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"