chorions depends on timing of split

not hereditary

Question 25

Fetal Membranes

Answer 25

2 membranes for expandable amniotic sac

Amnion: inner membrane produces the amniotic cavity (develops from the embryoblast)

Chorion: outer membrane or fetal side of placenta encircles the amnion, embryo and yolk sac (develops from the trophoblast)

BAC: baby, amnion, chorion

Question 26

TORCH Infections

Answer 26

T: Toxoplasmosis
O: Other (syphilis, parvo, varicella)
R: Rubella
C: Cytomegalovirus
H: Herpes/varicella

Question 27

Umbilical Cord

Answer 27

One vein, two arteries (AVA)
Vein delivers oxygenated blood (larger of the vessels)
Arteries carry deoxygenated blood
Wharton’s Jelly: specialized connective tissue that prevents compression of umbilical cord

Question 28

Fetal Circulatory System: Functions and Unique Features

Answer 28

Functions:
maintains blood flow to placenta
provides fetus with O2 and nutrients
removes CO2 and waste products

Unique Feature: high levels of O2 blood flows through umbilical vein to fetus

Question 29

Fetal Shunts

Answer 29

Ductus venosus: in liver, connects umbilical vein to inferior vena cava (bypassing liver) enabling the oxygenated blood to enter the right atrium

Foramen Ovale: opening between the left and right atria, oxygenated blood is shunted to the left atrium

Ductus Arteriosis: connects the pulmonary artery with the descending aorta, shunts blood to aorta and limits amounts going to lungs.

Question 30

Placental Functions

Answer 30

fetal respiration: site of metabolic gas exchange
nutrition: nutrients and O2 transferred through diffusion and active transport
excretion: fetal waste and CO2 is transferred back to maternal blood sinuses by diffusion
hormone production: hCG, progesterone, estrogen, hPL (promotes fetal growth)
Immunologic Properties

Question 31

Amniotic Fluid Functions

Answer 31

• cushion to protect the embryo against mechanical injury
• help control embryo’s temp (reliant on mother)
• permits symmetrical growth and development
• prevents adherence of fetus to amnion allowing freedom of movement
• allows umbilical cord to be free from compression
• acts as a wedge in labor
• provides fluid for analysis to determine fetal health and maturity