Prenatal Development(HD) Flashcards
Mitosis
- cell division
- one step process-mutiply then divide
- somatic cells divide producing exact copies of themselves
Meiosis
- cell division
- 2 step process-multiply,divide,divide
- meiosis creates gametes(sperm and eggs)
- meiosis ensures variability in off springs
Gametogenesis
- process in which cells divide by meiosis to form gametes
- oogenesis-results in one oocyte(ovum)
- spermatogenesis-occurs in testes results in sperm
Fertilization
- occurs in the outer third portion of the fallopian tube
- high estrogen levels increase peristalsis
- membrane cellular change
- zygote w/ 46 chromosomes
Sex Determination
- occurs at fertilization
- all oocytes have xchromosome
- sperm are carrying either an x or y chromosome
- sperm and oocyte have 23 chromosome-haploid number
- zygote has 46 chromosomes-diploid number
Fetal Development
Zygote(pre-embryonic)-first 2 weeks, fertilization,cell reproduction, implantation
Embyo(2-8weeks)-embryo is nourished and develops
Fetus(9th week-birth)-approx. 38-40weeks, growth and development
Tubal Transport of the Zygote
- Fertilzation in upper third of Fallopian Tube
- cells divide quickly 2-4-16(approx 3days) morula
- 32(5-7days) blastsyst
- Blastocyct implants into the thickened endometrium
- Trophoblast develops within 35 days and becomes embryo
Implantation of the Zygote
- Blastocyct imbeds into endometrium 5-6 days after fertilization
- blastocyst secrets HCG-Human Chorionc Gonadotropin
- villi on outer layer lets HCG into endometrium
- HCG signals the corpus luteum
- takes 2 weesk to complete
- endometrium is not the decidua
- structures will form
- gestation 280 days or 10 lunar months or 38-42 weeks
cell differentiation(embryo)
occurs after implantation
chorion(embryo)
outermost layer
villi(embryo)
fingerlike projection
amnion(embryo)
innner layer-cells secrete fluid
- maintain temp
- symmetrical growth
- movement,shock absorber
- prevents skin from sticking to amnion
germ layers
give rise to specific tissues and organs
endoderm
respiratory system
mesoderm
circulatiory system(Heart Beat heard at 5th week)
Ectoderm
skin, yolk sac-forms RBCs for first 6weeks
Placenta
- temporary organ
- 12 weeks to fully development
- nutrients to fetus
- waste to mom for excretion
Placental Transfer
- limited protection
- drugs can pass through
- A=do not cross placenta
- B=crosses w/o side effects
- C=crosses placenta membrane not sure of effect
- X=cannot be given
Placenta Metabolism
- capable of metabolism
- produces fatty acids,glycogen,cholesterol
Placenta Hormones
progesterone:
- maintains uterine lining
- reduce uterine contractions
- prepares alveolar glands
Estrogen:
- stimulates uterine growth
- increases blood flow to uterus
- stimulates lactiferous development
Human Chorionic Gonadotropin(HCG):
- signals corpus lutem to continue to secrete progesterone
- regulates sterioid production in fetus
Human Placental Lactogen(HPL)
- helps mom to increase glucose production in first trimester
- helps with breast development
- increases resistance to insulin
- HPL should decrease in second trimester, if it doesnt gestional diabetes will occur
Umbilical cord
- connecting link btw mother and fetus
- mom and fetus do not have blood
- 12-36inches, 1-3ft long
- 2 umbilical arteries(carries waste to mother)
- 1 umbilical vein(carries oxygen and nutrients to fetus)
- surrounded by whartons jelly-white gelatinous connective tissue
(Fetal Heart Rate: Development of the Embryo/Fetus:)
- Fetal Heart Rate:
- 5weeks=hb on sonogram
- 12weeks=hb w/ doppler
- 20weeks=hb w/ fetoscope
Movement of Embryo/Fetus
quickening at 20weeks
Recognition of gender
16 weeks=gender determination
age of viability
20 weeks(5months) =age of viability
vernix caseosa
thick cheesy substance that covers baby and protects the skin
goals for prenatal care
- protect and promote health and well being of the mother
- safeguard health and well being of the unborn infant
- avoid teratogens
- plan for a safe delivery
Prenatal visits
- conception to 28weeks=every 4 weeks
- 29-36weeks=every 2 weeks
- 37weeks-delivery=weekly
Ultrasonography
- can detect fetal movement
- identification of embryo or fetus
- gestational sac as early as 4-5 weeks
Amniocentesis
- early as 14weeks
- ultrasound
- 10-20ml
- diagnosis=sex,fetal status,genetic problems
Presemptive signs of pregnancy
- Amennorrhea-absence of menstruation
- Breast changes
- urinary frequency
- changes in shape of abdomen
- Linea Nigra-skin discolor
- Chloasma-skin discolor
- quickening
- nausea and vomitting
Probable signs of pregnancy
- enlarged uterus
- hegars sign: softening of fundus
- goodwells sign: softening of cerxix
- Chadwicks sign: blusish discoloration of vagina,cervix,labia due to increase blood flow
- ballottement:palpatating rebound of fetus
Probable signs of pregnancy pregnancy test
- urine for HCG
- radioimmunoassay(RIA)
- potential hydatidiform mole or cancer
Positive signs of pregnancy
- Fetal Heart Sounds
- 5 week=sonogram
- 12week=doppler
- 20 week=fetoscope
- uterine souffle
- funic souffle
- ultrasound
physical reproductive system changes
uterus:
- increase blood supple and size
- walls stretch and thin
Cervix:
- shorter and softer
- mucouse plug
Ovaries:
-continue to secrete estrogen/ovulation ceases
Fallopial tubes:
-no change
Vagina:
- increased blood supply
- thicker, increase secretions
Breasts:
- alveolar glands develo
- darker areola
sysyemic changes during pregnancy
resp:
- diaphragm up
- increase respirations
Cardio:
- hr up and left
- increase blood volume and co/ decrease hct
Gi:
- n/v/ ptyalism(increase salvation)
- softer gums
- hemorrhoids
Urinary:
- glycosuria
- proteinuria
- frequency
Integ:
- Linea Nigra
- Striae gravidarum(stretch marks)
- cholasma
skeletal:
-lordosis
Nageles Rule
- Estimated Date of Delivery(EDD)
- identify first day of menstrual period
- count back 3months
- add 7days
- only an estimate
- ultrasound evaluation
Obstetrical History= 2 digit method
Gravida: number of pregnancies
null=never before
primi=first pregnancy
multi=more than 1
Para: number of pregnancies that have gone past 24weeks(age of viability) whether infant was dead or alive
Obstetrical History= 5 digit method=GTPAL
G= number of pregnancies T= number of completed term pregnancies P=number of pre-term pregnancy A=number of abortions L=number of living children
First Prenatal Visit
- comprehensive history
- physical asses
- VS,Ht,Wt
- Fetal Heart Rate
- Fundal Height
- Pelvimetry
- Breast Exam
Psychosocial assesment
- support system
- emotional status
- economics
- cultrual preferences
Lab Test
- cbc,blood type
- Rh factor- if mom and dad negative no problem
- if mom - and baby + potential problems
- U/A, TB test
- test done later in pregnancy
- TORCH screen, triple screening, spina bifida, trisomy 21,mental retardation
weigh gain recommended
25-35lbs=for mom of normal weight
28-40lbs= for underweight mom
15-25lb= for overweight
Trimesters
- 1st-maternal tissue
- 2nd-maternal and fetal tissue
- 3rd-fetal tissue
Nutrition
- 2500 calories/day
- (more for teenage mom)
- increase fluids-8-10 glasses/day
- protein=60g/day
- calcium=1200mg/day
- iron=30mg/day
- vitamins(+prenatal vitamins)
- C=70mg
- A=800mg
- D=10mg
- Folic Acid=400mcg
- limit fats/sodium preservatives/caffeine
- consider dietary restrictions
- DM/HTN/Lactose intolerance/Celiac disorder
- culture
Foods to avoid
- solid white tuna
- shark, swordfish,tilefish
- deli meats
- raw fish
- soft scrambled eggs
- caffeine
- exercise=should be done in moderation
- can maintain non-pregnant activity
Patient education
- needs are assessed by health care team and individualized plan developed
- should include:
- travel restrictions
- activity level
- nutrition/exercise
- consider age of mom very young/advanced age
birth plan
- type of delivery
- setting
- partners role
- infant care classes
Reportable symptoms
- vaginal bleeding
- leaking of fluids
- unusual cramps
- unusual abdominal pain
- persistent N/V
- blurred vision
- persistant headache
- marked swelling of feet or hands
- pain or burning on urination
- fever/chills
- decreased fetal movement
Common discomforts(First trimester)
nausea -dry toast or cracker -drink fluids between meals not with meals -no fried food Vaginal discharge: -no douche -bathe daily -cotton underwear Fatigue -naps,try for good night sleep Nasal Stuffiness -Fluid Breast enlargement -support bra
Common discomfort(second trimester)
backache: -good shoes. proper lifting technique -knee chest position constipation: -increase fluids and roughage varicose veins: -elevate legs -support stockings -avoid standing and sitting for long periods
Common discomfort(third trimester)
Hemorrhoids -sitz bath; avoid constipation Heart Burn: -small meals,sit up after meals Dyspnea -sleep with pillows Leg cramps -diet, exercise Edema of legs -elevate legs, watch Na intake Mood Swings -emotional support
EDD,EDC
- estimated date of delivery
- estimated date of confinement
Quickening
-first movements of the fetus felt in the uterus(18-20wek)
Ballotment
palpation technique used in detecting or examining a floating object- rebound of the fetus or a fetal part when dislpaced by a light tap of the examining finger thru the vagina
Striae
shiny reddish lines as a result of stretching of the skin
RIA
radioimmunoassay
Chloasma Gravidarum
brownish pigmentation of the face occuring in pregnancy
Uterine Souffle
soft, blowing sound heard over the uterus during asesculation caused by blood entering diated uterine arteries
Lighteining
sensation of decreases abdominal distention produced by the descent of the fetus and uterus into the pelvic cavity
