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Fetal Growth + Development Flashcards

(53 cards)

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1
Q

What is the fetal period?
What occurs during this time?

A
  • From 9 weeks to term
  • physiological maturation of structures created in the embryonic period
  • period of preparation for transition to independent life after birth
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2
Q

Outline the patterns of growth during development of the fetus

A

Embryonic period:
- absolute growth is very small, except the placenta
- characterised by intense activity

Fetal period:
- growth + weight gain accelerate

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3
Q

What is the crown rump length?

A

Length of the fetus

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4
Q

Body proportions in the fetal period

A
  • at week 9, the half is 50% of the crown rumplength
  • after, the body length + lower limb growth accelerates
  • head makes up 25% of the length at term
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5
Q

How can fetal well-being be assessed?

A
  • last menstrual period (age of fetus + estimate due date)
  • ask the mothers (fetal movements)
  • symphysis fundal height
  • ultrasound scan
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6
Q

When do fetal movements start to happen?

A

~ 20 weeks

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7
Q

How is symphysis fundal height used to assess fetal wellbeing?

A

Normal SFH = number of week +/- 2cm

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8
Q

Why may symphysis-fungal height be larger?

A
  • polyhydramnios: if there is a lot of amniotic fluid
  • accumulation can happen due to swallowing difficulties or excessive urine production
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9
Q

Why may symphysis fundal height be low?

A
  • intrauterine growth restriction
  • oligohydramnios: lack of amniotic fluid production
  • normal near term as fetal head engages in the pelvis
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10
Q

What is the 20 week scan used for?

A

anomaly scan
- screen for fetal anomalies
- determine placental location
- sex of baby

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11
Q

What is the 12 week scan used for?

A
  • dating scan
  • determine gestational age
  • detect multiple pregnancy
  • screening for chromosomal abnormalities
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12
Q

What 2 scans are used in antenatal care?

A

12 week scan (dating scan)
20 week scan (anomaly scan)

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13
Q

When is the crown rump length used?

A

Measured between 7 -13 weeks to date pregnancy
In 12 week dating scan

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14
Q

What measurements are used to determine fetal size?

A

Crown rump length
Biparietal diameter
Abdominal circumference
Femur length

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15
Q

What is the biparitetal diameter measurement?
When is it used?

A
  • Distance between the parietal bones of the fetus
  • In 2nd + 3rd trimester
  • Used in combination with abdominal circumference
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16
Q

What is the abdominal circumference measurement?
When is it used?

A
  • measures widest part of the abdomen
  • in 2nd + 3rd trimesters
  • in combination with biparietal diameter + femur length
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17
Q

What measurement is used in the first trimester to help date pregnancy?

A

Crown rump length

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18
Q

What is the average normal brith weight at term?

A

~ 3.5 kg

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19
Q

What is macrosomia?

A

Large baby
>4kg

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20
Q

Birth weight ranges for babies at term

A
  • extremely low birth weight: <1kg
  • very low birth weight: 1-1.5kg
  • low birth weight: <2.5kg
  • average normal: ~3.5kg
  • macrosomia: >4kg
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21
Q

Why can babies have a low birth weight?

A
  • premature
  • constiutionally small
  • suffered growth restriction (associated with neonatal morbidity)
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22
Q

Types of fetal growth restrictions

Study These Flashcards
A

Symmetrical
Asymmetrical

23
Q

What is symmetrical intrauterine growth restriction?
What is it due to?

Study These Flashcards
A
  • occurs early on in pregnancy <20 weeks
  • abdominal circumference, biparietal diameter + fetal length all proportionally reduced
  • due to genetic disorders or TORCH infections
24
Q

Changes to fetal measurements in symmetrical intrauterine growth restrictions

Study These Flashcards
A

Abdominal circumference, biparietal diameter + fetal length ALL proportionally reduced

25
What is asymmetrical intrauterine growth restriction? What is it due to?
- occurs later on >20 weeks - abdominal circumference decreased - biparietal diameter + femur length normal - due to placental insufficiency *e.g. pre-eclampsia*
26
Changes to fetal measurements in asymmetrical intrauterine growth restrictions
- abdominal circumference decreased - biparietal diameter + femur length normal
27
Development of the respiratory system in the embryonic + fetal period
- lungs develop relatively late - **embryonic period**: only bronchopulmonary tree - **fetal period**: functional specialisation
28
What are the lung development stages?
**Every Penguin Can Swim Anywhere** Embryonic Pseudoglandular Canalicular Saccular Alveolar
29
What is made in the embryonic stage of lung development?
Only bronchopulmonary tree
30
What is made in the psuedoglandular stage of lung development?
**Terminal bronchioles** - duct system begins to form within the bronchopulmonary segments
31
What is made in the canalicular stage of lung development?
**Respiratory bronchioles** - budding from bronchioles formed in psuedoglandular stage - start of differentiation of cuboidal cells to type 1 + 2 pneumocytes
32
What is made in the saccular stage of lung development?
- terminal sac begin to bud from respiratory bronchioles - differentiation of type I + II pneumocytes > surfactant made
33
What is made in the alveolar stage of lung development?
- mature alveoli formation - proliferation + expansion of capillaries, nerves + gas exchange areas
34
What is fetal viability?
The ability of a fetus to survive outside the uterus
35
What is respiratory distress syndrome due to?
Insufficient surfactant production
36
When is the first heat beat of a fetus? When is definitive fetal heart rate achieved?
5-6 weeks 15 weeks
37
What is definitive fetal heart rate?
110-160bpm
38
What is fetal bradycardia a sign of?
Fetal distress
39
When does fetal kidney function begin?
Week 10
40
What is oligohydramnios? What can it be due to? What could indicate this?
- **Low volume of amniotic fluid** - due to placental insufficiency or poor renal function in fetus (poor blood supply) - Low symphysis-fundal height
41
What is polyhydramnios? What can it be due to? What could indicate this?
- **high volume of amniotic fluid** - due to fetal abnormalities (oesophageal atresia), gestation diabetes, fetal anaemia or multiple pregnancies - high symphysis-fundal height
42
When does myelination of the brain begin?
9th month
43
Role of magnesium sulphate during pregnancy
- given to women at high risk of imminent spontaneous preterm brith between 24-29 weeks gestation - given for fetal neuroprotection *e.g. reduces risk of cerebral palsy*
44
Why is the nervous system the most vulnerable to injury during development?
First to start development Last to finish
45
What do co-ordinated movements require? When does this form?
Corticospinal tract Begins to form in the 4th month
46
Why are new born babies unable to walk or perform coordinated movements until ~ 1 year?
Myelination of the corticospinal tract is incomplete at birth
47
When is fetal viability a possibility?
Once the lungs have entered the terminal sac stage of development >24 weeks
48
Antenatal managment of respiratory distress syndrome
**Glucocorticoid treatment** Boosts lung development > surfactant produced
49
Neonatal management of respiratory distress syndrome
- nCPAP (nasal continuous positive airway pressure) - surfactant replacement therapy - mechanical ventilation
50
What does a lack of fetal kidney function cause?
Oligohydramnios
51
What cells produce surfactant?
Type II pneumocytes
52
What glucocorticoid treatment used for during pregnancy? How does it work?
- Treatment of respiratory distress syndrome before baby is born - Boosts lung development > surfactant produced
53
What are the stages of respiratory development + what develops in each?
**Every Penguin Can Swim Anywhere** - **embryonic**: bronchopulmonary tree - **pseudoglanudlar**: terminal bronchioles - **canalicular**: respiratory bronchioles + pneumocytes - **saccule**: terminal sacs + surfactant produced - **alveolar**: alveoli

Reproductive System (21 decks)

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