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Page 1: PREGNANCY More Established Reproductive Technologies: Artificial Insemination: Artificial Insemination: Introducing sperm into woman’s vagina or uterus
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More Established Reproductive More Established Reproductive Technologies:Technologies: Artificial Insemination:Artificial Insemination:

Introducing sperm into woman’s vagina or uterus Introducing sperm into woman’s vagina or uterus by artificial meansby artificial means

single womansingle woman husband low sperm counthusband low sperm count husband deadhusband dead husband infertile: donor spermhusband infertile: donor sperm

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More Established Reproductive More Established Reproductive Technologies (Cont’d):Technologies (Cont’d): IVF: in vitro fertilization:IVF: in vitro fertilization:

test tube or Petri dish is used to mix gametes; test tube or Petri dish is used to mix gametes; once dividing, surgically implanted into woman’s once dividing, surgically implanted into woman’s uterusuterus

can use both parents’ gametescan use both parents’ gametes one parent plus donor’sone parent plus donor’s can be implanted in surrogate’s uterus (“rent-a-womb”)can be implanted in surrogate’s uterus (“rent-a-womb”)

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Testing the Conceptus for Abnormalities:Testing the Conceptus for Abnormalities: amniocentesis (11-14 weeks)amniocentesis (11-14 weeks) CVS: chorionic villus sampling (villi) (6-8 CVS: chorionic villus sampling (villi) (6-8

weeks)weeks)ultrasound (12-16 weeks)ultrasound (12-16 weeks)

fetoscopyfetoscopy

blood testblood test

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TERATOGENS:TERATOGENS: anything that causes birth defects (teratos = anything that causes birth defects (teratos =

monster)monster) Critical vs. sensitive periodsCritical vs. sensitive periods Maternal Diseases:Maternal Diseases:

RubellaRubella

Toxoplasmosis (cat’s feces, raw meat)Toxoplasmosis (cat’s feces, raw meat)

CMVCMV

AIDSAIDS

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TERATOGENS (Cont’d):TERATOGENS (Cont’d): RadiationRadiation Chemicals:Chemicals:

absorbed through lungs or skinabsorbed through lungs or skin High Temperature:High Temperature:

hot bathhot bath General Environmental Pollution:General Environmental Pollution:

what we eat, drink, breathe, touchwhat we eat, drink, breathe, touche.g. phthalates:e.g. phthalates: alter boys’ genitalsalter boys’ genitals found in:found in:

perfumesperfumesnail polishnail polishflooringflooringhard plasticshard plasticspaintspaintsadhesivesadhesives

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Drugs:Drugs: prescription, e.g. DES, thalidomideprescription, e.g. DES, thalidomide OTCOTC ““recreational”, illegalrecreational”, illegal caffeinecaffeine aspirin, etc.aspirin, etc.

•TERATOGENS (Cont’d):

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TERATOGENS (Cont’d):TERATOGENS (Cont’d): Smoking:Smoking:

nicotinenicotine CO:CO:

200 times more affinity to Hgb than oxygen200 times more affinity to Hgb than oxygen

oxygen supply compromised (5% less)oxygen supply compromised (5% less)

decreases sperm motility:decreases sperm motility: lower fertilitylower fertility

less progesterone:less progesterone: miscarriagesmiscarriages

placental problemsplacental problems

higher morbidity and mortality higher morbidity and mortality from 9/1000 to 33/1000from 9/1000 to 33/1000

higher rates of cleft palate and hare liphigher rates of cleft palate and hare lip

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TERATOGENS (Cont’d):TERATOGENS (Cont’d): Alcohol:Alcohol:

FASD (fetal alcohol spectrum disorder)FASD (fetal alcohol spectrum disorder) brain abnormalities:brain abnormalities:

learning difficultieslearning difficulties

ADDHADDH

mental retardation, etc.mental retardation, etc. possible damage to eyes, ears, immune system, internal possible damage to eyes, ears, immune system, internal

organs, joints, limbsorgans, joints, limbs low birth weightlow birth weight increased prematurity, miscarriage and stillbirth riskincreased prematurity, miscarriage and stillbirth risk

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TERATOGENS (Cont’d):TERATOGENS (Cont’d): Alcohol:Alcohol:

FASD (fetal alcohol spectrum disorder) (Cont’d)FASD (fetal alcohol spectrum disorder) (Cont’d) growth retardationgrowth retardation facial and cranial malformationsfacial and cranial malformations dose and timing relateddose and timing related no safe doseno safe dose there is no cure for FASDthere is no cure for FASD leading cause of leading cause of preventablepreventable mental retardation mental retardation

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TERATOGENS (Cont’d):TERATOGENS (Cont’d):All drug effects:All drug effects: Dose Related:Dose Related: Interactions: hard to tell main effectsInteractions: hard to tell main effects

Possible effects:Possible effects: miscarriagemiscarriage stillbirthstillbirth low birth weightlow birth weight irritability, hard to sootheirritability, hard to soothe shorter attention span (learning)shorter attention span (learning) tremorstremors digestive difficultiesdigestive difficulties

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TERATOGENS (Cont’d):TERATOGENS (Cont’d):

THERE ARE NO TOTALLY SAFE THERE ARE NO TOTALLY SAFE DRUGS!DRUGS! Most vulnerable:Most vulnerable:

brain, CNSbrain, CNS learning problemslearning problems ADHDADHD

Most common mechanism:Most common mechanism:oxygen deprivationoxygen deprivation

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TERATOGENS (Cont’d):TERATOGENS (Cont’d): Maternal stress:Maternal stress:

acute or chronic (worse)acute or chronic (worse) adrenaline, corticosteroids:adrenaline, corticosteroids:

compromise oxygen supply for infantcompromise oxygen supply for infant

after birth:after birth: digestive problemsdigestive problems low birth weightlow birth weight irritabilityirritability

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TERATOGENS (Cont’d):TERATOGENS (Cont’d): Maternal age:Maternal age:

no more obstetrical complications (if healthy)no more obstetrical complications (if healthy)

increased Down’s syndromeincreased Down’s syndrome Other effects of these variables:Other effects of these variables:

affect maternal-infant interactionaffect maternal-infant interaction

abuseabuse

neglectneglect

rejectionrejection

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Maternal Nutrition:Maternal Nutrition: First trimester:First trimester:

usually not an issue – special casesusually not an issue – special cases Second trimester:Second trimester:

qualityquality Third trimester:Third trimester:

quality and quantityquality and quantity Important:Important:

Folic acid: prevents neural tube defects (eg. spina Folic acid: prevents neural tube defects (eg. spina bifida)bifida)

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Maternal Nutrition (Cont’d):Maternal Nutrition (Cont’d): Infant Optimal Weight:Infant Optimal Weight:

77½ - 8 lbs. (European stock)½ - 8 lbs. (European stock) Low Birth Weight:Low Birth Weight:

5½ lbs. or 2,500 g5½ lbs. or 2,500 g

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Low Birth WeightLow Birth Weight

DefinitionDefinition

Low Birth WeightLow Birth Weight:: Infant weighs Infant weighs lessless than 5.5 pounds (2500 g) than 5.5 pounds (2500 g)

PrematurePremature:: Infant is born at Infant is born at lessless than 38 weeks gestation than 38 weeks gestation

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Causes of LBWCauses of LBW

There is no one cause for LBW, but some There is no one cause for LBW, but some include:include:

maternal smoking; drinking; drugsmaternal smoking; drinking; drugs maternal diabetesmaternal diabetes lack of adequate prenatal carelack of adequate prenatal care poor nutritionpoor nutrition infectioninfection unknown causesunknown causes

Even healthy mothers with good prenatal care Even healthy mothers with good prenatal care may give birth to a LBW infant (placental may give birth to a LBW infant (placental problems)problems)

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Risks for the LBW InfantRisks for the LBW Infant

HealthHealth heart & lungheart & lung visionvision hearinghearing motor problemsmotor problems developmental problemsdevelopmental problems

EnvironmentalEnvironmental abuseabuse attachment problemsattachment problems

Later DeficitsLater Deficits learning difficultieslearning difficulties health problems may persist into adulthoodhealth problems may persist into adulthood

There is no way to predict which problems, if any an infantThere is no way to predict which problems, if any an infant may havemay have

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Chromosomal disordersChromosomal disorders

Many congenital disease are caused by Many congenital disease are caused by chromosomal mutations.chromosomal mutations.

These disorders result from errors during These disorders result from errors during meiosis.meiosis.

Gametes are formed that have either too Gametes are formed that have either too few or too many chromosomes.few or too many chromosomes.

http://www.biostudio.com/d_%20Meiotic%http://www.biostudio.com/d_%20Meiotic%20Nondisjunction%20Meiosis%20II.htm20Nondisjunction%20Meiosis%20II.htm

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TrisomyTrisomy

Trisomy is the condition in which the Trisomy is the condition in which the offspring inherit an extra copy of a offspring inherit an extra copy of a chromosome.chromosome.

The most common type is called Downs The most common type is called Downs Syndrome.Syndrome.

Sufferers of this disease have three copies Sufferers of this disease have three copies of Chromosome 21.of Chromosome 21.

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MonosomyMonosomy

Sometimes the offspring only receive a Sometimes the offspring only receive a single copy of a chromosome, which leads single copy of a chromosome, which leads to a monosomy.to a monosomy.

Monosomy of X chromosome is called Monosomy of X chromosome is called turner syndrom.turner syndrom.

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Partial monosomyPartial monosomy

Sometimes offspring receive two copies of Sometimes offspring receive two copies of each chromosomes, but one of the copies each chromosomes, but one of the copies is incomplete.is incomplete.

The disease Cri-du-chat results from the The disease Cri-du-chat results from the partial monosomy of chromosome 5.partial monosomy of chromosome 5.

One copy of the chromosome is missing One copy of the chromosome is missing it’s short arm.it’s short arm.


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