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FERTILIZATION _________________________________ the union of egg cell and ___________ Normal amount of semen/ejaculation 3-5 cc =1 tsp Number of sperms

s 120-150 million/cc/ejaculation Mature ovum maybe fertilized for 12 24 hours after ovulation Sperms life span 3-4 days after ejaculation The sex of an individual is determined at the time of fertilization SPERM CELL X Y Chromosomes EGG CELL X X Chormosomes Once implantation has taken place, the endometrium is now termed as DECIDUA. Small amount of bleeding during implantation Fertilization would result to 46 chromosomes; 22 pairs of autosomes responsible for determining the trait of an individual 1 pair of sex chromosomes responsible for sex of an individual Fertilized ovum is now called a ZYGOTE 3 days of travelling in the fallopian tube Rapid cell division Blastomere 16 blastomere morula It continues to multiply/cell divide while it floats free in the uterine cavity for 3-4 days Large cells tend to mass at the periphery of the morula leaving a fluid space surrounding an inner cell mass. It called a blastocyst The TROPHOBLAST secretes certain cell enzymes that permit to invade the endometrium called the DECIDUA. It implants in the upper segment of the uterus The blastocyst consists of two primary cell types:

the inner cell mass, also known as the "embryoblast" (this part of the embryo is used in stem cell research) the inner mass cell, which will form the embryo On the 12th day after implantation , miniature villi or root like projections reach out from the layers of the cells into the uterine endometrium, these are termed CHORIONIC VILLI. Fingerlike projections Develops by 10th to 11th day of pregnancy CHORIONIC VILLI SAMPLING (CVS) removal of tissue sample from the fetal portion of the developing placenta for genetic screening and is done on 9-12th weeks of pregnancy. Common complication fetal limb defects such as missing digits and toes ZYGOTE fertilization to 14 days EMBRYO 14 days to 2 mos From 8th week until birth - FETUS 3 processes of implantation 1. APPOSITION when blastocyst begins to BRUSH the endometrial lining 2. ADHESION when the blastocyst begins to ATTACH to the endometrial lining 3. INVASION when the blastocyst begins to SETTLE DOWN the endometrial lining BLASTOCYST differentiates into three layers 1. the ectoderm 2. Mesoderm 3. Endoderm

ECTODER M
integumen tary system

MESOD ERM
heart

ENDODER M
Linings of the upper respiratory tract and GIT Thyroid for metabolis m the liver

CNS

Musculos keletal system Reproduc tive organ kidneys

5 Senses

hair

pancreas

nails

Thymus for the developme nt of immunity

Mucous membran e of anus and mouth

DECIDUA Thickened endometrium PARTS 1. basalis part of the endometrium which is located directly under the fetus where placenta is developed 2. capsularis part of the endometrium that encapsulates the fetus

3. vera remaining portion of the endometrium PLACENTA Fetomaternal organ consists of fetal and maternal portions. Organ that permits the exchange of materials carried in the blood streams of the mother and the embryo PLACENTAL FUNCTIONS Protection Nutrition Respiration Excretion Hormone production 100 maternal uterine arteries supply the placenta to provide enough blood for exchange PROTECTION Immunological functions of the placenta protects the fetus from pathogens and prevention from rejection by the mother. - viruses, bacteria, drugs to cross terratogenic UMBILICAL CORD/FUNIS Lifeline of the fetus It extends from the umbilicus of the fetus to the placenta. Within the cord are 2 arteries and 1 vein embedded in WHARTONS JELLY a thick substance that prevents kinking of the cord 50-55 centimeters or 20-21 inches long.

Short cord can lead to abruptio placenta and inversion of the uterus Long cord can lead to cord coil or cord prolapse AMNIOTIC FLUID Clear, musty odor with crystallized ferning pattern; slight alkaline Normal amount 500 1000 ml Oligohydramnios <300 ml Polyhydramnios > 2000 ml FUNCTIONS Cushions the baby against bumps or blows Maintains temperature Prevents cord compression Maintains constant temperature Provides fluid and nourishment for the embryo Prevents from adhering to the amniotic fluid bag DX TESTS FOR AMNIOTIC FLUID 1. AMNIOCENTESIS obtaining a sample of amniotic fluid by inserting a needle through the abdomen into the amniotic sac 2. Purposea.to determine the fetal lung maturity b.Genetic screening AMNIOSCOPY direct visualization through an intact fetal membrane 3. FERN TEST determines if bag of water has ruptured or not 4. NITRAZINE PAPER TEST to differentiate urine (acidicyellow) from amniotic fluid (alkaline- blue green/blue gray) HUMAN CHORIONIC GONADOTROPIN Produced by the placenta First appears in the maternal blood 10 days after fertilization 9-10 weeks at peak IT STIMULATES PROGESTERONE AND ESTROGEN PRODUCTION TO MAINTAIN PREGNANCY PREGNANCY TEST Excessive - twin pregnancy, H-Mole

Low levels ectopic pregnancy, missed/threatened abortion HUMAN PLACENTAL LACTOGEN Produced by the placenta It allows more protein to be available for fetal and maternal growth needs Responsible for the development of mammary glands Has a diabetogenic effect insulin antagonist - GDM If levels of HPL is low may result to threatened abortion or iugr RELAXIN Produced by the placenta It inhibits uterine contraction Melanocyte stimulating hormone MSH Produced by the ANTERIOR PITUITARY GLAND Causes darkening in the pigmentation of the skin in localized areas of the womans body. Works with estrogen to affect Darkening of the nipples and areola Linea nigra brown line in the middle of the womans abdomen Chloasma or melasma brownish patches in the face Moles become darker (appears in the middle of pregnancy) PROLACTIN Production starts late in pregnancy as the breasts prepare for lactation following birth OXYTOCIN Produced by POSTERIOR PITUITARY GLAND Late in pregnancy Stimulates contractions of the uterus But during pregnancy this action is inhibited by progesterone which relaxes the smooth muscle cells of the uterus After birth keep the uterus contracted

It stimulates milk ejection reflex in breastfeeding ESTROGEN ovaries and placenta during pregnancy uterine development to provide suitable environment for the fetus Stimulates MSH which is responsible for increased pirmentation Epistaxis Elevated estrogen rise in adrenal function weakening of the dermal elastic tissue striae gravidarum (stretch marks)

SECOND TRIMESTER Continuous growth and development. The focus is on the length of the fetus THIRD TRIMESTER The period of most rapid growth and development. The focus is on weight gaining MONTH 1st month 2 month
nd

MONTH

DEVELOPMENT

DEVELOPMENT

7th month

RAPID CELLULAR GROWTH 8th month All vital organs are formed or developed. Sex organs are formed Kidneys are functional Fetus begins to swallow amniotic fluid Sex is distinguishable FHT is audible by Doppler at 1012 weeks Lanugo begins to appear FHT audible by fetoscope 18-20 wks Buds of permanent teeth appears Lanugo covers the body Quickening Vernix caseosa Eyelids open Responds to sound Periods of sleep and activity 9th month

Surfactant develops Eyelids reopens, eyebrows, eyelashes present Respiratory movements seen Lanugo begins to disappear Subcutaneous fats deposit making body more rounded Nails extend to fingertips Average weigh 7-8 lbs Lanugo almost gone except on shoulders and upper back Vernix caseosa mainly seen in skinfolds and creases Body organs mature, eyes and extremities functional Fetus ready to be born

3rd month Increased estrogen level Flushing of the skin Womans body become more vascular Increasing blood flow to the fetus PROGESTERONE Produced by the ovary and placenta promotes development of the lining of the uterus Decreases contractility of the uterus Promotes devt of secretory ducts of breasts Stimulates sodium secretion Reduces smooth muscle tone causing discomforts such as CONSTIPATION, HEARTBURN, VARICOSITIES FETAL GROWTH AND DEVELOPMENT TRIMESTER FIRST TRIMESTER The period of organogenesis which is the most critical period in fetal growth and development 4th month

5th month 6th month

PHYSIOLOGIC AND PSYCHOLOGICAL CHANGES DURING PREGNANCY TERM MEANING

TERM

MEANING

PRETERM

Number of children or children born before the 37th weeks of gestation Number of child or child born between 37 42 wks gestation Pregnancy that did not reach the age of viability

1. ANTE 2. ANTEPARTUM 3. PRENATAL 4. GRAVIDA 5. PARA

before Time before delivery Time before birth Any pregnancy regardless of duration. Number of births after 20 wks gestation regardless of whether the infants were born alive or dead A woman pregnant for the first time A woman who is in her second or a subsequent pregnancy A woman who has not given birth A woman who has given birth to a fetus (dead or alive) that reached 20 wks gestation A woman who has given birth two or more times at more than 20 wks gestation A fetus born dead after 20 wks gestation

TERM ABORTION

6. PRIMIGRAVIDA 7. MULTIGRAVIDA 8. NULLIGRAVIDA 9. PRIMIPARA

10. MULTIPARA

11. STILLBIRTH

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