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Repro > Lecture 13 - Fetal Growth And Development > Flashcards

Lecture 13 - Fetal Growth And Development Flashcards

1
Q

What is the time period of the fetal period?

A

From 9 weeks onwards

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2
Q

What is the function of/what occurs in the fetal period?

A

Growth and weight gain due to structures developed in the embryonic period maturing

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3
Q

What is the main function of the embryonic period?

A

When the organs develop and theres some growth

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4
Q

What is the main process taking place in Stage 1 of growth?
(First trimester)

A

Hyperplasia
Rapid mitosis increasing DNA content

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5
Q

What is the main process taking place in Stage 2 of growth?
(Second trimester)

A

Hyperplasia and Hypertrophy
Mitosis starts decreasing but size starts to increase

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6
Q

What is the main process taking place in Stage 3 of growth?
(Third trimester)

A

Hypertrophy
Rapid increase in size, weight and muscle growth

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7
Q

How can you date a pregnancy?

A

Date of Last Menstrual Period

Fetal movements (start at 20 weeks)

Symphysis-fundal height

Ultrasound

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8
Q

What is symphysis fundal height?

A

The distance between the fundus of the uterus and the pubic bone

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9
Q

What is the significance of the symphysis fundal height in dating a pregnancy?

A

Normally it’s size in cm is equal to the number of weeks in the pregnancy + or - 2cm

So a 28wk old pregnancy should be 28cm +or- 2cm

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10
Q

What weeks are ultrasounds normally done?

A

12wk
20wk

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11
Q

What is the purpose of the 12wk ultrasound scan?

A

Date pregancy (gestational age)

Multiple pregnancy
Chromosomal abnormalities (Down syndrome)

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12
Q

What is the purpose of the 20wk ultrasound scan?

A

The anomaly scan

Screening for Fetal abnormalities

Placental location

Size of baby

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13
Q

What is crown rump length?

What is its use?

A

The distanc from the top of the foetuses head along its back to the rump

Can date a pregnancy

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14
Q

Between what weeks can crown rump length be used to date a pregancy?

A

7-13 weeks

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15
Q

What other measurements can be taken to date a pregnancy in the 2nd or 3rd trimester (late stage pregancy)?

A

Biparietal diameter (distance between parietal bones)

Abdominal circumference

Femur length

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16
Q

What is the average birth weight?

A

3.5kg

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17
Q

What is macrosomia?

A

Large baby at birth

Weight > 4kg

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18
Q

What is considered low birth weight, very low birth weight and extremely low birth weight?

A

Low < 2.5kg
Very low 1 - 1.5kg
Extremely low <1kg

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19
Q

Why is important to accurately date pregnancy?

A

To determine whether a baby is premature or whether they’ve suffered and growth restrictions

To help determine the reason for them being low weight

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20
Q

What are the 2 different types of Intrauterine Growth Restriction?

A

Symmetrical
Asymmetrical

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21
Q

What is the difference between symmetrical and asymmetrical Intrauterine growth restriction?

A

The timing at which the thing causing the growth restriciton occurs

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22
Q

What is symmetrical Intrauterine Growth restriction?

When does it occur?

A

When all the measurements of the baby are all proportionally reduced (abdominal circumference, biparietal diameter and femur length)

Occurs early on

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23
Q

What can cause symmetrical intrauterine growth restriction?

A

Genetic Disorders
TORCH infections

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24
Q

What are the TORCH infections?

A

Toxoplasmosis (cats)
Other - (syphilis, HIV, varicella zoster)
Rubella
Cytomegalovirus
Herpes simplex

25
Q

What is asymmetrical Intrauterine Growth restriction?

When does it occur?

A

When the biparaietal diameter diameter and fetal lenght are normal but th abdominal circumference are reduced
This is due to nutrients being focused to the brain

Occurs later on

26
Q

What can cause asymmetrical intrauterine growth restriction?

A

Placental insufficiency like pre-eclampsia

27
Q

What is the general function of the embryonic stage and the fetal stage for the development of the respiratory system?

A

Embryonic development = creates bronchopulmonary tree (basic structure)

Fetal development = functional specialisation

28
Q

What are the further 4 stages of lung development following from the embryonic period onwards?

A

Pseudoglandular stage
Canalicular stage
Saccular stage
Alveolar stage

29
Q

What occurs in the pseudogalndular stage of lung development?

A

Terminal bronchioles begin to form

30
Q

What occurs in the canalicular stage of lung development?

A

Budding from bronchioles begins to occur

Type 1 and Type 2 pneumocytes start to form from the differentiation of cuboidal cells

Some gas exchange can happen at the end of this stage

31
Q

What occurs in the saccular stage of lung development?

A

Terminal sacs start budding from the respiratory bronchioles and alveoli start to form

Surfactant starts being made from the Type 2 pneumocytes

32
Q

What occurs in the alveolar stage of lung development?

A

Mature alveoli form

Proliferation and expansion of capillaries nerves and gas exchange areas

33
Q

What age are the lungs mature by?

A

8yrs old

34
Q

What age is a fetus viable and why?

A

From week 24 onwards
(Saccular stage of lung development)

Alveoli are starting to form and SURFACTANT is being produced

35
Q

What stage of development is a fetus viable by?

A

When the lungs have entered the terminal sac/saccular stage
Which is week 24 onwards since some gas exchange is possible at the end of the canalicular stage

36
Q

What is Respiratory Distress syndrome?

A

When there is insufficient surfactant production
Often affect using premature births

37
Q

How is Respiratory Distress Syndrome managed before birth (antenatal)?

A

Glucocorticoid treatment

38
Q

Why are glucocorticoids given to a fetus in Respiratory Distress?

A

Try and boost lung development and stimulate surfactant production before delivery

39
Q

How is Respiratory Distress Syndrome managed after birth (neonatal)?

A

Nasal continuous positive airway pressure (nCPAP)
Surfactant replacement therapy
Mechanical ventilation

40
Q

Describe the cardiovascular set up of the fetus:

A

Oxygenated blood transported from placenta to fetus via umbilical VEIN

Deoxygenated blood transported from fetus to placenta via umbilical ARTERY

41
Q

What point is the first fetal heart beat heard?

A

Weeks 5-6

42
Q

What is normally Fetal heart rate once its developed?

A

110 - 160bpm

43
Q

What usually happens to the heart in repsonse to fetal distress?

A

Fetal bradycardia

44
Q

Why does Fetal Bradycadia occur with Fetal distress?

A

Low O2 reaching fetus
Leads to HR reducing too reduce the demand

45
Q

What week does the Fetal kidney begin to function?

A

Week 10

46
Q

What is the function of the Fetal urinary system?

A

Produces fetal urine which is a major contributor to amniotic fluid volume from week 20

47
Q

What is Oligohydramnios?

A

Too little amniotic fluid

48
Q

What is polyhydramnios?

A

Too much amniotic fluid

49
Q

What it’s the general function od amniotic fluid?

A

Protects/cushions the embryo/fetus

50
Q

What can cause Oligohydramnios?

A

Anything that impairs the fetal urinary system

Placental insufficiency
Fetal renal impairment
Premature ruptured of membranes
Pre-eclampsia

51
Q

What causes polyhydramnios?

A

Fetal abnormalities like oesophageal atresia (impaired swallowing) or anencephaly

Gestational diabetes (urinate more)

Fetal anaemia

Multiple pregnancy (more urine made overall)

52
Q

What is an issue with polyhydramnios?

A

Can lead to premature birth

53
Q

When do the corticalspinal tracts of the nervous system start to form so coordinated voluntary movement can happen?

A

4th month

54
Q

What month of development does myelination of the brain start?

A

9th month

55
Q

What is quickening?

A

When th mother becomes aware of Fetal movements from week 15-17 onwards

56
Q

When do fetal movements first start occurring?

A

8th wk

57
Q

What are premature infants more at risk of?

A

Higher risk of neuro developmental disorders like cerebral palsy (also due to lungs may not be fully developed so get hypoxia at brain)

Interventicular haemorrhage sync eblood vessels not fully developed

58
Q

What can be injected into the woman between weeks 24 - 29 who are at risk of premature birth for Fetal neuro protection?

A

Magnesium sulphate

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