Pregnancy And Conception Matetal Development: Assessment Of Maternal Health

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Pregnancy / Conception Fetal Development

* Assessment of Maternal Health * Preconception care
Identify communicable diseases- immunization status, STI’s, CMV, 5th disease, TB
Toxoplasmosis, Listeriosis
Toxic exposures
Lifestyle/fitness
*

Genetic risks family pedigree

Menstrual Cycle
Additional resource- http://www.biology.arizona.edu/human_bio/problem_sets/Human_Reproduction/05t.html *

Menarche 9-16 years cycle length 21-36 phases – ovarian, endometrial “hypothalamic/pituitary, ovarian axis”

ovarian follicular

ovulation

luteal

endometrial menses

proliferative

secretory

menstrual phase proliferative secretory menstrual phase proliferative secretory

*

Conception / Fertilization

* occurs in ampulla

* sperm penetration capitation, acrosomal rxn * OVA * zona pellucida * corona radiata

fertilization
--diploid # restored (46 chromosomes)
--rapid cell division begins
--zygote is formed

* Pre-embryonic Period (3-4 weeks)

Cell division
Morula
Blastocyst trophoblast implantation
Cell differentiation

* Embryonic Stage (5-11 weeks)

Development neural tube formation
HcG secreted
Amenorrhea
heart primitive

week 6 – neural tube formed, tail prominent 8 weeks - very susceptible to environmental hazards

Embryonic Period (stage) Embryonic membranes

umbilical cord (3 vessels) whartons jelly-

amniotic fluid- 500-1000 oligohydramnios polyhydramnios function- placenta development, circulation

* Fetal Stage (12weeks-birth)--Fetal circulation

fetal hemoglobin

Cord

flow

shunts

changes at birth

* Fetal Period 12 weeks
Developmental milestones- looks like a baby- now growth & refinement every organ and structure present may hear heart tones with Doppler uterus level of symphysis (size of orange) maternal nausea subsides

* 15 weeks genitals external maternal well being lanugo develops uterus mid way symphysis and umbilicus

* 20-24 weeks vernix caseosa lanugo surfactant begins to be excreted gas exchange possible

Genetics- Human cells
- Hereditary Factors * Transmission of traits by single genes * Traits classified as dominant or recessive * traits can be more prevalent in certain groups * new traits can emerge http://ghr.nlm.nih.gov/ http://www.history.nih.gov/exhibits/genetics/index.htm

Common Patterns of Inheritance-
Autosomal Dominant Parents | | | | | | | | |

Autosomal Recessive Parents | | | | | | | | |

Autosomal Recessive
(only one carrier) Parents | | | | | | | | |

Autosomal Recessive
(if one had disease)

Parents | | | | | | | | |

X Linked Recessive (affected males)

Parents | | | | | | | | |

X - Linked Recessive
(carrier daughters)

Parents | | | | | | | | | * Chromosome Disorders (Causes)

1. Numerical
-too many or too few
2. Structural
-part may be missing or added
3. Multifactorial
-combination of genetics and environment

Reduction of risks to fetal growth and wellbeing-

vulnerability /stages of susceptibility 2 weeks post conception- (4 weeks OB) 3-8 weeks post conception *** very susceptible (5-10 weeks) 10+ weeks (12+ weeks OB)
- all organs form, insults now related to growth & function categories of environmental risks temperature infection medications lifestyle environmental exposures- http://www.endocrinedisruption.com/prenatal.criticalwindows.references.php http://www.safecosmetics.org/
Study guestions- 1. What is the purpose of HcG and why is it important to the maintenance of the pregnancy? 2. What is responsible for the physiologic changes during pregnancy? 3. Summarize the changes in each system and
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