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Making Babies, Exam II

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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

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