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III. Developmental Hazards. Teratology…Teratogen Maternal diseases and health AIDS, rubella, syphilis, gonorrhea, polio, diabetes, herpes Age Nutrition RH factor Emotions/Stress Drugs. Drugs harmful to Prenatal Development. Thalidomide Barbituates Aspirin Megadoses of vitamins
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III. Developmental Hazards • Teratology…Teratogen • Maternal diseases and health AIDS, rubella, syphilis, gonorrhea, polio, diabetes, herpes • Age • Nutrition • RH factor • Emotions/Stress • Drugs
Drugs harmful to Prenatal Development • Thalidomide • Barbituates • Aspirin • Megadoses of vitamins • Alcohol • Nicotine • Caffeine • Narcotics • LSD • Marijuana • Cocaine
Figure 4.3 The most serious structural defects in prenatal development are most likely to develop during the embryonic period, when all the basic organs and limbs are being formed (during the first eight weeks). Periods of highest sensitivity to teratogens are shown in purple; periods of lower sensitivity are indicated in white.
6. Environmental hazards • Radiation • Pesticides • PCBs • Mercury • Lead • Toxoplasmosis • Hot temperatures
Figure 4.5 Rh(D) immunization flowchart. Immunization occurs when the Rh(D) factor is introduced into an Rh(D)-negative mother’s blood, leading to the formation of antibodies which, if they are later introduced into the bloodstream of an Rh(D)-positive fetus, attack the fetus’s blood cells in a potentially fatal condition termed fetal erythroblastosis. An injection of the drug Rhogam can prevent this condition.
Childbirth I. Some facts about childbirth -4 million a year -childbirth is natural, not a disease -lower infant mortality today
Figure 4.8 These cross sections show the first two stages of a normal presentation and delivery of a baby. The first stage (dilation and effacement of the cervix, illustrations 1 and 2) lasts an average of 12 hours for a first birth, and terminates with sufficient dilation of the cervix (the opening to the womb) so that the actual delivery can begin. The second stage (delivery, illustrations 3–6) seldom lasts more than an hour. The third stage (afterbirth; not shown) is the delivery of the placenta and other membranes.
II. Birth Status • Abortion: before 20th week, less than 1 1b. • Immature Birth: 20-28th week, 1-2 lbs • Premature Birth: 2. 5.5 lbs) • Mature Birth: 37-42nd week, 5.5 lbs or more • Post-mature Birth: later than 42 weeks
Prematurity • 36 weeks or less of gestation and low birth weight • Accounts for 60-80% of cerebral palsy cases • Higher incidence of childhood illnesses • Significantly poorer performance on most measures of intellectual functioning • Adequate childhood nutrition a must
What is Labor? • Oxytocin produced by fetus • Stages of Childbirth • Dilation (12-24 hours) -cervix dilating and effacing -dilate to about 4 cm -contractions 15-20 minutes apart
Labor Stage 2: Delivery • Cervix dilated to 10 cm. • Baby’s head starts to move to birth canal • Usually about 1.5 hours • Mother pushes
Labor Stage 3: Afterbirth • Placenta, umbilical cord, membranes expelled • Lasts a few minutes • Must make sure all has been expelled
IV. Complications of childbirth • Precipitate delivery--too rapid • Breech • Prolapsed umbilical cord Cesarean Section Pitocin Epidural Forceps
VII. Postpartum • Involution: uterus returns to prepregnant size (5-6 weeks) • Takes about 6 weeks for hormonal changes • 4-8 weeks next period if not breastfeeding • Bonding with baby important
V. Child Birth Strategies/Approaches • Prepared childbirth • Prenatal exercises • Psychological preparation • Emphasize proper nutrition & exercise • Lamaze & Bradley methods • Focus on breathing & relaxation techniques • Leboyer Method--birth without violence • Hospital vs. home vs. birthing center
Classification of Neonates • Mature birth occurs between the 37th and 42nd weeks after conception • Gestational Age • “Small for Gestational Age” • Important to separate SGA & Prematurity • Neonatal Scales • Apgar (assess newborn heartrate, respiratory effort, muscle tone, color, and reflex)
The Prepared Childbirth • Physical exercise • Psychological preparation • Lamaze & Bradley methods • Focus on breathing & relaxation techniques • Emphasize proper nutrition & exercise • Leboyer Method • Focuses on infant needs during delivery • Softly lit room, immersion in lukewarm bath