Fertilization and Pregnancy. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 2 What is the approximate annual cost of raising a child born.

Fertilization and Pregnancy

©2008 McGraw-Hill Companies. All Rights Reserved. 2Chapter 8

What is the approximate annual cost of raising a child born today?A. $5000B. $8000C. $12,000 C. According to the U.S. Dept. of

Agriculture, it costs more than $12,500 per year (on average) to raise a child born n 1995 to the age of 2. The cost jumps every 2 to 3 years. It will cost more than $250,000 (on average) to raise a child to age 18.


What is the leading cause of female infertility?A. Growths in the uterusB. Exposure to radiationC. Blocked fallopian tubes caused by STDs

C. If left untreated, the STDs gonorrhea and chlamydia can lead to tubal scarring and blockage. Leading causes of male infertility include low sperm count and poor sperm motility, usually as a result of injury, infection, birth defects, or subjecting the testes to high temperatures. One recent study linked repeated use of laptop computers with increased scrotal temperature and potential effects on male fertility.


Cigarette smoking before or during pregnancy is linked to which of the following?A. higher rates of infertility among men and womenB. Increased risk of low birth weight among infantsC. Decreased likelihood of having a mal infantD. Increased risk of attention-deficit/hyperactivity disorder among children exposed in utero

All four. Smoking has many negative effects on infants and on the reproductive systems of both men and women. The reduction in male births associated with smoking may result from problems with sperm quality, especially those sperm cells with a Y chromosome.


The position in which babies sleep has a significant impact on their risk of dying from sudden infant death syndrome (SIDS). True or False?

True. The rate of SIDS in the United States has dropped over 50% since 1992, when an education campaign called “Back to Sleep” was implemented to teach parents and caregivers to put babies to bed on their backs instead of their stomachs.


Statistics

An estimated half of the approximately 4.1 million babies born every year in the U.S. are from unintentional pregnancies.

The average age of first-time U.S. mothers has increased steadily since 1970 from 21.4 to 25.1 years.


Deciding to Become a Parent Physical health and age Financial circumstances

From birth to 18 years old costs $250,000 Relationship with your partner Education, career and child care plans Emotional readiness Social support Personal qualities Philosophical or religious beliefs


Preconception Care

1. Preexisting medical conditions?2. Prescription drug/OTC drug use?3. Prior pregnancy or delivery problems?4. Age?5. Smoking, alcohol or other drug usage?6. Any infections?7. Diet?8. Family history of genetic disorders?


Female Terms to know: Ovum – egg; female sex cell Ovary – produce eggs and sex hormones

Thousands of egg cells are stored here Follicle – saclike structure within the ovary where the

eggs mature Fallopian Tube – (Oviduct) where egg travels from

ovary to the uterus; the site of fertilization Uterus – where egg attaches and develops Endometrium – inner lining of the uterus Vagina – opening to the uterus Cervix – separates the vagina from the uterus Zygote – fertilized egg

©2008 McGraw-Hill Companies. All Rights Reserved. 10

Male Terms to know: Sperm – male sex cell Testicles/Testes – produce hormones and sperm cells

About 1,000 tubules where sperm are produced Scrotum – the sack that holds the testes Epidydimus – tube where sperm are held inside the

testes Vas Deferens – tube that opens into the urethra inside

the penis Prostate Gland and Cowper’s Gland – produce a

mixture of fluids called semen Testosterone – hormone that stimulates male sexual

characteristics

Chapter 8


Understanding Fertility

Conception involves the fertilization of a women’s ovum by a man’s sperm Each month a women’s ovaries release an egg It takes approximately 4 or more days for the

egg to travel through the fallopian tube Eggs alternate between the two fallopian tubes

each month The egg continues to travel into the uterus and

out the cervix and vagina. This process is called ovulation


Fertility

If the woman has intercourse during ovulation: During a man’s ejaculation millions of sperm

travel into the woman’s vagina, into the cervix and uterus

The sperm continue into the woman’s fallopian tube to meet the egg

Chapter 8


Fertility Only one of those sperm can permeate the

woman’s egg The sperm meets the egg in the fallopian tube The sperm releases an enzyme that does not

allow any other sperm to permeate the egg also If the sperm permeates the woman’s egg

fertilization takes place.

Chapter 8


Development As soon as fertilization occurs, the zygote

starts to undergo cell division that begins the growth process.

It continues to divide as it travels through the fallopian tube and to the uterus.

Upon reaching the uterus, the cluster of cells now known as a blastocyst becomes implanted in the endometrium (lining of the uterus). This is where the eventual fetus will develop until

birth


Fertilization and Early Development of the Embyro


Genetics

The ovum (egg) carries the hereditary characteristics of the mother and her ancestors; the sperm carries those from the father and his ancestors.

Each egg and sperm contain 23 chromosomes, each of which contains genes.

The fertilized egg or zygote will contain all 46 chromosomes


Twins or Multiples? The usual course of events is that one egg

and one sperm unite to produce one fertilized egg and one baby.

Fraternal Twins - If the ovaries release two (or more) eggs during ovulation and if both eggs are fertilized, twins will develop.

Identical Twins – If the fertilized egg divides into two cells that develop separately, shared genetic material will be split, twins will grow and develop.


Pregnancy

13 week trimesters for 38-40 total weeks or 266 days

Early Tests Can be performed as early as 2 weeks

after fertilization Home pregnancy kits sold OTC include a

small sample of red blood cells called Human chorionic gonadotropin (HCG)

Woman adds a small amount of her urine Instructions must be followed carefully


Fetal Development

First Trimester Blastocyst – for first 2 weeks

Inner cells divide into three layers One layer – inner body parts Middle layer – muscle, bone, blood, kidneys,

and sex glands Third layer – skin, hair, and nervous tissue

Embryo – At end of second week All major body structures are formed between 2nd

and 9th week Fetus - At 2nd Month


Early signs and symptoms

Missed menstrual period Softening of the uterus

Hegar’s sign found during pelvic exam Slight bleeding Nausea Breast tenderness Increased urination Sleepiness, fatigue and emotional upset


Continual Change in the Women’s Body Uterus size grows Around the Forth Month

Breast changes Muscles and Ligaments loosen Weight Gain


Changes During the Later Stages of Pregnancy Increased needs from the fetus are

placed on the mother Braxton hicks contractions

Preliminary contractions Lightening

When baby settles into pelvic bones with head down, causing the uterus to sink down 2 inches

Emotional responses to Pregnancy



Fetal Development Placenta

Network of blood vessels called chorionic villi Allows a 2-way exchange of nutrients and waste materials

between the mother and fetus Brings oxygen and nutrients to the fetus and transports waste

products out Does not provide a perfect barrier between fetal and maternal

circulation Some blood cells are exchanged and certain substances such

as alcohol pass freely from maternal circulation through placenta to the fetus

Umbilical cord The cord connecting the placenta and fetus, through which

nutrients pass Amniotic sac

A membranous pouch enclosing and protecting the fetus, containing amniotic fluid



Fetal Development Second Trimester

Fetus grows to about 14 inches and 2 pounds

Third Trimester Fetus gains protective fat layers,

Respiratory and Digestive organs develop


Diagnosing Fetal Abnormalities Ultrasonography (Ultrasound)

High frequency sound waves Amniocentesis

Fluid removal from the uterus Chorionic Villus sampling

Removal of tiny section of chorionic villi Triple marker screen (TMS)

Maternal blood test Fetal programming

Amniocentesis, CVS, and TMS Chromosomal, genetic and other abnormalities


The Importance of Prenatal Care

Regular medical checkups Blood tests Prenatal nutrition Avoidance of drugs, and other

environmental hazards Alcohol Tobacco Caffeine Drugs and chemicals STD’s and other infections


The Importance of Prenatal Care

Activity and exercise After 20 weeks avoid lying on your back Modify the intensity Avoid any potential for mild abdominal

trauma Avoid heat stress Unusual symptoms Resume prepregnancy exercise gradually Kegal Exercises

Preparation for childbirth


Complications of Pregnancy and Pregnancy Loss

Ectopic pregnancy Spontaneous Abortion, or miscarriage Preeclampsia/eclampsia Low-birth Weight (LBW)

5.5 LBS. Infant Mortality

SIDS Coping with loss


Childbirth

Choices in childbirth Who is going to assist with delivery? Where is the baby going to be delivered?


Labor and Delivery Entire process 2-36 hours. First stage of Labor.

13 hours for a first birth. Cervix is completely dilated (10

centimeters) Hormonal changes. Contractions. (30 seconds and occur

every 15-20 minutes) Mucus plug is expelled and amniotic sac

may rupture. Transition.


Childbirth

Second Stage of Labor Baby slowly pushed into birth canal Baby squeezes through pelvis Head is usually delivered first Umbilical cord is cut

Third Stage of Labor Delivery of the placenta

Apgar Scale of the Baby


Pain Relief During Labor and Delivery

Childbirth preparation courses Breathing and relaxation techniques Lamaze or Bradley

Epidural Narcotics

Fentanyl or demeral Provide less pain relief than a epidural


Cesarean Deliveries About 29% of babies born in the U.S. Surgical removal of the baby

Baby’s head too large Mother has a serious health condition Mother who is overweight or diabetes Difficult labor Fetal distress Dangerous infections 90% of cesarean mothers will have subsequent

deliveries by cesarean


Postpartum Period 3 months following childbirth. Critical family adjustment. Vaginal delivery leave hospital 1-3 days. Cesarean section 3-5 days. Breastfeeding

Just over 70% of mothers breast-feed Lactation begins about 3 days post childbirth Colostrum prior to lactation

Postpartum depression.


Infertility Millions of couples have difficulty

conceiving. Affects 10-20% of the reproductive-

age population in the U.S. Although the focus is usually on

women… 30-40% of contributing factors are male 10-30% of infertile couples, both the

male and female have problems


Infertility

Women Blocked fallopian

tubes Pelvic Inflamm.

Disease Endometriosis Hormonal imbalance Uterine Growths Allergic responses to

sperm Smoking Alcohol Toxic chemicals or

radiation

Men Low sperm count Poor motility Blocked

passageways Toxic substances Smoking Drugs Testicular injury Infections Birth defects High Temperatures


Infertility Treatment Intrauterine insemination

Artificial intrauterine insemination Success rate about 60%

IVF,GIFT, and ZIFT In vitro fertilization (IVF)

Eggs and sperm mixed in lab then put in uterus Used by women with blocked oviducts

Gamete intrafallopian transfer (GIFT) Sperm and egg placed in oviducts before fertilization

Zygote intrafallopian transfer Eggs fertilized then put in oviducts when cells begin to divide

Success rates vary from 27% to 51% Cost is between $8,000 and $12,000 per procedure and may

require 5 or more cycles to produce one live birth Increased chance of multiple births which increases rate of

complications


Infertility

Surrogate Motherhood Emotional Responses to Infertility

Pregnancy and Childbirth


Before conception and in the early weeks of pregnancy, adequate intake of which of the following nutrients can reduce the risk of spina bifida and other neural tube defects?A. IronB. Folic acidC. Calcium

B. It is recommended that all reproductive-age women consume folic acid from fortified foods and/or supplements each day to reduce the risk of spina bifida and other neural tube defects.

Fertilization and Pregnancy. Chapter 8 ©2008 McGraw-Hill Companies. All Rights Reserved. 2 What is the approximate annual cost of raising a child born.

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