1. Healthy Pregnancy

2. Prenatal Care no great change to a woman during embryonic period during late foetal period, foetus has high demands mother functions slow down  nutrients stay in blood longer constipation mothers blood vol increases (40%) & faster circulation (increased heart rate and vol) alcohol, drugs & antibodies may pass from mum to foetus increase energy intake to 850kJ / day Increase protein to at least 65g / day Increase Ca, Fe, folate, fluorine (in water) Weight gain (approx 0.5 kg / week) Maintain same exercise program as before pregnancy

3. Factors Affecting Foetal Development

4. 1. Environment: warmth, moisture & nutrition in Uterus Other people, climate, food, disease / Infection 2. Congenital Disorders defects or diseases that are present at birth may inherit a defective gene or due to mutation may be due to environmental factors (teratogenic agents) Teratogenic agents / Mutagens Mutagen: changes genetic info  increases frequency of mutations above normal level Teratogen: capable of interfering with development of foetus  birth defects

5. 3. Environmental factors causing non-inheritable changes

6. Infections Rubella  cause foetus to be deaf, blind, heart malformation or brain damage Hepatitis & mumps may have varying affects. Influenza may cause brain damage. Listeria infection (Listeriosis): Bacteria ingested in uncooked/old food. May cause miscarriages/stillbirths. MMR (Measles, Mumps and Rubella) vaccination for all 1 year olds Maternal diet Ca: bone growth Vit A (green / yellow veg’s): normal growth of cells Folic Acid (In whole grain bread/cereals, green leafy veg’s, legumes) : Normal cell division & protein manufacture (lack  spina bifida)

7. Alcohol Foetal Alcohol Syndrome (FAS) 1/1000 births Lower birth weight Small head Irregularities of the face Heart defects Malformed arms / legs Mental retardation Hyperactivity, nervousness or poor attention span

8. Smoking Decreased birth weight Increased respiratory problems (bronchitis, pneumonia) Increased risk of miscarriage SIDS Smoke + Breast milk = gastrointestinal problems Chemicals Thalidomide (sleeping pills): limb malformation Heroin / LSD

9. Smoking Decreased birth weight Increased respiratory problems (bronchitis, pneumonia) Increased risk of miscarriage SIDS Smoke + Breast milk = gastrointestinal problems Chemicals Thalidomide (sleeping pills): limb malformation Heroin / LSD

10. Diagnosis of Foetal Health

11. Ultrasound Inaudible, high frequency sound waves are reflected against foetal tissue are translated into a visual image on a computer screen. Chromosomal Analysis Karyotype: A photograph/drawing of chromosomes displayed Used to detect: down syndrome, cystic fibrosis, certain neural tube defects (spina bifida), tay-sachs disease, Duchenne muscular dystrophy & sickle cell anaemia. Can be obtained by amniocentesis and chorionic villus sampling Amniocentesis: during 16 -20 weeks, approx 130mL amniotic fluid Removal of approx 10-20mL amniotic fluid containing some floating living cells from foetus

12. Chorionic Villus Sampling: during 9-19 weeks, obtain foetal cells from Chorion Procedure and testing Faster than amniocentesis but 1/100 may result in a miscarriage Cannot detect spina bifida Blood tests of Mothers blood: after 6 weeks, sample treated with magnetised antibodies which attach to certain foetal cells, and they are removed for analysis. Fetoscopy Looking at foetus through a small, telescope-like instrument (fetoscope) which is inserted into abdominal wall. Used to detect: cleft lip/palate, missing/abnormal ears, deformed absent/limbs, spinal abnormalities.

13. Foetal Blood Sampling Blood is directly obtained from foetus and analysed. Diagnosis may be obtained on the same day. Foetal monitoring During labour/birth Regular monitoring of foetus’ heart rate using ultrasound & electrocardiography (electrical changes in heart) Produces an electrocardiogram (ECG) – graph then certain components of test DNA are missing Biochemical Analysis Assessment of marker proteins (if present the foetus has a certain defect) DNA Probes Segment of ‘labelled’ DNA, identical to that being tested is allowed to combine with test DNA If it does not combine completely then certain components of test DNA are missing