HPGC 101 Chapter 8
Pregnancy and Childbirth
Conception
Conception: Natural process of fertilization of an egg by a sperm
HCG
Human chorionic gonadotropin (HCG) Hormone initially produced by developing embryo Later produced by placenta Excreted via urine Basis for home/office pregnancy tests Presence of HCG confirms pregnancy
Fetal Development
As embryo grows/develops Other associated structures also develop Amniotic sac Placenta Umbilical cord
Amniotic Sac
Fluid-filled bag of thin tissue around embryo/fetus Embryo/fetus floats inside sac in amniotic fluid Cushions embryo from shock Keeps constant temperature
Placenta
Structure that attaches fetus to uterine wall Partially lines uterine wall Nourishes fetus (oxygen/nutrients) via mother's blood Provides 2-way exchange of nutrients/waste between Mom and fetus
Umbilical Cord
Cord-like structure between fetus and placenta Blood vessels in cord carry nutrients and oxygen from placenta to fetus Blood vessels in cord carry away wastes from fetus to placenta
Trimesters of Pregnancy
First Trimester Weeks 1-12
All major body structures formed between 2nd and 9th weeks
First Trimester: 4 weeks
Brain and spinal cord begin to form Heart begins to form Arm and leg buds appear Now 1/25 of an inch long
Embryo at 4 Weeks
2011
First Trimester: 8 weeks
All major organs have begun to form External body structures have begun to form Heart beats with a regular rhythm Arms and legs grow longer Fingers and toes have begun to form Sex organs begin to form Eyelids have formed Umbilical cord is clearly visible
Fetus at 8 weeks
First Trimester: 12 weeks
Nerves and muscles begin to work together Fetus can make a fist External sex organs show gender Eyelids close to protect developing eyes Stay closed until 28 weeks
Head growth has slowed Body length about 3 inches long Fetus weighs about one ounce
Fetus at 12 weeks
Second Trimester Weeks 13-28
End of 2nd trimester the earliest point when a fetus could survive outside womb
Second Trimester: 16 Weeks
Muscle tissue and bone continue to form as skeleton develops
Skin begins to form (transparent) Fetus makes sucking motions with the mouth (sucking reflex) Length now about 4-5 inches long Fetus weighs almost 3 ounces
Fetus at 16 weeks
Second Trimester: 20 weeks
Eyebrows, eyelashes, fingernails, and toenails have formed
Fetus is more active now Fetus can hear and swallow Length about 6 inches long Fetus weighs about 9 ounces
Fetus at 20 weeks
Second Trimester: 24 weeks
Footprints and fingerprints have formed Lungs are formed, but are immature/underdeveloped Testicles begin to move from the abdomen into the scrotum Uterus and ovaries are in place, and a lifetime supply of eggs have formed in the ovaries Length about 12 inches long Baby weighs about 1 pounds
Fetus at 24 weeks
Third Trimester Weeks 29-40
Third Trimester: 32 weeks
Bones are fully formed but still soft Lungs may be developed enough is born now
Eyes can open and close and sense changes in light Gaining about pound weight/ week Length about 15-17 inches long Weight now about 4 to 4 pounds
Fetus at 32 weeks
Third Trimester: 36 weeks
Protective waxy coating ( vernix) gets thicker Body fat increases Beginning to fill up uterine space Fetal movements more limited Length about 16 to 19 inches long Weighs about 6 to 6 pounds
Fetus at 36 weeks
Third Trimester: 37-40 weeks
Now considered full term Organs are ready to function on their own As due date approaches Baby should turn into a head-down position for birth
Third Trimester: Birth
Healthy Pregnancy
Prenatal care Drugs/alcohol/smoking Environmental exposures Nutrition Exercise Maternal age Women over 35: Higher incidence of both maternal and fetal complications
Rubella
Rubella (German measles) virus Usually mild and self-limiting Rubella in 1st 20 weeks pregnancy Congenital Rubella Syndrome Moms should be vaccinated prior to PG
Moms should avoid exposure to rubella during PG
Congenital Rubella Syndrome
Deafness Cataracts Retinopathy Patent ductus arteriosis (PDA) Microcephaly MR Hepatomegaly Micrognathia (small jaw)
Nutrition
Need more calories "eating for two" Balanced diet important for fetal development
Folic acid for prevention of neural tube defect before/during pregnancy Abnormalities of cord and brain including spina bifida
Exercise
Regular physical activity encouraged Moderate unless already an athlete
Walking is good Help to tone muscles for delivery
Drugs/Alcohol/Smoking
Discontinue as soon as + PG test Also stop if planning a pregnancy Ask medical professional before using any OTC medication
Avoid second-hand smoke Avoid other environmental exposures Smoking will likely result in low birth weight baby
Effects of Drugs/Alcohol/Smoking
Retarded fetal development Birth defects Addicted babies Risk of miscarriage Fetal Alcohol Syndrome Mental and physical developmental abnormalities Facial features - Microcephaly - Heart defects
Three Stages of Birth
1st Stage
Labor
2nd Stage
Deliver of baby
3rd Stage
Delivery of afterbirth
First Stage: Labor
Second Stage Delivery of Infant
Third Stage Delivery of Placenta (Afterbirth)
Apgar Scores
Performed at 1 minute and 5 minutes One Minute How well baby handled birth process
Five Minutes How well baby is adapting to life outside womb
Scores of 0-2 for each category Score of 7-10 at 5 minutes is good
Apgar Scores
Breathing effort Heart rate Muscle tone Reflexes Skin color
Sudden Infant Death Syndrome (SIDS)
Sudden, unexpected death of infant under one year of age No explainable cause identified at autopsy Greater risk while sleeping "Back to sleep"
