The Process of Conception The Miracle of Pregnancy

Spermatogenesis .Process by which sperm are produced. .Takes place in the testes .Meiosis is the process by which gametes reproduce .300 million are produced daily .Sperm consist of Head Midpiece Tail

Slide of Spermsperm

Oogenesis

.The process by which egg cells (ova-plural)

are ripened in the ovaries.

All the ova that a woman will have are present at birth. At puberty, there is an ongoing process of oogenesis.

Healthy Ovum

egg - 32 yr old woman

Conception

.Conception takes place in the upper third of the fallopian tube (usually). .Cilia help move the ovum down the tube .The trip to the uterus will take 3-4 days. .Ovum can live up to three days .Sperm can survive from 3 to 7 days.

ConceptionUterus

The Germinal Period .Covers time from moment of conception to moment of implantation. (about 2 weeks)

After the ovum is fertilized, the combined sperm and egg are referred to as a zygotefertilized egg The two circles in the middle show the two sets of chromosomes coming together

Cell division begins within the first 24 hours.

2cellembryo

The second cell division begins to take place at around 30-48 hours.4-cell stage

The third cell division produces 8 cells. After this, cell division speeds up.

.Here, the cells are clumped in a way you can.t see the four on the back side.

8-cell stage

As the cells continue to divide, they clump together to take the shape of a ball that looks like a mulberry. This is called a morula.MORULA

The BlastulaBlastocyst

Four blastocysts left over from IVF(in vitro fertilization)

4blastocysts

Ectopic (Tubal) Pregnancy

ectopicpregnancy

An Ovarian implantation.

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In Vitro Fertilization . About to inject the egg with a sperm. Holding pipette on left. ICSIneedle on right. Sperm head visible in needle at far right, just below X. Polar body of egg at 7 o'clock.

icsi

In Vitro Fertilization .Needle is advanced to the left. Shell of embryo has already been penetrated by needle. Membrane of egg (oolemma) is stretching and is about to break. Sperm head is visible at tip of needle .

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In Vitro Fertilization .ICSI needle has penetrated the egg membrane. A single sperm is being injected into the cytoplasm of the egg.

icsisperm

A blocked fallopian tube.

blocked tube

Embryonic Period .Begins at the end of the second week and ends by the end of the 8thweek. It.s duration is for 6 weeks. .This is a time of critical development .All the organs egin their development at th is time. .Rapid growth and daily change.

Embryonic Period .At the end of the fourth week of pregnancy and only 2 weeks into the embryonic period, the heart is beating, the nervous system, in its primitive form is functioning, and both now contribute to the rest of development.

Embryonic Period .During this period, all the structures we recognize as human develop. .To view more details on development at this stage, go to .http://www.visembryo.com/baby/stage8.html

Embryonic Period

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Embryonic Period

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Embryonic Periodexample18

Embryonic Periodexample19

Embryonic PeriodStage20embryo

Embryonic Periodexample23

Fetal Period

.Lasts from beginning of third month until birth (about 7 months) .Fetus begins to kick and squirm .Quickening occurs .During the third month, the first external signs of sex differentiation become apparent.

Fetal Period .Viable: refers to the ability of a fetus to live outside the mother.s body. .This is usually considered to be around 24 weeks (6 months) .Vernix caseosa covers the fetus .Gestational period is measured from mom.s last period to day of childbirth. .Full term = 37 41 weeks. .Post mature = over 42 weeks .Premature = less than 37 weeks.

Fetal Development Month by Month

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PREGNANCY Changes:

.Couples relationship .May deepen and strengthen the relationship .Need to resolve dependency issues and money issues .Sexuality may increase, decrease no rules about sex during pregnancy .Priorities & values change .Roles change

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First Month .By the end of the first month, the embryo is about 1/10 of an inch long. The heart, which is no larger than a poppy seed, has begun beating.

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Two Months

.The embryo is about 1 inch longand has distinct, slightly webbed fingers. Veinsare clearly visible. The hearthas divided into right and left chambers.

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Three Months .By now the fetus is 2 1/2 to 3 inches longand is fully formed. He has begun swallowing and kicking. All organsand muscleshave formed and are beginning to function.

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Four Months .Your baby is covered with a layer of thick, downy hair called lanugo. His heartbeat can be heard clearly. This is when you may feel your baby's first kick.

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Five Months

.A protective coating called vernix caseosabegins to form on baby's skin. By the end of this month, your baby will be nearly 8 inches long and weigh almost a pound.

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Six Months .Eyebrowsand eyelidsare visible. Your baby's lungs are filled with amniotic fluid, and he has started breathing motions. If you talkor sing, he can hear you.

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Seven Months .By the end of the seventh month, your baby weighs about 3 1/2 poundsand is about 12 inches long. His body is well-formed. Fingernailscover his fingertips.

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Eight Months .Your baby is gaining about half a pound per week, and layers of fat are piling on. He has probably turned headdown in preparation for birth. He weighs between 4 and 6 pounds.

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Nine Months .Your baby is a hefty 6 to 9 poundsand measures between 19 and 22 inches. As he becomes more crowded, you may feel him move around less.

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Fetal Circulation

Development of Fetal Circulation .By the end of the 3rdweek: The embryo has a system of paired vessels The vessels forming the heart have fused

Development of Fetal Circulation .Unique vascular modifications seen in prenatal development include umbilical arteries and veins, and three vascular shunts (occluded at birth) Ductus venosus venous shunt that bypasses the liver Foramen ovale opening in the interatrial septa to bypass pulmonary circulation Ductus arteriosus transfers blood from the right ventricle to the aorta

Circulation in Fetus and Newborn Figure 28.13

.28-13_FetusCircula_1.jpg 00022699 Macintosh HD ABA78158:

Extrauterine Life .At 1-5 minutes after birth, the infant.s physical status is assessed based on five signs: heart rate, respiration, color, muscle tone, and reflexes .Each observation is given a score of 0 to 2 .Apgar score the total score of the above assessments 8-10 indicates a healthy baby Lower scores reveal problems

First Breath .Once carbon dioxide is no longer removed by the placenta, central acidosis occurs .This excites the respiratory centers to trigger the first inspiration .This requires tremendous effort airways are tiny and the lungs are collapsed .Once the lungs inflate, surfactant in alveolar fluid helps reduce surface tension

Occlusion of Fetal Blood Vessels .Umbilical arteries and vein constrict and become fibrosed .Fates of fetal vessels Proximal umbilical arteries become superior vesical arteries and distal parts become the medial umbilical ligaments The umbilical vein becomes the ligamentum teres The ductus venosus becomes the ligamentum venosum The foramen ovale becomes the fossa ovalis The ductus arteriosus becomes the ligamentum arteriosum

THANK YOUslide 26 stonelady

TERATOGENS

Teratogens .External agents such as viruses, drugs, chemicals and radiation that can harm a developing embryo or fetus. .Time when organ system or body part is at highest risk of effects from teratogens is known as sensitive period.. .Effects of teratogens on a body part or organ system are worst during the period when that structure is forming and growing most rapidly.

Teratogens .The same defect can be caused by different teratogens. .A variety of defects can be caused by a single teratogen. .The longer the exposure or the higher the dose. of the teratogen, the more likely it is that serious harm will be done. .The long-term effects of a teratogen often depend on the quality of the postnatal environment.

CP1

Medications .Not all medications are safe while trying to conceive and during pregnancy. .Over-the-Counter .Prescription .Vitamins and Supplements .Pregnancy Risk Categories for Meds .Review all medications with a health care provider.

Substance Use / Abuse .Birth Defects and Learning Defects .Safety Issues impacting the ability to properly care for an infant .Family Dysfunction .Financial Stress .Potential for Law Enforcement Involvement .Pregnancy may be a strong motivator for change. .Refer for Substance Abuse Evaluation/Counseling

Alcohol Intake .Fetal Alcohol Syndrome is a leading cause of preventable mental retardation. .No level of alcohol is considered safe. .Advise to abstain when attempting to conceive and during pregnancy. .Refer for evaluation and treatment.

Tobacco Exposure .Smoking in pregnancy is associated with preterm delivery and low birth weight infants. .Smoking in the household is associated with Sudden Infant Death Syndrome, childhood respiratory illness, asthma, and otitis media. .Promote Smoking Cessation.

Environmental Hazards .Chemical: Lead, Mercury, Herbicides & Pesticides .Physical: Hyperthermia .Radiation: X-Ray .Infectious: Live Vaccines, STD.s, Toxoplasmosis, Cytomegalovirus, Parvovirus B19 (Fifth Disease) .Exposures at home, workplace and environment .Cultural considerations

Environmental Counseling .Avoid hot tubs, saunas, and x-rays. .Stay away from toxic chemicals like insecticides, solvents, mercury and lead. .Avoid cat litter, garden soil and raw meat. .Frequent hand washing .Universal Precautions for child care and health care .Cultural Practices