FETAL PHYSIOLOGY
Age conception of the week commonly used to indicate the status
of development of the embryo. Age concept...
accompanied

by

abnormalities

in

the

mother

or

fetus.

Oligohydramnios objectively determined by measuring the large...
hemoglobin and "packed cell volume" continued to increase during
pregnancy. Most of the erythrocytes containing HbF
5. Pha...
amniotic fluid. Gluconeogenesis from amino acids and glucose
accumulation in the liver is sufficient when the neonate has ...
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Fetal physiology

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Fetal physiology

  1. 1. FETAL PHYSIOLOGY Age conception of the week commonly used to indicate the status of development of the embryo. Age conception can be determined by measuring the fetus and is generally determined by measuring CROWN LENGTH Rump via ultrasound. A. GROWTH AND DEVELOPMENT : Growth and development during the first 8 weeks, the terminology used for the development of organisms embryos after 8 weeks, the terminology used by the fetus because most organs have been formed and have entered into the stage of growth and development continued. Fetus weighing 500 - 1000 g (22-23 weeks) called immature. From weeks 28-36 are called preterm and full-term fetus when the pregnancy is over 37 weeks. B. CHARACTERISTIC INDICATING MATURITY OF THE FETUS : 1. Nutrition intrauterine : Nutrition intrauterine fetal growth and placental function defined perfusion. Chronic malnutrition can cause anemia and low birth weight - low birth weight case of hypoxia, fetal obtain energy through anaerobic glycolysis, which originated from the reserve in the heart muscle and placenta. The fetus produces a specific protein called Alfafetoprotein - AFP from liver. The protein is secreted by the fetal kidneys and swallowed back to experience degradation in the gut. If the fetus is swallowing disorders (eg fetal abnormalities Anensepalus or another NTD's) the serum AFP levels increased. 2. Amniotic fluid : Amniotic fluid amniotic fluid volume at term about - about 800 ml and pH 7.2 polyhydramnios (hydramnios): amniotic fluid volume> 2000 ml, can occur in normal pregnancy but 50% of the state is 1
  2. 2. accompanied by abnormalities in the mother or fetus. Oligohydramnios objectively determined by measuring the largest bag with ultrasound that shows the number of less than 2 cm x 2 cm or 4 quadrant total amount of less than 5 cm (amniotic fluid index). SOLUTE AND WATER EXCHANGE IN THE AMNIOTIC FLUID : 1. Cardiovascular system : The cardiovascular system is an abrupt change from intrauterine life to extrauterine circulation neonates require adjustment include: diversion of blood flow from the lungs, Bottali closure of the ductus arteriosus and foramen ovale and ductus venosus obliteration Arantii and vasa umbilical. Dilatation vasa formation of pulmonary and pulmonary sirkluasi 2. Cardiovascular system : Cardiovascular system infant circulation consists of 3 phases: Phase intrauterine where the fetus depends on the placental phase transition that begins shortly after birth and the first cry adult phase generally lasts in full in the first month of life 3. Fetal circulation : Fetal circulation circulation adult: a series circuit where the blood flow through the right heart - lungs - left ventricle - the systemic circulation - fetal circulation right heart: a parallel circuit in which the cardiac output from the left ventricle and the right directly to different vascular tangle. Fetal circulation is characterized by a 'shunt': ductus arteriosus ductus venosus Arantii Botali 4. Phase intrauterine : Phase intrauterine umbilical vein brings oxygenated blood from the placenta to the fetus is more than 50% of cardiac out - put walked to the placenta through the umbilical artery. Red blood cells, 2
  3. 3. hemoglobin and "packed cell volume" continued to increase during pregnancy. Most of the erythrocytes containing HbF 5. Phase transition : Transition phase During labor, there are two events that alter fetal hemodynamic Ligation cord leading to the rise of CO2 levels increase in arterial pressure and a decrease in PO2 leading to early neonatal respiratory fetal circulation to be perfect after the closing ductus and foramen ovale ongoing arteriousus 6. Phase extrauterine : Phase extrauterine hemodynamically normal adults differ with the fetus in terms of: venous and arterial blood does not mix in the atrium Vena cava carries only deoxygenated blood into the right atrium, right ventricle and then into the blood and then pumped into the pulmonary artery and pulmonary capillary blood carries only Aorta oxygenated from the heart through the pulmonary vein to the left further distributed throughout the body of the fetus. 7. Respiratory function : Pregnancy 22 weeks respiratory function, pulmonary capillary system formed and already has the ability to exchange gases. Aterm, has formed 3-4 generations alveoli. Epithelium that originally shaped cabbage change a flat at the first breath. Gas exchange takes place in the placenta to the fetus. O2 partial pressure (PO2) of fetal blood <maternal blood, but because it contains a lot of HbF fetal blood oxygen saturation, then the fetus is able to make ends meet. 8. Gastrointestinal function : Function gastrointestinal partially swallowed amniotic fluid following cellular material contained therein through the enzymatic activity of bacteria and converted into meconium. Meconium remains in the intestine unless there is severe hypoxia that causes contraction of intestinal muscles so that meconium out and mixes with the 3
  4. 4. amniotic fluid. Gluconeogenesis from amino acids and glucose accumulation in the liver is sufficient when the neonate has not happened yet. 9. Renal function : Kidney function placenta, lung, and kidney maternal normally would regulate water and electrolyte balance in the fetus. Formation of urine begins the week of 9-12. At 32 weeks, urine production reached 12 ml/hour, at term 28 ml/hr. Fetal urine is a major component of the amniotic fluid. 10. Systems immunology : Systems immunology in early pregnancy fetal capacity to produce antibodies against the antigen maternal or very bad bacterial invasion. Since week 20 the immunological response of the fetus is expected to start happening. Fetal Response assisted with the transfer of maternal antibodies in the form of passive protection that persisted until some time after delivery. IgM is mainly derived from the fetus so that it can be used to determine the presence of intrauterine infection. 11. Endocrine : Thyroid is an endocrine gland endocrine first formed in the fetus. Pancreas formed at week 12 and the insulin produced by the pancreatic B cells. Maternal insulin can not cross the placenta so the fetus must form its own insulin for glucose metabolism interests. The fetus produces TSH - thyroid stimulating hormone since week 14 which causes the release of T3 and T4. 4

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