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  • Implantation: blastocyst forms tendrils which attach to the uterine wall Support System includes amnion (water like membrane to regulate temperature and cushion), chorion, placenta, umbilical cord.
  • Neural tube: spinal cord develops from ectoderm and becomes the CNS. ectoderm develops into nervous system, skin & hair Mesoderm develops into muscle, bone & circulatory system Endoderm develops into digestive system, lungs, and other vital organs
  • Age of viability: a point between the 22-28 th weeks in which survival outside the uterus may be possible.
  • Sensitive periods: each organ has a time when it is highly susceptible to teratogenic agents. Example: 6 9h week of development is a sensitive period for external genital development.
  • Thalidomide: used in the 1960’s to help mothers who experienced nausea. DES: drug prescribed in 1940’s-50’s. Later risk for abnormalities in reproductive organs, including cervical cancer Drugs: marijuana, heroin, cocaine, amphetamines, sex hormones, vitamins, aspirin, tranquilizers.
  • Folic acid should be consumed to prevent CNS defects Mothers should gain between 25-35 pounds, ideally. Prolonged & severe stress tends to have effects such as irritability, low weight, and irregular sleeping and feeding habits on babies. Ideal age to bear children is between 16-35.
  • First stage: contractions are at 10-1 minutes intervals. Second stage: baby delivery
  • If experiencing post partum depression, seek professional help. Otherwise, infant attachment may be insecure.
  • NBAS: ideally, heart rate :over 100bpm. Respiratory effort: good, baby is crying Muscle tone: strong & Active motion Color: completely pink Reflex: vigorous cries, coughs, sneezes
  • Rh factor: blood protein that when present in fetus, but not mother, can cause antibodies to be produced which may attack the red blood cells in subsequent fetuses who have the protein in their blood. Respiratory distress syndrome: irregular breathing due to insufficient surfactin. Medications can cross placenta and make the baby lethargic or inattentive
  • Babinksi: fanning/curling toes when foot is stroked
  • Infants spend have of their sleeping hours in REM sleep. SIDS: leading cause of death of infants within first year of life
  • Chapter4Shaffer.ppt

    1. 1. Chapter 4: Prenatal development, birth, and newborns’ readiness for life. Dr. Pelaez
    2. 2. From conception to birth <ul><li>Prenatal development is divided into 3 major phases: </li></ul><ul><ul><li>Germinal period </li></ul></ul><ul><ul><li>Embryonic period </li></ul></ul><ul><ul><li>Fetal period </li></ul></ul>
    3. 3. Germinal Period <ul><li>From conception to implantation (about 14 days). </li></ul><ul><li>Zygote moves toward uterus through fallopian tube </li></ul><ul><li>Implantation occurs </li></ul><ul><li>Support system develops (4 structures) </li></ul>
    4. 4. Embryonic period <ul><li>Lasts from week 3 to week 8. </li></ul><ul><li>Neural tube development begins. </li></ul><ul><li>Heart begins to beat </li></ul><ul><li>Grows about 1/30 inches per day. </li></ul><ul><li>External body structures form (ears, limbs, eyes) </li></ul>
    5. 5. Fetal period <ul><li>Lasts from week 9 to term. </li></ul><ul><li>By end of month 3, sex can be detected on ultrasound </li></ul><ul><li>Neural and muscular systems continue to develop </li></ul><ul><li>By second trimester (month 5-6), covered by vernix & lanugo (substance that protects fetal skin & fine hair which helps vernix to stick to body). </li></ul><ul><li>Third trimester (weeks 25-38) involve rapid growth and maturity of all organ systems. </li></ul>
    6. 6. Teratogens <ul><li>External agents such as viruses, drugs, and radiation that can be harmful to developing embryo or fetus. </li></ul><ul><li>Sensitive periods </li></ul><ul><li>Long-term effects depend on the quality of postnatal environment </li></ul>
    7. 7. Maternal diseases <ul><li>Diseases capable of passing through placenta and damage embryo/fetus </li></ul><ul><li>Rubella. 60-85% of babies exposed will have birth defects. </li></ul><ul><li>STD’s (AIDS, herpes, syphilis). </li></ul><ul><li>Toxoplasmosis </li></ul><ul><li>Influenza </li></ul><ul><li>Malaria </li></ul><ul><li>Tuberculosis </li></ul>
    8. 8. Drugs <ul><li>Drugs taken by mother can have harmful effects on children: (low birth weight, heart defects, brain & neurological defects, and death). </li></ul><ul><li>Thalidomide </li></ul><ul><li>Diethylstilbestrol (DES) </li></ul><ul><li>Alcohol </li></ul><ul><li>Cigarettes </li></ul><ul><li>Illegal, prescription, and over the counter drugs </li></ul>
    9. 9. Environmental hazards <ul><li>Environmental hazards that may cause low birth weight, miscarriages, or genetic defects to embryo/fetus: </li></ul><ul><li>Radiation </li></ul><ul><li>Lead </li></ul><ul><li>Zinc </li></ul><ul><li>Mercury </li></ul><ul><li>Other harsh chemicals </li></ul>
    10. 10. Maternal characteristics <ul><li>Maternal behavior can affect the outcome of her pregnancy </li></ul><ul><li>Mother’s diet </li></ul><ul><li>Mother’s emotional well-being </li></ul><ul><li>Mother’s age </li></ul>
    11. 11. Birth Process <ul><li>Perinatal environment: environment surrounding birth; includes influences such as drugs given to the mother, delivery practices, and the social environment. </li></ul><ul><li>3 stage process: </li></ul><ul><li>1. first stage of labor: uterine contractions. Lasts about 3-8 hours. </li></ul><ul><li>2. second stage of labor: fetus moves through birth canal & emerges from mother’s body. </li></ul><ul><li>3. third stage of labor: expulsion of the placenta </li></ul>
    12. 12. Three stages of child birth.
    13. 13. Social environment at birth <ul><li>First 12-16 hours are a sensitive period of emotional bonding. </li></ul><ul><li>Postpartum depression may inhibit emotional bonding. </li></ul><ul><li>Early father-infant interactions may make fathers feel more a part of the family. </li></ul>
    14. 14. Assessing the baby’s condition <ul><li>Apgar test: assess newborn heart rate, color, respiration, muscle tone, and reflexes. </li></ul><ul><li>Neonatal Behavioral Scale (NBAS): assess neonate’s neurological integrity and responsiveness to environmental stimuli. </li></ul><ul><ul><ul><ul><li>NBAS administered a few days after birth </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Assess 20 reflexes. </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Low scores may indicate brain damage or other neurological problems </li></ul></ul></ul></ul>
    15. 15. Birth complications <ul><li>Anoxia </li></ul><ul><ul><ul><li>Oxygen deprivation </li></ul></ul></ul><ul><ul><ul><li>Breech position </li></ul></ul></ul><ul><ul><ul><li>Rh factor </li></ul></ul></ul><ul><li>Premature delivery </li></ul><ul><ul><ul><li>Preterm: born 3 weeks or more before term. </li></ul></ul></ul><ul><ul><ul><li>Small for date babies </li></ul></ul></ul><ul><li>Low birth weight </li></ul><ul><ul><ul><li>Small for date: slow growth </li></ul></ul></ul><ul><ul><ul><li>Under 5 lbs </li></ul></ul></ul><ul><ul><ul><li>May experience respiratory distress syndrome </li></ul></ul></ul>
    16. 16. Readiness for life <ul><li>Healthy newborns display a number of reflexes. </li></ul><ul><li>Survival reflexes: breathing, sucking & swallowing </li></ul><ul><li>Primitive reflexes (disappear during first year of life): babinksi reflex, swimming, stepping reflex </li></ul>
    17. 17. Readiness for life continued <ul><li>Infant states. </li></ul><ul><ul><li>Regular sleep: 8-9 hours/day </li></ul></ul><ul><ul><li>Irregular sleep: 8-9 hours/day </li></ul></ul><ul><ul><li>Drowsiness: ½-3 hours/day </li></ul></ul><ul><ul><li>Alert inactivity: 2-3 hours/day </li></ul></ul><ul><ul><li>Alert activity: 1-3 hours/day </li></ul></ul><ul><ul><li>Crying: 1-3 hours/day </li></ul></ul>
    18. 18. Reflexes in full term infants Table 4.6 Pg. 135
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