CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌

   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
TOPIC‌‌5:‌‌FETAL‌‌DEVELOPMENT‌  ‌
 ‌
 ‌ ● Conceptus‌  ‌– ‌ ‌all‌  ‌tissue‌  ‌products‌  ‌of‌‌
 
  ‌ conception,‌‌embryo,‌‌fetal‌‌membranes.‌  ‌
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PREGNANCY‌‌CALCULATION‌  ‌

● Pregnancy‌‌   calculated‌‌
  to‌‌
  last‌‌
  an‌‌
  average‌‌
 of‌‌
 
10‌  ‌  ‌
lunar‌‌months:‌‌40‌‌weeks‌‌or‌‌280‌‌days,‌  ‌
calculated‌‌f rom‌‌onset‌‌of‌‌last‌‌normal‌  ‌
menstrual‌‌period‌‌to‌‌time‌‌of‌‌birth‌  ‌
● Human‌‌development‌‌follows‌‌three‌‌stages:‌  ‌
○ Pre-embryonic‌‌stage‌‌(first‌‌14‌‌days)‌  ‌
○ Embryonic‌  ‌stage‌  ‌(15th‌  ‌day‌  ‌to‌‌  
eighth‌‌week)‌  ‌
○ Fetal‌  ‌stage‌  ‌(eighth‌  ‌week‌  ‌to‌‌  
delivery)‌  ‌
 ‌
DEFINITION‌‌OF‌‌TERMS‌  ‌

● Zygote‌  ‌– ‌ ‌cells‌  ‌result‌  ‌f rom‌  ‌fertilization‌  ‌of‌‌  

 ‌
ovum‌‌and‌‌sperm.‌  ‌
FETAL‌‌CIRCULATION‌‌
   ‌
● Blastomere‌  ‌– ‌ ‌daughter‌  ‌cell‌  ‌arising‌  ‌f rom‌‌  
mitotic‌‌division‌‌of‌‌the‌‌zygote.‌  ‌
● Morula‌  ‌– ‌ ‌solid‌  ‌ball‌  ‌of‌  ‌cell‌  ‌formed‌  ‌by‌  ‌16‌  ‌or‌‌
 
more‌‌blastomeres.‌  ‌
● Blastocyst‌  ‌– ‌ ‌morula‌  ‌with‌  ‌a ‌ ‌fluid‌  ‌cavity‌‌  
stage‌  ‌of‌  ‌human‌  ‌development‌  ‌within‌  ‌the‌‌  
uterine‌‌cavity‌  ‌
● Embryo‌‌   – ‌‌made‌‌   of‌‌
  an‌‌ embryo-forming‌‌  cell‌‌ 
group‌‌as‌‌the‌‌inner‌‌cell‌‌mass.‌ 
● Embryonic‌  ‌period‌  ‌– ‌ ‌3rd‌  ‌to‌  ‌7th‌  ‌week‌  ‌after‌‌  
fertilization.‌  ‌
● Fetus‌  ‌– ‌ ‌developing‌  ‌conceptus‌  ‌after‌  ‌the‌‌  
embryonic‌‌period,‌‌8th‌‌week‌‌to‌‌term.‌  ‌
 ‌

 ‌
PROPERTY‌‌OF‌‌ODLID‌  ‌
28‌  ‌
 ‌
CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌
   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
SUBSTANCES‌‌THAT‌‌MOVE‌‌ACROSS‌‌THE‌‌
 
PLACENTA‌  ‌ ● 28‌‌weeks‌   ‌
○ High‌‌rate‌‌of‌‌survival‌  ‌
● Simple‌  ‌diffusion‌  ‌including‌  ‌water,‌  ‌oxygen,‌‌
  ● 32‌‌weeks‌‌
   ‌
carbon‌  ‌dioxide,electrolytes,‌  ‌anesthetic‌‌   ○ Fetus‌  ‌is‌  ‌aware‌  ‌of‌  ‌sounds‌  ‌outside‌‌
 
gases,‌‌and‌‌drugs.‌  ‌ the‌‌mother’s‌‌body‌  ‌
● Facilitated‌  ‌transport‌  ‌includes‌  ‌glucose,‌‌   ● 36‌‌weeks‌‌
   ‌
galactose,‌‌and‌‌some‌‌oxygen.‌  ‌ ○ Lanugo‌‌disappears‌  ‌
● Active‌  ‌transport‌  ‌includes‌  ‌amino‌  ‌acids,‌‌   ○ Lungs‌‌are‌‌well‌‌developed‌  ‌
calcium,‌  ‌iron,‌  ‌iodine,water-soluble‌‌   ● 40‌‌weeks‌‌
   ‌
vitamins,‌‌and‌‌glucose.‌  ‌ ○ Full‌‌term‌‌pregnancy‌  ‌
● Functional‌  ‌exchange‌  ‌at‌  ‌the‌  ‌placental‌‌   ○ little‌  ‌lanugo,‌  ‌vernix‌  ‌caseosa‌  ‌still‌‌
 
membrane‌  ‌can‌  ‌include‌  ‌reduction‌  ‌of‌‌   present‌  ‌
surface‌  ‌area‌  ‌(abruption)‌  ‌and‌  ‌diffusion‌‌  
distance(labor,‌‌pre-eclampsia).‌  ‌
 ‌
FETAL‌‌DEVELOPMENT‌  ‌

First‌‌Trimester‌  ‌

● 4‌‌weeks‌‌
   ‌
○ Fetal‌‌heart‌‌begins‌‌to‌‌beat‌  ‌
● 8‌‌weeks‌‌
   ‌
○ organogenesis‌‌is‌‌complete‌  ‌
○ head‌  ‌large‌  ‌in‌  ‌proportion‌  ‌to‌  ‌rest‌  ‌of‌‌
 
the‌‌body‌  ‌
● 12‌‌weeks‌‌
   ‌
 ‌
○ Embryo‌‌called‌‌fetus‌  ‌
○ doppler‌‌can‌‌be‌‌used‌‌for‌‌FHB‌  ‌ MANIFESTATION‌‌OF‌‌PREGNANCY‌  ‌

Presumptive‌‌evidence‌‌of‌‌pregnancy‌  ‌
Second‌‌Trimester‌  ‌
a.‌‌Presumptive‌‌symptoms‌  ‌
● 16‌‌weeks‌‌
   ‌
● Nausea‌‌with‌‌or‌‌without‌‌vomiting‌  ‌
○ Quickening‌  ‌(earliest‌  ‌fetal‌‌
 
● Disturbance‌‌in‌‌urination‌  ‌
movement‌‌felt‌‌by‌‌multigravida)‌  ‌
● Fatigue‌  ‌
○ Placenta‌‌completely‌‌formed‌  ‌
● Perception‌‌of‌‌fetal‌‌movement‌  ‌
● 20‌‌weeks‌‌
   ‌
● Breast‌‌tenderness‌‌and‌‌tingling‌‌sensation‌  ‌
○ vernix‌‌caseosa‌‌and‌‌lanugo‌‌appears‌  ‌
b.‌‌Presumptive‌‌signs‌  ‌
○ Quickening‌‌(primigravida)‌  ‌
● Cessation‌‌of‌‌menstruation‌  ‌
● 24‌‌weeks‌   ‌
● Anatomical‌‌breast‌‌changes‌  ‌
○ Active‌  ‌production‌  ‌of‌  ‌lung‌‌ 
● Changes‌‌in‌‌vaginal‌‌mucosa‌  ‌
surfactant‌‌begins‌‌(Lecithin)‌  ‌
● Skin‌‌pigmentation‌‌changes‌  ‌
Third‌‌Trimester‌  ‌ ● Thermal‌‌signs‌  ‌
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PROPERTY‌‌OF‌‌ODLID‌  ‌
29‌  ‌
 ‌
CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌
   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
Probable‌‌evidence‌‌of‌‌pregnancy‌  ‌  ‌
● Wobbly‌‌gait‌  ‌
● Enlargement‌‌of‌‌the‌‌abdomen‌  ‌ ● Leg‌‌cramps‌  ‌
● Changes‌  ‌in‌  ‌size,‌  ‌shape,‌  ‌consistency‌‌
  of‌‌
  the‌‌
 
uterus‌  ‌
● Anatomical‌‌changes‌‌in‌‌the‌‌cervix‌  ‌
● Braxton‌‌Hicks‌‌contractions‌  ‌
● Physical‌‌outlining‌‌of‌‌the‌‌fetus‌  ‌
● Positive‌‌result‌‌of‌‌endocrine‌‌tests‌  ‌
 ‌
Positive‌‌evidence‌‌of‌‌pregnancy‌  ‌

● Identification‌‌of‌‌fetal‌‌heart‌‌tones‌  ‌
● Perception‌  ‌of‌  ‌active‌  ‌fetal‌  ‌movement‌  b
‌ y‌‌
 
 ‌
the‌‌examiner‌  ‌
6.‌‌TEMPERATURE‌‌CHANGES‌  ‌
● Recognition‌  ‌of‌  ‌embryo‌  ‌or‌  ‌fetus‌  ‌by‌‌  
● Slightly‌  ‌increased‌  ‌due‌  ‌to‌  ‌increased‌‌  
ultrasound‌‌or‌‌radiological‌‌methods‌  ‌
progesterone‌  ‌
 ‌
7.‌‌ENDOCRINE‌‌CHANGES‌  ‌
SYSTEMIC‌‌CHANGES‌  ‌
● Addition‌  ‌of‌‌   placenta‌‌   as‌‌
  another‌‌   endocrine‌‌  
1.‌‌CIRCULATORY/CARDIOVASCULAR‌  ‌ organ‌  ‌
● Physiologic‌  ‌Anemia‌  ‌Of‌  ‌Pregnancy‌  ‌(easy‌‌   ● Moderate‌  ‌enlargement‌  ‌of‌  ‌the‌  ‌thyroid‌‌  
fatigability‌  ‌and‌  ‌shortness‌  ‌of‌  ‌breath,‌  ‌light‌‌
  gland‌  ‌
hypertrophy‌  ‌of‌  ‌the‌  ‌heart,‌  ‌systolic‌‌   ● Increased‌‌size‌‌of‌‌the‌‌parathyroids‌  ‌
murmurs,‌‌nosebleeds)‌  ‌ ● Increased‌  ‌size‌  ‌and‌  ‌activity‌  ‌of‌  ‌the‌  ‌adrenal‌‌
 
● Palpitations,‌‌increase‌‌heart‌‌rate‌‌(80-100)‌  ‌ cortex‌  ‌
● Edema‌  ‌andVaricosities‌  ‌of‌  ‌the‌  ‌lower‌‌   ● Gradual‌  ‌increase‌  ‌in‌‌   insulin‌‌   production‌‌   but‌‌
 
extremities‌  ‌ the‌  ‌body’s‌  ‌sensitivity‌  ‌to‌  ‌insulin‌  ‌is‌‌  
● Varicosities‌‌of‌‌the‌‌vulva‌‌and‌‌the‌‌rectum‌  ‌ decreased‌  ‌
● Increased‌‌Level‌‌of‌‌circulating‌‌fibrinogen‌  ‌ 8.‌‌WEIGHT‌  ‌
2.‌‌GASTROINTESTINAL‌‌CHANGES‌  ‌ ● 1st‌‌trimester‌‌weight‌‌gain‌‌is‌‌1.5-3‌‌lbs‌  ‌
● Morning‌‌sickness‌  ‌ ● 2nd-3rd‌  ‌trimester‌  ‌weight‌  ‌gain‌  ‌is‌  ‌10-11‌  ‌lbs‌‌
 
● hyperemesis‌‌gravidarum‌  ‌ per‌‌trimester‌  ‌
● Constipation‌‌and‌‌flatulence‌  ‌ ● Total‌  ‌allowable‌  ‌weight‌  ‌gain‌  ‌during‌  ‌the‌‌  
● Haemorrhoids‌  ‌ entire‌‌pregnancy‌‌is‌‌20-25‌‌lbs‌  ‌
● Heartburn‌  ‌ ● Pattern‌  ‌of‌  ‌weight‌  ‌gain‌  ‌is‌  ‌more‌  ‌important‌‌  
3.‌‌RESPIRATORY‌‌CHANGES‌  ‌ than‌‌amount‌‌of‌‌weight‌‌gained‌  ‌
● Shortness‌‌of‌‌breath‌  ‌ ● PRODUCTS‌‌WEIGHT:‌  ‌
4.‌‌URINARY‌‌CHANGES‌  ‌ 1. Fetus‌‌3400‌‌gms‌‌(7.5lbs)‌  ‌
● Urinary‌‌f requency‌  ‌ 2. ‌Placenta‌‌450gms‌‌(1lbs)‌  ‌
● Sugar‌‌in‌‌the‌‌urine‌  ‌ 3. ‌Amniotic‌‌fluid‌‌900gms‌‌(2‌‌lbs)‌  ‌
5.‌‌MUSCULOSKELETAL‌‌CHANGES‌  ‌ 4. Uterus‌‌1100‌‌gms‌‌(2.5‌‌lbs)‌  ‌
● Lordotic‌‌position‌  ‌ 5. Breast‌‌tissues‌‌1400‌‌gms‌‌(3‌‌lbs)‌  ‌

 ‌
PROPERTY‌‌OF‌‌ODLID‌  ‌
30‌  ‌
 ‌
CARE‌‌OF‌‌MOTHER,‌‌CHILD,‌‌
   ‌
ADOLESCENT,‌‌AND‌‌FAMILY‌‌    ‌
IDIANALE‌‌BATCH‌‌2024‌  ‌
ST.‌‌LUKE’S‌‌COLLEGE‌‌OF‌‌NURSING‌  ‌
 ‌
6. Blood‌  ‌volume‌  ‌1800‌  ‌gms‌  ‌(4lbs)‌‌   ○ Mask‌  ‌of‌  ‌pregnancy‌
1500ml‌  ‌
7. Maternal‌‌   stores‌‌   1800‌‌   – ‌‌3600‌‌  gms‌‌  (4‌‌
 
to‌‌8‌‌lbs)‌  ‌
● Total‌‌11,000‌‌–‌‌13,000gms‌  ‌
● (11‌‌to‌‌13‌‌kgs‌‌or‌‌24‌‌-28lbs)‌  ‌
9.‌‌LOCAL‌‌CHANGES‌  ‌
● UTERUS‌  ‌
○ Weight‌‌increase‌‌–‌‌1000‌‌grams‌  ‌
○ Shape‌‌f rom‌‌pear-like‌‌to‌‌ovum‌  ‌
○ Hegar’s‌  ‌sign-‌  ‌softening‌  ‌of‌  ‌lower‌‌  
segment‌‌of‌‌the‌‌uterus‌  ‌
○ Operculum-‌‌mucus‌‌plug‌  ‌
○ Goodell's‌  ‌sign-‌  ‌softening‌  ‌of‌  ‌the‌‌  
cervix‌  ‌  ‌
● VAGINA‌  ‌ ● BREASTS‌  ‌
○ Chadwick’s‌‌   sign‌‌   - ‌‌f rom‌‌  light‌‌
 pink‌‌ to‌‌
  ○ All‌  ‌changes‌  ‌due‌  ‌to‌  ‌increased‌‌  
violet‌  ‌ estrogen‌  ‌
○ Leukorrhea‌  ‌- ‌ ‌increased‌  ‌amount‌  ‌of‌‌   ○ Increased‌‌in‌‌size‌  ‌
discharges‌  ‌ ○ Feeling‌  ‌of‌  ‌fullness‌  ‌and‌  ‌tingling‌‌
 
○ Ph‌‌   of‌‌
  vagina‌‌   - ‌‌f rom‌‌   normally‌‌   acidic‌‌
  sensation‌  ‌
to‌‌alkaline‌  ‌ ○ Nipples‌‌become‌‌more‌‌erect‌  ‌
● SKIN‌  ‌ ○ Montgomery‌  ‌glands‌  ‌become‌‌ 
○ Linea‌  ‌nigra-brown‌  ‌line‌  ‌running‌‌   bigger‌‌and‌‌more‌‌protuberant‌  ‌
from‌‌umbilicus‌‌to‌‌symphysis‌‌pubis‌  ‌ ○ Areola‌  ‌become‌  ‌darker‌  ‌and‌‌
 
○ Melasma‌  ‌or‌  ‌chloasma-extra‌‌   diameter‌‌increases‌  ‌
pigmentation‌‌   on‌‌  cheeks‌‌  and‌‌
 across‌‌  ○ Skin‌‌surrounding‌‌areola‌‌turns‌‌dark‌  ‌
the‌‌nose‌  ‌ ○ Colostrum‌‌formation‌‌by‌‌4th‌‌month‌  ‌
○ Sweat‌‌glands‌‌unduly‌‌activated‌  ‌ ● OVARIES‌‌
   ‌
○ Striae‌‌gravidarum‌  ‌ ○ No‌‌activity‌  ‌
 ‌
Chadwick‌‌   sign‌‌
  - ‌‌bluish‌‌
 discoloration‌‌ of‌‌
 the‌‌
 cervix,‌‌
 
vagina,‌‌  & ‌‌labia‌‌
  resulting‌‌   f rom‌‌
 the‌‌
 increased‌‌ blood‌‌
 
flow‌‌(6‌‌-‌‌8‌‌weeks).‌  ‌
Goodell‌  ‌sign‌  ‌- ‌ ‌softening‌  ‌of‌  ‌the‌  ‌cervix‌  ‌f rom‌‌
 
increased‌‌vascularization.‌  ‌
Hegar’s‌‌sign‌-‌ ‌‌softening‌‌of‌‌the‌‌uterus‌  ‌
Quickening‌‌‌-‌‌fetal‌‌movement‌  ‌
Ballottement‌‌‌-‌‌bouncing‌‌effect‌‌upon‌‌IE‌  ‌

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PROPERTY‌‌OF‌‌ODLID‌  ‌
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