Module Two & Three

Question 1

Intrauterine Environment

Answer 1

Placenta, Umbilical Cord, Fetal membranes, Amniotic Fluid

Question 2

Placenta: Structurally Complete by:

Answer 2

12th week

Question 3

Placenta: Functions:

Answer 3

Supplies O2, Nutrients, Removes CO2 & Wastes

Question 4

Placenta: Hormones:

Answer 4

Maintain Pregnancy, Facilitate Fetal Development, Prepare woman’s body for birth and lactation

Question 5

Placenta: Layers

Answer 5

Maternal: Decidua Basalis
Fetal: Chorionic Sac

Question 6

Two Protein Hormones produced by Placenta

Answer 6

1) Human Chorionic Gonadotropin

2) Human Chorionic Somatomammotropin

Question 7

Two Steroidal Hormones produced by Placenta

Answer 7

1) Estrogen

2) Progesterone

Question 8

Human Chorionic Basalis

Answer 8

Preserves function of corpus luteum, ensuring continued supply of estrogen and progesterone to maintain pregnancy

Question 9

Human Chorionic Somatomammotropin

Answer 9

Stimulates fat metabolism to supply nutrients for fetal growth, increases maternal resistance to insulin, facilitates glucose transport across the placenta and stimulates breast development

Question 10

Estrogen

Answer 10

Stimulates uterine growth, uteroplacental blood flow, causes proliferation of breast glandular tissue

Question 11

Progesterone

Answer 11

Maintains endometrium, decreases contractility of uterus, stimulates development of breast alveoli, stimulates mat metabolism

Question 12

Umbilical Cord and Membranes

Answer 12

Transport fetal blood to and from placenta

Question 13

Umbilical Cord has this many veins and this many arteries

Answer 13

One Vein, Two Arteries. Vein carries O2 and nutrients from placenta –> Fetus, Arteries transport CO2 and Wastes from fetus to placenta

Question 14

Fetal Membranes: Two:

Answer 14

Chorion and Amnion

Question 15

Amniotic Fluid

Answer 15

700-1100 ml at term.
Oligohydraminos: <300 ml in third trimester
Polyhydraminos: >2L in third trimester

Question 16

Amniotic Fluid Functions

Answer 16

• maintain temp
• equalize pressure and cushion from trauma
• protect from infection
• freedom of movement
• Provides fluid for fetus to swallow & breathe
• prevents embryo and membranes from tangling
• Repositioning for fetal waste (urine)
• Protects from pressure to contractions and aids in effacement and dilation of the cervix during labour

Question 17

Growth

Answer 17

Increase in # of fetal cells, Increase in size of fetal cells

Question 18

Development

Answer 18

Functional and structural changes that occur in fetal organ systems that have developed

Question 19

Organogenesis

Answer 19

fetus’ organs and structures begin to form and function. During early period the fetal brain undergoes extremely rapid growth and development, using a considerable amount of total nutrients available.

Question 20

Pre-Embryonic

Answer 20

0-2weeks. Conception –> 14 days of development. Fertilized egg differentiates into different specialized cells and travels down fallopian tube for implantation in uterus

Question 21

Embryonic

Answer 21

2-8weeks. 14 days after conception –> end of 8th week. Rapid growth and development- organogenesis. Embryo’s heart starts beating, head is disproportionately large, arms and legs have joints & fingers distinct.

Question 22

Fetal

Answer 22

9-40weeks. 9th week after conception –> birth. Viable at 22 weeks. Significant size increase in weeks 28-40

Question 23

Nagele’s Rule

Answer 23

Subtract 3 months and add 7 days

Question 24

5 Key Features of Fetal Circulation

Answer 24

1. Fetal O2 needs are relatively low because O2 activities are carried out by maternal system via placenta.
2. Placenta is organ of gas exchange
3. Fetal lungs are hypoperfused & fluid filled
4. Fetal Brain and Heart have increase O2 needs
5. R –> L shunting occurs through foramen ovale & ductus arteriosus

Question 25

TORCH- Infections in Pregnancy

Answer 25

Toxoplasmosis
Other: Syphilis, Varicella, Hepatitis, HIV
Rubella
Cytomegalovirus
Herpes

Question 26

Intrauterine Growth Restriction

Answer 26

symmetrical or asymmetrical.
Factors: multiple gestation, poor maternal nutrition, maternal heart disease, maternal collagen disease, maternal HTN, fetal infection, drug/alcohol use, maternal infection, maternal autoimmune diease, fam hx of IUGR, smoking, antepartum hemorrhage, fetal cardiovascular anomalies, fetal congenital anomolies

Question 27

Macrosomia

Answer 27

estimated weight more than 90th percentile.

Baby may experience birth trauma, asphyxia, and congenital anomalies such as heart defects