pregnancy + maternal + cogenital

amniotic fluid

special fluid that surrounds fetus in uterus. fetus has no lung function at this time as they are filled with this

umbilical arteries

2

from fetal internal iliac arteries to placenta

umbilical vein

1

taking nutrients back to fetus

umbilical cord

umbilical arteries + umbilical vein + wharton’s jelly

instances where a vein contains oxygenated blood

umbilical veins in fetus

pulmonary vein in adult

HCO3-/bicarbbonate

transport CO2 in blood

wharton’s jelly

protects the vessels of the umbilical cord

mom’s uterine arteries

brings O2 and resources like glucose TO placenta

spiral arteries

mom’s uterine veins

remove O2 poor blood away from placenta & back to her systems

basal plate

layer of placenta associated with mom’s uterine tissue

trophoblasts

cells from fetal tissue

nourish cells

form fingerlike extensions called chorionic villi w/ blood vessels & capillaries (sites of exchange)

O2 Diffusion

gas from placental space/pool and into fetus blood cells/chorion

carbon dioxide diffusion

uses gradient

gas from fetal umbilical vessels in the chorionic villi across the trophoblast cell layer and into the placenta space/pool

chorionic plate

part of the fetus tissue that forms the placenta

gradients

gases follow simple, passive diffusion by using these

surface area

structures designed to maximize efficiency exchange

ex: villi/brush border

want large surface area to volume ratio

full term/total gestation

37-40 weeks

normal labor is after 37 weeks

divided into 3 stages

STAGE 1 of labor

2 parts: latent (initial) & active

latent initial part of stage 1 of labor

cervix is stretched

sends signals to hypothalamus & posterior pituitary to release hormone oxytocin

oxytocin stimulates uterus contractions

placenta secretes prostaglandins → help with contractions

positive feedback

positive feedback

more stimulus = more response

cervix continues to stretch, more hormones are secreted, more contraction occur

oxytocin

made in hypothalamus, stored in posterior pituitary

stimulates uterus contractions

positive feedback

active phase of stage 1 of labor

entered as labor progresses & the cervix stretches & thins (effacement) @ 3 cm

cervix will continue to dilate and thin up to 10 cm (full dilation)

uterus will continue to contract

baby’s head will crown

breech position

if baby’s feet first

STAGE 2 of labor

from full dilation until baby is born

uterus is still undergoing regular painful contractions

STAGE 3 of labor

delivery of placenta

uterus still contracting at this stage → will be given an oxytocin injection so we can further stimulate placental delivery - can be delivered

placenta previa

placenta separated from uterus, sitting on surface, covers cervix

abruptio placentae

placenta separated from the uterus, internal bleeding, torn off endometrium (growth layer)

preeclampsia

serious, potentially life-threatening blood pressure disorder occurring after 20 weeks of pregnancy or postpartum

spiral arteries dilate less

characterized by high blood pressure (mmHg) and signs of organ damage, such as protein in the urine, severe headache, blurred vision, nausea

risk is 35 or older, obesity, family history of diabetes

gestational diabetes

hyperglycemia diagnosed for the first time during pregnancy usually caused by placenta -produced hormones blocking insulin action → similar to type 2 diabetes mellitus

often can cause no symptoms but can cause increased thirst and urination

if unmanaged: can cause excessive birth weight and breathing issues for the baby

gestational diabetes key risk factors

being overweight, being over age 35, having previous history of the condition

type 2 diabetes mellitus

insulin resistance

make insulin (beta) but cells don’t respond

fetus lungs

has fluid → need to bypass w/ fetal adaptations

ductus venosus

get O2 from mom, bypass liver

foramen ovale

skips right side & pulmonary → go to left atrium → left ventricle → aorta

ductus arteriosus

if any gets into pulmonary artery, this connects to pulmonary artery to aorta

contigency plan

first trimester

first two months → baby will develop from a ball of cells called a blastocyst to an embryo that will develop into your baby

second trimester

baby’s sex will become apparent

circulatory system will begin pumping blood

bones will harden

third trimester

over last 6-12 weeks of pregnancy, baby’s brain will be developing billions of neurons. their skin will fill out with baby fat as their body prepares for the outside world

week 40

baby ready for life outside womb

average weight is 7.5 lbs & average length is 20 inches

zygote

1 diploid cell after fertilization

egg + sperm

embryonic

zygote becomes this @ 8 weeks

fetus

9-12 weeks @ birth

becomes gestation

neonate

1-28 days post partum

cell cleavage

rapid series of mitotic divisions following fertilization where a single celled zygote divides into numerous small cells called blastomeres w/o overall grgowth

→ blastocyst → increase cells

morula

solid, spherical ball of 16-32 blastomeres formed 3-4 days post fertilization via rapid cleavage of zygote. day 4 after zygote

after blastocyst develops day 5 & receives signals to differentiate

endoderm, mesoderm, ectoderm

gastrulation

differentiation

fundamental 3rd week human embryological process connecting the biliminar embryonic disc (epiblast + hypoblast) into a three-layered trilaminar disc

forms definite germ layers: ectoderm, mesoderm, endoderm

ectoderm

external

becomes hair, nails, skin (largest external organ), nervous system (reacts to external)

mesoderm

middle layer

becomes circulatory system (blood, vessels = connective tissue), lungs (epithelial layers → covers lungs, serous pleural), skeletal system, muscular system

endoderm layer

lines yolk sac

internal

becomes digestive system, liver (largest internal), pancreas, lungs (inner layer)

congenital/birth defects

structural & functional abnormalities present at birth

can be chromosomal changes, environmental issues during gestation

spina bifida

spine & spinal and don’t form properly and form a sac outside the body

aka neural tube doesn’t form properly

neural tube

structure in a developing embryo that becomes the brain, spinal cord, and the tissues that enclose them (meninges)

meninges

tissues that enclose brain & spinal cord

dura mater, pia mater, arachnoid mater

congenital disorder problems related

bowel and bladder problems, hydrocephaly, bone and joint deformations, neurological

hydrocephaly

neurological excess CSF build up

b9

vit b/folate deficient in mother problem related to

b12

rbc problem in mother problem related to

atrial septal defect

abnormal hole in wall between right and left atria

allows oxygenated blood to pass from left atrium, thru opening, & into right atrium causing blood to mix

leads to increased blood flow thru right side of heart and lungs

atrial septal defect early presentations

dyspnea (abnormal breathing), mummers, etc

mummers

valve or something causing abnormal sound → gurgle

atrial septal defect long term issues

extra blood volume stresses the heart and causes the right atrium, ventricle, and pulmonary arteries to dilate (Wider)

can eventually lead to heart failure, pulmonary hypertension, and/or heart rhythm abnormalities (arrhythmias=brady, tachy, palpitations)

myocardium

O2 → systemic circuit

cleft palate

failed fusion: occurs when the palatal (hard palate) shelves of maxillae (top jaw) which form the roof of the mouth fail to join during the first or second month of pregnancy

epispadias

urethra does not form into a full tube causing urine to exit from an abnormal location on top of the penis or the in the pubic area in females

• urethra voids urine from body

• idiopathic

hypospadias

urine exists abnormal from bottom of penis

trisomy 21/downs/aneuploidy

genetic condition caused by an extra copy of chromosome 21, resulting in mild-to-moderate intellectual disability

developmental delays & characteristic physical features

the most common chromosomal condition

often featuring hypotonia (low muscle tone), a flat facial profile, and upward slanting eyes

not inherited due a nondisjunction during meiosis (chromosomes don’t separate)

associated w heart defects

blood volume

increases

originally @ 5L → increases 40% → more O2 carried

blood pressure

decreases → progesterone, placenta

heart rate

increases 15 BPM

stroke volume

increases

volume of blood per contraction

cardiac output

amount pumped/min

more blood to meet demands of baby

increases

HR x SV

progesterone

relaxes smooth muscle (uterus + arteries) → dilation of vessels

affects endometrium thickens

blood pressure decreases

acts on central respiratory center in brain to take in more air

placenta

drops blood pressure bc it needs blood too

another place for blood to go to

oxygen consumption

increases → minute ventilation icreases

carbon dioxide

decreases → increases bicarbonate secretion

keeps pH balanced

volume of air

minute ventilation

increases

diaphragm

pushes up 4 cm

shifts up

chest wall

more mobile & flexible

circumference is larger

nephron

tube unit of kidneys

glomerulus

capillary filter inside

blood flow to kidney

increases → increases glomerulus filtration rate

glomerulus filtration rate

more filtrate = more urination

uterus myometrium

muscle layer becomes hypertrophic (enlarges/growing tissue)

cervix

muscle plug to prevent infection

hormones

T3 metabolic , prolactin

T3 metabolic

increases

thyroid

imporrtant for fetal neurological develolpment

prolactin

mammary, increases

for breastfeeding

resistance

blood flow drops

ex: like turning on all showers in one houose, water pressure drops

air volume

increases → gives O2 to baby

tidal volume

increases

more CO2 exhaled per breath

capacity

chest volume relaxes and increases

supine postural hypotensive syndrome

blood pressure decreases. uterus beomes larger and compresses inferior vena cava → less blood is pushed back to heart

solution: turn left