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Fetal period 9th week through birth. Germinal: ... Fetal Alcohol Syndrome (FAS) ... Most individuals affected by alcohol exposure before birth do not have the ... – PowerPoint PPT presentation

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Title: Life%20Span%20Development%20%20Prenatal%20Development%20and%20Birth%20


1
Life Span Development Prenatal Development
and Birth Chapter 4
  • June 15, 2004
  • Class 3

2
The First Trimester
  • Pregnancy is the process referring to the
    gestation period of a human being
  • A pregnancy is initiated when a fertile sperm
    from a male bonds with a fertile egg from a
    female
  • The period of pregnancy (from the woman's last
    menstrual cycle to the birth of the child)
    usually is 40 weeks
  • This 40 weeks is divided into three subperiods,
    known as "trimesters
  • The first thirteen weeks of pregnancy are
    referred to as the "first trimester"

3
Development of the Embryo and Fetus
  • Obstetricians count "weeks of pregnancy" from the
    first day of a woman's last menstrual cycle
    because there is often no way to determine
    exactly when conception occurred
  • Embryologists, however, typically describe the
    developing embryo or fetus by the number of weeks
    since conception

4
From Zygote to Newborn
  • Germinal periodfirst 14 days
  • Embryonic period3rd through 8th weeks
  • Fetal period9th week through birth

5
Germinal The First 14 Days
  • Zygote divides and keep dividing (at least though
    3rd doubling they are the same)
  • At this stage (8 cells) differentiation begins
  • early stem cells take on distinct
    characteristics
  • they gravitate to locations, foreshadowing the
    type of cells they will become

6
Germinal The First 14 Days
  • At about a week after conception the multiplying
    cells separate into two masses
  • first task of out cells to achieve implantation
    embed themselves into the nuturant environment of
    the uterus
  • 60 of all natural conceptions fail to implant
    70 of in vitro procedures fail to implant

7
Development of the Embryo and Fetus
  • The zygotes outer part attaches to the uterine
    wall forming the placenta
  • The inner cells are referred to as the embryo
  • By nine weeks, the embryo clearly looks human and
    is now a fetus

8
Role of the Placenta
  • The placenta carries nourishment and oxygen from
    the mother to the fetus and at the same time
    screens out many potentially harmful substances
  • Unfortunately some get through

9
Fetal Alcohol Syndrome (FAS)
  • FAS is a lifelong yet completely preventable set
    of physical, mental and neurobehavioral birth
    defects associated with alcohol consumption
    during pregnancy
  • Alcohol enters the mothers and the fetus
    bloodstream
  • FAS is the leading known cause of mental
    retardation and birth defects
  • Small disproportioned head and lifelong brain
    abnormalities

10
How does a mothers drinking affect her unborn
child?
  • Facts
  • Through the blood vessels in the placenta, the
    mothers blood supplies the developing baby with
    nourishment and oxygen
  • If the mother drinks alcohol, the alcohol enters
    her blood stream and then, through the placenta,
    enters the blood supply of the growing baby
  • So, when a pregnant woman drinks alcohol, so does
    her baby
  • Alcohol is a teratogen, a substance known to be
    toxic to human development

11
Fetal Alcohol Syndrome (FAS)
  • Prenatal alcohol exposure does not always result
    in FASalthough there is no known safe level of
    alcohol consumption during pregnancy
  • Most individuals affected by alcohol exposure
    before birth do not have the characteristic
    facial abnormalities and growth retardation
    identified with FAS, yet they have brain and
    other impairments that are just as significant

12
Sad facts
  • In addition to mental retardation, individuals
    with FAS may have other neurological deficits
    such as poor motor skills and hand-eye
    coordination
  • They may also have a complex pattern of
    behavioral and learning problems, including
    difficulties with memory, attention and
    judgment.
  • As many as 12,000 infants are born each year with
    FAS

13
What if I am pregnant and have been drinking?
  • If you consumed alcohol before you knew you were
    pregnant, stop drinking now!
  • Abstaining from alcohol for the remainder of your
    pregnancy can have a beneficial effect even on
    functions that might have been affected by
    earlier drinking
  • The sooner you stop drinking, the better the
    chance of having a healthy baby

14
Smoking cigarettes during pregnancy (US Dept. of
Heath and Human Services, 2001)
  • The rate of smoking during pregnancy dropped 33
    percent between 1990 and 1999, so that in 1999
    just over 12 percent of all women reported
    smoking during their pregnancies, according to a
    new report from the Centers for Disease Control
    and Prevention
  • The greatest success in reducing smoking was for
    women in their late twenties and early thirties,
    where there was over a 40 percent drop since 1990
  • Teenagers were more likely than women of any
    other age to smoke while pregnant
  • After experiencing a dramatic 20-percent decline
    in the first part of the decade, smoking rates
    among pregnant teenagersunlike women of all
    other ages--increased by 5 percent from 1994 to
    1999
  • The highest rate in 1999 (19 percent) was for
    women 18-19 years of age

15
Smoking during pregnancy is related to violent
crimes
  • Brennan, Grekin, Mednick (1999)
  • Subjects were a birth cohort of 4169 males born
    between September 1959 and December 1961 in
    Copenhagen, Denmark
  • During the third trimester of pregnancy, mothers
    self-reported the number of cigarettes smoked
    daily
  • When the male offspring were 34 years of age,
    their arrest histories were checked in the Danish
    National Criminal Register

16
Brennan, Grekin, Mednick (1999)
  • Found the following data relating smoking during
    pregnancy to offsprings arrest rate for violent
    crimes
  • Mother did not smoke8
  • Mother smoked 1-2 cigarettes per day9
  • Mother smoked 3-10 cigarettes per day11
  • Mother smoked 10-20 cigarettes per day15
  • Mother smoked gt 20 cigarettes/day18
  • What do you think of these numbers???

17
Embryo From the Third to the Eighth Week
  • First sign of human structure thin line down the
    middle (22 days) that becomes the neural tube,
    which eventually forms the central nervous
    system, including brain and spinal column
  • fourth week
  • head begins to take shape
  • heart begins with a miniscule blood vessel that
    begins to pulsate

18
Embryo From the Third to the Eighth Week
  • fifth week
  • arm and leg buds appear
  • tail-like appendage extends from the spine
  • eighth week
  • embryo weighs 1 gram and is 1 inch long
  • head more rounded face formed
  • all basic organs and body parts (but for sex)
    present
  • 20 of all embryos spontaneously abort now

19
Fetus
  • Called a fetus from 9th week on

20
Third Month
  • Sex organs take shape (Y cell sends signal to
    male sex organs for females, no signal occurs)
  • genital organs fully shaped by 12th week
  • All body parts present
  • Fetus can move every part of body
  • Fetus weighs 3 ounces and is 3 inches long

21
First Trimester For the Mom
  • There are a wide variety of changes that a woman
    can experience
  • These physical changes can also cause emotional
    reactions
  • Sometimes women during the first trimester notice
    an energy boost and overwhelming happiness other
    women complain that they are fatigued and
    emotionally unstable it is also possible for
    women to not even be aware of drastic
    fluctuations in their bodies and emotions
  • Many women worry that these changes during the
    first trimester may adversely affect the growth
    of the fetus, but in most cases they do not
    threaten the well-being of the fetus

22
First Trimester For the Mom
  • Some pregnant women notice aches and pains
  • Common complaints are back pains, joint aches,
    and leg cramps
  • It is essential that the woman rests often in
    order to alleviate these aches
  • Almost all women notice that they are more tired
    than usual during the first trimester
  • This feeling of fatigue sometimes remains for the
    duration of the pregnancy, although most women
    feel noticeably stronger by the third trimester

23
Morning Sickness
  • Another problem that affects the mother during
    early pregnancy is nausea
  • This is a very common problem as it affects
    almost three-fourths of all pregnant women
  • Most doctors think that "morning sickness" is
    caused by the overproduction of hormones (mostly
    estrogen) that occurs during the early pregnancy
  • These estrogen hormones then circulate throughout
    the bloodstream and affect the body
  • Some doctors think that this excess of hormones
    causes the stomach to digest food more slowly,
    which results in the nausea and the vomiting
  • Stress and fatigue may also play a part in
    causing nausea and vomiting

24
Common Complications During The First Trimester
  • Serious complications that can harm either the
    mother or the baby occur in about a fifth of all
    pregnancies
  • There are other common complications that may
    cause alarm in the mother, but that typically do
    not impact the success of the pregnancy
  • For example
  • Vaginal bleeding occurs in about 25 of
    pregnancies
  • Most cases this is not serious

25
A very risky time
  • It is estimated that 10 percent of all recognized
    pregnancies spontaneously abort during the first
    trimester
  • The actual number of miscarriages is much higher
  • Perhaps fifty percent of all conceptions
    spontaneously result in miscarriage before the
    woman even knows that she is pregnant

26
Second Trimester Middle Three Months
  • The second trimester of pregnancy encompasses
    weeks 14 through 27
  • In the fetus
  • Growth continues quickly from now until birth
  • Organs such as the heart and kidneys develop
    further
  • Eyebrows and fingernails form
  • The skin is wrinkled and covered with fine hair
  • periods of activity and quiet occur as the fetus
    moves, kicks, sleeps, and wakes
  • By the end of the second trimester, the fetus is
    about 11 to 14 inches long and weighs about 2 to
    2 1/2 pounds
  • It can swallow, hear, and urinate

27
Middle Three Months Preparing to Survive
  • Heartbeat stronger
  • Digestive and excretory systems develop more
    fully
  • Impressive brain growth (6X in size and
    responsive)
  • new neurons develop (neurogenesis)
  • synapsesconnections between neurons
    (synaptogenesis)

28
Middle Three Months Preparing to Survive
  • Age of viabilityage at which preterm baby can
    possibly survive (22 weeks)
  • 26 weeks survival rate about 50
  • brain maturation critical to viability
  • weight critical to viability
  • 28 weeks survival rate about 95

29
Second Trimester For the Mom
  • During the second trimester, continuing growth
    and development in mother and fetus cause many
    changes to occur
  • Women may notice the following
  • Their abdomen begins to swell. By the end of the
    second trimester, the uterus is near the rib
    cage.
  • The skin on the abdomen and breasts stretches.
    Stretch marks may be visible.
  • Movements made by the fetus. Known as quickening,
    this often occurs sometime around weeks 16 to 20.
  • A dark line forming from the navel down to the
    middle of the abdomen
  • Brown, uneven marks on the face or other changes
    in skin pigment
  • Darkening of the area around the nipples

30
No more morning sickness
  • Often, the second trimester delivers a welcome
    energy boost to women and an end to morning
    sickness. It may also bring
  • nasal congestion and occasional nose bleeds
  • whitish vaginal discharge
  • less of a need to urinate often
  • constipation
  • increase in appetite
  • Braxton Hicks contractions in which the uterus
    becomes hard and tight and then relaxes
  • leg cramps
  • backache
  • fatigue

31
Miscarriage is now at a much lower risk
  • Miscarriage in low-risk pregnancies is rare at
    this time, but women sometimes have other
    problems in the second trimester, including
  • High blood pressure
  • Sugar in the urine. This may be a sign of
    gestational diabetes, a form of diabetes
    associated with pregnancy
  • Iron-deficiency anemia

32
Final Three Months Viability to Full Term
  • The third trimester of pregnancy generally spans
    weeks 28 through 40
  • Maturation of the respiratory and cardiovascular
    systems
  • critical difference
  • Gains weight4.5 lbs. in last 10 weeks

33
Third Trimester
  • As the fetus gets bigger, it has less room to
    kick and stretch, so the movements felt by the
    mother may decrease
  • Fine body hair disappears
  • Most bones harden, but bones of the head stay
    soft and flexible for birth
  • As the time for birth approaches, the fetus
    usually moves down into the pelvis and settles
    into a good position
  • At 40 weeks, the fetus is considered full term.
    It is about 20 inches long and weighs 6 to 9
    pounds

34
Risk Reduction
  • Despite complexity, most babies are born healthy
  • Most hazards are avoidable
  • Teratologystudy of birth defects
  • teratogensbroad range of substances that can
    cause environmental insults that may cause
    prenatal abnormalities or later learning abilities

35
Determining Risk
  • Risk analysisweighing of factors that affect
    likelihood of teratogen causing harm

36
Timing of Exposure
  • Critical periodin prenatal development, the time
    when a particular organ or other body part is
    most susceptible to teratogenic damage
  • entire embryonic period is critical

37
Amount of Exposure
  • Dose and/or frequency
  • Threshold effectteratogen relatively harmless
    until exposure reaches a certain level

38
Amount of Exposure
  • Interaction effectrisk of harm increases if
    exposure to teratogen occurs at the same time as
    exposure to another teratogen or risk

39
Genetic Vulnerability
  • Genetic susceptibilities product of genes
    combined with stress
  • Folic-acid deficiency may cause neural- tube
    defects
  • occurs most commonly in certain ethnic groups and
    less often in others
  • Males are more genetically vulnerable

40
Specific Teratogens
  • No way to predict risk on an individual basis
  • Research has shown possible effects of most
    common and damaging teratogens
  • AIDS and alcohol extremely damaging
  • pregnant women with AIDS transmit it to their
    newborns high doses of alcohol cause FAS
    alcohol drug use increase risk to developing
    organism

41
Low Birthweight
  • Low Birthweight (LBW)
  • less than 5 1/2 lbs.
  • grows too slowly or weighs less than normal
  • more common than 10 years ago
  • second most common cause of neonatal death
  • Preterm
  • birth occurs 3 or more weeks before standard 38
    weeks

42
Low Birthweight
  • Small for Gestational Age (SGA)
  • maternal illness
  • maternal behavior
  • cigarette smoking (25 of SGA births)
  • maternal malnutrition
  • poorly nourished before and during pregnancy
  • underweight, undereating, and smoking tend to
    occur together

43
Low Birthweight
  • Factors that affect normal prenatal growth
  • quality of medical care, education, social
    support, and cultural practices

44
Third Trimester For the Mom
  • Women may notice the following
  • Movements of the fetus can be felt more strongly
  • Abdominal pain that may or may not be true labor
    pains
  • Shortness of breath because the uterus is pushing
    against the diaphragm. The diaphragm is a flat,
    strong muscle that aids in breathing. Towards the
    end of the third trimester, the baby may drop
    down into a lower position. This will make it
    easier for the mother to breathe
  • A need to urinate more often when the baby drops
    down into a lower position in the pelvis
  • Yellow, watery fluid leaking from her nipples,
    known as colustrum
  • Her navel sticking out

45
Third Trimester For the Mom
  • During the third trimester, certain discomforts
    and mood changes may occur
  • fatigue or extra energy, or alternate periods of
    both
  • increasingly heavy white vaginal discharge
  • more mild lower abdominal pains with uterine
    tightening and then relaxing
  • more or less of an appetite
  • constipation, heartburn, indigestion, gas, and
    bloating
  • headaches, dizziness, or faintness
  • more trouble sleeping
  • itchy abdomen
  • varicose veins
  • swelling of the legs, feet, and hands
  • increasing clumsiness as shape and balance
    changes
  • anxiety, impatience, and restlessness
  • irritability and unusual sensitivity

46
The Birth Process
  • Hormones in mothers brain signals process
  • Contractions begin strong and regular at 10
    minutes apart
  • average labor for first births is 8 hours

47
The Newborns First Minutes
  • AssessmentApgar scale
  • five factors, 2 points each
  • heart rate
  • breathing
  • color
  • muscle tone
  • reflexes
  • score of 7 or better normal
  • score under 7 needs help breathing
  • score under 4 needs urgent critical care

48
Variations
  • Parents Reaction
  • preparation for birth, physical and emotional
    support, position and size of fetus, and
    practices of mothers culture
  • Medical Attention
  • birth in every developed nation has medical
    attention
  • 22 of births in U.S. are cesarean section
  • removal of fetus via incisions in mothers
    abdomen and uterus
  • is medical intervention always necessary?

49
Birth Complications
  • Cerebral Palsy
  • brain damage causing difficulties in muscle
    control, possibly affecting speech or other body
    movements
  • Anoxia
  • lack of oxygen that, if prolonged, can cause
    brain damage or death

50
First Intensive Care . . . Then Home
  • At the Hospital
  • many hospitals provide regular massage and
    soothing stimulation ideally, parents share in
    caregiving
  • At Home
  • complications, e.g., minor medical crises
  • cognitive difficulties may emerge, but high-risk
    infants can develop normally

51
Mothers, Fathers and a Good Start
  • Strong family support
  • Fathers play a crucial role
  • may help wives abstain from drugs or alcohol
  • can reduce maternal stress
  • Parental alliancecommitment by both parents to
    cooperate in raising child
  • helps alleviate postpartum depression

52
Mothers, Fathers and a Good Start
  • Parent-infant bondstrong, loving connection that
    forms as parents hold, examine, and feed their
    newborn
  • immediate contact not needed for this to occur
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