Prenatal Care and Development

Prior to getting pregnant

• Take Prenatal vitamins• Eat Folic Acid• Stop smoking (if you smoke)• Stop drinking & drugs (most Rx too)• Be as healthy as you can be (sleeping, eating,

& relationships)• Avoid cleaning out cat litter• Avoid harsh cleaning chemicals

Get Pregnant

• Ovulation– How many eggs? How often?

• One egg per month after menarche until menopause; average 300 eggs in a lifetime

• released at ovulation, lasts 3-4 days

• Ejaculation– How many sperm? How often?

• 400,000,000 to 700,000,000 (million) with EACH ejaculation whenever he ejaculates, from spermarche until death

• Sperm can live in vagina for up to 7 days and can live outside the body for up to 72 hours!!!!!!!!!!!!!

• Conception– Egg and sperm meet, egg fertilize, and you now have a

ZYGOTE! (and you are pregnant)

Fertilization & Implantation

• Sperm and egg usually join together in the fallopian tube

• Fertilized egg begins to undergo millions of cell divisions (called mitosis)

• Travels to and implants itself in lining of uterus (endometrium)

Fertilization and Implantation

Implantation of blastocyst

Day 7 Fertilization

Day 4

Day 3 Day 2

Day 1

Day 0

Egg released by ovary

Uterine wall

Blastocyst

Morula

4 cells 2 cells Zygote

Ovary

Fallopian tube

Am I pregnant?Conception shows no physical signs to a woman

Usually takes about 3-4 weeks to realize you are pregnant

- Missed period and breast tenderness

- Nausea/vomiting and frequent urination

ONLY reliable source: Urine or Blood test by Doc

- changes in cervix and uterus observed

- detect Human Chorionic Gonadotropin

HcG

Human Chorionic Gonadotropin (HcG) is secreted by the zygote and can be detected 7 days after conception

HcG also increases estrogen and progesterone to maintain uterine lining and prevents additional eggs from being released

3 developmental stages of baby in utero

• 1. Zygote: (1st 2 weeks)• fertilized egg during day of fertilization until day 4• Day 4: Morula• Day 5-14: Blastocyst

• 2. Embryo (weeks 3-8)• Rapid growth with important changes

• 3. Fetus (week 9-40)• Major organs present but still forming

From Zygote to Embryo• 7-8 days, blastocyst attaches to endometrium

becomes an embryo!

• Next 5 weeks embryo grows rapidly 1000xs the original egg and differentiate into 3 layers of cells:• 1. ectoderm: will turn into brain, spine, and nerves and hair, skin,

nails

• 2. mesoderm: will turn into bones, muscles, blood vessels, heart, and kidneys

• 3. endoderm: digestive system organs and lungs

So what does this have to do with prenatal care?

• Good question!

• BRAIN is one of first organs to develop (day 18)

• So alcohol, drugs, chemicals, and certain bacteria can cause:– physical deformities

– Mental Retardation or Learning Disabilities

– Even miscarriage

• All before you even know you’re pregnant!

Support Systems for Embryo

• 1st trimester, as zygote becomes embryo, the support systems develop too.• 1. Amnion:

• protective sac that surrounds embryo with amniotic fluid, acts as shock absorber and cushion

• 2. Placenta:• forms along uterus and has rich network of blood

vessels to transfer O2 and nutrients from mom to baby • Serves as lungs, liver, kidneys, endocrine glands and

digestive system for embryo

Support Systems for Embryo• 3. Umbilical cord: connects embryo to

placenta, ~20 inches long• Embryo blood vessels connect to placenta from

umbilical cord and Mom blood vessels connect to placenta

• NEVER do Mom’s blood and Baby’s blood mix!• Why?• Blood vessels come close enough for diffusion

to take place • Diffuse nutrients, oxygen, and waste

Brief overview of Characteristics of Pregnancy

• 1st Trimester (1st 12 weeks):– Breasts get fuller and tender

– Blood vessels are more prominent and areola darkens

– Nausea, constipation, backache, heartburn, fatigue

– Mood changes/hormonal changes

– Brain and heart are present

– 3rd month most begin to “show” Fatigue• Mostly because of intestinal bloating than baby

Brief overview of Characteristics of Pregnancy

• 2nd trimester– Bigger abdomen due to growth of fetus and uterus

– Appetite increases• But caloric intake only needs to increase by 300-500

calories!

– Fluttery movements felt

– Possible leg cramps and back aches now

– Volume of blood increases as well as energy

– Increases in frequency of urination (why?)

Characteristics of Pregnancy• 3rd trimester

– Most gain 25-40 lbs (healthy = 15-35 lbs)

– Blood volume increases 30-40% so Heart beats faster

– Leg cramps

– Swollen hands/feet and stretch marks

– Nightmares and sleep problems

– Non-painful and irregular contractions

– Urine leaking and very frequent urination

– Uterus stretches and pushes up diaphragm, stomach, small intestines, etc

– Difficulty breathing and eating due to baby’s size

Pregnancy Nutrition needs• Overall 300-500 calorie increase per day from:

• Extra protein – For energy and development of placenta, amnion, blood and baby’s

brain

• Extra calcium– Bones and teeth for both

• Extra Vitamin E– Tissue growth and red blood cells

• Extra Iron– Red blood cells and blood production for both

• Folic Acid– Prevents neural tube defects like spina bifida

Pregnancy & Exercise• Exercise is beneficial BEFORE, DURING & AFTER

pregnancy!

• Boosts energy, mood, reduces stress!

• 30 min or more EVERYDAY of low-impact and moderate intensity exercise

– Walking, jogging, swimming, and Kegels to help heart, lungs, circulation, and pelvic floor

• Few restrictions on activities with normal preg – Use common sense: avoid risks of falling, sudden changes, and contact

sports

– Consult your doctor 1st

• Plenty of sleep (night) and rest (day) is vital

Your first Pregnancy/Prenatal visit: usually around 8-10 weeks…the longest visit

• Full history and physical• Pap smear• Gonorrhea and Chlamydia cultures• Blood type screen• Rubella, syphilis, and Hepatitis B screen• HIV testing is offered• Urine culture• Nutrition counseling if needed

What are the 3 Stages of Labor

1. First Stage: Dilation and Effacement of the Cervix

2. Second Stage: Pushing and Birth 3. Third Stage: Delivery of the Placenta

Epidural

• Episiotomy: – Surgical cutting of the perineum…Tissue that

connects the vaginal to the anal openings.

Operative Delivery

Cesarean Section

The Third Stage

Time from fetal delivery to placental delivery is considered to be prolonged if it is more than 30 minutes.

Signs of placental separation: cord lengthening, bleeding, globular shape of uterus

Life’s Greatest Miracle

• http://www.pbs.org/wgbh/nova/miracle/program_t.html