Outline
I. Overview
A. Pregnancy and Gestation [FAP 29-2, 29-3]
first trimester
fertilization through early organogenesis
implantation
development of placenta
HCG from chorion supports corpus luteum of pregnancy
development of placental circulation
second trimester
completion of organogenesis
fetoplacental unit
produces estrogen and progesterone
maintains uterine lining
third trimester
fetal growth
maturation and functionality of organ systems
viability of fetus
B. Development Overview [FAP 29-1]
fertilization and implantation
multiple embryos/births
dizygotic/polyzygotic
monozygotic
monozygotic developmental anomalies
sinus inversus
conjoined twins
fetus in fetu
embryogenesis
fetal development
parturition
postnatal development
puberty
C. Aging and senescence
II. First Trimester
A. Fertilization [FAP 29-2]
ovulation
migration through oviduct
sperm contact and penetration
blocks to polyspermy
early cleavage
morula and blastocyst stages
B. Implantation and placental development
[FAP
29-4; Table 29-2]
endometrial contact
gastrulation and gastrula
extraembyonic membranes
yolk sac - blood cell and vascular formation
amnion - surrounds amniotic cavity
allantois - urinary bladder and waste storage
chorion -vascular development for nutrient exchange
placenta
develops from maternal enometrium
vascularization
chorionic villi
C. Hormones
HCG - human chorionic hormone (FSH & LH analog)
Estrogen and Progesterone - the "feto-placental unit"
HPL - human placental lactogen (Prolactin analog)
relaxin
D. Embryogenesis
neurulation and the neurula
organogenesis and the pharyngula
sexual determination and differentiation - beginning
week 6
II. Second and Third
Trimesters [FAP 29-5]
A. Completion of organogenesis
B. Fetal growth
C. Quickening
first pregnancy - detectable at 18-20 weeks
subsequent pregnancies - detectable at 15-17 weeks
D. Maternal changes
increased RR and TV
increased BV
preeclampsia
increased nutritional requirements
increased GFR
uterine growth
mammary gland development
III. Labor, Delivery,
Parturition [FAP 29-6]
A. Orientation of fetus
B. Onset of labor
placental estrogen increase
endometrial prostaglandins
myometrial sensitivity/excitability increase
oxytocin release - fetal and maternal
placental relaxin
C. Stages of labor
dilation stage
contractions every 10-30 minutes
dilation and effacement of cervix
descent of fetus through pelvic inlet
rotation of fetal head
rupture of amnion
complications/interventions
fetal monitoring
premature labor
induced labor
expulsion phase
completion of cervical dilation
passage of fetus through cervix and "birth canal"
rotation of fetal head and shoulders
complications/intervention
episiotomy
nonideal presentations - face, brow, shoulder, breech
placenta previa
forceps delivery
cesarian section
placental phase
decrease in uterine size
detachment and delivery of placenta
endometrial vasoconstriction
the "umbilical transfusion"
complications/intervention
Iplacenta accreta
post partum bleeding/hemorrhage
IV. Neonatal Period [FAP 29-7]
A. Maternal
lactation
development of lactiferous glands and ducts - E, P
milk production and "letdown" - prolaction
colostrum
milk ejection - oxytocin
postpartal hormonal changes
B. Fetal
lungs
circulatory pattern changes
ductus arteriosus -> ligamentum arteriosum
foramen ovale -> fossa ovalis
umbilical arteries -> lateral ligaments of the bladder
umbilical vein - > round ligament of the liver
heart rate 150->130 bpm
fetal-to-adult hemoglobin transition
digestive system activation - meconium
urinary system activation
incomplete thermoregulation
V. Maturation
and senesence [FAP 29-7]
A. Infant growth
B. Puberty
hormonal triggers
increased GnRH production and sensitivity ->
increased FSH, LH production ->
gonadal maturation ->
increased E,P,T ->
primary and secondary sexual characteristics
growth rate increase, then fusion of epiphyseal plates
production of gametes
initiation of ovarian/uterine menstrual cycling
C. Senescence
molecular/cellular changes
reduced organ system functionality
menopause and andropause
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