Course Title: Fetal Development

Credits: 1.0

Course Description: This course follows the origin and development of the fetus from zygote to birth, requiring an understanding of the month-by-month development of fetal structure and the growth of fetal capacities. This course explores the structure and function of the placenta, chorionic villi, umbilical cord, and amniotic sac and fluid. This course uses current research in midwifery and obstetrics to broaden the student’s understanding of the following NARM skills and MANA core competencies learned under clinical supervision:

NARM Skills

II. General Healthcare Skills

(31)-II D 8. Gestation calculation wheel/calendar

Learning Activities:

Student reads appropriate sections from the Learning Materials/Resources.

Student answers the questions listed in the Learning Objectives by researching the Learning Materials/Resources for the course and correctly cites the sources and page numbers for each of their answers.

Student presents answers the questions listed in the Learning Objectives for review by preceptor.

Student participates in preceptor elaboration/discussion of Learning Objectives.

The student must research, prepare & present a summary of current best midwifery care/practices appropriate to a topic covered in this course from a current journal article/study, less than 5 years old.

Recommended Role-playing and/or Clinical Interactions

Note: The clinical requirement of NARM /Clinical Skills is completed at any time throughout the ASM apprenticeship during actual clinical practice and is NOT a requirement to complete this academic course.

Activities specific to NARM skills learned in this section:

1. Practice estimating due date from LMP with a gestational age calculation wheel.

2. Create a handout that outlines fetal development during the different phases of pregnancy to give to parents.

Learning Materials / Resources:

Please use textbooks less than 5 years old or most recent edition.

1. Moore, Keith. Before we were born: Essentials of embryology and birth defects. 9th edition. Saunders Publishing.2015.

2. Coad, Jane. Anatomy and Physiology for Midwives. 3rd edition. Churchill Livingston Press. Elsevier Limited. 2012

3. MEAC Abbreviated NARM Skills Form: http://www.midwiferycollege.org/AcademicProgram/Downloads/ASM/Clinical/Form-NARMSkills.pdf

4. MEAC Essential Competencies: http://www.midwiferycollege.org/downloads/worddocs/Curriculum-Checklist-of-Essential-Competencies-rev-2014.pdf

5. Midwives Model of Care®: http://cfmidwifery.org/mmoc/brochures.aspx

6. Students must find 1 article/study less than 5 years old. Recommended internet links as needed for latest developments in midwifery care: https://www.midwiferycollege.edu/resources-national-college-of-midwi

Evaluation Tools / Methods:

Minimum passing grade for each course is a cumulative 80% / B-. Students and preceptors are encouraged to work together until the student masters the information.

Final grade for the course is based on preceptor evaluation of the following:

A. Learning Objectives count for 50% of the final grade.

The preceptor evaluates each answer based on three elements:

1. Answers should reflect a thorough review of current literature regarding best current practices in midwifery care.

2. Each answer should be formed in the student’s own words or paraphrased from the text. The answer should be minimal, not a re-write of the entire text, but enough to show appropriate comprehension of the learning objective.

3. Student identification of sources and page numbers for each of the Learning Objectives. (Preceptor should do a random check to determine that sources cited are correctly identified.)

B. Enrichment Activities, including research essays and summaries of articles: 20%

C. Discussions: 15%

D. Tests and Exams: 15%

Course credit:

One Academic credit equals approximately 15 hours of formal time plus 30 hours of additional study or homework. Formal time is defined as the amount of time taken to answer the Learning Objectives to the level of 80% and to complete any learning activities to the preceptor's satisfaction, including any time spent face to face with the preceptor. Informal time includes any time spent actively reading relevant sources and textbook/s, researching Learning Objectives, and studying for examinations.

Learning Objectives:

A. The student must research, prepare & present a summary of an aspect of current best midwifery care/practices appropriate a topic from this course from a current journal article/study.

B. Student answers the questions below and cites the sources and page numbers.

1. Define gametogenesis.

2. Briefly describe how the sperm and oocyte are transported to meet each other in fertilization.

3. Where is the usual site of fertilization?

4. Define zygote.

5. List the phases of fertilization.

6. What are the immediate results of fertilization?

7. How is the zygote genetically unique from both contributing parents?

8. Explain at what point is the genetic sex of the fetus determined.

9. Define trophoblast.

10. Define embyroblast.

11. At what point does implantation usually occur during early development?

12. Explain when the embryonic period begins.

13. Describe the embryonic disc.

14. Which embryonic structures give rise to the chorion?

15. When can hCG first be detected by blood assay?

16. Define gastrulation.

17. What tissues eventually develop from the endoderm?

18. What tissues eventually develop from the ectoderm?

19. What tissues eventually develop from the mesoderm?

20. Define the notochord.

21. Briefly describe neurulation.

22. Describe the development of the intraembryonic coelem.

23. What cavities arise from the intraembryonic coelem?

24. When does the fetal heart start beating after conception?

25. When are limb buds first recognizable on the embryo?

26. At what point in early development does the embryo take on a C-shaped curve?

27. What measurements are usually used to measure a maturing embryo?

28. Explain when the fetal period begins.

29. Briefly describe the two dates from which gestational age can be calculated.

30. How many days does the average fetal gestation last?

31. Describe the various sites where blood cell production occurs in a fetus.

32. When does the fetus begin to develop lanugo and head hair?

33. When does urine formation begin in the fetus?

34. When are fetal lungs first capable of breathing air?

35. Name the age of fetal viability if a baby is born prematurely.

36. When does the fetus begin to put on significant body fat?

37. Describe the major fetal development that occurs from 35 weeks until birth at term.

38. Follow a drop of blood from the left atrium of the fetus' heart to the right atrium.

39. Name the organ that is derived from the fetal chorion and the maternal decidua at the site of implantation.

40. Describe the importance of the chorionic villi.

41. Describe the decidua.

42. Define the fetal part of the placenta.

43. Define the maternal part of the placenta.

44. What is meant by the cotyledons of the placenta?

45. Define the relationship between the amnionic and chorionic membranes.

46. Describe how the amniochorionic membrane may differ with multiple gestations.

47. Describe how maternal blood comes in contact with the placenta.

48. Describe how fetal blood comes in contact with the placenta.

49. Explain if there is mixing of maternal and fetal blood in a normal pregnancy.

50. Describe the structure of the umbilical cord.

51. Briefly describe the function of the umbilical cord.

52. List five functions of the placenta.

53. Describe how the placenta facilitates gas exchange between maternal and fetal blood.

54. Describe the placenta’s role in hormone production.

55. What is the make-up of amniotic fluid?

56. Describe how amniotic fluid helps to maintain fetal homeostasis.

57. Describe 5 other functions of amniotic fluid.

58. How does the fetus take in amniotic fluid?