Prenatal development and Birth Flashcards

1
Q

what is the zygote/germinal stage?

A

Zygote or Germinal Stage (0-2 wks): Conception to implantation

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2
Q

What is the embryo stage?

A

Embryo (3-8 wks)
Structural Development
• Neural tube: Becomes brain & spinal cord
• Amniotic sac: Fluid-filled membrane protecting embryo
• Placenta: Disc-like structure connecting embryo to uterus
• Umbilical cord: Tube connecting embryo to placenta • Provides oxygen & nutrients • Removes carbon dioxide & waste
• Miscarriage risk highest
Can look around and feel- feet and mouths

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3
Q

What si the Foetus stage?

A

Foetus (9-38 weeks): functional development
Brain development and CNS development- connections strengthen- cerebral cortex develops a lot through this
Responds to stimulation
Wk 12: can tell sex
Reflexes develop
Wk 17-20 mother feeels movement
Wk 22-26: viability – if the baby was born prematurely it would probably be able to survive.
Last few weeks baby turns around so it’s born headfirst rather than feet first.

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4
Q

WHat is a teratogen?

A

Teratogen: An environmental agent that causes prenatal damage
9/10 births are normal
Effects during critical/sensitive periods
• Effects are specific
• Longer exposure is worse
• Some First 2 weeks- Zygote usually isn’t susceptible to teratogens as it’s not connected to mother yet.
EMbryonic stages 3-8: major structure abnormalities caused by teratogens
e.g. heart, eye, CNS, ears, genitals have no effect on mother
• Maternal/foetal genes may counteract effect

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5
Q

What is Thalomide?

A

Drug for morning sickness (1957-61)
• Caused structural abnormalities in limbs & face
Must have taken through week 4-5
Majority exposed didn’t get symptoms.

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6
Q

What is DES?

A

Hormone to prevent miscarriage (1947-64)

• Linked to reproductive problems & cancers in offspring

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7
Q

Give some legal teratogens?

A

Caffeine:
Miscarriage
Low birth weight e.g. 200mg

Tobacco 
Chemicals in smoke 
Miscarriage and prematurity  
Nicotine affects placenta --> poor nutrition --> low birth weight  
Role of oxygen  
ADHD 
Carbon monoxide- displaces Oxygen so foetus gets less oxygen  
Mother should give up a month before 
Passive smoking also effects it.  

Alcohol:
Passes right through placenta into foetus

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8
Q

What can some teratogens lead to?

A

Foetal Alcohol Syndrome (FAS):
Stunted growth, physical defects, often mental retardation

Foetal Alcohol Spectrum Disorder (FASD)
• Role of oxygen
• Last trimester worst (unlike most teratrogens- affects brain development as this is period of time where it’s developing rather than structure)
• 1-5% affected in UK

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9
Q

give some environmental toxins

A

Radiation (atomic bomb, nuclear reactor meltodowns)
-Miscarriages, stunded growth, physical defects, cancer

Pollution (lead, murcurary e.g. in tuna, PCBS) - PRematurity, LBW or cognitive impairments.
Air pollution particles found in mothers placenta…

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10
Q

Outline how infectious diseases can be an example of a tetarogen

A

Infectious diseases
serious (TORCH) •
Toxoplasmosis: Parasitic infection in cats & raw meat
brain & eye damage
• Other viruses (e.g., HIV/ AIDS
Mortality, small head, physical & mental defects)
25% mother untreated
1% if mother is treated
• Rubella: Virus damages eyes, ears, heart; causes mental retardation
20,000 babies effected with heart issues
• CMV: Virus w/ mild (or no) flu-like symptoms- visual,hearing difficulties, mental retardation…
• Herpes: Sexually transmitted virus; damages eyes, brain, motor system

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11
Q

give some other diseases not included in TORCH that affects pre-natal development

A

Chlamydia- issues with fertility
Syphilis passed on

Zika Virus
• Mosquito-borne infection; Identified in Uganda (1947)
• 2016 epidemic: Asia, South America
• Can cause mild fever in mother
• Causal link to infant microcephaly (small brain) confirmed Sep 2016
• Infects foetal brain tissue
• No vaccine (yet)
• Lifelong sensory, motor & cognitive disability

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12
Q

Outline maternal risk factors that can affect development

A

Age
• Fertility problems increase w/ age
• Miscarriage & chromosomal damage risks increase w/ age
• Teen mums also at risk- less likely to have prenatal care…more detail needed
Old mums- who have had a child- lower risk of defects

Nutrition
• Weight gain
• Affected by ethnicity and SES
•(needed) Folic acid or: Neural tube defects
If neural tube doesn’t close at end so not enough pholic acid- Anencephaly
If the neural tube doesn’t close at the lower end the spinal cord sticks out- spina Bifida

Prenatal Care
• Health
• Toxaemia/Pre-eclampsia: Pregnancy-caused high blood pressure
Restricted growth, preterm birth, stillbirth

• (Gestational) Diabetes-
High birth weight, preterm birth, temporary breathing problems

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13
Q

Outline what is meant by the APGAR scoring system Outl

A
activity, 
Pulse, 
Grimace(reflex irritability) 
Appearance(skin colour) (reparations) 
1minute after baby is born and then 5 minutes after baby is born     

10 is baby Is perfect condition 1 is baby is in need of urgent care.`

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14
Q

Outline the risks with preterm babies

A
Preterm: < 36 wks  
• < 10% births (UK)  
• Avg weight 2.3 kg (5 lb) 
 • Risk of cognitive delay  
• Appropriate weight for pregnancy length 
 • Very preterm: < 32 wks  

• Extremely preterm: < 26 wks
• Inadequate surfactant (liquid in lungs that sends O2 into blood)
• May cause respiratory distress syndrome
• Risk Factors – only evident in half of cases
Hard to predict what causes preterm births
Something like half of babies pre-term births for no apparent reason.

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15
Q

Outline the risks of small-for date- babies (LBW)

A

Full-term OR preterm
• BELOW expected weight for pregnancy length

• ‘Normal’ birth weight is approx. 3.5 kg (7.7 lb)
Low Birth Weight (LBW) < 2.5 kg (5.5 lb) Very Low Birth Weight (VLBW) < 1.5 kg (3.3 lb) Extremely Low Birth Weight (ELBW) < 1.0 kg (2.2 lb)

Issues with placenta- infections
Links with learning diificulites, mental difficulties, poor social skills, issues in school

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16
Q

Why isn’t small-for date babies always an issue?

A

Why more serious problems?
• Most catch up by 4 yrs
• Can have motor & cognitive problems longer term

However:
Babies less than 1500g- make less friends and reach lower qualifications though rate self-esteem and quality of life same of peers

Babies born 1986

17
Q

explain what a stimulation programme is

A

Stimulation Programmes for Preterm Babies
• Used to be isolated to protect health
• But under-stimulation delays development
• What kind of stimulation is best?
• Mimic the sensations of the womb?
• Skin-to-skin contact (kangaroo care)?- keep temperature regulated as if they were inside the womb.
• Massage?
• Interact same as if full-term newborn, or is this overstimulating?

18
Q

Outline 3 types of stimulation programme

A

breathing bear
massage stimulation
parent intervention

19
Q

what is the breathing bear?

A

e.g., Thoman et al., 1995, as cited in Leman et al., 2012
• Investigated the sleep/wake states of preterm babies
• At 33 wks conceptional age (CA), babies were randomly assigned to a Breathing Bear (BB; n = 27) or a Non Breathing Bear (NB; n = 26) condition.

  • At 35 wks CA, behavioral observations were made over a 2-hr period, recording babies’ sleep/wake states: Active sleep, quiet sleep, sleep-wake transition, waking, or fuss/crying.
  • Movements and startles were also measured.

• BB babies showed less waking, more quiet sleep, fewer startles in quiet sleep, and less crying.
• BB babies were more likely to smile than grimace during active sleep, whereas NB babies had the opposite pattern.
Didn’t differ in respiration rates- between groups. Original purpose was to see if breathing regulated by hearing someone breath next to you.

20
Q

Outline massage stimulation

A

Preterm infants were assigned to treatment and control groups. Treatment infants received three 15-min massages daily for 10 days. Control infants received no massage. Treated infants gained more weight per day and were discharged from hospital several days earlier than control infants.

21
Q

Outline Parent interventions

A

Preterm babies need even more sensitive care than full-term babies, but likely to get even less sensitive care due to:
• Physical appearance- babies look different-smaller than normal babies- may distress parent
• High-pitched cry – can set parents on edge
• Feeding difficulties
• Lower responsiveness- again causes distress for parent

Hospital or home-based interventions aim to improve parent-infant interaction

Parent intervention:
Effectiveness of interventions depends on many factors (e.g., Landsem et al., 2015; Welch et al., 2015)
• Nature of intervention (e.g., massage, maternal sensitivity, infant self-regulation)
• Infant characteristics (e.g., how preterm, how stable/healthy otherwise) • Intervention duration and/or intensity (short term interventon, short term effects- may not benefit long term much…)
• Length of follow-up (e.g., 6 months, 9 years)
• Outcome measures (e.g., physical dev., cognitive dev., attention, behaviour problems) might be more effective for different problems.