Prenatal and Childbirth Development PDF

PRENATAL DEVELOPMENT AND BIRTH Pregnancy, Birth Process, and Current Trends LEARNING OUTLINE Course of Prenatal Development Teratology and Hazards to Prenatal Development Current Trends GERMINAL PERIOD  What is it?...

PRENATAL DEVELOPMENT AND BIRTH Pregnancy, Birth Process, and Current Trends LEARNING OUTLINE Course of Prenatal Development Teratology and Hazards to Prenatal Development Current Trends GERMINAL PERIOD  What is it? p e r io d o f pr e n a t a l p e ri o d is th e The germinal i n g th e f ir st h a t ta k e s p la ce d u r development t io n. It in c lu d e s th e a ft e r c o n c e p t two weeks , c a lle d a h e f e r ti li z e d e g g creation o f t t h e a tt a c h m e n t o f iv is io n ; a n d zygote; cell d t h e u te ri n e w a ll the zygote to Germinal Cells Blastocyst - The inner layer of cells that develops during the germinal period. These cells later develop into the embryo. Trophoblast - The outer layer of cells that develops in the germinal period. These cells provide nutrition and support for the embryo. EMBRYONIC PERIOD  What is it? pe rio d o f p re n a t a l ic p e r io d is th e The embryon w o t o ei g h t h a t oc cu rs fr o m t development t n. D u ri n g th e c o n c e p ti o weeks after e of c el l e rio d , t h e r a t embryonic p p o r t s ys te m s n in t en s if ie s , s u p differentiatio a r. , a n d o rg a n s a p p e for cells for m  THREECHILD LAYERSBIRTH OF EMBRYO Endoderm Mesoderm Ectoderm The Inner Layer The Middle Layer The Outermost Layer  Life Support Systems As the embryo’s three layers form, life-support systems for the embryo develop rapidly. These include the amnion, the umbilical cord and the placenta.  ORGANOGENESIS Is the process of organ formation during the first two months of prenatal development. For example, In the third week after conception, the neural tube that eventually becomes the spinal cord forms. FETAL PERIOD  What is it? u t se ve n mon th s , is od , la sting a b o The fetal peri tw o m on t h s l p e rio d be tw e e n the prenata in ty p i c a l io n an d b ir th after concept pregnancies. BRAIN DEVELOPMENT DURING PRENATAL PERIOD Neural Tube Neuronal Migration Neurogenesis Neural Connectivity  Neural Tube This forms at about 18 to 24 days after conception, develops out of the ectoderm. The nervous system begins forming as a long, hollow tube located on the embryo’s back.  BIRTH DEFECTS Two birth defects related to a failure of the neural tube to close are anencephaly and spina bifida. The highest regions of the brain fail to develop when fetuses have anencephaly or when the head end of the neural tube fails to close, and these fetuses die in the womb, during childbirth, or shortly after birth.  BIRTH DEFECTS Spina bifida results in varying degrees of paralysis of the lower limbs. Individuals with spina bifida usually need assistive devices such as crutches, braces, or wheelchairs.  Neurogenesis The generation of new neurons is called neurogenesis, a process that continues through the remainder of the prenatal period.  Neurogenesis At the peak of neurogenesis, it is estimated that as many as 200,000 neurons are generated every minute.  Neuronal Migration At 6 to 24 weeks after conception, neuronal migration occurs. Once a cell has migrated to its target destination, it must develop into a more complex structure.  Neural Connectivity At about the 23rd prenatal week, connections between neurons begin to occur, a process that continues postnatally. TERATOLOGY AND HAZARDS TO PRENATAL DEVELOPMENT  TERATOGENS A teratogen is any agent that 01 can potentially cause a birth defect or negatively alter cognitive and behavioral outcomes The field of study that 02 investigates the causes of birth defects is called teratology WHAT INFLUENCES DEFECTS? 01 Dose 02 Genetic susceptibility 03 Time of exposure TYPES OF TERATOGENS gene Chromosome DNA Prescription Drugs Nonprescription Drugs Incompatible Blood Types Include antibiotics, such as Nonprescription drugs Incompatibility between streptomycin and tetracycline; the mother’s and father’s some antidepressants; that can be harmful blood types poses another certain hormones, such as include diet pills and risk to prenatal progestin and synthetic high dosages of aspirin development estrogen; and Accutane COMMON Psychoactive Drugs TERATOGENS 1 Caffeine 2 Alcohol 3 Nicotine 4 Cocaine 5 Marijuana  These include chemicals in the environment that ENVIRONMENTAL the pregnant woman cannot control and may not even be aware of. HAZARDS 1 Radiation 2 Chemicals and Pollutants 3 Fertilizers and Pesticides  RUBELLA The risk of eye and heart defects is greatest in the first 8 weeks (when these organs are forming), whereas deafness is more common if the mother comes down with rubella in weeks 6 through 13. SYPHILLIS Damage to offspring includes MATERNAL stillbirth, eye lesions (which can cause blindness), skin lesions, DISEASES and congenital syphilis  GENITAL HERPES About one-third of babies delivered through an infected birth canal die; another one- fourth become brain damaged AIDS A mother can infect her offspring MATERNAL with HIV/AIDS in three ways: (1) during gestation across the placenta, (2) during delivery and (3) DISEASES through breast feeding QUICK RECALL: Other Maternal Factors Maternal Diet and Nutrition Maternal Age Emotional States and Stress A recent study revealed The mortality rate of A research review indicated that that at 14 weeks following infants born to adolescent pregnant women with high conception fetuses of obese mothers is double that of infants levels of stress are at pregnant women had less born to mothers in their twenties. increased risk for having a child efficient cardiovascular When mothers are 35 years and with emotional or cognitive functioning and were associated older, risks also increase for low problems, attention with an increased risk of preterm birth weight, fetal death, and deficit hyperactivity disorder birth down syndrome (ADHD), and language delay PATERNAL FACTORS 1 Exposure to chemicals and radiation 2 Smoking 3 Increasing Paternal Age PRENATAL CARE OBJECTIVES A defined schedule of visits for medical care Exercise during pregnancy Information about pregnancy, labor, delivery, and caring for the newborn QUIZ TIME! Mentimeter Code: 2861 4770 https://www.menti.com/algnyrhm7 5br CURRENT TRENDS  GENETIC TESTING AND SCREENING The Study of Pös et al. (2019) reported that Genetic testing opens the door to gene therapy, Prenatal testing in recent years has been moving an experimental technique for repairing, toward Non-Invasive Prenatal Testing (NIPT) to replacing, or regulating defective genes. determine the fetal risk for genetic disorders without incurring the risk of miscarriage. NIPT is becoming more widely used as a safer option for detecting chromosomal abnormalities such as Down syndrome. Research is also exploring the potential of NIPT to identify a broader range of genetic conditions.  ASSISTED REPRODUCTIVE TECHNOLOGY Current trends in in vitro fertilization (IVF) The Study of Singh and Dewani (2022) reflect significant technological advancements, emphasized the trend in Preimplantation as well as evolving approaches to improve Genetic Testing (PGT), allowing for the success rates, reduce costs, and enhance screening of embryos for genetic abnormalities patient experiences. before implantation Low-Cost IVF: Efforts are being made to develop more cost-effective IVF procedures, making them accessible to a broader range of patients.  INTEGRATION OF ARTIFICIAL INTELLIGENCE (AI) The Study of Ramakrishnan et al. (2021) Artificial intelligence offers novel approaches identified that machine learning, has been used to prediction modeling, diagnosis, early to predict preterm birth, birthweight, detection, and monitoring in perinatal health preeclampsia, mortality, hypertensive disorders, and postpartum depression. Real-time electronic health recording and predictive modeling using artificial intelligence have found early success in fetal monitoring and monitoring of women with gestational diabetes especially in low-resource settings.  WHOLE GENOME SEQUENCING Studies are investigating the use of whole- Whole genome sequencing enables the genome sequencing in prenatal care to provide comprehensive analysis of almost all genetic a comprehensive view of the fetus's genetic information from an individual in one assay in a makeup, allowing for early diagnosis and short turnaround time. (Liu & Vossaert, 2022) potential interventions. While not ready for clinical implementation, emerging technologies such as long-read and Hi-C sequencing analyses prove to be useful in interpreting the expanding genetic data sets generated by genome-wide sequencing.  References Feldman, R. D., Martorell, G., & Papalia, D. E. (2014). Experience human development. McGraw-Hill Education. Liu, P., & Vossaert, L. (2022). Emerging technologies for prenatal diagnosis: The application of whole genome and RNA sequencing. Prenatal Diagnosis, 42(6), 686–696. https://doi.org/10.1002/pd.6146 Papalia, Diane E., Martorell, Gabriela. (2024). Experience Human Development, 15th ed. (13). : McGraw-Hill International Editions. Pös, O., Budiš, J., & Szemes, T. (2019). Recent trends in prenatal genetic screening and testing. F1000Research, 8, 764. https://doi.org/10.12688/f1000research.16837.1 Ramakrishnan, R., Rao, S., & He, J. (2021). Perinatal health predictors using artificial intelligence: A review. Women S Health, 17, 174550652110461. https://doi.org/10.1177/17455065211046132 Santrock. (2017). Life-Span Development 16E (Bound). Singh, K., & Dewani, D. (2022). Recent advancements in in vitro fertilisation. Cureus. https://doi.org/10.7759/cureus.30116 THE MIRACLE OF CHILD BIRTH LEARNING OBJECTIVES Describe the birth process Explain potential complications of childbirth and the prospects for infants with complicate birth Current trends in childbirth “Let choice whisper in your ear and love murmur in your heart. Be ready. Here comes life”. - Maya Angelou (1928-2014)  THE BIRTH PROCESS Parturition is the act or process of giving birth, and it typically begins about 2 weeks before delivery. The uterus contracts and the cervix becomes more flexible. Amniotic fluid flows from the uterus through the cervix and out of the vagina STAGE 1 Longest stage of birth: 12-16 hours for first birth and 4 - 6 hours for later births Contractions increase in frequency and power Cervix dilated from 1 cm- 10 cm Cervix widens and thins to create a clear exit for the baby STAGE 2- DELIVERY OF THE BABY Shorter stage - 50 minutes for first birth, 20 minutes for later births Strong contractions convulse the uterus The baby is born but still attached to the placenta ELECTRONIC FETAL MONITORING Electronic fetal monitoring can be used to track the fetus’s heartbeat during labor and delivery and to indicate how the fetal heart is responding to the stress of uterine contractions CESAREAN DELIVERY Cesarean delivery-delivery of a baby by surgical removal from the uterus -labor progresses too slowly -when the fetus seems to be in trouble premature infants - breech position  CESAREAN DELIVERY Cesarean deliveries carry risks to the mother such as bleeding, infection, damage to pelvic organs, and postoperative pain, and heighten risks of problems in future pregnancies deprive the baby of important benefits of normal birth Vaginal birth after cesarean (VBAC) should be attempted only with caution.  MEDICATED VERSUS NONMEDICATED DELIVERY natural childbirth or prepared childbirth -eliminate the use of drugs and enable both parents to participate fully in a natural, empowering experience. a. Lamaze method- mother learns to relax her muscles and controlled breathing b. LeBoyer method - gives birth in a quiet room under low lights , and the newborn is gently massaged to ease crying c. Water birth - French physician Michael Odent d. Doula- an experienced mentor, coach, and helper who can furnish emotional support and information Childbirth and the covid 19 pandemic no enough research data on intrauterine transmission of the virus (Wei et al, 2020) vaccinated pregnant mothers pass on antibodies to their babies. prenatal visits were shifted online during delivery, very limited people were present MEDICATED VERSUS NONMEDICATED DELIVERY local (vaginal) anesthesia, also called a pudendal block analgesic (painkiller), reduces the perception of pain by depressing the activity of the central nervous system epidural or spinal injections- blocks the nerve pathways that would carry the sensation of pain to the brain  STAGE 3- PLACENTA IS EXPELLED Lasts between 10 minutes to 1 hour The placenta and the remainder of the umbilical cord are expelled from the mother  MEDICAL AND BEHAVIORAL ASSESSMENT Averages - length: 20 inches, weight: 7.5 lbs APGAR Scale- a quick measure of baby’s physical condition - 7+ means baby is going fine - 5–7 means the baby needs help to establish breathing - below 4 the baby needs immediate lifesaving treatment apgar scale Neonatal Screening for Medical Conditions  body system If a neonate does not begin breathing within about 5 minutes, maybe caused by anoxia, lack of oxygen, or hypoxia, a reduced oxygen supply neonatal jaundice- caused by immaturity of liver and evidenced by yellowish appearance fontanels where the bones of the skull do not meet lanugo , a fuzzy prenatal hair vernix caseosa (“cheesy varnish”), an oily protection against infection that dries within the first few days.  states of arousal Degrees of sleep and wakefulness new babies sleep up to 18 hours a day but wake up every 3 to 4 hours, day and night, for feeding marker of neurological organization organized sleep patterns early in life have better motor and and cognitive performance.  Complications of childbirth Low-birth-weight babies (LBW) neonates born weighing less than 5 lbs. at birth higher birth risks and lower survival rate a. preterm (premature) infants- born before the 37th weeks b. small for date (small-for-gestational-age) infants  Immediate Treatment and Outcomes isolette, an antiseptic,temperature- controlled crib) and fed through tubes.  Immediate Treatment and Outcomes Kangaroo care-soothing maternal contact to reduce stress on the central nervous system and help with self- regulation of sleep and activity  Complications of childbirth postmature - a fetus not yet born as of 2 weeks after the due date or 42 weeks Still birth- sudden death of a fetus at or after the 20th week of gestation, is a tragic union of opposites- birth and death Antiphospholipid syndrome (APS) is caused by the body's immune system producing abnormal antibodies called antiphospholipid antibodies. The spectrum of aPL-positivity includes: -Asymptomatic aPL-positive patients – those with no history of blood clots or pregnancy complications; -APS patients with pregnancy complications only; -APS patients with blood clots with or without pregnancy complications  extended gentle CS protocol was compared with the gentle CS observing the delivery from the abdomen through a transparent drape Multivariable regression did not reveal a statistically significant difference for extended gentle CS with regard to satisfaction with childbirth and mother-to-child bonding. most women expressed a preference for this technique. it is recommended to offer this option. This study evaluates the effectiveness of ChatGPT and the Open AI text-embedding-ada-002 (ADA) model in detecting post- traumatic stress disorder following childbirth (CB-PTSD) 1295 women to recount their childbirth stories each participant, was assessed PTSD symptoms associated with childbirth using the PTSD Checklist of the DSM-5 OpenAI’s text-embeddings-ada-002 model yields the best performance for this task  References Bartal A.,Jagodnik K., Chan S. & Dekel S. (2024). AI and narrative embeddings detect PTSD following childbirth via birth stories. Scientifc Reports https://doi.org/10.1038/s41598-024-54242-2 Christoph P., Aebi J., Sutter L., Schmitt K., Surbek D., Oelhafen S. (2023) Archives of Gynecology and Obstetrics 1481–1488. https://doi.org/10.1007/s00404-023-06913-0 D’Ippolito S.,Barbaro G., Paciullo C., Tersigni C., Scambia G., & Di Simone N. (2023). Antiphospholipid Syndrome in Pregnancy: New and Old Pathogenetic Mechanisms. International Journal of Molecular Science https://doi.org/10.3390/ijms24043195 Feldman, R. D., Martorell, G., & Papalia, D. E. (2014). Experience human development. McGraw-Hill Education. Papalia, Diane E., Martorell, Gabriela. (2024). Experience Human Development, 15th ed. (13). : McGraw-Hill International Editions.