Fetal Development Notes PDF

Summary

These notes contain information on fetal development, from zygote to fetus, including stages of development and timelines. The document also covers topics like abortion, estimated date of confinement, and maternal factors influencing pregnancy. The summary includes some key anatomy of the uterus which assist with understanding the developmental stages.

Full Transcript

Test 25mc 45mins Zygote Embryo , Fetus ↓ ↓ ↓ the fusion of orum...

Test 25mc 45mins Zygote Embryo , Fetus ↓ ↓ ↓ the fusion of orum developmental unborn child + stage of from Sweek-term spermatozoon zygote (from fertilizationto (implantation to implantation 5 - 8 weeks) period of time - end of a pregnancy => baby born normally. Term Normally duration = 37-42 weeks Abortion Removal & expulsion of can't survive outside the uterus an embryo/ fetus End of pregnancy => Stetus's condition · before 24 weeks of gestation. ~ Spontaneous /V induced fetus born without sign of life >24 weeks of gestation birth weight> 500gm Stillbirth Estimated date of confinement (EDC) delivery day for a pregnant women ↳ Average 280 40 weeks days : * Expected date of delivery/estimated due day. I trimester : conception - 13 weeks 6 days 2 trimester : 14 Weeks - 27 Weeks 6 day Trimester 3 trimester : 28 weeks - delivery Maturity : Age of fetus , same as gestational age Pregnant = Gravida (G) G = the number of pregnancies of a pregnant woman Given birth to an infant alive/dead : * after 24 weeks) = 500gm Para/Parity (P) (PO) birth to viable child Nullipara : never given a Primipara (P1)delivered : one viable child Multipara (P2/4) delivered: more than one viable child Grand (P5) delivered five/more viable children multipara :. Primigravida Advanced maternal age ↑35(calculated EDC) Pregnant for the first time Pregnant Elderly Primigravida Multigravida Pregnant for the first time Pregnant for more than once at 1 above 35 age Uterus ~ Pear shape organ ~ thick muscular wall v mucous membrane lining ~ Rich blood supply = Anteflexion ~ Normal bent Slighty forward Fundas : upper portions Structure corpus : Body 3 sections #31 Cervix -ba Endometrium : * contains rich blood supply inner layer -33. Myometrium : thick muscular 3 layers wall. Perimetrium the outer layer : support bladder and bowel Allow fetus development Functions Accept fertilied orum from fallopian tube Allow orumimplanted into the endometrium & derives nourishment from blood Cervix ~ constituts the lower third of the uterus half of cervix projecting into the vagina. Presence of muches - plug in the cervical v hallow part of the cervix canal => Prevent ascending infection Cervix canal consists of external and internal os Cervix OS During labour Ind trimester - 3ra trimester v Remain closed until onset of labour ~ Effacement and dilation occurs during onset of labour ~ Provide Stable support for the baby's head ~ key determination of labour Allow descend into the uterus in preparation of birth progress dilatation from Ocm-10cm ~ by examination of the external os v Allow descent of fetus and birth canal passage for menstrual flow ~Passage for spermatozoa which deposited Vagina during sexual intercourse function Barrier to prevent ascending infection because of its acid secretion Exit for the fetus during deliver Fetal Skull · bone frontal bones Parietal bonesoccipital 1 left & (left & right) Right) temporal bone 1 left a right) not been suture FrontalSuture ossified fused in the early adulthood when ossification of skull completes Coronal suture Sagittal Suture Lambdoid Suture ↑ Fontanelles membranous non-ossified area , of the skull found where 314 futures meet. Anterior fontanelle Bregmal Posterior Fontanelle size & ~ Kite shaped I diamond shape ~ small triangular shape ~ closed at. 18 months v close at 6 weeks. futures and fontanelles allow overriding of - > the fetal skull during labour As guiding point in ↓ vaginal in examination locating position. temporary alter the shape Vertex presentation (fully flexed head ~ for safe delivery. ~ most favorable shape for dilating the Cervix & vaginally delivered Bones of vault allow a slight degree change of shape of fetal of bending and override at the sutures head > - take place its passage during through the birth Canal molding of fetal skull Reduction in the ~ protective mechanism and prevent size of the fetal brain from presenting the 1. not excessive being compressed 2. too rapid 3. in an unfavorable direction Caput succedaneum v Area of edema over presenting part of fetus/ newborn => from the pressure the cervix during labour against ~ occurs in the skin superficial to skull & periosteum usually heal without any medical majoy intervention membrane -> covers Cephalohaematoma. ~ Pressure during between periosteum foringkcause bleeding & skull " v Reason - : difficult/prolonged birth - Cephalopelvic disproportion (baby's head > mother's pelvic opening) - Big baby - Abnormal presentation heal without any - usually major medical intervention - use birth-assisting tool of (forceps/vacuum delivery * If improperly treat Permanent brain damage - - Anaemia - Meningitis Caput succedaneum VS Cephalohaematoma - Present at birth - Not present at birth present , after birth May cross a suture line Never cross a suture line - - Size depends rate of labour depends of trauma on progress on degree - - - gradually subsides - > tend to grow less - May increase in the first 1-2 days - Pits on pressure - X pit on pressure at about 4-6 weeks -disappear completelyWithin 24-48hrs disappear completely - - Unilateral (Double caput = rare) - Bilateral => common - No harm - Harmful = Neonatal Jaundice , anaemia , brain damage Breast T " Anatomy Hormonal influences = 1 Trimester ~ composed of fat fibrous tissued mammary -4 level of oestrogen and , progesterone glands v fat and fibrous tissue are sensitive to v Rich in hormones lymphatic network ↳ cause milk ductal sprouting and branching Milk production & X Progesterone ↓ after Alveoli contract and eject milk into the ducts Estrogen delivery - through the nipple Prolactin and initiates milk production Mammary gland can produce colostrum - & before - birth can produce milk several days after birth storage & & Milk is transported in lactiferous ducts and - transports stored in lactiferous Sinus. development of fetal stage I ①Pre-embryonic Stage first 2 weeks beginning : with fertilization ② Embryonic Stage from 3 weeks : to 8 weeks ③ fetal stage Sweeks birth : - 2 surfaces A : dark red in color with > B Fetal. (Shiny white cotyledons 9 covered by amnion and ~ chorion with insertion of umbilical ~ vascular unit for cord. nutrients exchanges gases & size about Locm in Placenta diameter , 2. 5-3cm thickness weight 16 of : birth of weight metabolic & nutrient baby /400-boogi exchange between the embrynoic & Purplish red maternal circulation & round shape Located where embryo attaches to uterine wall & normally in upper uterine segment fluid Surrounds the growing , feths during pregnancy clear , pale straw-coloured alkaline fluid in amniotic a volume 1000m/ in composition : : 98% Water Singleton pregnancy. 2% water organic & nutrients , electrolytes Aminotic fluid metabolites/waste products promote fetus movement & fetus skin cell. Vernix , langolfine hair Provide some maintain constant permit symmetric nutritive substances & fetus maintain fluid a growth development temp for. electrolyte balance Prevent umbilical cord cushions the fetus from trauma - compression yellow = function of Aminoticfluidwine Pregnancy - * Labour during ~ equalize uterine pressure during contractions to protect the placenta and umbilical cord ~ aids effacement of cerrix and dilatation of the cervical OS Duration of Pregnancy : 40 weeks first time pregnancy : Primigravida second time 14 Multigravida · : Full Term : 37 - 42 weeks Quickening : primigravida - 16-22 weeks · 1st Trimester : Conception - 14 weeks 2nd Trimester : 14-28 weeks 3rd Trimester : 28 ~ delivery caloric intake during pregnancy Normal weight ↑ for multiple pregnancy - 1800kcal - first trimester with adding 300 kcal for - 2200 - 2500 + second trimester each baby. - 2400 - 2500 > - third trimester ! Inadequate nutritional intake Excessive nutritional intake # maternal overweight Poor weight gain H ↓ cause cause 1. Fetal macrosomia ( > 4000g) 1. Preterm delivery 2. difficult birth 2. Low birth weight 3. Increased rate of 3. Congenital anomalies instrumental delivery 4. Neonatal hypoglycemia 5. Continued obesity 6. Pre-eclampsia. Gestational 7 diabetes. First Antenatal visit ① Body weight. height & BP ↳ baseline measurement & BMI ③ Nurse & interview history taking ~ Social history ② urine analysis : Protein & Sugar ~ personal history ↳ ~ menstrual history comprehensive gestational DM and hypertension ~ obstetric history health assessment ~ medical history ⑦ Doctor interview & physical examination v family history ⑤ Antenatal blood investigation present pregnancy Significance & impacts ~ Last Menstrual period ~ Calculating EDD and present ~ Menstrual history gestational age at which menstruation ~ Age ~ Reter early dating ultrasound scan began if LMP not sure/irregularity of ~ Number of days and regularity menstruation ~ Education and advise in the cycle on present pregnancy pregnancy according to the gestation ~ Previous abortion Provides management ~ Previous birth strategies of handling (Gravity ; parity problems and complications in Previous Pregnancies present pregnancy History ~ complication of last pregnancy may be repeated/ even appears earlier in this pregnancy Refer of ~ prenatal diagnosis medical illness previous children with ~ illness , operation ( Congenital disease accident which could complicate pregnancy v To close monitoring past health history the present disease ↓ Surgical illness ~ operation on the spine , may deteriorate of uterns/the pelric flood complicated during ~ direct relationship pregnancy Family medical history ~ ~ Hereditary genetic disease for consideration of the v Chronic disease mode of delivery ~ History of multiple pregnancy Calculation of Estimated date of confinement Method ① take LMP e - g (MP 12/4/2024 ② + + days + Adays : 1914/2024 ③ - 3 months - 3 months : 19/1/2024 & Adjust the year Adjust years : 19/1/2025 Method 2 Method 3 & using the gestational calendar By ultrasound ② the using gestational table measure rump length crown , head and abdominal circumferences. femur length estimate gestational age. ↑ ~= Labour * Presence of regular uterine contractions with progressive cervical dilation and effacement · premonitory Signs of labour Lightening Braxton Hicks Contractions (False Labour ( ~ descent of the fetal presenting part v irregular : intermittent into pelvis contraction -> occurring & occurs approximately 10-14 days before throught out the pregnancy labour begins ~ Activites of toning the uterine ~ Fundus height slightly falls below xyphoid process muscle ↓ Lighter' uterus will be felt by mother ~ Contractions usually felt in lower abdomen / groin show ~ blood-tinged mucus inside the cervical canal expelled Repture of membrane at the onset of labour cleaking) ~ Sudden gush & scanty, ~ Normal : small amount in slow seeping of clear fluid bloody/pinkish mucus based pale yellow fluid from Vagina ↓ 80 % -90%, labour will ~ Abnormal : large amount Occur within 24 hrs of fresh blood noted Signs ~ occur is in anytime of of labour , onset with/without labour onset r leaking prolonged : Risk of infection ↑ v leaking can be sometimes Test of aminotic fluid leaking confused with urinary ~ Amniotic test incontinence ↓ Non-invasive ~ pool of fluid Uterine Contractions dipping to the involuntary and without warning in the vagina during speculum ~ test ~ Start : fundus of uterns I back & lower abdomen ~ Nitraline-based amnicators swab Progressive 4 in frequency , duration & intensity and will response to pH medium from ~ Push the fetus againsts and dilate the cervix blue uterine contraction be taken by cadiotocography yellow to v can up * Signs of labour onset ↳ Cervical effacement cervical dilatation Regular reterine contraction + + Stage of Labour First Stage : (Effacement & Stage dilatation Second Stage : (Expulsion Stage) >baby delivery Third Stage : (Placental Stage Fourth Stage : Post-placenta delivery Stage ↳ check mother's condition Passenger fetus Passage/passageway& - (birth canal : maternal pelvis Soft tissues ↓ fetus head attitude ,. ~ size of the maternal pelvis presentation and position (diameter of pelvic inlet , mid-pelvis ~ Placenta & membranes and outlets ↓ types of pelvis (gynecoid = best) Power uterine contractions ~ Ability of the cervix to dilate and efface ~ frequency , duration & ~ The Stretching of the perineum intensity Factors affecting labour process ↓ effacement & dilatation (5P) of cervix v controlled by maternal expulsive forces , used of intra-abdominal pressure Position (maternal Psyche-level V passive counter pressure ~ squatting , water birth of the pelvic floor v excitement , fear and tension experienced by the women Vaginal delivery ~ safest for the fetus and for the mother when the newborn is full-term ~ Always a preferred method for childbirth v ↑ morbidity & mortality associated with caesarean section Vaginal deli very Satest for * the tetus & for the mother when the newborn is full term & Preferred method for childbirth /4 mobility & mortally associated with Caesarean section Indicators Contra-indications ~ Fetal distress ~ spontaneous labour ~ Maternal distress ~ complicated gestation v Malposition / Post - term pregnancies ~ Malpositon of the placenta ~ Induction of labour ~ Genital tractInfection ~ HIV cases Assisted delivery & devices+ used to help vaginally deliver the fetus faster at end of second of labour stage Maternal exhaustion & distress (e. g high BP) Prolonged second stage (more than 1 hours) unfavorable fetal position Clinical large baby high fetal head Vaginal breech delivery (Protect the baby's last coming head from the perineum) - Preterm baby delivery (Protect the soft head from perimnem baby' birth by - Assist onlywe me applying added pullstraction down the birth 9 -gradually help lift Canal > - tetus Ventrose (Vacuum) delivery Forceps delivery out the perium Maternal fetal Fetal Maternal I risk of operative delivery ventrose site Marks & bruise of episiotomy ~ ~ Chigon on ~ on ~ rate of fetal application attempt higher failing rate) (limited , scalp area ~ Genital tract injury I rate of ~ episiotomy ~ ↑ develop Cephalohaematoma ~ Perineal tear ~ injury to perinal muscle ~ ↑ neonatal jaundice v Laceration/cutson ↑ Postpartum baby face haemorrhage. Caesarean Section * use of surgery to delivery baby through incisions in the abdomen and uterus Planned/Emergency - Presentation Breech - Multiple Pregnancy - Preterm birth - Placenta Previa -small for gestational age baby - Predicted cephalopelivic disproportion in labour - Previous Caesarean section - obstructed labour Maternal request · Lower Segment Caesarean Section Classical Caesarean Section (LSCS) (CCS) ~ vertical incision in uterns carity ~ Lower transverse incision in uterine ~ for rapid/ very preterm delivery cavity ~ CS for future pregnancy ↓ Most common ~ used after lower segment of uterus is formed

Use Quizgecko on...
Browser
Browser