III.Developmental Hazards

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III. Developmental Hazards

• TeratologyTeratogen
• Maternal diseases and health
• AIDS, rubella, syphilis, gonorrhea, polio,
  diabetes, herpes
• Age
• Nutrition
• RH factor
• Emotions/Stress
• Drugs

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Drugs harmful to Prenatal Development

• Thalidomide
• Barbituates
• Aspirin
• Megadoses of vitamins
• Alcohol
• Nicotine
• Caffeine
• Narcotics
• LSD
• Marijuana
• Cocaine

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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.
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6. Environmental hazards

• Radiation
• Pesticides
• PCBs
• Mercury
• Lead
• Toxoplasmosis
• Hot temperatures

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Figure 4.5  Rh(D) immunization flowchart.
Immunization occurs when the Rh(D) factor is
introduced into an Rh(D)-negative mothers blood,
leading to the formation of antibodies which, if
they are later introduced into the bloodstream of
an Rh(D)-positive fetus, attack the fetuss blood
cells in a potentially fatal condition termed
fetal erythroblastosis. An injection of the drug
Rhogam can prevent this condition.
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Childbirth

• I. Some facts about childbirth
• -4 million a year
• -childbirth is natural, not a disease
• -lower infant mortality today

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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 36) seldom lasts more
than an hour. The third stage (afterbirth not
shown) is the delivery of the placenta and other
membranes.
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II. Birth Status

1. Abortion before 20th week, less than 1 1b.
2. Immature Birth 20-28th week, 1-2 lbs
3. Premature Birth 2. 5.5 lbs)
4. Mature Birth 37-42nd week, 5.5 lbs or more
5. Post-mature Birth later than 42 weeks

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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

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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

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Labor Stage 2 Delivery

• Cervix dilated to 10 cm.
• Babys head starts to move to birth canal
• Usually about 1.5 hours
• Mother pushes

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Labor Stage 3 Afterbirth

• Placenta, umbilical cord, membranes expelled
• Lasts a few minutes
• Must make sure all has been expelled

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IV. Complications of childbirth

• Precipitate delivery--too rapid
• Breech
• Prolapsed umbilical cord
• Cesarean Section
• Pitocin
• Epidural
• Forceps

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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

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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

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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)

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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

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