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Questions and Answers
What role does Human Chorionic Gonadotropin (hCG) play during pregnancy?
What role does Human Chorionic Gonadotropin (hCG) play during pregnancy?
What is the primary function of progesterone during pregnancy?
What is the primary function of progesterone during pregnancy?
How are chorionic villi related to the placenta?
How are chorionic villi related to the placenta?
What is the normal amount of amniotic fluid at term?
What is the normal amount of amniotic fluid at term?
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What is the purpose of the amniotic membrane during pregnancy?
What is the purpose of the amniotic membrane during pregnancy?
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What common condition results from excess amniotic fluid?
What common condition results from excess amniotic fluid?
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What is the significance of the umbilical cord during pregnancy?
What is the significance of the umbilical cord during pregnancy?
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Which hormone is primarily responsible for regulating maternal metabolism during pregnancy?
Which hormone is primarily responsible for regulating maternal metabolism during pregnancy?
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At what week does passive antibody transfer from mother to fetus begin?
At what week does passive antibody transfer from mother to fetus begin?
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What significant development occurs in the fetus by the end of 24 weeks regarding viability?
What significant development occurs in the fetus by the end of 24 weeks regarding viability?
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Which of the following developments begins at the end of the 32nd gestational week?
Which of the following developments begins at the end of the 32nd gestational week?
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What indicates the presence of hearing by the end of 24 weeks?
What indicates the presence of hearing by the end of 24 weeks?
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By the end of the 36th gestational week, what starts to diminish?
By the end of the 36th gestational week, what starts to diminish?
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What characteristic appearance change occurs due to fat deposition by the end of the 32nd week?
What characteristic appearance change occurs due to fat deposition by the end of the 32nd week?
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What function begins at the end of the 28th gestational week concerning lung development?
What function begins at the end of the 28th gestational week concerning lung development?
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What critical process begins after the entirety of the 36th gestational week?
What critical process begins after the entirety of the 36th gestational week?
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At what gestational age do most babies typically turn into a vertex (head down) presentation?
At what gestational age do most babies typically turn into a vertex (head down) presentation?
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What is the average weight of a fetus at the end of the 40th gestational week?
What is the average weight of a fetus at the end of the 40th gestational week?
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When does fetal movement, known as quickening, typically begin to be felt by the mother?
When does fetal movement, known as quickening, typically begin to be felt by the mother?
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What measurement does McDonald’s rule use to determine fetal growth during midpregnancy?
What measurement does McDonald’s rule use to determine fetal growth during midpregnancy?
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Which of the following is an accurate heart rate for a fetus throughout pregnancy?
Which of the following is an accurate heart rate for a fetus throughout pregnancy?
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What does a nonstress test measure?
What does a nonstress test measure?
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What does Nagele’s Rule help to estimate?
What does Nagele’s Rule help to estimate?
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How far does the symphysis-fundal height measure at 20 weeks of pregnancy?
How far does the symphysis-fundal height measure at 20 weeks of pregnancy?
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What is a characteristic of emotional lability during pregnancy?
What is a characteristic of emotional lability during pregnancy?
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Which of the following describes presumptive signs of pregnancy?
Which of the following describes presumptive signs of pregnancy?
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What change occurs in vaginal secretions during pregnancy?
What change occurs in vaginal secretions during pregnancy?
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How do Braxton Hicks contractions function during pregnancy?
How do Braxton Hicks contractions function during pregnancy?
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What is a probable sign of pregnancy?
What is a probable sign of pregnancy?
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What happens to the breasts during early pregnancy due to hormonal changes?
What happens to the breasts during early pregnancy due to hormonal changes?
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How does pregnancy affect the levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH)?
How does pregnancy affect the levels of Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH)?
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What changes occur in the uterus during pregnancy?
What changes occur in the uterus during pregnancy?
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What is defined as a BMI above 30 kg/m2?
What is defined as a BMI above 30 kg/m2?
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Which of the following complications are morbidly obese women more prone to during pregnancy?
Which of the following complications are morbidly obese women more prone to during pregnancy?
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What is a common dietary concern for vegetarians during pregnancy?
What is a common dietary concern for vegetarians during pregnancy?
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What should be the minimum daily caloric intake for pregnant women?
What should be the minimum daily caloric intake for pregnant women?
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What can complicate the performance of a cesarean birth in obese women?
What can complicate the performance of a cesarean birth in obese women?
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Why might vegetarians need prenatal supplements?
Why might vegetarians need prenatal supplements?
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What condition is more likely to occur in obese women during pregnancy?
What condition is more likely to occur in obese women during pregnancy?
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What might be prescribed to aid lower leg circulation for morbidly obese pregnant women?
What might be prescribed to aid lower leg circulation for morbidly obese pregnant women?
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Study Notes
Fertilization and Implantation
- Conception, also known as impregnation, initiates pregnancy.
- Following fertilization, the fertilized egg implants in the uterine lining.
Embryonic and Fetal Structures
- Decidua (Uterine Lining): The uterine lining thickens and becomes more vascular under the influence of Human Chorionic Gonadotropin (hCG), preventing its shedding.
- Chorionic Villi: Develop from the single-layer cells of the embryo, extending into the uterine endometrium to form the placenta. Approximately 200 villi form by term. Components include the syncytiotrophoblast and cytotrophoblast (Langhan's layer).
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Placenta: A 15-20cm diameter, 2-3cm deep organ with endocrine functions, producing hCG, progesterone, estrogen, and hPL.
- hCG: Maintains the uterine lining and suppresses maternal immune response.
- Progesterone: Maintains pregnancy, reduces uterine contractility. Placental production begins around week 12.
- Estrogen: Contributes to mammary gland growth and uterine growth.
- hPL: Growth-promoting and lactogenic hormone; regulates maternal glucose, protein, and fat metabolism.
- Amniotic Membrane and Fluid: The membrane supports and produces amniotic fluid, also producing a phospholipid that initiates prostaglandin formation, potentially triggering labor. Normal amniotic fluid volume at term is 800-1200 mL. Hydramnios (excess fluid) and oligohydramnios (reduced fluid) are noted deviations. Amniotic fluid pH is approximately 7.2.
- Umbilical Cord: Connects the fetus to the placenta, providing a circulatory pathway. Brown fat (for temperature regulation) starts forming in the fetus near the kidneys, sternum, and neck. Vernix caseosa begins to form, covering the skin. Passive antibody transfer from mother to fetus begins; sleep/wake cycles establish.
Fetal Development Timeline
- 24 Weeks: Length 28-36cm; weight 550g; meconium present in rectum; lung surfactant production begins; eyebrows and eyelashes well-defined; eyelids open; pupils react to light; considered a lower-end age of viability with intensive care.
- 28 Weeks: Length 35-38cm; weight 1200g; lung alveoli mature; surfactant in amniotic fluid; testes begin descent; retinal blood vessels form, vulnerable to high oxygen.
- 32 Weeks: Length 38-43cm; weight 1600g; subcutaneous fat deposits; responds to external sounds; Moro reflex present; iron stores develop.
- 36 Weeks: Length 42-48cm; weight 1800-2700g; glycogen, iron, carbohydrate, and calcium stores deposited; additional subcutaneous fat; sole of foot has minimal creases; lanugo diminishes; most fetuses are in vertex presentation.
- 40 Weeks: Length 48-52cm (crown-rump 35-37cm); weight 3000g; active kicking; fetal hemoglobin converts to adult hemoglobin (about 20% adult at birth); vernix caseosa fully formed; fingernails extend beyond fingertips; foot creases cover at least two-thirds of the sole.
Assessing Fetal Growth and Development
- Health History: Essential for assessment.
- McDonald's Rule: Symphysis-fundal height measurement estimates fetal growth during mid-pregnancy: at the symphysis pubis at 12 weeks, umbilicus at 20 weeks, xiphoid process at 36 weeks.
- Nägele's Rule: Estimates due date by subtracting 3 months from the first day of the last menstrual period and adding 7 days.
- Fetal Movement (Quickening): Typically felt by the mother at 18-20 weeks, peaking at 28-38 weeks; at least 10 movements daily are expected.
- Fetal Heart Rate: 120-160 bpm throughout pregnancy; detectable with Doppler from 10-11 weeks. Assessment methods include Rhythm Strip Testing, Nonstress Testing, Vibroacoustic Stimulation and Contraction Stress Testing.
Pregnancy Signs
- Presumptive Signs: Subjective, experienced by the woman but not verifiable by an examiner.
- Probable Signs: Objective signs verifiable by an examiner, including laboratory tests (pregnancy tests).
- Positive Signs: Diagnostic findings confirming pregnancy.
Reproductive System Changes
- Uterine Changes: Anteflexion, increased size and softness; Braxton Hicks contractions appear. Ballottement is evident at 16-20 weeks.
- Cervical Changes: Softening and increased vascularity.
- Vaginal Changes: Vaginal secretions shift from alkaline (pH>7) to acidic (pH 4-5).
- Feedback Mechanisms: Increased estrogen and progesterone inhibit FSH and LH, preventing ovulation.
- Breast Changes: Increased fullness, tingling, tenderness due to estrogen stimulation; areola darkens and enlarges.
Pregnancy and Specific Patient Populations
- Obese Women: Increased risk of gestational diabetes, pregnancy-induced hypertension, thrombophlebitis, macrosomia in infants; increased difficulty in monitoring fetal heart tones and delivery; more difficult ambulation increasing risk of complications. Caloric intake should not fall below 1500-1800 calories to maintain adequate nutrition.
- Morbidly Obese Women: Increased risk of complications such as gestational diabetes, type 2 diabetes, hypertension, back pain, and thrombophlebitis; prone to sleep apnea. Monitoring the fetus and delivery becomes more difficult. Support hose may be recommended for leg circulation. Cesarean births are more frequent.
- Vegetarian Women: Risk of deficiencies in vitamin B12, calcium, and vitamin D; prenatal vitamins are essential. Lacto-ovo vegetarians, lactovegetarians, and vegans each present specific considerations regarding nutrient intake.
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Description
Test your knowledge on the processes of fertilization and implantation in human pregnancy. This quiz covers key concepts such as embryonic structures, the role of the placenta, and hormone functions during early pregnancy. Perfect for students in reproductive biology or prenatal development studies.
