Making Babies, Exam II
Terms
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- DeMasters Article states that frozen sperm specimens can result in a pregnancy for up to ___ years.
- 20 or longer.
- o T/F: Transfer of 5 day old blastocysts allows nature to weed out most chromosomally abnormal embryos.
- True
- Infertility
- No pregnancy after one year of unprotected sex.
- Demasters article states that for normal sperm development the temp. of the testicles must be
- two degrees cooler than body temperature.
- T/F: Transfer of 5 day old blastocysts allows nature to weed out most chromosomally abnormal embryos.
- true
- From the Sandelowski article, “Alone in a Crowd†infertile couples
- may or may not want to discuss fertility, and may feel isolated from people with children.
- T/F: Post-Coital Test is NOT a method of at home fertility monitoring.
- True
- STI’s may cause
- PID, no symptoms, scarring and irreversible damage, and infertility.
- T/F: Infertility is a 1/3 male issue, 1/3 female issue, and 1/3 an undeterminable issue.
- True
- ⬢ US Fertility clinics are legally permitted to return how many embryos to womb?:
- unlimited amount. discrimination of clinic.
- T/F: ⬢ it is possible for post-menop. woman to become preg. thru building endro. lining and egg transfer.
- true
- what is US legal age limit for ARTs?
- none. clinical discretion.
- microsort
- method of sex selection
- ICSI
- injecting sperm into the egg's cytoplasm.
- T/F: o The mother and the fetus share the same blood supply
- FALSE
- placenta
- o The role of the placenta during pregnancy is to provide oxygen to the fetus, nutrients to the fetus, and can filter toxins and microbes to protect the fetus.
- Group B Strep
- can be treated during labor with an IV of: antibiotics.
- Risk of invasive prenatal testing
- miscarriage.
- why was prenatal care developed?
- to diagnose eclampsia and pre-eclampsia.
- placenta previa
- -painless bleeding -IUGR caused by placenta previa is due to poor placental perfusion.
- Hyperglycemia
- a high level of glucose
- Gestational Diabetes (GDM)
- may result in neonatal hypoglycemia, childhood obesity
- PIH (pregnancy induced hypertension)
- disorders include elevated blood pressure.
- EDD
- Estimated Due Date
- LMP
- Last Menstrual Period
- Gravid
- definition: pregnant Primigravida: first pregnancy Multigravida: second, third⬦pregnancy
- Para
- Definition: a women who has given birth. Nullipara: never given birth Primipara: first birth Multipara: second, third⬦birth (includes twins)
- Quickening
- when mother feels fetal movement
- Progesterone
- -Thickens the endometrium (vascular) -Supresses development of a new follicle⬦ -Inhibits uterine contractions
- Embryonic/Fetal Highlights
- 1st Trimester: heart develops first, beats at ~5 to 6 weeks All major organs grossly developed by week 10 2nd Trimester: detailed development of organs and fetal growth Hearing ~ 26 weeks Eyes reopen ~ 26 weeks 3rd Trimester: fetal growth continues
- Which changes occur during the third trimester?
- Braxton-Hicks contractions. Painless cramps that prep women for real labor pains.
- Sex selection can be achieved using
- Microsort, pre-implantation genetic diagnosis, or an ultrasound at 16-20 weeks
- nytimes article
- ⬢ A new prenatal test for down syndrome is being developed to detect abnormal fetal cells in maternal blood.
- Screening Test
- ⬢ A screening test (opposed to a diagnostic test) will reveal the chances of a possible abnormality.(opposed to a diagnostic test)
- What test can be conducted for Down Syndrome?
- ⬢ An ultrasound at 9-13 weeks to measure nuchal folds with an AFP test can screen for Down Syndrome.
- Fetal blood sampling
- performed at 18 weeks or later to detect chromosomal disorders, infections, of fetal blood disorders.
- Amniocentisis
- is performed between 15-17 weeks to reveal chances a fetus may have a neural tube defect or a chromosomal abnormality.
- DIAGNOSTIC TEST
- determines with a relative certainty whether a fetus has a specific problem or abnormality.
- Prenatal Tests
- -Urine Test -Cervical Test -Maternal Blood Test -Ultrasound (US) -Amniocentesis -Chorionic Villus Sampling (CVS) -Fetal Blood Sampling (PUBS) -New and emerging technologies⬦
- The “AFP†screen
- AFP (alpha-fetoprotein) hCG estriol inhibin-A* Levels are calculated with maternal age, gestational age and determine personal risk estimate often reported as a ratio
- Types of Ultrasound
- Transvaginal : early pregnancy Standard : 2-D image Advanced : targets a suspected problem/more sophisticated equipment Doppler : detects frequency changes (blood flow) 3-D : special probes w/ software to generate 3-D images 4-D or Dynamic 3-D : 3-D in motion Fetal Echocardiography: heart anatomy and function
- Why do an amniocentisis?
- Neural Tube Defects (NTD): spina bifida, anencephaly Chromosomal disorders: Trisomy 21 (Down syndrome), 13, 18, Fragile X Genetic disorders: cystic fibrosis, Turner syndrome.
- Amniocentisis Risks
- infection PROM (premature rupture of membranes) Fetal injury Clubfoot w/ early amnio 1/1000
- Chorionic Villus Sampling (CVS)
- TWO METHODS: Transcervical: ( most common method) US, thin catheter to suction chorionic villi cells Transabdominal: Similar to amnio larger sample, faster results. Why? chromosome abnormalities genetic disorders
- Fetal Blood Sampling (PUBS):
- performed at 18 weeks or later US to identify structures a thin needle through abdomen and uterus to umbilical cord. Small amt of cord blood extracted results usually within 72 hours Why: If diagnostic information cannot be obtained through amnio, CVS, or ultrasound, or the results of these tests were inconclusive chromosome abnormalities Fetal malformations *Blood disorders (i.e. fetal hemolytic disease.) *Fetal infection (i.e. toxoplasmosis, rubella) *Fetal platelet count in the mother *Fetal anemia *Isoimmunisation
- A reactive non-stress test includes
- FHR 130-140 WITH ACCELERATIONS.
- o After a non-reactive NST, what should happen next?:
- A biophysical profile.
- o Why would FHR accelerations NOT occur during a non-stress test (NST):
- fetal immaturity.
- The leading cause of prematurity
- pre-eclampsia
- “Choosing Naia�
- -Down syndrome was the parents primary concern ⬢ The first indication that Naia had an abnormality was diagnosed by an ultrasound.
- Spina Bifida
- a neural tube defect (NTD) which can be diagnosed by ultrasound during pregnancy.
- options for women carrying a baby with Down Syndrome
- abortion, adoption,raising the child.
- What is the role of the placenta during pregnancy?:
- Provides nutrients to fetus and filters toxin.
- Bainbridge Article states what...
- sperm are necessary for placenta development.
- ovulation occurs ____ after LMP
- 2 weeks
- what test can provide quantitative results?
- serum (blood) test detects levels of hcG in blood.
- JAMA
- fetal pain perception is unlikely until the third trimester.
- Methods of emergency contraception include
- post-coital insertion of IUD
- Leading jurisdiction that solidified abortion rights in US
- Roe vs. Wade, 1973
- Abortion Options by Trimester
- 1- +Medicinal *Methotrexate-Orally up to 6 weeks *Mifepristone - Orally up to 9 weeks (RU486) +Surgical * MVA: Manual Vacuum Aspiration * D&C: Dilation and Suction Curettage 2- +Surgical *D&E: Dilation and Evacuation
- Multifetal Pregnancy Options
- *Wait and See: 10-30% will spontaneously reduce +Elective reduction: Usually done 9-12 weeks -Ultrasound used to guide needle to inject Potassium chloride (vaginal or abdominal) -17% result in total pregnancy loss -Preterm labor occurs in 75% of MFR pregnancies. +Carry higher-order multiple pregnancy
- T/F: - In the US, abortion in the first trimester is a safe and legal option.
- TRUE