NSD Pathophysiology102

Psychological andPhysiologicChangesof Mother
3rd Week: Milestone of Fetal Growth and
Development
 Single heart tube begins to form.
 The respiratory and digestive tracts exist as a
single tube.
 A neural plate is apparent.
9th Week: Milestone of Fetal
Growth and Development
 Spontaneous respiratory practice
movements begin and continue
throughout pregnancy.
A
4th Week: Milestone of Fetal Growth and
Development
 The Length of embryo is 0.75 cm, Weight is
400 mg.
 Heart beats begin.
 A septum begins to divide the oesophagus
from the trachea (end of 4th week).
 Lung buds appear on the trachea.
 Rudimentary kidneys are present.
 The spinal cord is formed and fused at the
midpoint.
 The heart bulge on the anterior surface.
 Arms and legs are bud-like structures;
rudimentary eyes, ears, and nose are
discernible.
Development
 Placenta begins to produce hPL/hCS.
 The septum that divides the heart into
chambers develops (6th or 7th week).
7th Weeks: Milestone of Fetal Growth and
Development
 The heart valves develop.
 The diaphragm continues to divide the
thoracic cavity from the abdomen.
 The gonad (testes) form.
8th Weeks Milestone of Fetal Growth and Development
 The length of the fetus is 2.5 cm (1 in); weight is 20 g.
 Organogenesis is complete.
 Facial features are definitely discernible; arms and legs have developed.
 External genitalia are forming, but sex is not yet distinguishable by simple
observation.
 The abdomen bulges forward because the fetal intestine is growing rapidly.
 The developing placenta begins to produce progesterone and decrease of hCG.
 The brain waves can be detected on an EEG.
 The heartbeat heard with a Doppler
instrument (10th to 12th week of
pregnancy).
 A portion of the intestine is pushed
into the base of the umbilical cord
until the abdominal cavity has
grown large enough to
accommodate the bulky intestines.
 An ECG may recorded on a fetus
 A fetus can be seen to move on
ultrasonography (quickening) until
20 weeks.
 The length of the fetus is 7 to 8 cm;
weight is 45 g.
 Nail beds are forming on fingers and
toes.
 Bone ossification centers begin to
form.
 Tooth buds are present.
 Sex is distinguishable on outward
appearance.
 Urine secretion begins but may not
yet be evident in amniotic fluid.
 Spontaneous movements are
possible, although they are usually
too faint to be felt by the mother.
 Some reflexes, such as Babinski
reflex, is present.
 Level of progesterone keeps on
increasing
 Braxton Hicks contraction
B
F
E
T
U
S
MOTHER
 Breast Changes
 Nausea,Vomiting
 Amenorrhea
MOTHER
 Frequent urination
MOTHER
 Chadwick’s sign.
 Goodell’s sign.
 Hegars’s sign.
 Sonogram shows a gestational sac.
33

Development
 The length of the fetus is 10 to17 cm;
weight55 to 120 g.
 Fetal heart sounds are audible by an ordinary
stethoscope.
 Lanugo is well formed.
 Both liver and pancreas are functioning.
 The fetus actively swallows amniotic fluid,
demonstrating an intact but uncoordinated
swallowing reflex; urine is present in amniotic
fluid.
 Sex can be determined by ultrasonography.
 Vernix caseosa forms on the fetal skin.
 The length of fetus is 28 to 36 cm;
weight 550 g.
 Meconium is present as far as the
rectum.
 Surfactant formed which excreted
by the alveolar cells of the lungs.
 Eyelids now open.
 The eyes exhibit the pupillary
reaction, indicating sight is
present.
 The ear is capable of responding to
the sound.
Development
 The length of fetus is 25 cm; weight is 223 g.
 Spontaneous fetal movements can be sensed
by the mother.
 Antibody production is possible.
 Hair, including eyebrows, forms on the head;
vernix caseosa begins to cover the skin.
 Meconium is present in the upper intestine.
 Brown fat, special fat aides in temperature
regulation, begins to form behind the
kidneys, sternum, and posterior neck.
 Passive antibody transfer from mother to
fetus begins.
 Definite sleeping activity patterns are
distinguishable as the fetus develops
biorhythm that will guide sleep/wake patterns
throughout life.
Development
 Further development occurs.
 Fetal heart rate; 110 to 160
beats/min.
Development
 Quickening
 The length of fetus is 35 to 38 cm;
weight is 1,200 g.
 Lung alveoli are almost mature;
surfactant can be demonstrated in
amniotic fluid.
 Testes begin to descend into the
scrotal sac from the lower
abdominal cavity.
 The blood vessels of the retina are
formed.
Development
C
B
MOTHER
 Fatigue.
 Uterine enlargement.
MOTHER
 Lineanigra
 Melasma
 Striae gravidarum
MOTHER
 Ballottement.
MOTHER
 Quickening
34

32nd Week: Milestone of Fetal Growth and
Development
 The length of the fetus is 38 to 43 cm; weight is
1,600 g.
 Subcutaneous fat begins to be deposited.
 Fetus responds by movement to sounds outside
the mother’s body.
 An active Moro reflex is present.
 Fingernails reach the end of fingertips.
 Sucking and swallowing reflexes are matured.
 A surge in the production of
lecithin (2:1).
 The testes descend into the scrotal
sac (34th to 38th week).
c
v
c
v
36th Week: Milestone of Fetal Growth and Development
 The length of the fetus is 42 to 48 cm; weight is 1,800 to 2,700 g (5-6 lb).
 Body stores of glycogen, iron, carbohydrate, and calcium are deposited.
 Additional amount of subcutaneous fat are deposited.
 The ability of the gastrointestinal tract to secrete enzymes essential for CHO and protein
digestion is mature.
 Sole of the foot has only one or two crisscross creases, compared with a full crisscross
pattern evident at term.
 Amount of lanugo begin to diminish.
40th Week: milestone of gth n edevelopment lahat
 The length of fetus is 48 to 52 cm (crown to rump, 35 to 37 cm); weight is 3,000 g (7 to
7.5 ib).
 Fetus kicks actively, which because the mother considerable discomfort.
 Fetal haemoglobin begins its conversion to adult haemoglobin.
 Vernix caseosa fully formed.
 Fingernails extend over the fingertip.
 Creases on the soles of the feet cover at least two thirds of the surface.
C
Placental separation
LABOR
Stages of labor
Descent
Flexion
Internal
Rotation
Extension
External
Rotation
EXPULSION
37th Week: Milestone of Fetal Growth and Development
 Development continues.
Engagement
Placental Expulsion
Latent Phase/ 0-3cm
Active Phase/ 4-8cm
Transitional Phase/ 9-10 cm
Dilated cervix/10cm
1st Stage
2nd Stage
3rd Stage
c
v
Theories of Labor
Maximum Stretching of
the uterus
Increase Oxytocin
what happen to
Increase Prostaglandin
Theory
Decrease Progesterone
Aging of the placenta
LABOR
35

NSD Pathophysiology102

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NSD Pathophysiology102