Chapter 2: Prenatal Development and The Newborn Period Flashcards

1
Q

Ovulation

A

First half (day 1-14): estrogen phase (building up endometrial lining)

Second half (day 14-28): progesterone phase (lining becomes soft, spongy, and wet.

Bleeding starts the cycle, ovulation is in the middle (usually day 10-14) and implantation usually occurs around day 22.

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2
Q

Signs of Ovulation

A

–> Discharge: mucus becomes more substantial, thinner, and slippery, provides good host environment for sperm to survive + reach egg

  • if you want to be pregnant then its best to do it before ovulation as the sperm lives longer than the egg
  • -> Cervical position change (about to ovulate)
  • -> Middlesschmertz (about to ovulate)
  • -> Basal temperature rises (after ovulation)
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3
Q

What does the endometrial lining provide?

A

nutrients to the fertilized egg

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4
Q

Period of Zygote

A
  • Fertilization - 2 weeks
    From conception to implantation,
    blastocyte from implantation to 7-9 weeks
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5
Q

Period of the Zygote: support structures

A

–> Trophoblast: Amnion - encloses organism, amniotic fluid

  • -> Chorion - becomes lining of placenta
  • -> Placenta - semi permeable organ
  • -> umbelical cord
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6
Q

Period of the embryo: first month

A
  • rapid growth
  • -> early on: 3 cell layers
  • ecoderm: nervous system, skin, and hair
  • mesoderm: muscles, bones, and circulatory system
  • endoderm: becomes digestive system, lungs, urinary tract, other vital organs
  • -> Neural tube: FOLIC ACID VERY IMPORTANT
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7
Q

Period of the embryo: Second month

A
  • ears formed
  • rudimentary skeleton
  • limbs development
  • brain develops rapidly
  • indifferent (genital ridge) gonad appears
  • about 2.5 cm long and 4 grams
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8
Q

Period of the fetus

A
weeks 9-38 
- rapid growth and refinement 
Third Month: 
fetus able to kick, twist (not felt by mother) 
swallow, digest, urinate 
testosterone secreted by testes of males 
--> 12th week sex can be determined 
7.5 cm long  > 28g
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9
Q

Sex determination

A

If Y absent:
- develop ovaries producing estrogen which enables development of the müllarian duct (uterus, oviducts,uppes vagina)

If Y Present:

  • Testes form and secrete 2 hormones
  • AMH (or MIS) destroys Müllerian duct
  • testoserone - masculinizes the fetus
  • allow wolffian duct to develop into vas deferens/ seminal vesicles
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10
Q

Second Trimester

A

months 4-6
- refined motor actions (thumbsucking)
- heartbeat heard with stethoscope
- eyebrows, eyelashes, and scalp hair appear
- vernix (cheesy white substance - protection )
- Lanugo (fine layer of hair)
Brain development - billion of neurons in place (glial cells continue to develop

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11
Q

Third Trimester

A

Finishing Phase

  • organ systems maturing
  • weight gain ( small for gestational age is more of a concern than low birth weight when premature)
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12
Q

Age of Viability

A

22-28 weeks

  • survival outside uterus possible
  • better if 28-32 weeks
  • neural organization

–> males more likely to be premature bc they are genetically xy rather than xx (females)

  • moves to head down position in 9th month (ideal birthing position is head down and back up)
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13
Q

Teratogen

A

agents such as viruses, drugs, chemicals, radiation etc. that can harm developing fetus

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14
Q

Behavioural Teratogen

A

Harm to brain and nervous system affecting future functioning, emotional, and or intellect

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15
Q

Environmental Influences: Determining the effect of a teratogen

A

1) Timing: age of organism at time of exposure
2) Amount: dose and over what duration
3) Hereditary: genetic vulnerability

Multiple negative factors worsen the impact

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16
Q

Sensitive periods

A

Time when particularly susceptible to damage from teratogens
(recall rapid development during embryonic period)

once fully formed, parts are less susceptible to damage

–> long term outcome: may be affected by postnatal care

17
Q

Types of teratogens

A
  • -> Drugs:
  • thalidomide (60’s), DES
  • prescription, non prescription
  • illicit drugs
  • -> Alcohol (FASD)
  • -> Chemicals (Mercury, PCB’s etc)
18
Q

Maternal Teratogens

A
  • diseases, std’s, toxoplasmosis
  • diet: adequate nutrients, folic acid
  • emotional health ( stress hormones )
  • age both young and old
19
Q

Medications and Childbirth

A

Positives:
- lower rates of infant and maternal death

Negatives:

  • interventions increased
  • more epidurals
  • induced labour
  • c-sections
  • can effect: mom infant and future children
20
Q

Birth

A
  • begins when fetal hormones trigger uterine contractions
  • -> can be seen as traumatic or transition
  • Contractions raise level of catecholamines (stress hormone) which prepares the fetus for the journey out
  • elective c-section babies don’t experience this catecholamine surge
21
Q

3 stages of labour

A

Stage 1: dialation and effacement of cervix
–> during transition from stage 1-2 many often become very nauseous and vomit which means your ready to push

Stage :

  • pushing and delivery
  • -> once head is out then the rest is usually a little easier

Stage 3: placenta delivery

22
Q

Newborn assessment

A
  • check skin tone to make sure blood flow is good
  • apgar test, given minute 1 and again at 3 or 5
  • physical condition at birth out of 10 (want to get 7 or better)
23
Q

Apgar Test

A
Appearance 
Pulse 
Grimace 
Activity 
Respiration
24
Q

what is another commonly used scale at newborn stage?

A

NBA (Brezelton’s Neonatal Bhavioural Assessment Scale)

Reflex’s, states, reactions,

  • a more subtle test that is good for parental training
25
Q

Post Birth Issues

A

attachment does not equal bonding

  • emotional bonding (contact in first few hours, quite special)
  • helps but is not critical

Fathers experience engrossment (overcome with emotion and love)

26
Q

Postpartum Depression

A
  • more commonly experience by those who have experienced depression before, but doesnt mean that you will or wont get it
  • more common when child is unwanted or there are problems with the father
  • can still happen with seemingly no cause as well
27
Q

Low Birth Weight

A
  • associated with outcome - good or bad

- length of baby indicative of final height more than weight

28
Q

Pre Term

A
  • -> 3 or more weeks early
  • outcome depends on many factrors
  • surfactin hasnt been produced yet and so lack of this at time of birth can mean that the baby will have lung problems
  • respiratory distress syndrome
  • respiratory systems is one of the last to be developed so when they arrive early this is where the most concern could be
29
Q

SGA (Small for Gestational Age)

A
  • weigh less than expected for age
  • at greater risk for major complications
    >5 pounds = magic#, much better outcomes
30
Q

outcomes of preterm babies

A
  • long term consequences are possible
  • in part depends on the type of care provided
  • hospital care stresses the importance of skin to skin contact and care
  • stimulation also important
  • “kangaroo care” started from hospitals that lacked resources
  • training of hospital or care personnel
31
Q

Reflexes

A

Survival:

  • breathing
  • blinking
  • pupillary
  • rooting
  • sucking
  • swallowing

Primitive reflexes:

  • swimming
  • stepping
  • palmar
  • moro

both are:

  • inborn automatic
  • adaptive value
  • related to later development