Care of the mother and fetus during perinatal period

Perinatal period - 154 days of gestation

- 7 days after birth

Intrapartum - labor and delivery

Postpartum - after delivery

Prenatal Care
FETAL FORMATION

FERTILIZATION

- conception, fecundation, impregnation

- 23 PAIRS OF CHROMOSOMES
- the union of mature egg cell and sperm cell at
- 22 AUTOSOME, 1 PAIR SEX
the ampulla.
CHROMOSOME
- formation of zygote with combination of genetic
mtri
EMBRYO DEVELOPMENT - Embryogenesis
- Sperm-lives for 72 hrs. (48hrs prior ovulation &
24 hrs after); 5 minutes to travel
Morula - 16 cells
- Ova-24-48 hrs only
Blastula - arrange themselves a hollow mass structure
- Hyaluronidase

FOETAL STAGE
- Embryo - fetus
FETAL FORMATION

Viviparity - baby grows inside the mother

Factors affecting fertilization:
Oviparity - egg
- Equal maturation of sperm and ovum
Blastocyst
- Ability of sperm to reach ovum (SPERM
CAPACITATION)
- Ability of sperm to penetrate the zona pellucida
& cell membrane (ACROSOMAL REACTION)
- Contains hyaluronidase in the corona
radiata

FACTORS AFFECTING FERTILIZATION

FETAL FORMATION
FUNCTIONS OF THE PLACENTA
IMPLANTATION - nidation - Transport of nutrients and fluid
- Excretion of amniotic fluid
- 8-10 days after fertilization; at fundal portion - Respiratory organ
- Protective barrier
- c/o trophoblast - Secretes hormones

- Chorion

- Amnion

- Langerhans layer (prevents peneration of viruses

during thebearly stages of pregnancy)

Nono pregnancies
- Ectopic pregnancy
- Placenta previa
Duncan - dirty part
- Beefy like structure

Schultz - where fetus lies

- Cord of the placenta

Nursing responsibilities - check for cotyledons

FETAL FORMATION PLACENTAL HORMONES

PLACENTA
• HUMAN CHORIONIC GONADOTROPIN (HCG)
- 400-600 grams - present in urine & blood after first missed
menstruation up to 1-2 weeks postpartum
Union of chorionic villi & decidua - suppress rejection of placenta N= 400,000
- Loses function beyond 42 wks IU/24 hrs
• Decidua - supported by Hcg (Human Chorionic - Pregnancy kits detect HCG
Gonadotropin) - HCG is responsible for the nausea and vomiting
 ✔Fetal temperature

UMBILICAL CORD

- AVA (determinant for heart & kidney dses)

- Covered by Wharton's jelly (gelatinous
mucopolysaccharide)
- Nuchal cord

PLACENTAL HORMONES

• PROGESTERONE- maintain pregnancy & prevent

FETAL FORMATION
uterine contraction
STAGES OF INTRAUTERINE DEVELOPMENT
• ESTROGEN- mammary gland & uterine development
• HUMAN CHORIONIC SOMATOMAMOTROPIN
1. Pre-embryonic stage-1st 2 weeks after
- Promotes lactation
fertilization; ovum -- zygote
2. Embryonic-3-8 weeks after fertilization; period
of organogenesis.
AMNIOTIC FLUID
- Most dangerous stage
- clear, straw-colored fluid; slightly alkaline
3. Fetal - 8 weeks up to birth
- (Ph7.2) - 800ml 1200ml
- Age of Viability - at least 20-24 weeks
& >500grams
• Source:
a. Amniotic membrane
EMBRYONIC GERM LAYERS
b. Fetal urine
• Oligohydramnios <500ml; kidney problem
• Polyhydramnios >2,000ml; esophageal atresia

- In a cephalocaudal fashion
AMNIOTIC FLUID
-Green-colored amniotic fluid-meconium stained CARDIOVASCULAR SYSTEM (mesoderm)
-Golden-colored amniotic fluid-hemolytic dse. - @16th day of life
Purpose: - FHT via Doppler at 10-12 wk
Shock absorber
Medium of excretion

Specimen