Lecture 18- Prenatal to Neonatal Flashcards
What are the four terms used during Prenatal and Neonatal Development?
Pre-embryonic stage, Embryonic, Fetal, Neonate.
What is the Pre-embryonic stage? (cells)
Pre-embryonic stage (first 2 weeks) -zygote implants into uterine wall
What is the Embryonic stage?
Embryonic (3 to 8 weeks)
The blastocyst begins to take on distinct human characteristics.
It’s now called an embryo.
Structures and organs like the neural tube (which later becomes the brain and spinal cord), head, eyes, mouth and limbs form. The embryo’s heart begins to develop and pulse around the sixth week
What is the Fetal stage?
9 weeks to birth, usually 40 weeks.
During this stage, the fetus will continue to develop organs, including the brain and spinal cord. Between weeks nine and 12, the fetus will begin to make movements with their arms and legs
What is the Neonate stage?
birth to 28 days
What are neonates are assessed immediately after birth?
APGAR scale
Whats the APGAR scale?
The APGAR scale is designed to indicate how the newborn is transitioning to life outside the womb. The APGAR test examines five key factors. Each category can score between 0 to 2 points. A score of 9 to 10 is ideal. A lower score may indicate that the newborn requires medical attention.
What does APGAR stand for?
A appearance (pink or blue complexion, pink is good)
P pulse rate (ideally over 100)
G grimace (responds to stimulation)
A activity (muscle flexion and resistance)
R respiration (solid breathing, crying is good)
How many points can each APGAR category score?
What is the best score for a neonate?
0-2 points for each category.
A score of 9 to 10 is ideal.
What’s the normal weight of a just-birthed baby?
3.4kg (7lb 8oz).
What is the fontanel?
A fontanelle is a ‘soft spot’ of a newborn baby’s skull. There’s posterior and anterior.
What can be used to assess hydration status in neonates?
Fontanel
What reflexes do newborns have? (5)
Moro reflex (Arms out, unsettled)
Stepping reflex (appears to take steps or dance when held upright with his or her feet touching a solid surface)
Palmar (Grasp) reflex
Tonic neck reflex (T pose)
Sucking and hand-to-mouth activity
Seeking (or rooting) reflex (This reflex starts when the corner of the baby’s mouth is stroked or touched. The baby will turn their head and open their mouth to follow and root in the direction of the stroking. This helps the baby find the breast or bottle to start feeding)
What senses do neonates have?
- At birth, a neonate can see colour and form (they can make out a human face and focus on objects about 20-25cm away from them).
- They can hear and turn towards sounds
- smell and taste
- touch and feel pain.
What is the beginning of cognitive development in neonates?
Cognitive development begins with inherent behaviour, reflexes and sensory function.
What is psychosocial development?
describes how a person’s personality develops, and how social skills are learned from infancy through adulthood.
Psychosocial development occurs as children form relationships, interact with others, and understand and manage their feelings.
In emotional and social development, forming healthy attachments is very important and is the major social milestone of infancy. Attachment is a long-standing connection or bond with others.
What is the average pulse rate of neonates?
Pulse rate 80-180 beats per minute
What is the average RR of neonates?
respiratory rate 30-80 breaths per minute
What is the average BP of neonates?
blood pressure 73/55 (mmHg)
What is the average temperature of neonates?
Average temperature 36.8 (axillary).
What tests are screened in newborns?
- Phenylketonuria (PKU)
- Congenital hypothyroidism (Cretinism)
- Cystic fibrosis
- Galactosaemia
What parts of the fetus are at high risk embryonic stage? (10)
neural, heart, upper limbs, lower limbs, ears, eyes, palate, teeth, external genitalia, and major abnormalities.
What are three main causes of abnormal development
Genetic
Environmental
Unknown
What stage is the most critical for the development of organs, etc. and when can most development abnormalities occur?
Embryonic stage
What are examples of genetic fetal abnormalities?
Cystic fibrosis, sickle cell anemia, Tay-Sachs disease, hemophilia, Marfan syndrome, Down syndrome, etc
Why do genetic fetal abnormalities occur?
Some genetic disorders are passed down from parents to children through their genes.
Sometimes there are sporadic changes in the DNA of a gene that cause the developing baby to be affected without a prior family history.
Multifactorial or complex disorders are caused by a combination of genetic predispositions and environmental factors, which makes it harder to predict who may be at risk
What are examples of environmental fetal abnormalities?
Spina bifida, cleft lip or palate, gastroschisis, hypospadias, chromosomal congenital anomalies such as Down syndrome, and some heart and blood vessel defects
What are examples of environmental factors that can cause fetal abnormalities?
Others occur because of environmental factors like maternal infections (syphilis, rubella, Zika)
exposure to radiation, certain pollutants
maternal nutritional deficiencies (e.g., iodine, folate deficiency)
illness (maternal diabetes)
certain drugs (alcohol, phenytoin).
What is the condition called when babies are born with abnormalities due to alcohol?
FASD- Fetal Alcohol Spectrum Disorder
What are affects of Fetal Alcohol Spectrum Disorder?
Trouble with learning, problem solving, understanding cause/ effect and long-term consequences
Smaller brain, Smaller corpus callosum, low birth weight distinctive facial features, heart defects, behavioural problems intellectual disability.
What are visual indicators of FASD?
Small eyes, an exceptionally thin upper lip, a short, upturned nose, and a smooth skin surface between the nose and upper lip
How many babies are born with FASD each year in nz?
1800 - 3000 babies
