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Questions and Answers
What is the term for the condition characterized by too little amniotic fluid?
What is the term for the condition characterized by too little amniotic fluid?
Which of the following is a function of amniotic fluid?
Which of the following is a function of amniotic fluid?
Which condition is associated with a volume of more than 2 liters of amniotic fluid?
Which condition is associated with a volume of more than 2 liters of amniotic fluid?
Which complication is most commonly associated with decreased amniotic fluid?
Which complication is most commonly associated with decreased amniotic fluid?
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What is the typical volume of amniotic fluid present at birth?
What is the typical volume of amniotic fluid present at birth?
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What is the function of the foramen ovale in fetal circulation?
What is the function of the foramen ovale in fetal circulation?
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Why do fetal lungs not participate in gas exchange?
Why do fetal lungs not participate in gas exchange?
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What role does the ductus arteriosus play in fetal circulation?
What role does the ductus arteriosus play in fetal circulation?
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What adaptation helps increase the oxygen-carrying capacity in a fetus?
What adaptation helps increase the oxygen-carrying capacity in a fetus?
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What condition makes a newborn more susceptible to jaundice?
What condition makes a newborn more susceptible to jaundice?
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At what gestational week does the gastrointestinal system begin to mature?
At what gestational week does the gastrointestinal system begin to mature?
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Which statement is true regarding the liver's role in fetal iron storage?
Which statement is true regarding the liver's role in fetal iron storage?
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What is a consequence of a sterile gut in the fetus regarding vitamin K?
What is a consequence of a sterile gut in the fetus regarding vitamin K?
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What is the threshold of viability for a fetus?
What is the threshold of viability for a fetus?
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Which structure connects the umbilical vein to the inferior vena cava in fetal circulation?
Which structure connects the umbilical vein to the inferior vena cava in fetal circulation?
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What condition is likely to occur due to a lack of adequate fetal renal function?
What condition is likely to occur due to a lack of adequate fetal renal function?
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What is the primary function of the placenta related to nutrient supply?
What is the primary function of the placenta related to nutrient supply?
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Dizygotic twins originate from how many fertilized ova?
Dizygotic twins originate from how many fertilized ova?
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What role does amniotic fluid play in fetal development?
What role does amniotic fluid play in fetal development?
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Which type of twins can potentially develop into conjoined twins?
Which type of twins can potentially develop into conjoined twins?
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What describes the relationship between carbon dioxide and fetal blood in the placenta?
What describes the relationship between carbon dioxide and fetal blood in the placenta?
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What condition is primarily caused by uncontrolled diabetes in pregnancy?
What condition is primarily caused by uncontrolled diabetes in pregnancy?
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At what point during pregnancy does the fetal pancreas begin to secrete insulin?
At what point during pregnancy does the fetal pancreas begin to secrete insulin?
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What is a consequence of fetal hyperinsulinemia due to maternal diabetes?
What is a consequence of fetal hyperinsulinemia due to maternal diabetes?
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Which system shows cephalocaudal development during pregnancy?
Which system shows cephalocaudal development during pregnancy?
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What is the function of thyroxine secreted by the thyroid during pregnancy?
What is the function of thyroxine secreted by the thyroid during pregnancy?
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What characteristic of urine is noted in the fetus during the first trimester?
What characteristic of urine is noted in the fetus during the first trimester?
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At birth, how does the size of the brain compare to that of an adult's brain?
At birth, how does the size of the brain compare to that of an adult's brain?
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What role does the adrenal cortex play during pregnancy?
What role does the adrenal cortex play during pregnancy?
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What is the primary difference between dizygotic and monozygotic twins?
What is the primary difference between dizygotic and monozygotic twins?
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Which of the following statements is true regarding monozygotic twins?
Which of the following statements is true regarding monozygotic twins?
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Which type of monozygotic twin pregnancy can result in conjoined twins?
Which type of monozygotic twin pregnancy can result in conjoined twins?
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What term describes twins that developed from two separate fertilized eggs?
What term describes twins that developed from two separate fertilized eggs?
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How is the placenta involved in fetal development?
How is the placenta involved in fetal development?
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How many liters of amniotic fluid indicate oligohydramnios?
How many liters of amniotic fluid indicate oligohydramnios?
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At what point is a fetus considered viable?
At what point is a fetus considered viable?
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When does the fetal pancreas begin to secrete insulin?
When does the fetal pancreas begin to secrete insulin?
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Study Notes
Amniotic Fluid
- Amniotic fluid acts as a cushion, maintains constant body temperature, prevents entanglement in membranes, provides freedom of movement for musculoskeletal development, serves as a source of fluid and a repository for waste, and enhances lung development.
- Approximately 700-1000ml of amniotic fluid is typically present at birth.
- Oligohydramnios is a condition where there is less than 300ml of amniotic fluid, which is often associated with fetal renal abnormalities.
- Polyhydramnios is a condition where there is more than 2L of amniotic fluid, which is associated with gastrointestinal and other fetal malformations.
Fetal Circulatory System
- The fetal circulatory system is unique because the lungs don't function for gas exchange, and there are three unique vascular shunts: the ductus venosus, foramen ovale, and ductus arteriosus.
- The ductus venosus connects the umbilical vein to the inferior vena cava, allowing oxygenated blood to bypass the liver.
- The foramen ovale is a shunt that allows blood to bypass the lungs, diverting it from the right atrium to the left atrium. It is a “hole in the heart” that closes shortly after birth.
- The ductus arteriosus connects the pulmonary artery to the aorta, allowing blood to bypass the lungs.
Fetal Oxygenation Adaptations
- The fetus maintains oxygenation through increased oxygen-carrying capacity, increased carbon monoxide levels, fetal hemoglobin carrying 20-30% more oxygen, and a fetal heart rate between 110-160 beats per minute.
Gastrointestinal System
- The fetus swallows amniotic fluid to promote GI system maturation, which is typically complete by 36 weeks.
- Waste products accumulate in the digestive tract near term, leading to the creation of meconium.
Hepatic System
- Fetal livers store glycogen, two times that of an adult at term.
- Iron is stored in the liver and is enough to last 6 months.
- Fetal livers lack enzymes to conjugate bilirubin, which can lead to jaundice, and cannot make key coagulation factors.
- Sterile gut cannot synthesize vitamin K, and vitamin K is administered intramuscularly after birth.
Renal System
- Fetal kidneys function in the first trimester and fully develop by birth.
- The Glomerular Filtration Rate (GFR) is low in fetuses, and they lack the ability to concentrate urine.
- Urine is secreted into the amniotic fluid.
Neurologic System
- The neural tube closes by week four.
- Cephalocaudal development occurs, where head to rump growth dominates.
- The forebrain, midbrain, and hindbrain develop by week five.
- At birth, the brain is approximately one-quarter the size of an adult brain.
- Lower body parts must grow more to reach adult size.
Endocrine System
- The thyroid gland secretes thyroxine by week eight.
- The adrenal cortex forms during the sixth week.
- The pancreas secretes insulin by week 20.
- Hormones are secreted by weeks eight and nine.
Uncontrolled Diabetes in Pregnancy
- Maternal hyperglycemia leads to increased glucose to the fetus, potentially resulting in fetal hyperinsulinemia, macrosomia, and hypoglycemia after birth due to the removal of the maternal glucose supply.
Multiple Births and Conjoined Twins
- Dizygotic (fraternal) twins originate from two zygotes.
- Monozygotic (identical) twins originate from a single zygote.
- Monochorionic diamniotic twins have two amnions.
- Monochorionic monoamniotic twins have one amnion and are at risk for conjoined twins.
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Description
Explore the crucial roles of amniotic fluid and the fetal circulatory system. Learn about conditions like oligohydramnios and polyhydramnios and their implications. Understand how fetal vascular shunts function to ensure proper development before birth.