Module 4: Care of Mother and Fetus during Perinatal Period

• Fertilization - the union of the ovum and sperm that occurs in the fallopian tube.
• There is 50-200 million number of sperm per cc
• Implantation - the contact between growing structure and uterine endometrium, approximately 8-10 days after fertilization
• Decidua - endometrium term during pregnancy
• Decidua basalis - the maternal component of placenta. The outermost layer of the decidua.
• Decidua capsularis - the superficial portion of the decidua
• Decidua vera / parietalis - lining of the main cavity of the uterus
• Ectoderm - outer layer of the germ which forms the exoskeleton
• Mesoderm - middle layer of the germ layer which develops into organs
• Endoderm - inner most layer of the germ that forms the inner lining of organs
• Chorion - outermost membrane, contains chorionic villi; develops from trophoblast
• Amnion - innermost membrane, contains amniotic fluid; develops from interior of blastocyst
• Amniotic fluid - a clear, watery fluid that surrounds the developing embryo and fetus. May contain vernix/ lanugo.
• Umbilical Cord - formed from fetal membranes, the amnion, and chorion. It provides circulatory pathwayy that connects the embryo to the chorionic villi of the placenta. It transports oxygen and nutrients tot he fetus from the placenta and return waste products from the fetus to the placenta
• Placenta - complete at 12 weeks of gestation and grows diameter until 20 weeks. It is divided into 15-20 cotyledons which are the functional unit of the placenta.
• Progesterone - a hormone that maintains pregnancy. Maintains uterine lining for implantation and reduced uterine contractions.
• Estrogen - a hormone of women which stimulates uterine growth and development of breast ducts to prepare for lactation
• Human Chorionic Gonadotropin - a hormone which makes pregnancy tests appear positive. It maintains corpus luteum.
• Human Chorionic Somatomammotropin - Prepares breasts for lactation, regulates glucose metabolism, and helps make more glucose available to fetus to meet growth needs.
• 4 Weeks

  • spinal cord is formed
  • arms and legs= bud-like
  • rudimentary eyes, ears, nose are discernable
  • circulation of blood through the placenta is well established
  • weight: 400 mg
  • length: 0.75 cm
• 8 weeks

  • organogenesis
  • heart beats rhythmically
  • gestational sac if visible in the sonogram
  • weight: 20 g
  • length: 2.5 cm
• 12 weeks

  • Bone ossification
  • Tooth buds are present
  • Kidneys begin to form urine
  • Fetal Heart rate is heard via Doppler(110-160 bpm)
  • weight: 45g
  • length: 7-8 cm
• 16 weeks

  • Sex is determined
  • Amniotic Fluid is 200 ml (amniocentesis is 14-16 weeks)
  • Lanugo is well-formed
  • FHR can be heard via stethoscope
  • weight: 55-120g
  • length: 10-17 cm
• 20 weeks

  • quickening (spontaneous moving)
  • hair growth on eyelashes and brows
  • Passive antibody transfer
  • sleeping patterns and activity patterns are distinguishable
  • Weight: 223 g
  • length: 25 cm
• 24 weeks

  • Meconium
  • Lung surfactant present
  • Hearing
  • Age of Viability
  • weight: 550 g
  • length: 28 to 36 cm
• 28 weeks

  • lung alveoli are almost mature
  • newborn can breathe if bron
  • weight:1200 g
  • length: 35-38cm
• 32 weeks

  • subcutaneous fat begins to be deposited
  • iron stores beginning to be built
  • weight: 1600g
  • length: 38-43 cm
• 36 weeks

  • additional amounts of subcutaneous fat are deposited
  • lanugo disappears
  • vernix increases
  • testes palpable in scrotum
  • weight: 1800-2700 g
  • length: 42-48 cm
• 40 weeks

  • fetus kicks actively
  • fetal hemoglobin to adult hemoglobin
  • sole creases cover the feet at least 2/3
  • lightening occurs
  • weight: 3000 g
  • length: 48-52 cm
• Ductus Venosus - connects the umbilical vein and the inferior vena cava by passing through the liver
• Foramen Ovale - the opening between the right and left atria of the heart by passing through the lungs
• Ductus arteriosus - connects the pulmonary artery into the aorta, by passing through the lungs.
• Teratogens - any substance that could be harmful to a fetus
• During pregnancy there is no ovulation due to FSH and LH being reduced
• Chadwick's Sign - increased vascularity and discoloration of the vagina
• Leukorrhea - a clear discharge that is foul-smelling, yellowish, and abnormal
• The vagina is prone yeast infection( candidiasis infections ) due to change in pH which makes the vagina less acidic.
• Goodell's Sign - softening and loosening of the cervix in preparation for labor and delivery
• Operculum - is the increase of mucous production and a plug is formed to serve as a bacterial barircade
• Uterus - it rises out of the pelvic cavity by 16th week of pregnancy