2. Perkembangan Pranatal

4.  Uterus ◦ A muscular chamber about the size and shape of a pear. ◦ Located in a woman's abdomen, is a hollow, elastic reproductive organ, where a baby develops during pregnancy.

5.  Sperm is the male reproductive cell Chief Characteristics: 1. Tightly packed tip (acrosome) that contains 23 chromosomes that carry genetic information 2. Short neck region 3. Trail to propel it in its search for the ovum 4. Microscopic

6.  Remains capable of fertilizing egg for 24- 48 hours after ejaculation  Of 200 million sperm that enter the vagina, only about 200 survive the journey to the fallopian tubes, where fertilization occurs  Males, at birth, have in their testes those cells that will eventually produce sperm

7.  The ovum is the female reproductive cell Chief Characteristics: 1. Round 2..01 mm in diameter 3. Consistency of stiff jelly 4. Contributes 23 chromosomes

8.  Females already have 1-2 million primal eggs at birth  Eggs usually fertilized about 12 hours after discharged from the ovary or they die within 12-24 hours

9. ◦ Germinal stage ◦ Embryonic stage ◦ Fetal stage

10.  Starts at conception (fertilization) until implantation  14 days.  Conception process  When the sperms meets the egg (ovum) in the fallopian tube  travel down into the uterus where it implants in the uterine lining and begin to grow (implantation).

11.  Conception occurs when the sperm meets and penetrates the ovum, or egg sperm ovum

12.  Normally, only one sperms will succeed penetrating through the ovum wall.

13.  When one sperms succeeded penetrating the ovum wall, a protective lining will form around it  preventing other sperms to enter/penetrate.  The combination of ovum & sperms  form zygote (with one nucleus).  Zygote will later develop into blastosist  a complex organism with millions of cells  with various functions.

15.  A zygote is a fertilized egg with 46 chromosomes  Genetic potential determined at this time  Egg is 2.5 mm in diameter at end of 1st week  Mitosis, a process of cell division, occurs during this period

16.  2 kinds: ◦ Reproductive cells divide through meiosis process. ◦ All other body cells divide through mitosis process  Meiosis ◦ a complex process by which gametes form; involves duplication and division of reproductive cells and their chromosomes. ◦ The number of chromosomes in cells divide into two’s, and each set of cell will receive 1 from each sets of chromosomes  makes up 23 sets.

17.  Mitosis ◦ The creation of new cells through duplication of chromosomes & divisions of cells  cells duplicates (From 1  2  4  16  32, etc)  Cells developed into organs, brain, heart etc.

18.  The differentiation of embryonic cells into layers marks the beginning of the embryo, or embryonic period  Period when all body systems form  Highly sensitive for susceptibility of congenital malformations, or abnormal conditions with which an infant is born

19.  The Genetic Code ◦ Basis of heredity is a chemical called deoxyribonucleic acid (DNA), which contains all the inherited material passed from biological parents to children ◦ Every cell except the sex cells has 23 pairs of chromosomes--46 in all ◦ Genetic action that triggers growth of body and brain is often regulated by hormones

20. ◦ Sex chromosomes are either X chromosomes or Y chromosomes ◦ When an ovum (X) is fertilized by an X-carrying sperm, the zygote formed is XX, a female ◦ When an ovum (X) is fertilized by a Y-carrying sperm, the resulting zygote is XY, a male

21.  Boy or girl?  Chromosomes determine sex : ◦ 23 pairs of sex chromosomes ◦ Female: XX pairs of sex chromosomes ◦ Male: XY pairs of sex chromosomes AYAH=XYIBU=XX XY (anak lelaki)XX (anak Perempuan)

22.  What Causes Multiple Births? ◦ Dizygotic (two-egg) twins=fraternal twins ◦ Monozygotic (one-egg) twins=identical twins ◦ The rise in multiple births is due in part to a trend toward delayed childbearing  Infertility ◦ Inability to conceive a baby after 12 to 18 months of trying

23. ◦ Some defects are due to abnormalities in genes or chromosomes, which may result from mutations ◦ Many disorders arise when an inherited predisposition interacts with an environmental factor, either before or after birth

24.  Nature: ◦ genetics  Nurture: ◦ Asuhan/persekitaran  How Heredity and Environment Work Together? ◦ A combination of constitutional factors (related to biological and psychological makeup), and social, economic, and cultural factors help shape development

25.  The phase after implantation.  after the development of zygote  and developing its blastosist.  Embryo  composed of millions of cells with various functions (week 3-8)

26.  The differentiation of embryonic cells into layers marks the beginning of the embryo, or embryonic period  Period when all body systems form  Highly sensitive for susceptibility of congenital malformations, or abnormal conditions with which an infant is born

27.  1/4 inch (6 mm) long  1 oz. Weight  Crescent-shaped with small limb buds on sides  Tail with tiny ridges  Rudimentary circulatory system is forming  Heart begins to beat  Growth acceleration

28.  1.5 inches long  Beginning of face, neck, fingers, toes develop  Limb buds lengthen  Muscles enlarge  Sex organs begin to form  Rapid brain development  Embryo is firmly planted on uterine wall and is receiving nourishment from placenta and umbilical cord

29.  Embryo develops  fetus (baby in the uterus).  Cells that represents eyes, head, body, hands, legs  further develops  larger. (Week 8 – delivery)  The period of consumption until baby is born  40 weeks (sometimes 38-36 weeks).

30.  Period of the fetus begins around the 3rd month and continues until delivery  Movement first becomes apparent to mother at this time  No new anatomical features appear during this period, yet still critical time

31.  Rapid growth, 3 inches long at end of 3rd month  Sexual differentiation continues  Teeth buds emerge  Stomach and kidneys begin to function  Vocal cords appear  Reflex actions felt: opens/closes mouth, clenches fist, sucks thumb

32.  Most rapid growth rate (doubles in length to 6-8 inches)  6 oz. Weight  Hands fully shaped  Bony tissue begins to form

33.  Reaches 1/2 of birth length (8-10 inches)  Only 10% of birth weight (1/2 lb.)  Skin, hair, nails appear  Internal organs grow and assume proper anatomical positions  Pigmented hair on head and eyebrows appears

34.  13 inches long  1 lb. Weight  Eyelids reopen and are completed  Structurally complete but functionally immature

35.  From the 7th month to birth, the fetus triples in weight  This is a period of filling out  Preparation for birth

36.  A layer of adipose tissue begins to form under skin (serves as both insulator and food supplier)  Rapid 2-4 lb. Weight gain  14-16 inches long  Fetus is quiet for long periods of time  Brain more active and is increasing control over body systems

37.  Fetus is more active (frequent changes in position)  Fatty deposits distributed  16-18 inches long  4-6 lbs.

38.  19-21 inches long  6-8 lbs.  Birth process is initiated by placenta and contraction of uterine muscles  Birth generally occurs after week 40 of gestation (normal is 38-42 wks.) Find out more about birth at:

39.  Amniotic Sac  Placenta  Amniotic fluid  Umbilical cord

40.  Stages in pregnancy: ◦ First trimester (week 1-12) ◦ 2 nd Trimester (week 13 -24) ◦ 3 rd Trimester (week 25 & above)

42.  Women 30-39 are having more babies-risk down syndrome (mental retardation and physical abnormalities) ◦ Amniocentesis  draws fluid from amniotic sac ◦ Ultrasound or sonography  uses high-frequency sound waves ◦ Fetoscopy  small incision and optical viewer ◦ Chorionic villus sampling  snip tissue from fetal sac ◦ Maternal Blood Analysis/Maternal Serum Alpha Fetoprotein

43.  Amniocentesis Fetoscopy

45.  Track the baby’s heart rate during labor.  Safe procedure that has saved the lives of many babies in high- risk situations.

46.  Normal Delivery (Spontaneous vaginal delivery SVD)  Forcept  Vacuum  Induction  Cesarean

47.  Used when the mother’s pushing during the second stage of labor does not cause the baby to move through the birth canal in a reasonable amount of time.  Forceps are metal clamps placed around the baby’s head to pull the infant from the birth canal.  Risk: can result in head injury or brain damage

48.  A vacuum extractor is a suction tube that is attached to a plastic cup placed on the baby’s head.

49.  Labor is started artificially by breaking the amnion and giving the mother a hormone that stimulates contractions.  Used when continuing the pregnancy threatens the well-being of mother or baby  Contractions often longer, harder, and closer together.

50.  A cesarean delivery is a surgical birth in which the doctor makes an incision in the mother’s abdomen and lifts the baby out of the uterus.  When babies are in a breech position (turned so that the buttocks or feet would be delivered first) cesareans are often justified.  Although the operation is safe, mothers need more time for recovery and cesarean newborns are more likely to be sleepy and unresponsive and to have breathing difficulties.

51. What signs indicate that labor is near? Stage 1: Time interval? What happens? Stage 2: Time interval? What happens? Stage 3: Time interval? What happens?

53.  The longest stage of labor ◦ First baby  12 - 14 hours ◦ Sebsequent babies  4 - 6 hours  Dilation of the cervix ◦ is the widening and thinning of the cervix  resulting in a clear pathway from the uterus into the birth canal.  Contractions are forceful and regular  Gradually, they get closer together, occurring every 2 to 3 minutes, and become more powerful, continuing for as long as 60 seconds.  Transition is reached when the frequency and strength of contractions are at their peak and the cervix opens completely.

54. Figure 7.10.1

55.  First baby  50 minutes  Subsequent births  20 minutes  Strong contractions continue  mother feels a natural urge to squeeze and push with her abdominal muscles  forcing the baby down and out.  An episiotomy is a small incision at the perineum  increases size of the vaginal opening  permits baby to pass without damaging the mother’s tissues.  The baby’s head crowns when the vaginal opening stretches around the entire head.

56. Figure 7.10.2

57.  The final stage lasts about 5 to 10 minutes.  The final contractions and pushes cause the placenta to separate from the uterine wall and be delivered.

58.  Faulty Power ◦ Problem with mother  Contraction not strong enough  Faulty Passageway ◦ Problem in the uterus  Placenta Previa  Placenta Abruption  Faulty Passenger ◦ Problem with baby  Breech  Head too big

59.  Weigh les than 2,500gm (5 ½ pound)  2 category ◦ Preterm (premature)  Baby born before completing the 35 th week of gestation ◦ Small for date  May not be preterm but weigh less than 90% of all babies of the same gestational age

61.  1 in 16 infants is born underweight  More common among low-income, ethnic minority pregnant women.  Small-for-date babies are associated with more serious problems  Infections  Brain damage  Infant death  Poor school achievement  Probably due to inadequate nutrition before birth. Perhaps mothers didn’t eat well or placenta did not function normally or babies themselves have defects that prevent them from growing normally.

62.  Parents age ◦ Too Young ◦ Mum too old ◦ Dad too old  Mother’s Pregnancy History ◦ Frequent pregnancy ◦ Frequent miscarriage/abortion  Mother’s Physical condition ◦ Size (too fat/thin)  Mother’s Diet  Mother’s Emotion  Teratogenic Agent