Prenatal, Perinatal & Parental Transitions Flashcards
Gametes
• Sperm: 200-300 million cells daily & begins in puberty
• Eggs: 400,000 immature cells & are present at birth
- only 400-500 mature
Conception
- Sperm meets ovum (unfertilized egg) & fertilization occurs
* Both biological parents contribute 23 chromosomes
Pathways to parenthood: Deciding
- lifestyle they want to live
- heritable diseases
- egg count & egg health of female
- sperm count & sperm health of male
- same sex partner
- single parent?
Ways to parenthood
- Intercourse
- Artificial insemination
- Gamete intrafallopian transfer
- Invivo fertilization
- Invitro fertilization
- Surrogate mother
- Adoption
Artificial Insemination
• Sperm donor
Invitro fertilization
- eggs removed from ovulary & put in petri dish, then transfer embryo to the uterus.
- people do this when the fallopian tube is damaged
- unknown infertility
- females with ovulation disorders
- tubes tied
Gamete intrafallopian Transfer (GIFT)
- Fertilization happens in the tube and not in the lab
- Egg & sperm transfered into the fallopian tube
- Tubes must be healthy
Invivo fertilization
Fertilization that occurs in the womb
What are the effects of assistance in reproduction
- Higher likelihood of multiples
* Increased rate of preterm & low birth weight in babies
Adoption as an option
- If the parents are infertile
* Mother possibly may not want to deal with uncontrollable changes in the body
Prenatal Developmental Stages
- Zygotic/Germinal Stage (conception-2 weeks)
- Embryonic Stage (2-9 weeks)
- Fetal Stage (9 weeks-38 weeks)
Zygotic/Germinal Stage
- Sperm penetrates egg =fertilization
- Once fertilization occurs and a zygote (fertilized egg) is created outside of egg thickens so that no other sperm enters the egg
- Zygote to the fallopian tube & cell division begins
- Implantation in uterus occurs
- Blastocyst= balls of cells form
- Inner cell= becomes embryo
- outter cell= tropoblast (placenta & chorion)
Zygotic/Germinal Stage: Blastocyst: Inner cell
Becomes embryo
Zygotic/Germinal Stage: Blastocyst: Outter cell (tropoblast)
Support system in pregnancy: placenta & chrorion
Embryonic Stage
- Support system
- Period of rapid development (sensitive, practically critical period)
- Period most at risk from teratogens
- Fetal Membranes
Fetal Membranes in Fetal Stage
- Amnion inside chorion
- Chorion = gives rise to placenta
- Amnion = cushions & protects fetus
Ectodermin Fetal Stage
- skin
- sensory
- organs
- brain
- spinal cord
Mesoderm in Fetal Stage
- Muscles
- Blood
- Bones
- Circulatory system
Endoderm in Fetal Stage
- Respiratory
- Digestive
- Liver
- Pancreas
Organogenesis in Fetal Stage
- development of organs
- heart begins to beat
- miscarriage is common (50-80% due to chromosomal abnormalities)
- Cephalocaudal direction of development
Cephalaudal development
• Development from the head down through the lower part of the body
Fetal development (9 weeks-38 weeks)
- can tell sex
- muscular development
- Quickening (kicking)
- facial features
- development of senses
- sucking, swallowing, hiccups (5 months)
- eyes open & close (6 months)
- Brain connections
Age of Viability (6.5 months/28 weeks)
- immature systems
- lung development
- respiratory system of most control
Fathers prenatal experience
- support for mother: emotionally, physically & financially
- sympathetic pregnancy: experience some symptoms of pregnancy
- 11-65% men experience weight gain, mood swings, etc.,
Having a healthy pregnancy
- prenatal pregnancy
- prenatal medical care
- maternal diet
- stress management
Teratogens
Non-genetic agents that can cause abnormal prenatal development
Maternal Illness
- Rubella
- Syphilis
- HIV
Maternal Illness: Rubella
- German measles
- Damage to the CNS= Blind, deaf, mental retardation, heart, liver, bone structure
Maternal Illness: Syphilis
- exposure in 4th-5th month
- Damage to CNS
- Damage in bone structure including teeth
Maternal Illness: HIV
- Fewer than 2% of women w/ HIV have children that are HIV positive if mother remains on medication
- 200-300 children born with HIV
Effects of Thalidomide use during pregnancy
- 60’s sedative
- deformed limbs
- defect in internal organs
- brought to light effects of drug use during pregnancy
Effects of heroin use during pregnancy
- Increase chance of premature birth
- withdrawal symptoms: tremors
- Irritability
- growth retardation
- increased likelihood of Sudden Infant Death Syndrome (SID)
Effects of Cocaine use during pregnancy
- Reduced blood flow in placenta
- increased likelihood of SID
- Risk of miscarriage
- Risk of still-birth
- Risk of premature birth
- born irritable, inconsolable, shaky, irregular patterns including sleep/wake cycle patterns
- if still using after: could effect maternal bonding
Effects of Marijuana use during pregnancy
- most commonly used illicit drug
- results: low birth weight, growth retardation
Effects of Nicotene use during pregnancy
- including second hand
- low birth weight
- 25-56% to die as an infant (neo-nataly)
- 50% more likely to develop cancer
- likely to have respiratory issues like asthma
- SIDS
- ADHD
- Learning disabilities
Effects of Prescription Drugs use during pregnancy
- should be avoided & if use should be discussed with a physician
Fetal Alcohol Syndrome
- Known since 70’s
- abnormal facial features
- smooth ridge
- thin upper lip
- eyes look apart
- CNS
- smaller head size
- significant changes in the structure of the brain
- functional defects
- low IQ, learning disabilities
- attention prob./ hyperactivity
- executive function (planning, organizing, grasping cause & effect)
- social skills, immature for age
Environmental exposures
- Lead poisoning (e.g: lead base paint, effects brain dev. adhd like system)
- Mercury (in vaccinations?) limit fish during pregnancy
- Radiation (effects cell dev)
Fawcette’s study: advantages of having a 1st child
- Excitement to life
- Someone to give/receive love
- Strengthen the bond btwn. parents
Fawcette’s study: disadvantages of having a 1st child
- Financial resources
- Loss of freedom
- Worry (safety, health of child)
Fawcettes Study
- 3 Advantages/Disadvantages
- Overall joyful & stressful
- 75% children are their main satisfaction
- Only 8% regret parental responsibility
Postpartum Depression (baby blues)
• Less involved with children • negative when interacting w/ children • children of depressed mothers 1. higher behavior problems 2. lower cognitive functions • Higher rate of maternal depression in low resource countries
Cultural Norms
- Medicalized culture (epidural, prenatal vitamins, ultra sounds, blood tests)
- Father presence in birthing room
- Breast Feeding
- Increasing use of mid-wives, doulas, birthing centers
3 Stages of Perinatal Period
- Contractions/ Active Labor
a. contractions become larger, stronger & more frequent.
b. cervix dilated 4cm
c. lasts 3-8 hrs - Delivery
a. baby moves into position
b. urge to push - After birth
a. delivery to placenta
Risks: Maternal Death
- having a child, 1 of the biggest health risks for women WORLDWIDE
- 1500 die everyday
Anoxia
Oxygen deficiency to cells can produce tissue damage, brain damage.
Anoxia Mechanisms
- Umbilical cord wrapped around the neck
- Rip, Tears in the placenta
- Medication effecting the breathing of a child
- Breach Birth (not positioned properly)
- Mucus
- RH factor
Infant mortality
- 1,000 live births
* increases in preterm deliveries
Effects of low birth weight
- less than 5 pounds, 4 ounces
* developmental issues
Neonatal
After birth
Sudden Infant Death Syndrome (SID’S)
- Infant dies suddenly without reason
- usually during the night
- happens btwn 1- 12 month olds
- highest risk 2-4 months
- 3,000 cases anually
“Back to sleep”
• lay the child on their back to sleep to prevent accidents
“Tummy Time”
• To develop motor skills
Neonatal Assesments
- Apgar Exam
2. Brazelton
What does the Apgar Exam Examine?
- Administered @ birth
- Ranges on a scale of 0-10
- Up to 2 pts. each
- Lower #’s signify an issue
- Appearance/ Color
- Pulse, Heart rate (much higher than adults)
- Grimace (look for response)
- Activity (movement, muscle tone)
- Resperation (strong-shallow-no breath)
What does the Brazelton examine?
• 1 week old & done later on in infancy • ability to interact 1. Attention 2. Muscle tone 3. Movement 4. Control of alertness (habituation)
Habituation
Paying less attention to stimuli you have already been exposed to
6 states of arousal
- Quiet-deep sleep
- Active-light sleep
- Drowsiness
- Alert inactivity
- Alert activity
- Crying
Changing sleep paterns
- new borns sleep up to 18 hrs/day
- REM Sleep
- Autostimulation
- 5-6 wks= adopt 24 hr schedule
- 12-16 wks=typically sleeping through the night & awake during the day
REM Sleep
- Rapid eye movement
* might promote brain development in infancy
Autostimulation
• REM Decreases as brain develop increases
Breast Feeding Advantages
- antibodies for immune systems
- natural for babies
- reduced risk of allergies to milk
- postive effect on mothers mood (octyocins)
- Weight management
Breast Feeding Disadvantages
- Responsibility vs. parental
- mother is busier, ability to rest?
- father inclusion? less bonding?
Iron defficiancy
- begins to modify the brains metabolism
* 19/21 studies reported poorer mental, motor & social functions
