Week 1 maternal and fetal part 4 of 4 Flashcards
name the most common cause of polyhydramnios
esophageal atresia
which nerve is most commonly injured during abdominal hysterectomy
femoral nerve
which nerve may be injured during vaginal hysterectomy
how does this manifest?
common peroneal nerve
leads to foot drop
which nerve is commonly injured during vaginal delivery
lumbosacral nerve
what is the most common cause of anesthesia related maternal mortality
airway complications
fetal development size at 2-3 weeks post fertilization
fetus is microscopic in size.
fetal development
length at 12 weeks
10cm long
fetal development length at 20 wks
25cm long
fetal development 40 wks term length
53cm (21in)
fetal development weight reaches 1 lb at how many months
5.5mo
weight reaches 3 lbs at what month
7mo
weight reaches 4.5lbs at what month
8mo
term fetal weight
7lb
mother typically gains 11kg due to increase in what three things?
increased blood volume
size of fetus
placenta
heart rate close to term
140 bpm
when does fetal heart begin beating?
what is the average bpm at that point?
4 weeks
65bpm
fetal development cardiac output is constant at what Fetal heart rate?
constant from 120-180bpm
between what two weeks does surfactant production begin
23/24 weeks
** exam** how much pressure is needed to open airways
25-40mmhg
fetal development characteristic of liver metabolism
decreased liver metabolism
*** where does the spinal cord end in the fetus
L3
smaller airways leads to
high risk of obstruction
is fetal development lung compliance and FRC increased or decreased
decrease lung compliance
decrease FRC
fetal lungs have ____ closing capacity
increased closing capacity
fetal large tongue=
high risk of obstruction
difficult intubation
HR fetal development
100-180bpm
what does cardiac output depend on
heart rate
fetal pC02=
40-45mmhg
fetal p02=
30mmhg
describe fetal shivering
unable to shiver meaning they are higher risk of hypothermia
how does the fetus produce heat
by burning brown fat
maintain room temp at
26c
fetal development 3rd week- nucleated RBC’s formed where?
nucleated RBC’s formed in yolk sac and mesothelium of placenta
fetal development 4 weeks
non - nucleated RBC’s formed
formed by fetal mesenchymal and endothelial cells.
at 6 weeks blood cells are formed where?
liver forms blood cells
at 12 weeks. what happens to RBC development
spleen and lymphoid tissue, also bone marrow: red and white blood cells, other structures lose ability to form blood cells.
diffusion through placental membrane
simple diffusion from sinuses through villus membrane down pressure gradient to fetus
simple diffusion from sinuses through villus membrane down pressure gradient to fetus
mean p02 in fetal blood pressure
30mmhg
simple diffusion from sinuses through villus membrane down pressure gradient to fetus
mean p02 in villus
50mmhg
simple diffusion from sinuses through villus membrane down pressure gradient to fetus
from maternal blood pressure
100mmhg
what is the fetal Hb affinity for 02
very high affinity
fetal Hb can carry how much more 02 % than maternal Hgb
20-30% more 02
which way does newborn oxygen-hb curve shift
left shift
fetal Hb concentration in blood is what % greater than in mother
50%
anemia when Hb< ___ newborn
13
10- g/dl in >3mos
name the two ways nutrients go from mother to fetus
similar to oxygen- higher to low gradient
electrochemical gradients.
CO2 builds up until it is slightly higher in fetus umbilical arteries (___mmhg)
48mmhg
co2 is higher in fetus umbilical arteries at 48mmhg than in intervillous space (___mmhg)
43mmhg
fetal affinity for co2
affinity for c02 is lower in fetus- favoring transfer from fetus to mother
receptor mediated endocytosis from mother:
LDL
what does this mean
renin increases late in gestation due to what three things
Renal sympathetic nerve activity
Reduction in Na and blood volume
Change in renal perfusion pressure
fetal GFR and concentrating ability
low GFR
Low Concentrating ability
due to decrease GFR and decrease concentrating ability can the fetus tolerated volume overload
no they cannot tolerate volume overload.
fetal aldosterone level?
low, rapid clearance
angiotensin II not directly related to
renin (LOW ACE, HIGH CLEARANCE)
noninvasive diagnosis of fetal well being
transvaginal ultrasound: visualize vertebrae, kidneys, bladder, fingers and toes by 12 wks gestation
invasive diagnosis of fetal well being
amniocentesis
14-16 weeks: when amniotic cavity contains 150-200ml remove 20ml; with simultaneous ultrasound karyotyping, biochemical analyses, dna
diagnosis of fetal well being
Chorionic villus sampling
cytogenetic and biochemical testing recommended after 10 wks gestation; usually 2nd and 3rd trimester
Chorionic villus sampling - when is this testing recommended
recommended after 10 wks gestation, usually 2nd and 3rd trimester
diagnosis of fetal well being
Fetal blood sampling
transabdominal; from 17 wks into umbilical vein about 1 cm from placental cord insertion site
