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Reproductive System > Session 9: Fetal Growth & Development > Flashcards

Session 9: Fetal Growth & Development Flashcards

1
Q

Define fetal period.

A

Longest period of devopment from 9 weeks and onwards. It is a period of physiological maturation of the structures created during the embryonic period.

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2
Q

Explain what crown rump length is.

A

The length of the fetus from head to tail.

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3
Q

Why is crown rump length useful?

A

It can monitor development particularly in early pregnancy.

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4
Q

Why is crown rump length a useful tool to monitor develoment in early pregnancy?

A

Because it increases dramatically in a linear fashion during the pre-embryonic and early fetal periods.

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5
Q

In early fetal period, what is the main contributing factor to weight?

A

Proteins (muscle development)

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6
Q

In late fetal period, what is the major contributory factor to weight?

A

Adipose tissue for metabolism and regulation of heat.

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7
Q

Proportion of the head compared to the rest of the body throughout development.

A

50% of total length of body early on.

1/4 of the body’s total length at delivery.

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8
Q

Give examples of how you can assess fetal wellbeing.

A

Ask the mother

Symphysis-fundal height

Ultrasound scan

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9
Q

Why might asking the mother about her experience so far in her pregnancy make it possible for you to assess fetal wellbeing?

A

Fetal movements start to happen around 20 weeks.

Kicking e.g. is a good sign of fetal wellbeing

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10
Q

Explain what symphysis-fundal height is.

A

Non-invasive way to assess growth of fetus.

The length from pubic symphysis to the top of the fundus of the uterus

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11
Q

What should the SFH be at 20 weeks?

A

Roughly at the umbilicus.

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12
Q

How will SFH change after 20 weeks?

A

The fetal age in weeks should roughly equal the number of cm of this measurement. (28 cm means 28 weeks)

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13
Q

The SFH is not always able to correlate with the weeks of gestation.

Why might the measurement be larger than weeks of gestation?

A

If there is a lot of amniotic fluid also called polyhydramnios the measurement of SFH will be much larger.

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14
Q

Give causes of polyhydramnios.

A

Accumulation of amniotic fluid due to swallowing difficulties or excessive urine production.

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15
Q

The SFH is not always able to correlate with the weeks of gestation.

Why might measurement be smaller than weeks of gestation?

A

Intrauterine growth restriction or a lack of amniotic fluid production called oligohydramnios.

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16
Q

Give examples of use of ultrasound scan (USS).

A

Date of pregnancy

Rule out ectopic

Identify multiple pregnancy

USS can also in combination with blood tests screen for Down’s syndrome.

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17
Q

What is the ‘20 week scan’?

A

A measure of fetal growth by taking specific measurements and assess any developmental abnormalities.

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18
Q

Give examples of how you might estimate fetal age.

A

Last menstrual period (LMP)

Developmental Criteria:

USS measurement

Crown Rump Length

Biparietal diameter

Abdominal circumference

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19
Q

How is pregnancy dated?

A

From the date of the last menstrual period. This means that a full pregnancy is 40 weeks even though gestation is usually around 38 weeks as ovulation and fertilisation occur around two weeks after LMP.

20
Q

How can USS be used to estimate fetal age?

A

By CRL, biparietal diameter, abdominal circumference and femur length and then compare to normal values.

21
Q

When is CRL useful?

A

Between 7-13 weeks.

22
Q

What is biparietal diameter?

A

Used later in pregnancy which is the distance between the two parietal bones in the fetal skull.

23
Q

When is biparietal diameter used?

A

In second and third trimester.

24
Q

What is abdominal circumference?

A

It is the widest part of the abdomen.

25
Q

When is abdominal circumference used?

A

It is used in the combination with biparietal diameter in second and third trimesters.

Often in combination with femur length as well.

26
Q

Average weight of fetus.

A

3500g

27
Q

Range of normal weight of a fetus.

A

2500-4500g

28
Q

Common causes of <2500g baby.

A

Premature

Constitutionally small

Growth restriction

29
Q

Common cause >4500g baby.

A

Poorly controlled gestational diabetes.

30
Q

Briefly outline the development of the respiratory system.

A

Happens relatively late as gas exchange isn’t needed until after partum.

1 - Outpouching of foregut to create bronchopulmonary tree in embryonic period.

2 - Budding and branching of bronchioles in fetal period (pseudoglandular stage) 8-16.

3 - Further branching to form respiratory bronchioles (canalicular stage) 16 - 26.

4 - Terminal sac development with alveoli.

Stage 4 is also when Type I and Type II pneumocytes develop in order to produce surfactants.

31
Q

How can fetal viability be assessed in relation with lung development.

A

If there are no pneumocytes presents gas exchange cannot occur and lungs do not produce surfactant.

This means that the fetus is not compatible for life.

This can be a complication of premature delivery e.g.

32
Q

If a pre-term delivery is unavoidable but predictable, how can you resolve the absence of surfactant?

A

Give the mother glucocorticoids to help stimulate the production of surfactant in the fetus.

33
Q

What is the average fetal heart rate?

A

110-160 bpm

34
Q

Why is this heart rate important to know?

A

To know what bradycardia is for a foetus.

35
Q

The fetus starts to produce urine in the fetal period but cannot yet drain it. How is removal of waste managed in utero?

A

By the placenta and largely reliant on the maternal renal function for excretion.

36
Q

How can you measure kidney function in the fetus?

A

By the amniotic fluid volume.

37
Q

What does oligohydramnios suggest? (think renal)

A

Low volume of amniotic fluid that can be due to placental insufficiency or indicate poor renal function in the fetus.

38
Q

What does polyhydramnios suggest? (think renal)

A

Issue in recycling of amniotic fluid.

E.g. CNS-defect where swallowing isn’t possible.

Congenital abnormalities like a trachea-oesophageal fistula.

39
Q

If there is an absence of surfactant in the fetal lungs, what might this cause post-partum?

A

Respiratory distress syndrome.

40
Q

What is the most vulnerable system to injury during the developmental process?

Why?

A

Nervous system.

First to start to develop and last to finish.

41
Q

When is the corticospinal tract starting to develop?

A

During the 4th month

42
Q

Why is the corticospinal tract important?

A

Required for co-ordinated movements.

43
Q

If the corticospinal tract begins to develop in the 4th month, why can’t a newborn walk until approx. a year after birth?

A

Because the myelination of the corticospinal tract is incomplete at birth.

44
Q

When will movement start in utero?

A

No movement until 8th week.

45
Q

What is quickening?

A

The mother becoming aware of the baby moving around

46
Q

When does myelination of the brain start to occur in the brain?

A

Around week 36

Reproductive System (31 decks)

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