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ESA 4 - Repro > Session 9 - Fetal Growth and Development > Flashcards

Session 9 - Fetal Growth and Development Flashcards

1
Q

During which weeks are the pre-embryonic, embryonic, and fetal periods?

A

pre-embryonic - up to 3 weeks

embryonic - 3 to 8 weeks

fetal - 9 to 38 weeks

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2
Q

How does crown rump length change during pregnancy?

A

Increases rapidly until early fetal periods.

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3
Q

At what week is the head approx half of the crown rump length?

A

9

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4
Q

What is the proportion of the body to the head at healthy birth?

A

head is 1/4 of body

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5
Q

At what stage and week is the resp system specialised

A

In fetal period after 24 weeks

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6
Q

What are the 4 stages of development of the resp system? Name their time periods

A
  1. Pseudoglandular: 8 to 16 weeks
  2. Canalicular stage: 16 to 26 weeks
  3. Terminal Sac stage: 26 week to term
  4. Aleolar period: late fetal to 8 years
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7
Q

What occurs in the pseudoglandular stage?

A
  • Duct system forms within the bronchopulmonary segments
  • Bronchioles develop
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8
Q

What occurs in the canalicular stage?

A
  • Forming of resp bronchioles
  • More vascular
  • May be viable
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9
Q

What occurs in the terminal sac stage?

A
  • Terminal sacs bud from resp bronchioles
  • Primitive alveoli
  • Differentiation of pneumocytes to form type 1 (gas exchange) and type 2 (surfactant production)
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10
Q

How are the lungs prepared before birth?

A
  • Breathing movement - conditioning of resp musculature
  • Fluid filled - helps development
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11
Q

What is the function of corticospinal tracts? WHen do they start to form?

A

Required for coordinated voluntary movement. Begin to form in 4th month

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12
Q

When does myelination of the spinal cord and the brain begin?

A

Spinal cord - 20th week

Brain - 36 week

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13
Q

After what week does the fetus begin to move?

A

week 8

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14
Q

What changes occur to the brain during the fetal period?

A
  • Differentiation of cerebrum and cerebellum
  • Formation of gyri and sulci as brain grows faster than head
  • Formaton and myelination of nuclei and tracts
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15
Q

At what week is the mother made aware of fetal movement?

A

week 17+

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16
Q

When is the definitive fetal heart rate achieved?

A

After 15 weeks

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17
Q

At what week is the renal pelvis and calcyes present?

A

23

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18
Q

What is the major constituent of amniotic fluid?

A

urine

19
Q

How can fetal development be assessed?

A

USS

Non stress tests

Measuring biophysical profiles

20
Q

What are the 5 factors measured in biophysical profiles? What does each test?

A
  1. Fetal movement - nervous, MSK
  2. Fetal tone - nervous, MSK
  3. Fetal breathing - Resp, MSK, nervous
  4. Amniotic fluid volume - Urinary, GI
  5. Fetal Heart Rate - Resp
21
Q

What causes asymmetrical growth restriction?

A

Occurs with deprivation of nutritional and oxygen supply to the fetus

22
Q

How can the duration of pregnancy be measured?

A
  • Fertilisation age
  • Age since mothers last menstrual period
23
Q

What are criteria that can be used to estimate fetal age? What measurements are specific to T1 and T2/3

A
  • Foot length
  • Weight after delivery
  • Appearance after delivery

T1 - crown rump length

T2/3 - biparietal diameter of head

24
Q

What is oligohydramnios? What can it cause?

A
  • Too little amniotic fluid
  • Can cause placental insufficency, fetal renal impairment, pre-eclampsia
25
Q

What is polyhydramnios and what are its consequences?

A
  • too much amniotic fluid
  • Results in inability to coordinate swallowing movements and blind ended oesophagus
26
Q

What are the weight limits for restricted growth, average, and macrosomia?

A

<2500g = growth restricted

3500g = average

>4500g = macrosomia

27
Q

What is the effect of poor nutrition on early and late pregnancy?

A

Early - nerual tube defects e.g. digeorge syndrome

Late - asymmetrical growth restriction

28
Q

Describe the fetal circulation before birth

A
  • Liver bypassed by ductus venosus
  • Blood goes from RA to LA via foramen ovale
  • Lungs bypassed via ductus arteriosus (pulmonary artery to aorta)
  • Blood enters and leaves via 2 umbilical arteries and a vein
29
Q

What happens after the baby takes its first breath?

A
  • Pressure in lungs reduced leading to pressure in LA > RA, closing foramen ovale
  • Increased oxygen saturation in blood and removed prostaglandins results in constriction of ductus arteriosus and umbilical artery
  • Stasis of blood in umbilical vein and ductus venosus leads to clotting of blood and closure due to subsequent fibrosis.
30
Q

What is the function of amniotic fluid?

A

Provides shock absorption and a moist environment for the fetus

31
Q

How much urine is produced at 25 weeks and at term?

A

25 weeks - 100 ml per day

at term - 500 ml per day

32
Q

What happens to the swallowed amniotic fluid?

A
  • Fetus abosrbs water and electrolytes
  • washes away cells in fetal gut
  • forms meconium along with gut debris
33
Q

What happens to fetal bilirubin?

A
  • babby cant conjugate bilirubin
  • Bilirubin crosses placenta and is excreted by mother
34
Q

What stimulates the neonate liver to begin conjugation?

A

light

35
Q

How long are fetal oxygen stores?

A

2 minutes worth - very low

36
Q

What can be used to indicate foetal o2 sats?

A

fetal heart rate

37
Q

What is fetal po2 and normal po2 in adults?

A

fetal - 4kpa

adults - 13kpa

38
Q

How is fetal hb adapted to contain the same amount of o2 per litre as adults?

A

fetal hb has gamma chains which are 70% saturated at 4kpa

39
Q

How does the mother blow off the extra co2 from the baby?

A

hyperventilation

40
Q

why is a USS at 20 weeks recommended?

A

organs big enough to see but still early enough to abort if necessary

41
Q

Why should pregnant women take folic acid?

A

important for neural tube development

42
Q

What is the average fetal heart rate at term?

A

140-160 bpm

43
Q

what is fetal abdominal circumference assessing?

A

growth of fetal liver and amount of sub-cutaneous fat

44
Q

What does meconium in the amniotic fluid indicate?

A

fetal distress

ESA 4 - Repro (15 decks)

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