Lecture 1 Flashcards
pre-embryonic stage
secondary oocyte–> sperm cells–> fertilization–> second polar body –> zygote–> cleavage from 2 celled to 8 celled (this is at hour 30) –> morula (hour 72) –> blastocyst –> implanted blastocyst (day 6)
zygote
the moment the ovum is fertilized and has chromosomes from the mother and father
After zygote stage
cell division then mitosis and during this it is travelling down fallopian tube to uterus
* hour 72 is morula
between day 6 and 10
cells of pre-embryonic stage
blastocyst implants to uterus
placental cells
outer cells of blastocyst called trophoblast
embryo cells
inner cells of blastocyst
function of progesterone in pre-embryonic stage
allows for strong blastocyst implantation and more vascular endometrial lining
embryonic stage
10-12 days after fertilization until 8 weeks
- organogenesis occurs (formation of organs)
First system created in embryo stage
cardiovascular
embryonic period
organ development, abortion is common at this point, highly susceptible to teratogens
fetal stage
11 weeks gestation to birth
- officially a fetus
week 3 organ
heart and CNS
week 4-5 organ
eyes, arms, legs
week 6 organ
teeth and ears
week 7 organ
palate
week 8-9 organ
external genitals
week 9-16 organ
brain
placental development
occurs when
occurs with first contact of outer shell of developing blastocyst with the uterine mucosa
3 functions of placenta
circulation, protection, hormone production
Hcg
production location and what it is
produced by placenta; value looked at in pregnancy test
estrogen
purpose for pregnancy
allows for growth of uterus and growth and development of mammary glands for breastfeeding
fetal circulation
pathway
placenta accepts deoxygenated blood via umbilical arteries then blood flowing through placenta picks up oxygen and is brought to fetus via umbilical vein then to the liver then to right side of heart
patent foramen ovale
hole between right and left atrium that allows oxygen rich blood to go from right to left atrium –> ventricle –> then aorta
ductus arteriosus
sends oxygen poor blood to organs in lower half of fetal body
prenatal care during first trimester
1-2 visits
- bloodwork, assessment, dating ultrasound
prenatal care during second trimester
3-4 visits
- ongoing assessments, fetal assessment, anatomy ultrasound at week 18/20, GDM
prenatal care during third trimester
3-5 vitis
- maternal and fetal assessments, GBS swab at 35 weeks
fundal height measurement
should be correlated to weeks of gestation with 2 cm leniency
Leopold maneuver
what does it determine and what needs to be done immediately before
fetal lie, presentation, attitude, position
- important to empty bladder first
first maneuver of leopold
determines what
determines where fetal head and bum are
2nd leopold maneuver
determines what
determines where fetal back is (where doppler goes)
3rd leopold maneuver
determines what
determines how low the baby is
- station
4th leopold maneuver
determines what
determines degree of fetal extension into pelvis
healthy pre-pregnancy weight
BMI 18.5-24.9
recommended weight gain for healthy BMI
11.5kg-16kg (25-35lb)
weight gain for BMI less than 18.5
12.5-18kg (28-40lb)
weight gain for BMI of 25.0-29.9
7-11.5kg (15-25lb)
weight gain for BMI 30 or over
5-9kg (11-20lb)
recommended fetal movement in 2 hours
6 movements
- should be laying on side or sitting when assessing
Nonstress test
woman pushes button every time she feels baby move
- baby HR is compared during movement and contractions; should increase when it moves
variability of HR determines..
normal pH
decelerations of HR determines..
O2 levels/deprivation
contractions indicate what for fetus
may be cause of O2 deprivation
accelerations of HR is what in terms of pH..
a marker of normal pH
baseline fetal HR
110-160
moderate variability in HR
5-25bpm
- this is ok
absent variability
0-1bpm
minimal variability
less than 5bpm
marked variability
greater than 26 bpm
- could be due to hypoxia or cord compression
accelerations
normal; result of fetal movement
- should be 15x15 and subside in 2 min
early decelerations
occurs early in contraction
- could be due to head compression
- lowest point of decel is at highest point of contraction
late decelerations
occurs after onset of contraction and reflects shape of contraction
- could be due to placental insufficiency
- starts to dip down when contractions has already been occuring
variable deceleration
onset varies in timing with onset of contraction
- abrupt drop
- could be due to cord compression
clamping of the umbilical cord at birth
it is done to stimulate baby’s lungs to start working because CO2 goes up when it is clamped
initial newborn assessment 3 points
done within first few minutes of birth, determines need for resuscitation, delayed cord clamping 60 seconds
Appearance (APGAR)
if pink - 2
if blue extremities- 1
if pale or blue- 0
Pulse (APGAR)
greater than 100- 2
less than 100- 1
no pulse- 0
Grimace (APGAR)
cries/pulls away- 2
grimace/weak cry- 1
no response- 0
Activity (APGAR)
active- 2
flexed arms/legs- 1
no movement- 0
Respiration (APGAR)
strong cry- 2
slow/irregular- 1
no breathing- 0
baseline respirations
30-60
baseline temperature
36.5-37.2
conduction as a mechanism for heat loss
transfer of heat by direct contact
- prewarmed surface or skin to skin
convection as a mechanism for heat loss
cool air in the hospital
- putting blankets on baby
evaporation as a mechanism for heat loss
drying baby body to ensure not heat is lost to cool/wet secretions
radiation as a mechanism for heat loss
don’t put baby by cold window
Vitamin K prophylaxis
purpose and what it prevcents
given because neonates lack intestinal flora to make vitamin
- prevents hemorrhagic disease of newborn
umbilical cord consists of..
2 umbilical arteries and 1 umbilical vein
