Fetal Development & Maternal Adaptation During Pregnancy PDF

Fetal Development & Maternal Adaptation During Pregnancy Courtney Russell MSN, RN  Learning Objectives 1. Describe the development, structure, and functions of the placenta, umbilical cord, and amniotic fluid 2. Outline normal fetal development from conception to...

Fetal Development & Maternal Adaptation During Pregnancy Courtney Russell MSN, RN  Learning Objectives 1. Describe the development, structure, and functions of the placenta, umbilical cord, and amniotic fluid 2. Outline normal fetal development from conception to term gestation or birth 3. Describe fetal circulation 4. Analyze the potential effects of teratogens during vulnerable periods of embryonic and fetal development. 5. Discuss the anatomic & physiologic changes that occur during pregnancy along with associated signs & symptoms 6. Differentiate between subjective (presumptive), objective (probable), and diagnostic (positive) signs of pregnancy. 7. Summarize the nutritional needs of the pregnant woman and her fetus.  Terminology Goal gestation: 37-42 weeks Preterm: 42 weeks gestation  Terminology Antepartum: prior to labor and childbirth Intrapartum: onset of labor through the delivery of the placenta Postpartum: after birth and until return of reproductive organs to normal nonpregnant state (approx. 6 weeks) Gestation: process of carrying embryo/fetus in the uterus Abortion: loss prior to 20 weeks gestation Stillbirth- fetal death occurring at 20 weeks or later  Terminology Gravida- pregnancy G status – How many times has she given Pregnancy EX: if you give birth to triplets, it is only considered one pregnancy and one birth Parity- Birth after 20 weeks Nulligravida – Has never been pregnant Primigravida – First pregnancy or been pregnant only once Multigravida – Has been pregnant more than one time Nullipara – Never given birth after the 20-week mark or beyond Primipara – Given birth once at the 20-week mark or beyond Multipara - Given birth more than once at the 20-week mark or beyond TPAL- term, preterm, abortion, living SAB – spontaneous abortion  Practice GP-TPAL Mrs. Smith has been pregnant 4 times. Her first pregnancy resulted in SAB at 8 weeks. 2nd & 3rd pregnancy delivered at 38/4 and 37/6. The 4th pregnancy delivered at 36/2. She has 2 boys and 1 girl living. - G4P3 - T2P1A1L3 Mrs. Young is pregnant for the 5th time. Her first 3 pregnancies resulted in SAB at 7 wks, 8 wks, & 6 wks. Her 4th pregnancy she delivered twins at 37/1 who are now 3 years old. - G5P1 - T1P0A3L2 Fetal Development  Embryonic Stage: implantation- end of 8th week post conception  Fetal Stage: Beginning of 9th week post conception- birth  Factors Affecting Embryonic & Fetal Development Quality of Ova & Sperm Issues with genetic code can cause miscarriage, anomalies, chromosomal, genetic problems Extra chromosome- Trisomy 21, Missing- Monosomy X- Turner’s Syndrome Intrauterine Environment If unsuitable may have spontaneous abortion Teratogens Agents that can cause development of abnormal structures (drugs, chemicals, viruses, alcohol, stress)  Teratogens Chemical: Alcohol: no safe amount Tobacco/Vape/Illicit drugs Medications: Accutane, Lithium, Coumadin, Phenytoin Infections: Rubella: deafness, cardiac anomalies, miscarriage Cytomegalovirus (CMV)- 40% transmission rate: microcephaly, hearing and cognitive impairment Syphilis: check & treat during prenatal care; blindness, deafness, issues with MSK, liver, spleen Toxoplasmosis: teach avoid raw/rare meat and cat litter; blindness, cognitive impairment Zika: microcephaly/cognitive impairment  Embryonic Membranes Chorion- Outermost Layer with finger like projections called chorionic villi which assist in attaching and implanting into uterus which then gives way to the placenta - Placenta is the babies lifeline Amnion- Fuses with chorion to become amniotic sac; thin inner protective membrane contains the embryo and amniotic fluid  Amniotic Fluid Amniotic Fluids- Constantly formed and reabsorbed Fetus swallows and urinates it At term amount is 700-1,000 mL of amniotic fluids Polyhydramnios > 2,000 mL- caused by GI problems/anomalies Baby peeing off too much fluid and its not being absorbed fast enough Oligohydramnios