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1

What occurs in the fetal period (breifly)

Growth and maturation of structures developed in embryonic period
Early = protein deposition
Late = adipose desposition

2

LMP vs weeks post fertilisation?

LMP = fert +2

3

When does the CRL increase rapidly?

Pre to early fetal

4

Ante-natal assessment of fetal well being?

Mother and fetal movements
Uterine expansion - symphysis fundal height
Ultra sound

5

Uses of Obstetric ultrasound scan (USS)?

Check age in early pregnancy
20 weeks
Fetal abnormalities and growth

6

Purposes of a 7-13 week scan?

Estimate from CRL the EDD and the time of cenception
Check location, number and viability

7

Uses of the biparietal diameter

Used to date pregnancies in T2/3 in combination with other measurements e.g. abdominal circumference and femur length.
Also used for anomaly detection (more AC and FL)

8

Describe the classification of birth weights

3500g normal
4500 maternal diabetes - macrosomia

9

Stages of lung development?

Pseudoglandular 8-16 weeks
Canalicular - 16-26
Terminal sac stage - 26+

10

Describe the pseudoglandular stage

Duct system develops from the bronchopulmonary trunk
Bronchioles

11

Describe the canalicular stage

Respiratory bronchioles bud off from bronchioles formed during the pseudoglandular stage

12

Describe the terminal sac stage

Terminal sacs bud from resp bronchioles.
Differentiation of Type 1 and 2 pneumocytes (surfactant)

13

What factors aid lung development?

Fluid filled
Breathing movements

14

What are the implications for pre term survival

THreshold of viability is the lungs, only possible once lungs have entered the terminal sac stage >24 weeks

15

What is respiratory distress syndrome?

Pre mature infants
insufficient surfactant pproduction
glucocorticoid treatment for mother as this increases surfactant

16

Definitive fetal HR when?

15 weeks

17

Describe development of urinary system later

Kidney function at 10 weeks
Not neccessary for survival but without there is oligohydramnios

18

Desribe the development of the nervous system

Myelination of brain begins at 9 months and finishes after birth
Coordinated voluntary movement develops at 4 month

19

First movement?

8 weeks

20

What is quickening

at 17 weeks, increase in fetal awareness
way of antepartum surveilance

21

Describe O2 supply to fetus

Incre pO2 in mother and low in fetus (4kPa).
Hb 70% sat at 4kPa - more hb than adults
Double bohr effect in both fetal and maternal blood??

22

Describe CO2 and the fetus

Cannot tolerate CO2
Lower maternal CO2
Prog stimulates maternal hyperventilation

23

Sat of blood and to the brain in fetus

Blood shunted to brain- bypass liver via Ductus venosus (70-65% with IVC) - bypass lungs via foramen ovale (directed by crista dividens- part of septum secundum, joins pulmonary flow in LA 65-60%) and ducuts arteriosus
SVC tends to go to RV as is superior to RV

24

Describe functions and secretions of amniotic fluid

Mechanical protection
Moist environment
Other functions
10ml at 8 weeks
1l at 38 weeks
300ml at 42 weeks.
Constant turnver - early maternal secretion and diffusion with embryo ECF. late - fetal production.

25

Production of fetal urine

100ml a day at 25 weeks to 500ml hypotonic.
Constantly swallows amniotic fluid forming meconium

26

Fetus and bilirubin

Fetus cannot conjugate and thereofore remove bilirubin so crosses the placenta - may get jaundiced as a neonate if conjugation does not establish quickly

27

Describe rhythms in the fetus

Breathing movement and HR.

28

Function of cytotrophoblast

Repairs syncytiotrophoblast

29

Function of the syncytiotrophoblast

Invades maternal epithelium and lacunae to establish utero-placental blood flow.
Allows for diffusion - multi nucleated sheet

30

what does haemomonochromal mean?

The chorion/ membrane/ placenta is in direct contact with maternal blood