Prenatal

Sex Cells

Gametes, Male Gamete=Sperm, Female Gamete=Ovum

Zygote

sperm cell fuses with an ovum

Spermatogenesis

process of sperm production in the testes

Oogenesis

Eggs cells (Ova) are ripened in the ovaries

Assisted Reproductive Technology (ART)

done to increase your chance of becoming pregnant

Causes of infertility in women

• may not ovulate - not releasing eggs to be fertilized

• eggs may be abnormal

• fallopian tubes may be blocked

• fertilized eggs can’t be implanted

Causes of infertility in men

• produce too few sperm (marijuana)

• sperm are damaged (radiation)

• Sperm may lack mobility (age)

• blocked passage way

In Vitro Fertilization (IVF)

“test tube baby” 1978

• egg and sperm are removed and fertilized in petridish

• place the embryo (fertilized egg) into the uterus and hope implantation takes place

• 25% effective

Intracytoplasmic Sperm Injection (ICSI)

the injection of a single sperm into an egg, good for men with impaired sperm

Gamete Intrafallopian Transfer (GIFT)

Egg and sperm get placed in the perfect spot in fallopian tube (1/3 in) then nature takes over

40% effective

Zygote Intrafallopian Transfer (ZIFT)

• combines IVF + GIFT

• fertilizes egg then places it

• 25% effective

35% of infertility is…

from men

10% of infertility is….

no reason

55% of infertility is…

from women

Stages of Prenatal Development

• Germinal stage

• Embryonic stage

• Fetal Stage

Germinal Stage

• zygote

• Fertilization-two weeks

• when cell division occurs

Embryonic Stage

• embryo

• week 3-week 8

• major organ and structure development

• placenta develops

• most susceptible time for teratogens and outside influences to cause major structural abnormalities

Fetal Stage

• fetus

• week 9 - full term

• growth and maturation, continued development

• brain development is critical

Structural Birth defects

• muscoskeletal system

• heart

• face

• mouth

Neural Tube Defects (NTDs)

defects that involve abnormal development of the neural tube (brain and spinal cord)

Spina Bifida

“open spine” failure of the fetus’s spine to close properly during the first month of pregnancy

Anencephaly

anterior end of the tube fails to close, absence of major portion of the brain, skull, and scalp, lacks forebran and cerebrum. More serious and typically leads to stillbirth

Stillbirth

Death of fetus past 20 weeks

Miscarriage

death of fetus prior to 20 weeks

90% of NTDs are made up by

Spina Bifida and anencephaly

Encephalocele

infrants brain tissue protrudes through abnormal openings in the skull

Hydranencephaly

Infants brain is filled with sacs of cerebrospinal fluid; thought to be caused by infections or traumatic events during or after the 12th week

Prevention of NTDs

50% or more could be prevented by adequate amounts of folic acid (400 micrograms daily, 4000 micrograms if prior NTD occurred)

umbilical cord

caries nourishment to fetus, carries metabolic waste to mother

placenta

metabolic exchange

Amniotic Sac

fetus grows inside of it, filled with amniotic fluid

Teratogens

environmental agents that cause deviations from normal development durng the prenatal period and lead to abnormalities or death

Teratogen factors:

• when exposure occurs

• exposure time

• length of exposure

• size of exposure

• dose threshold

Nicotine:

• intrauterine growth restriction (constricts uterine blood vessels and decreases blood flow)

• miscarriage, premature, adverse mental development

Alcohol:

• prenatal and post natal growth deficiency

• FAS

• cell goes past during neuron migration

Tetracycline (Type of antibiotic)

deposited into embyros bones and teeth through placenta (embryonic stage)

Thalidomide (tranquilizer)

• limb abnormalities

• organ malformations

• absence of ears

• congenital heart disease and hemangiomas

• 24-36 days after fertilization is critical period

Retinoic Acid (Vitamin A derivatives)

• cranial dysmorphisms

• cleft palate

• neural tube defects

• embryonic stage

Caffeine

• 3+ cups a day may lead to miscarriage

• low birth weight and withdrawal

Marijuana

• chromosomal damage

• cancer to kids

• similar affects to FAS

Cocaine

• malformed genital and urinary organs

• brain damaging strokes

• doesn’t go far enough during neuron migration

Rubella (German Measles)

• almost 100% chance of deafness

• delays, eyes, heart, ears, and nervous system defects

• 11 weeks and prior is critical period

Acquired Immune Deficiency Syndrome (AIDS)

• small heads, slanted eyes

• boxlike foreheads

• cognitive impairment

Genital Herpes

• problem occurs when delivered during active stage

• periodic skin sores

• serious brain and spinal cord inflammation

• death and blindness

Maternal Chicken Pox

• microcephaly

• critical period is before 20 weeks

Mercury Poisoning

brain and nervous system from eating contaminated fish

Air Pollution (Smog)

3x more likely to have a baby with a cleft lip or palates, and defective heart valves

Radiation

• small degrees of exposure can cause brain damage and leukemia

• most dangerous during 8-15 weeks

Chronic Stress

• infant apathy

• neuroses

• alteration in maternal-fetus blood flow

• baby sleep and digestive disorders

Age

• teens - too soon and too small

• over 40 - huge risks

Malnutrition

• stillbirth

• reduction in brain cells

• premature

• epilepsy

Ultrasound

no risks

between 16-20 weeks

Aninocentesis

• 15-18 weeks

• needle removes sample of amniotic fluid for chromosomal defects

• risk of miscarriage

Chronic Villus Sampling (CVS)

• removes small amount of chorion tissue from amniotic sac for chromosomal abnormalities or birth defects

• will only test if theres a risk

Maternal Blood Screening

detects neural tube defects but have a high false positive rate

Stages of Childbirth:

• Labor

• Second stage

• birth

Lamaze

• patented controlled breathing

• empowering women

Bradley Method (Husband coach)

natural childbirth with no medication

Mongan Method

hypno-birthing

braxton hicks:

false contractions

Labor:

involves dilation and effacement of cervix, takes several days can be unnoticed

Early Labor phase:

1cm to 4cm, contractions are mild

middle labor phase:

4cm to 8cm, contractions are intense, back pain, epidural is good to have

transition phase:

8cm to 10cm, most difficult, women feel out of control, shortest phase

Second stage:

baby descends into birth canal, should be head first. approximately 1 ½ to 2 hours, more pleasant for mother who is actively participating in pushing

Birth

crowning can be painful, easing baby out reduces pain, once shoulders are out the baby should slide out

post birth

umbilical cord is clamped then cut, APGAR score is calculated

c-sections

cuts through abdomen, special circumstances only.

ex: placenta may be blocking cervix, or umbilical cord may be wrapped around neck

complete breech

fully folded pretzel

incomplete breech

half folded

frank breech:

feet up, may try vaginal birth

third stage:

point of birth, more contractions to make placenta detach from uterine wall within a half hour

special deliveries

multiples, after multiples more likely to have defects

postpartum

emotional and tired immediately after, parents bond with baby, increased hormone last for days to weeks, sleep deprivation makes it worse

baby blues

(80%) anxious, tired, and emotional

postpartum depression

(15%) diagnosable depression

Postpartum psychosis

already has a mental condition and childbirth triggers mental break in small percent of mothers

Newborn:

are most aware in the hours after birth than they will be for the first month of life

APGAR score

1-5 minutes post birth, activity (muscle tone), pulse, grimace (reflex irritability), appearance (skin color), respiration (crying)

• 7-10 is excellent

• 4-6 is moderate

• 0-3 is severe danger

Brazelton Neonatal Behavioral Assessment Scale (NBAS)

interactive assessment from birth to second month