Prenatal Care - Dr. Oortman 11-27-07

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Embryo

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human conceptus from fertilization through the eighth week of pregnancy

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fetus

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from the eighth week until delivery

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gestational age

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the estimated age of the fetus is calculated from the first day of the last (normal) menstrual period (LMP), assuming a 28-day cycle. Gestational age is expressed in completed weeks

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developmental age (fetal age)

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which is the age of the offspring calculated from the time of implantation.

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Gravid

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total number of pregnancies (normal or abnormal)

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Parity

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; the state of having given birth to an infant or infants weighing 500 g or more, alive or dead. In the absence of known weight, an estimated duration of gestation of 20 completed weeks or more (calculated from the first day of the LMP) may be used. From a practical clinical viewpoint, a fetus is considered viable when it has reached a gestational age of 23–24 weeks and a weight of 500–600 g or more. However, only very rarely will a fetus of 20–23 weeks weighing 500 g or less survive, even with optimal care. With regard to parity, a multiple birth is a single parous experience.

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Live birth

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the complete expulsion or extraction of a product of conception from the mother, regardless of the duration of pregnancy, which, after such separation, breathes or shows other evidence of life (e.g., beating of the heart, pulsation of the umbilical cord, or definite movements of the involuntary muscles) whether or not the cord has been cut or the placenta detached.

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preterm infant

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is defined as one born prior to the 37th week of gestation (259 days).

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Abortion

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the expulsion or extraction of all (complete) or any part (incomplete) of the placenta or membranes, without an identifiable fetus or with a fetus (alive or dead) weighing less than 500 g. In the absence of known weight, an estimated duration of gestation of under 20 completed weeks (139 days) calculated from the first day of the LMP may be used.

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immature infant

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weighs 500–1000 g and has completed 20 to less than 28 weeks of gestation.

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premature infant

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one with a birthweight of 1000–2500 g and a duration of gestation of 28 to less than 37 weeks

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low-birthweight infant

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any live-born infant weighing 2500 g or less at birth.

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undergrown or small-for-gestational-age infant

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one who is significantly undersized (< 2 SD) for the period of gestation.

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mature infant

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live-born infant who has completed 37 weeks of gestation (and usually weighs more than 2500 g).

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postmature infant

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one who has completed 42 weeks or more of gestation.

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postmaturity syndrome

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characterized by prolonged gestation, sometimes an excessive-size fetus (see Large-for-Gestational-Age Pregnancy in Chapter 16), and diminished placental capacity for sufficient exchange, associated with cutaneous and nutritional changes in the newborn infant.

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Birth rate

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commonly expressed in terms of the number of live births per 1000 population.

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fertility rate

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expressed as the number of live births per 1000 women ages 15–44 years and is thus a more sensitive measure of the reproductive activity of a given population.

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Current Stats as of 2004

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estimated 4,115,590 live births in the United States in 2004. The birth rate is currently 14.0 per 1000 total population, which is slightly increased compared to its nadir of 13.9 in 2002. The general fertility rate is currently 66.3 births per 1000 women aged 15–44. Indeed, the fertility rate appears to have peaked in 1990 at 71.1, after having been 67.1 in 1988.*

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neonatal interval

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from birth until 28 days of life. During this interval, the infant is referred to as a newborn.

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Neonatal period I

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birth through 23 hours, 59 minutes.

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Neonatal period II

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24 hours of life through 6 days, 23 hours, 59 minutes.

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Neonatal period III

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seventh day of life through 27 days, 23 hours, 59 minutes.

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perinatal period

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the time from 28 weeks of completed gestation to the first 7 days of life, spanning the fetal and early neonatal interval.

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Jeopardy to life is greatest during the ________ period than at any subsequent time. Current data indicate that the number of lives lost during the 5-month period from the 20th week of gestation to the 7th day after birth is almost equal to the number lost during the next 40 years of life. One half of these deaths occur in utero.

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perinatal

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In addition, 70% of deaths occurring in the first year of life will occur in the first 28 days of life (the _______ period). Thus if one adds the neonatal loss rate to the fetal loss rate, it is the period of greatest threat to life for a given interval.

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neonatal