WEEK 3: Prenatal Care: Care of the fetus

CREATED BY S.I.

ovulation

before fertilziation, at 14th week (release of ovum)

conception, fecundation, impregnation

other terms for fertilization

72 horurs; 5-6 mins

sperm lives; travels how longq

hyaluronic acid

holds together cells covering the ovvum

hyaluronidase

dissolves hyaluronic acid covering ovum

24-48 hrs

ova lives for

zona pellucida, corona radiata

layers of ova

zona pellucida

inner layer of ova

corona radiata

outer layer of ova

vitelline membrane

what does sperm come in contact when it penetrates ova pellucida

differentiation

one cell gets differentiated from other cells in vicinity

nidation

other term for implantation

8-10 days after fertilization; fundal portion

when does implantation happen

upper 1/3 uterus

where is fundal portion located

ectopic pregnancy

abnormal implantation site

trophoblast

responsible of attaching itself to material side

amnion

inner fetal membrane; encloses amniotic cavity

chorion

outer membrane; contains amnion and part of placenta

langerhans layer

prevents penetration of viruses

400-600 grams

how heavy is placenta

chorionic villi and decidua

what is placenta made up

42 weeks

when does placenta lose function

decidua

thickened endometrial lining

basalis, capsularis, marginalis, parietalis

four decidua

Decidua Basalis

Portion of the Placenta

Portion beneath site of implantation

Decidua parietalis/Vera

Portion of the Placenta

Lies the remainder of the uterus

Decidua capsularis

Portion of the Placenta

Portion overlying the developing fetus

Human Chorionic Gonadotropin (HCG)

what supports decidua; maintains pregnancy

transport nutrients and fluids

excretion of amniotic fluid

respiratory organ of fetus

placental barrier

secretes hormones

functions of placenta

duncan

maternal side of placenta

schultz

fetal side of placenta

- human chorionic gonadotropin

- estrogen

- progesterone

- human chorionic somatomammotropin

- human placental lactogen

placental hormones

Human Chorionic Gonadotropin

Placental hormone

• Secreted as early as 8-10 days of fertilization, detected in the serum as early as the time of implantation by pregnancy test

• Suppress the rejection of the placenta

• Responsible for the nausea and vomiting experience

• NOT all women with increased of this hormone is pregnant

Progesterone

Placental hormone

• Maintains pregnancy and prevents uterine contraction

Estrogen

Placental hormone

• Mammary gland and uterine development

Human Chorionic Somatomammotropin/Human Placental Lactogen

Placental hormone

• Principal diabetogenic factor since it is a major insulting antagonist

• Prepares the breast of the mother for lactation

hydatidiform mole

rare complication of pregnancy characterized by trophoblast

Amniotic Fluid

Clear, straw-colored fluid in which the fetus floats

Originates from the fetus and the mother

800-1200 mL

Oligohydramnios

• <500 mL amniotic fluid

• Indicates a kidney problem

Polyhydramnios

• >2000 mL amniotic fluid

• Indicates esophageal atresia

Meconium-Stained

What does a green-colored amniotic fluid indicate?

High bilirubin due to Hemolytic disease

What does a golden colored amniotic fluid indicate?

Umbilical Cord

Conduit between the developing embryo or fetus and placenta

AVA

• 2 Arteries

• 1 Vein

Blood vessels of the umbilical cord

Wharton’s Jelly

The gelatinous mucopolysaccharide covering the umbilical cord that prevents the cord from compression

110-116 bpm at 28 wks

fetal heart rate

10 kicks per hours, 2 in 10 minutes

how many kicks baby

sadovsky method

1. Lie in a left recumbent position after a meal.

abdomen, your hands are warm and not cold because

2. Observe and record the number of fetal

this can cause alteration or cause the abdomen to

movements (kicks) their fetus makes over the

next hour

contract

● Every after meal, the fetus is active

which is why it is the best time to

● Through this rule, we will be able to have

monitor its movements

● Follow a symphysis fundal height measurement

● Typically, the distance from the uterine fundus to

● We make measurements from the notch of the

● We use a tape measure in centimeters and

● This rule becomes inaccurate during the third

● Until then, a fundal height much greater than this

● A fundal measurement much less than this

● In this position, a fetus normally

approximate data or information on how heavy the

moves a minimum of twice every 10

baby is.

minutes or an average of 10-12 times

determining during mid pregnancy that a fetus is

● Having an empty bladder, we measure the fundal

an hour

growing in utero

height in centimeters then we minus with 'n'

.

● If less than 10 movements occur

○ When we say engaged, the fetus is

within an hour, the woman will repeat

the symphysis pubis in centimeters is equal to the

already down the ischial spine of the

the test in the next hour. We need to

weeks of gestation between the 20th - 31st weeks

alot 2 hours for this test.

pelvis. This happens on the late days of

of pregnancy

○ She should call her

pregnancy.

healthcare provider if she

○ When we say unengaged, the head of

feels fewer than normal

symphysis pubis to over the top of the uterine

the fetus is still above the ischial spine.

movements (half the

fundus as the woman lies supine.

● We then multiply it with '155' which is a constant

normal movements) during

value.

the chosen hours.

rhythym strip testing

assessment of fetal heart rate for whether a good baseline reads in a degree of variability is present

baseline

average of rate of the fetal heartbeat per minute

variability

small changes in rate if fetal parasymp and symp are receiving oxygen and nutrients

accelration of hr

stressed fetus

decreased hr

weak fetus

absent or non apparent, minimal, moderate, marked variability

categories of variability

absent or non apparent

no changes

minimal

extremely small fluctuations

moderate

6-25 bpm

marked variability

25 bpm and above

acceleration

increase of fhr due to uterine contraction or stress

deceleration

drop of fhr caused by stress

vena cava syndrome/supine hypotension syndrome

Weight of uterus on vena cava decreases venous return to heart and decreases placental blood flow

-Use wedge under right hip to correct

cardiff count to 10 movement method

has chart; similar to sadovsky method

nonstress testing/cardiotocogram

measures response of fhr to fetal movement; fhr, contraction, movement

CONTRACTION STRESS TESTING

administering oxytocin

oxytocin challenge test and nipple stimulation test

2 tests under contraction stress testing

negative (norma;)

no deceleration on 3 contractions

positive (abnormal)

on ctg with 3 contractions and w deceleration

cardio topograph

relation between fhr and uterine contractions

vibroacoustic stimulation

sharp sound; 80 decibels at 8- hertz

ultrasonography

6 weeks

biophysicial profile

check on baby's wellbeing

fetal breathing, fetal movement, fetal tone, amniotic fluid level, fhr-nst

what to assess in biophysical profile

sonnogram

how to assess biophysical profile

fetal ultrasound

how tomeasure amniotic fludui

modified biophysical profile

amniotic fluid index plus nst,,,

0

placenta in 12-24

1

placenta in 30-32

2

placenta in 36 weeks

3

placenta in 38 weeks

maternal serum

identiffy ppresence of alpha-fetoprotein/afp

amniocentesis

aspirate amniotic fluids

percutaneous umbilical blood sampling

cordocentesis; 2nd to 3rd trimester, utz

fetoscopy

16-17 weeks