Prenatal(Dev elopmentAnnouncements• Due$dates:• Exam$1$next$Wednesday• Turn$in$HW$for$Monday,$on$MondayOutline(– Prenatal(Dev elopment• Periods$of$Prenatal$development• Prenatal$assessments• Hazards$to$prenatal$development• Birth• Low$birth$weight$and$preterm$infants• Post-partum$care• http://www.youtube.com/watch?v=fKyljukBE70• Min$2-6Periods(of(Prenatal(DevelopmentPeriod Length Key EventsZygote 2 weeks§ Fertilization§ Implantation§ Start of placentaEmbryo 6 weeks§ Arms, legs, face, organs, muscles all develop§ Heart begins beatingFetus 30 weeks§ “Growth and finishing”Dev elopmental(“rules”• Cephalocaudal development:• “Head$to$tail”• Proximodistal development:• “near$to$far”Germinal(Stage(Dev elopmentEmbry onic Stage(Char acteristics• Approximately$2$to$8$weeks• Cell$d ifferentiation,$prod uction$&$migration• Organogensis:$the$beginning$of$organs• Respiratory• Digestive• Nervous• Risk$of$spontaneous$abortio n,$or$miscarriage$greatestEmbry o(lif e(support• Amnion:$water$sac$• Chorion:$becomes$lining$of$placenta• Placenta:$interchange$point:$both$mom’s$ & $baby’s$tissue$meet$but$don’t$directly$mix;$• Umbilical$cord:$• baby’s$veins$&$arteries• belly$button$(mammals)• stem$cellsSex(differentiation• 6th$to$8th$week$after$conception• Y-Chromosome$produces$testosterone$Dev elopment(During(Fetal Stage• 8$weeks$to$birth• Organs$and$body$become$more$complex• Development$of$toenails,$eyelids• Appearan ce$of$bone• Development$of$memory:$• A$baby$knows$its$mother’s$voice$and$language• DeCasper &$Spence,$1986The(Brain• At$birth,$b abies$have$app roximately$100$billion$neurons• 1-2$trimesters• the$basic$structure of$the$bra in$is$assembled• 3$trimester$– 2$years$of$postnata l$l i fe$• connectivity and$functioning of$neurons$developsBr ain(development• Neural$tube$$-- 18-24$days• Anencephaly$&$spinabifida$if$neural$tube$doesn’t$close• Neurogenesis -- 5$weeks,$up$to$200,000$neurons$formed$per$minute• Neuronal$migration$and$connectivity$continuesPrenatal(Assessment(and(Interv ention• Ultrasound• Amniocentesis• Fetal$MRIInfertility(and(Reproducti v e(Technologies• 10-15%$of$couples$in$US$deal$with$infertility$(2$million$couples)• Cause$could$be$due$to$woman$or$man• Treatments$• Surgery• Hormones• IVF$(40,000$per$year)Hazards'to'Pr enatal'Dev elopment• Teratogen• Drugs• Incompatible$blood$types• Environmental$pollutants• Infectious$diseases• Maternal$stress,$ advanced$$$$$maternal$and$p aternal$age• Critical$PeriodsCritical(periodsMor e'Hazar ds'to'Pr enatal'Dev elopment• Maternal$d iet$and$nutrition• Mother$is$overweight• Folic$acid$– low$levels• High$mercury$levels$- careful$eating$too$much$fish$• StressMother’s(Age• Safest$age:$16$to$35$years$old$• Younger$or$older$women$more$high$risk• Younger$than$16:• Older$than$35:FREQUENCY OF DOWN SYNDROME (PER 1000)MATERNAL AGE (YEARS)15 20 25 30 35 40 45 501009080706050403020100Relationship Between Maternal Age and the Incidence of Down SyndromeMother’s(Emotional(Condition• Stress$à hormones• may$cross$the$placenta• Short$duration$&$Minor$stress:$• Chronic$&$severe$stre ss:$Paternal(Factors• Environm ental$hazards$àAbnormal$sperm$àMiscarriage$or$diseases$• Heavy$smokers$àsecond-hand$smoke$àIncreased$risk$of$early$miscarriage$The'Birth'Process'• The$Birth$Process$• first$stage• second$stage• third$stageMethods(of(childbirth• In$the$USA,$9 9 $percent$of$births$are$in$hospitals• Fathers/Partners$usually$present• Midwifery• 8%$of$births• Methods• Natural• Medicated$• Water$birth/massage/acupuncture$• Cesarean$=$34%$of$births$in$USApgar(ScaleGood, CryingIrregular, slowAbsentRespirationStrongWeakLimpActivityCoughing & CryingGrimaceNoneGrimaceRapidSlow (<100)AbsentPulseAll PinkBody Pink, Limbs BlueBlue & PaleAppearance210Signrange 0 to 10; healthy average 7Neonate AbilitiesSize(and(Appear ance(of(Newborns(• Average$newborn$is:$• 20$inches$long$&$7.5$pounds• Fontanels• Lanugo• Vernix0caseosaLo w'Birth'Weight'and'Pr eterm'Infants• Low$birth$weight -- less$than$5½$pounds$at$birth• Preterm – 3+$weeks$before$full$term$• Small-for-date -- birth$weight$is$below$normal$for$gestationImmediate(Treatment(for(Prematurity• Intravenous$feeding• Surfactant• Isolette – controlled$environment, like$an$incubator• Massage,$gentle$handling• Kangaroo$carePost-partum(Depr ession• Post-partum$emotions• 70%$$- blues• 10%$- depression$and$dysfunctionPost-partum(Depr ession• Outcomes$• Treatment$• Father’s$rolePrep(for(exam• TLC$– where ’s$that?? ?