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Childhood & Adolescence > In Utero > Flashcards

In Utero Flashcards

1
Q

When you were a twinkle in your mother’s eye…

A
  • Development trajectories started before you were even a thought
  • Epigenetics (you are older than you think)
  • Maternal behaviours had an impact on you
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2
Q

Conception: The First Stage

A
  • Age of conception is getting higher in Canada

- Rates of triplets, quadruplets and quintuplets has increased over 230% since the mid 1990s

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3
Q

Advanced Maternal Age (AMA)

A
  • Increased AMA leads to an increase in conception of multiple births, and an increase in the use of assisted human reproductive techniques
  • Fertility drugs-> assisted reproductive techniques
  • Cryopreservation-> freezes the embryos created in IVF
  • Benefit package in Silicon Valley-> young women= prime age to work
  • Artificial Insemination-> injects sperm directly into a woman’s uterus
  • Age and reproductive techniques lead to multiple births
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4
Q

Antenatal

A

conception-> postpartum

-6-8 weeks after you’ve had the baby (under the care of an obstetrician or midwife)

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5
Q

Pregnancy

A

physical condition in which a woman’s body is nurturing a developing embryo or fetus (40 weeks)
-4-5 weeks pregnant before you realize that you’re pregnant (factors into the 40 weeks)

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6
Q

Prenatal

A
  • process that transforms a zygote into a newborn

- Determine when it acc applies

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7
Q

1st Trimester

A
  • from the zygote implantation to 12 weeks

- Most at risk for miscarriage

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8
Q

2nd Trimester

A

12-24 weeks

  • begin to feel movement of the baby
  • when everything develops
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9
Q

3rd Trimester

A

25+ weeks

  • Increased emotional attachment to the fetus
  • Realize that the fetus is coming
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10
Q

Key issues in 1st Trimester

A
  • Ectopic pregnancy-> implants outside the uterus
  • Abnormal urine & blood tests
  • Normal bleeding in the first trimester
  • Miscarriage
  • Malnutrition-> why is it a Canadian issue?
  • Lower SES countries
  • Could be quality of food
  • Morning sickness and hyperemesis (morning sickness on steroid-> vomiting throughout the pregnancy, hospitalized as they attain nothing)
  • 1 in 50 women
  • Kate Middleton suffered with it: reshaped the way that we think of pregnancy
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11
Q

Key issues in 2nd Trimester

A
  • Gestational diabetes-> baby gains too much weight (hard delivery)
  • Screening test (drinking sugary syrup and tests how your body absorbs it)
  • Improved diet and exercise (intervention is nothing compared to the screening for it)
  • Excessive weight gain
  • Rh incompatibility of mother (blood types don’t match and mom’s body attacks it)
  • Miscarriage= 13-20 weeks
  • Premature labour= 21+ weeks (broad spectrums in medicine)
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12
Q

Key issues in 3rd Trimester

A

o Increased BP
o Bleeding
-Premature labour
-Bladder infection-> asymptomatic
-Toxemia-> pre-eclampsia (Eclampsia= pre-eclampsia + seizures)
-After 20 weeks gestation
-6 weeks after delivery (naturally dissipates over time)
-Hypertension & proteinuria
-Swelling, blurred visions, headaches
-Treat it by delivering the baby and the placenta (baby needs to reach that viability)
-Managing the health of the baby and the mother
-Development of an abnormal placenta

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13
Q

Obsession with Growth

A

-Compare babies to the size of fruit

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14
Q

What is Normal during Pregnancy… Everything and Anything (mostly)

A
  • Not many studies to see what is normal during pregnancy?
  • Feet grow, hair falls out/ stays in
  • Paradoxes are normal
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15
Q

Ethical debate of when to intervene

A
  • e.g. thalidomide case preventing morning sickness
  • Crossed the placental barrier and effect the baby
  • We don’t have a good understanding of development (leave it alone?)
  • Risk vs benefits (health of fetus and woman)
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16
Q

Age of viability in London, ON

A

24 weeks

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17
Q

viability at 23 weeks

A

17%

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18
Q

viability at 24 weeks

A

39%

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19
Q

viability at 25 weeks

A

50%

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20
Q

viability at 26 weeks

A

80%

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21
Q

viability at 27 weeks

A

90%

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22
Q

viability at 28-31 weeks

A

90-95%

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23
Q

viability at 32-33 weeks

A

95%

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24
Q

viability at 34+ weeks

A

100%

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25
Q

Age of Viability Stats

A

o Age of viability is decreasing as medicine is increasing

  • Repercussion of lowering the age-> use a lot of resources on 1 person ($$$), implications for abortion, survival rate doesn’t mean that it will be developed like a full-term baby (intellectual and developmental delay)
  • Increased rate of children with medical complexity
  • Technology dependant
  • 2 or more underdeveloped organs
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26
Q

9-12 weeks

A
  • Fingerprints, grasping reflex, facial expressions, swallowing and rhythmic “breathing” of amniotic fluid, urination, genitalia appear, alternating periods of physical activity and rest
  • Behaviours originate in utero
27
Q

13-16 weeks

A

-Hair follicles, responds to mother’s voice and loud noises, 8-12cm long (crown to rump), weights 25-100g

28
Q

17-20 weeks

A

-Fetal movements felt by mother, heartbeat detectable with stethoscope, lanugo (hair) covers body, eyes respond to light introduced into the womb, eyebrows, fingernails

29
Q

21-24 weeks

A

-Vernix (oily substance) protects skin, lungs produce surfactant (vital to respiratory function), viability becomes possible

30
Q

25-28 weeks

A

-Recognition of mother’s voice, regular periods of rest and activity, good chance of survival if born now

31
Q

28-32 weeks

A
  • Very rapid growth, antibodies acquired from mother, fat deposited under skin
  • Fully formed just needs to grow
32
Q

33-36 weeks

A
  • Movement to head-down position for birth lungs mature

- Flip is important (c-section may be needed if not)

33
Q

37+ weeks

A
  • Full-term status
  • London, ON: you can go 40 weeks and 10 days before they induce you
  • Survival rate begins to decrease after this
  • Midwives may let you go to 42 weeks if you know the risk
34
Q

Queen’s University Study

A

Female Fetuses:
-More sensitive to external stimulation
-Advance more rapidly in the womb
-Advance more rapidly in skeletal development
Male Fetuses:
-more physical active in utero and vulnerable to all kinds of prenatal problems
-more likely to be spontaneously absorbed and have birth defects

35
Q

A mother’s voice: newborns appear to remember stimuli from the womb

A
  • Queens’ university
  • Exposed full term fetuses to either their mother’s voice or a stranger’s voice and in both cases the same poem was read
  • significantly different heart rate pattern in response to the poem read by their mother (heart rate increased) vs stranger (heart rate decreased) or stayed the same
  • talking to the fetus in utero-> sense of familiarity
36
Q

Genetic Disorders

A
  • Autosomal dominant disorders (e.g Huntington’s disease, extra fingers)
  • Autosomal recessive disorders (e.g. sickle-cell anemia, CF)
  • Sex-linked recessive disorders (e.g. red-green colour blindness, missing front teeth)
37
Q

Chromosomal Errors

A
  • Trisomy (3 copies- e.g. down syndrome)
  • Anomalies with sex chromosomes (turner’s syndrome)
  • Too many or too little sex chromosomes
38
Q

Teratogens

A
  • Maternal disease-deviations in prenatal development stemming from teratogens (Agents that cause damage to the fetus)
  • Greatest risk within the first 8 weeks
  • Substances & maternal conditions
  • Legislative change effects prenatal development
  • E.g. marijuana legislation (implications over the course of pregnancy)
39
Q

Obesity

A
  • Immediate risk includes gestational diabetes, preeclampsia, stillbirth and congenital abnormalities
  • Mother= risk of heart disease and hypertension
  • Child= risk of obesity and heart disease
40
Q

Alcohol

A

-Fetal alcohol syndrome-> developmental disabilities in children and causes distinctive facial features, growth problems and problems bonding/attachment (foundational)

41
Q

Smoking

A
  • Preterm birth, low birth weight, birth defects of the mouth/lip that increases the risk of SIDS (if smoking during the postpartum period)
  • Damages the fetus’s brain and lung development
  • High risk of chronic disease
  • Less reserves to fight off illness
42
Q

Goldilocks Effects on Birthweight

A

ELBW- extremely low birth weight baby
VLBW- very low birth weight baby
LBW- low birth weight
-Normal birth weight is between 6ish & 10ish (constantly increasing due to the obesity epidemic)
-Diff based on who you talk to
-Avg birthweight in 2012: 8 pounds 7 ounces
-What you weight when you’re born effect your long-term outcomes

43
Q

Marijuana

A
  • Development problems during adolescents
  • Higher rates of depression, hyperactivity and inattention
  • No longitudinal studies on the effects
  • Don’t introduce anything within the first 8 weeks
44
Q

Depression

A
  • Miscarriage, preterm birth, LBW
  • Increases the risk for postpartum depression which can affect bonding
  • Mental health= physiological effects on your body
  • Depression doesn’t mean you will get postpartum depression (vice versa)
  • Not the baby blues (more extreme)-> hormones need to leave
  • Significant and long term effects of postpartum depression
45
Q

Anxiety

A

-LBW, fetus growth restriction, lower neonatal Apgar score, change in language development

46
Q

APGAR Test

A

Appearance, Pulse, Grimace, Activity or Respiration)

  • 2 points for each categories
  • Blue hands and feet-> lower blood circulation (protection mechanism to new environment)
  • Is intervention necessary?
47
Q

Preterm Babies

A
  • Life long effects-> cerebral palsy, cognitive impairment, visual and hearing impairment, poor health, growth, behavioural and social-emotional problems
  • Designed to stay in utero for 40 weeks
  • Milestones that you should reach
  • Gestational age vs real age
48
Q

LBW and VLBW Babies

A
  • Negative effects on mental and motor development and growth at 9 months- 2 years of age
  • Effects on mental development seems to lessen over time but growth effects do not
49
Q

Prenatal Care

A
  • Health of the mother-> blood pressure, urine, weight gain and blood work
  • Health of the baby-> uterus growth, heart beat & fetal movement
50
Q

Intrapartum Care

A

labour & delivery

51
Q

Postpartum Care

A

birth to 6-8 weeks after

52
Q

OB Services

A
  • Twins, high risk pregnancies, high risk deliveries or if you want anesthesia as well as normal babies
  • Epidural
  • Hospital setting
53
Q

Midwife Services

A
  • Normal single baby deliveries
  • Can be done at home or the hospital
  • Can be paid for by the gov
  • Low risk deliveries
  • 1 male in all of Canada
54
Q

Hospital

A
  • OB or Midwife in the birth suites
  • Bed, tub, yoga ball and medical equipment
  • London= level 3 hospital & 1 trauma centre
55
Q

Home Birth

A
  • Midwife
  • Comfort of home all the medical equipment from a rural hospital
  • Midwives can stabilize you if something goes wrong and transfer you out
56
Q

Home Birth… who does it and is it safe?

A
  • 9% of first-time moms plan a home birth and 21% of second time moms
  • Only offered to women with no risk factors and spontaneous labours (can’t be induced)
  • Low risk women can have good/ better outcomes than hospital births (no risk from a hospital setting)
57
Q

Why people prefer home births?

A
  • minimal intervention during their labour
  • labour without pain medication
  • private birth with minimal interruptions (busy places at hospitals)
  • known, clean comfortable environment
  • prefer to have care providers drive to them
  • Concerns about quick labours and roadside births
  • Risk of having birth at home (baby was born in 7 mins)
  • water birth
  • use aromatherapy during labour (scent free)
  • Fear of hospitals/ negative hospital experiences
  • 1st midwife comes in labour to help the mother
  • 2nd midwife comes to take care of the baby
  • Hospitals and ambulances on standby
58
Q

Stage 1 of labour

A

muscles of the uterus start to tighten (contract) and then relax these contractions help to thin (efface) and open (dilate) the cervix so the baby can pass through the birth canal (time depends on the person)

59
Q

Stage 2 of labour

A

the cervix is dilated completely (10cm) and the baby is born (takes 2 hours ish)

60
Q

Stage 3 of labour

A

this stage occurs after the baby is born and you have contractions until the placenta is delivered

61
Q

Stage 4 of labour

A
  • this is the first few hours after birth (breastfeeding)
  • Uterus needs to contract back slowly over 6 weeks (1st time)
  • Retraction is faster each time after
  • Contractions get worse after birth to contract
62
Q

Process of birth

A
  • During the process some babies go into fetal distress (sudden change in fetal HR)
  • Anoxia (oxygen deprivation) can result in death or brain damage
  • Baby needs to be delivered by forceps or vacuum
63
Q

After Birth Recovery

A

-most women require a period of a month or so to recover
(Physically)
-Unrealistic expectations that effect the mental health of women
-Celebrities have normalized
-Still look 6 months after birth (takes months to lose baby weight)
-Mental health of mothers is affected by stereotypes and unrealistic expectations

64
Q

What we know about pregnancy?

A
  • The health of the fetus is impacted long before conception right up until delivery (and beyond) the health influences include emotional, behavioural, physical and motor with long lasting effects
  • Kent Thornburg
  • Emotional & social cultural effects
  • Health issues were predetermined based on in-utero experience

Childhood & Adolescence (2 decks)

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