Study Guide Block Growth and Development

CURRICULUM

Aims:

To assess growth and development in children and adolescents.
To diagnose, manage, and refer if required, common disorders of growth and development.
Awareness of the general means to assess fetal growth (intrauterine growth).
Awareness of the common health implications of normal and abnormal aging.

Learning outcomes:

Assess physical growth of children and adolescents.
Diagnose and manage common nutritional problems in children and adolescents.
Investigate infant or child with suspect failure to thrive.
Identify common congenital anomalies in infants and children.
Assess fetal growth (intrauterine growth).
Assess development of children in specific domains.
Awareness of common developmental disorders in children.
Awareness of the normal sexual developmental sequence in children and adolescents.
Capability to evaluate critically the use of medicine in pregnancy, children, and elderly.
Detection of developmental deviation in children (Screening & Stimulation).
Awareness of the impacts of aging on the common health parameters of the elderly.
Awareness of the common clinical manifestations and disorders in the elderly.
Diagnose and manage common health problems and disorders in the elderly.

Curriculum contents:

Normal growth patterns in children and adolescents.
Nutritional impacts on growth (and development) in infant, children and adolescents.
Clinical manifestations and diagnosis of failure to thrive.
Common congenital anomalies in infants and young children.
Clinical assessment of intrauterine growth (fetal growth).
Drug recommendation and toxicity on pregnancy and Children.
Assess development of children and adolescents in specific domains.
Methods of developmental deviation detection and stimulation.
Common developmental disorders in children and adolescents.
Diagnose common sexual developmental problems in children and adolescents.
Aging and physiologic changes in health parameters.
Common clinical manifestations and problems and management in the elderly.

PLANNERS TEAM

NO / NAME / DEPARTMENT
1. / Dr.dr. I G A Trisna Windiani, SpA (K) (Head) / Child Health
2. / dr. I NyomanG.Wardana, M.Biomed (Secretary) / Anatomy
3. / Prof. dr. Soetjiningsih, SpAK, IBCLC / Child Health
4. / Prof.Dr.dr.I Nym Mangku K, M.Repro / Anatomy
5. / dr. Eka Putra S, Sp.THT / ENT
6. / dr. Wayan Eka Sutyawan, SpM / Ophthalmology
7. / Dr.dr. R A Tuty Kuswardhani, SpPD (K.Ger).,MARS / Geriatri

GROWTH AND DEVELOPMENT LECTURERS

NO / NAME / DEPARTMENT
1 / Prof. dr. Soetjiningsih, SpAK, IBCLC / Child Health
2 / Dr.dr. I G A Trisna Windiani, SpA (K) / Child Health
3 / dr. I Made Kardana, SpA / Child Health
4 / dr. IGusti Agung Ngurah Sugitha Adnyana, SpA / Child Health
5 / dr. AAN Prayoga, SpA / Child Health
6 / dr. Made Suksmawati, SpA / Child Health
7 / dr. Made Arimbawa, SpA / Child Health
8 / dr. IGA Endah Ardjana, SpKJ / Child Health
9 / dr. I Gusti Lanang Sudiartha, SpA / Child Health
10 / dr. Dewi Sutriani Mahalini, SpA / Child Health
11 / Prof.Dr.dr.I Nym Mangku K, M.Repro / Anatomy
12 / dr. Eka Putra S, Sp.THT / ENT
13 / dr. Wayan Eka Sutyawan, SpM / Ophthalmology
14 / Dr.dr. R A Tuty Kuswardhani, SpPD (K.Ger).,MARS / Geriatri
15 / dr. Nyoman Astika, SpPD / Geriatri
16 / dr. I GK Arijana, MSi.Med / Histology
17 / Dr.dr. Made Jawi, M.Kes / Pharmacology
18 / Dra. Adijanti Marheni, M.Si / Psychology

~FACILITATORS ~

REGULAR CLASS

NO / NAME / GROUP / DEPT / PHONE / VENUE
1 / Dr.dr. ElysantiDwiMartadiani, Sp.Rad / 1 / Radiology / 081805673099 / 2nd floor: R.2.01
2 / dr. Reni Widyastuti, S.Ked / 2 / Pharmacology / 08174742501 / 2nd floor: R.2.02
3 / dr. Ni KetutPutriAriani, Sp.KJ / 3 / Psychiatry / 082237817384 / 2nd floor: R.2.03
4 / dr I GustiAgungGede Utara Hartawan, Sp.An, MARS / 4 / Anasthesi / 08123868126 / 2nd floor: R.2.04
5 / dr. Ni LuhAriwati / 5 / Parasitology / 08123662311 / 2nd floor: R.2.05
6 / dr. I G KamasanNyomanArijana, M.Si, Med / 6 / Histology / 08124665966 / 2nd floor: R.2.06
7 / Dr.dr. Ni Nyoman Sri Budayanti, Sp.MK(K) / 7 / Microbiology / 08553711398 / 2nd floor: R.2.07
8 / dr. Ni NyomanMahartini, Sp.PK / 8 / Clinical Pathology / 081337165577 / 2nd floor: R.2.08
9 / dr. I WayanSugiritama, M.Kes / 9 / Histology / 08164732743 / 2nd floor: R.2.21
10 / dr. Ryan SaktikaMulyana, M.Biomed, Sp.OG / 10 / Obgyn / 082147087905 / 2nd floor: R.2.22

ENGLISH CLASS

NO / NAME / GROUP / DEPT / PHONE / VENUE
1 / dr. KunthiYulianti, Sp.KF / 1 / Forensic / 081338472005 / 2nd floor: R.2.01
2 / dr. I Nyoman Budi Hartawan, M.Sc., Sp.A(K) / 2 / Pediatri / 081353027973 / 2nd floor: R.2.02
3 / dr. I WayanSurudarma, M.Si / 3 / Biochemistry / 081338486589 / 2nd floor: R.2.03
4 / dr. I GustiAyuArtini, M.Sc / 4 / Pharmacology / 08123650481 / 2nd floor: R.2.04
5 / dr. I KetutMariadi, Sp.PD / 5 / Interna / 08123853700 / 2nd floor: R.2.05
6 / Dr.dr. Ni Made Linawati, M.Si / 6 / Histology / 081337222567 / 2nd floor: R.2.06
7 / dr. I NyomanGedeWardana, M Biomed / 7 / Anatomy / 087860405625 / 2nd floor: R.2.07
8 / dr. I WynSubawa, Sp.OT / 8 / Orthopaedy / 081338913087081337096388 / 2nd floor: R.2.08
9 / Dr.rer.Nat. dr. Ni NyomanAyuDewi, M.Kes / 9 / Biochemistry / 081337141506 / 2nd floor: R.2.21
10 / dr. I KomangArimbawa, Sp.S / 10 / Neurology / 081338226892 / 2nd floor: R.2.22

TIME TABLE

Regular Class

DAY/
DATE / TIME / ACTIVITY / CONVEYER
1
Monday
18 Jan 16 / LEARNING OUTCOMES 1: ASSESS PHYSICAL GROWTH OF CHILDREN AND ADOLESCENTS
08.00 – 08.30
08.30 – 09.00
09.00 – 11.30
11.30 – 12.30 / Intro: General Concepts of Growth and Development
Lecture 1:Assessment Physical Growth of Children And Adolescents
Independent Learning + Learning Task
Break / Prof. Soetji
Prof. Soetji
LEARNING OUTCOMES 2: ASSESS FETAL GROWTH (INTRAUTERINE GROWTH)
12.30 – 13.30
13.30 – 15.00 / Lecture 2: The Stages of Prenatal Development
Independent Learning + Learning Task / Mangku K
2
Tuesday
19 Jan 16 / 08.00 – 08.30
08.30 – 09.00
09.00 – 11.30
11.30 – 12.30 / Lecture 3: Embriology of Fetal Growth
Lecture 4: Assessment Growth and Development in Neonatus
Independent Learning + Learning Task
Break / Mangku K
Suksmawati
LEARNING OUTCOMES 3: IDENTIFY COMMON CONGENITAL ANOMALIES IN INFANTS AND CHILDREN
12.30 – 13.30
13.30 – 15.00 / Lecture 5: Prenatal Genetic Evaluation and Counseling
Independent Learning + Learning Task / Arijana
3
Wednesday
20 Jan 16 / LEARNING OUTCOMES 4: CAPABILITY TO EVALUATE CRITICALLY THE USE OF MEDICINE IN PREGNANCY, CHILDREN, AND ELDERLY
08.00 – 09.00
09.00 – 11.30
11.30 – 12.30 / Lecture6: Drugs in Pregnancy, Children, and Elderly
Independent Learning + Learning Task
Break / Jawi
LEARNING OUTCOMES 5: DIAGNOSE AND MANAGE COMMON NUTRITIONAL PROBLEMS IN CHILDREN AND ADOLESCENTS
12.30 – 13.00
13.00 – 13.30
13.30 – 15.00 / Lecture 7: Principles Breastfeeding for Infants With Normal Delivery
Lecture 8: Principles
Feeding for Infants With Complicated Delivery
Independent Learning / Prof. Soetji
Kardana
4
Thursday
21 Jan 16 / 08.00 – 09.00
09.00 – 11.30
11.30 – 12.30
12.30 –13.30
13.30 – 15.00 / Lecture 9: Vitamin A, Fe & Iodine Deficiencies
Independent Learning + Learning Task
Break
Lecture 10: Protein Energy Malnutrition (PEM) & Obesity
Independent Learning + Learning Task / Prayoga
Lanang
5
Friday
22 Jan 16 / 08.00 – 10.00
10.00 – 11.00 / SGD LO 1- 5
Break / Facilitator
LEARNING OUTCOMES 6: INVESTIGATE INFANT OR CHILD WITH SUSPECT FAILURE TO THRIVE
11.00 – 12.00
12.00 – 13.30
13.30 – 15.00 / Lecture 11: Failure to Thrive
Independent Learning + Learning Task
Break / Lanang
6
Friday
22 Jan 16 / LEARNING OUTCOMES 7: ASSESS DEVELOPMENT OF CHILDREN IN SPECIFIC DOMAINS
08.00 – 08.30
08.30 – 09.00
09.00 – 11.30
11.30 – 12.30 / Lecture 12: Assess Development in Motoric
Domains
Lecture 13: Assess Development in Language Domains
Independent Learning + Learning Task
Break / Sugitha
Sugitha
LEARNING OUTCOMES 8: DETECTION OF DEVELOPMENT DEVIATION IN CHILDREN (SCREENING AND STIMULATION)
12.30 – 13.00
13.00 – 13.30
13.30 – 15.00 / Lecture 14: Cognitive Development
Lecture 15: PsychosocialDevelopment
Independent Learning + Learning Task / Marheni
Marheni
7
Tuesday
26 Han 16 / 08.00 – 09.00
09.00 – 10.30
10.30 – 12.30
12.30 – 13.30
13.30 – 15.00 / Lecture 16: Detection of Developmental Deviation In Children (Screening & Stimulation)
Individual Learning + Learning Task
SGD 2 (LO 6-8)
Break
Individual Learning + Learning Task / Trisna
Facilitator
8
Wednesday
27 Jan 16 / LEARNING OUTCOMES 9: AWARENESS OF THE NORMAL SEXUAL DEVELOPMENT SEQUENCE IN CHILDREN AND ADOLESCENT
08.00 – 09.00
09.00 – 11.30
11.30 – 12.30 / Lecture 17: Sexual
Developmental Sequence in Children and Adolescent
Independent Learning + Learning Task
Break / Arimbawa
LEARNING OUTCOMES 10: AWARENESS OF COMMON DEVELOPMENTAL DISORDERS IN CHILDREN
12.30 – 13.00
13.00 – 13.30
13.30 – 15.00 / Lecture 18: Visual Impairment
Lecture 19: Hearing Impairment
Independent Learning + Learning Task / Eka Sutyawan
Eka Putra
9
Thusday
28 Jan 16 / 08.00 – 08.30
08.30 – 09.00
09.00 – 11.30
11.30 – 12.30
12.30 – 13.00
13.00 – 13.30
13.30 – 15.00 / Lecture 20: Learning Disorders
Lecture 21: Down Syndrome and Mental Retardation
Independent Learning + Learning Task
Break
Lecture 22: Attention Deficit/Hyperactivity Disorders
Lecture 23: Autism Spectrum Disorders
Independent Learning + Learning Task / Endah
Endah
Trisna/Endah
Sugitha
10
Friday
29 Jan 16 / 08.00 – 09.00
09.00 – 11.30
11.30 – 13.30
13.30 – 14.30
14.30 – 15.00 / Lecture 24: Cerebral Palsy
Independent Learning + Learning Task
SGD 3 (LO 9-10)
Independent Learning + Learning Task
Break / D. Sutrini
Facilitators
11
Monday
1 Feb 16 / LEARNING OUTCOMES 11: AGING AND ITS CLINICAL IMPLICATIONS
08.00 – 09.00
09.00 – 11.30
11.30 – 12.30
12.30 – 13.30
13.30 – 15.00 / Lecture 25: Aging Process
Independent Learning + Learning Task
Break
Lecture 26: Clinical Implication of Aging Process
Independent Learning + Learning Task / Tuty K
N Astika
12
Tuesday
2 Feb 16 / 08.00 – 10.00
10.00 – 11.00
11.00 – 12.00
12.00 – 13.00
13.00 – 14.00
14.00 – 15.00 / SP Presentation
SGD 3 (LO 11)
Lecture: General Principles of Physical Examination
Lecture: Vital Sign Measurement
Break
Independent Learning / Facilitators
Tim
Ratna S
Ratna S
13
Wednesday
3 Feb 16 / SILENT DAY
14
Thursday
4 Feb 16 / EXAMINATION

Venue: 402 (4th Floor)

TIME TABLE

English Class

DAY/
DATE / TIME / ACTIVITY / CONVEYER
1
Monday
18 Jan 16 / LEARNING OUTCOMES 1: ASSESS PHYSICAL GROWTH OF CHILDREN AND ADOLESCENTS
09.00 – 09.30
09.30 – 10.00
10.00 – 12.30
12.30 – 13.30 / Intro: General Concepts of Growth and Development
Lecture 1:Assessment Physical Growth of Children And Adolescents
Independent Learning + Learning Task
Break / Prof. Soetji
Prof. Soetji
LEARNING OUTCOMES 2: ASSESS FETAL GROWTH (INTRAUTERINE GROWTH)
13.30 – 14.30
14.30 – 16.00 / Lecture 2: The Stages of Prenatal Development
Independent Learning + Learning Task / Mangku K
2
Tuesday
19 Jan 16 / 09.00 – 09.30
09.30 – 10.00
10.00 – 12.30
12.30 – 13.30 / Lecture 3: Embriology of Fetal Growth
Lecture 4: Assessment Growth and Development in Neonatus
Independent Learning + Learning Task
Break / Mangku K
Suksmawati
LEARNING OUTCOMES 3: IDENTIFY COMMON CONGENITAL ANOMALIES IN INFANTS AND CHILDREN
13.30 – 14.30
14.30 – 16.00 / Lecture 5: Prenatal Genetic Evaluation and Counseling
Independent Learning + Learning Task / Arijana
3
Wednesday
20 Jan 16 / LEARNING OUTCOMES 4: CAPABILITY TO EVALUATE CRITICALLY THE USE OF MEDICINE IN PREGNANCY, CHILDREN, AND ELDERLY
09.00 – 10.00
10.00 – 12.30
12.30 – 13.30 / Lecture6: Drugs in Pregnancy, Children, and Elderly
Independent Learning + Learning Task
Break / Jawi
LEARNING OUTCOMES 5: DIAGNOSE AND MANAGE COMMON NUTRITIONAL PROBLEMS IN CHILDREN AND ADOLESCENTS
13.30 – 14.00
14.00 – 14.30
14.30 – 16.00 / Lecture 7: Principles Breastfeeding for Infants With Normal Delivery
Lecture 8: Principles
Feeding for Infants With Complicated Delivery
Independent Learning / Prof. Soetji
Kardana
4
Thursday
21 Jan 16 / 09.00 – 10.00
10.00 – 12.30
12.30 – 13.30
13.30 –14.30
14.30 – 16.00 / Lecture 9: Vitamin A, Fe & Iodine Deficiencies
Independent Learning + Learning Task
Break
Lecture 10: Protein Energy Malnutrition (PEM) & Obesity
Independent Learning + Learning Task / Prayoga
Lanang
5
Friday
22 Jan 16 / 09.00 – 10.00
10.00 – 12.00 / Break
SGD 1 (LO 1-5) / Facilitator
LEARNING OUTCOMES 6: INVESTIGATE INFANT OR CHILD WITH SUSPECT FAILURE TO THRIVE
12.00 – 13.00
13.00 – 14.30
14.30 – 16.00 / Lecture 11: Failure to Thrive
Independent Learning + Learning Task
Break / Lanang
6
Friday
22 Jan 16 / LEARNING OUTCOMES 7: ASSESS DEVELOPMENT OF CHILDREN IN SPECIFIC DOMAINS
09.00 – 09.30
09.30 – 10.00
10.00 – 12.30
12.30 – 13.30 / Lecture 12: Assess Development in Motoric
Domains
Lecture 13: Assess Development in Language Domains
Independent Learning + Learning Task
Break / Sugitha
Sugitha
LEARNING OUTCOMES 8: DETECTION OF DEVELOPMENT DEVIATION IN CHILDREN (SCREENING AND STIMULATION)
13.30 – 14.00
14.00 – 14.30
14.30 – 16.00 / Lecture 14: Cognitive Development
Lecture 15: PsychosocialDevelopment
Independent Learning + Learning Task / Marheni
Marheni
7
Tuesday
26 Han 16 / 09.00 – 10.00
10.00 – 11.30
11.30 – 12.30
12.30 – 14.30
14.30 – 16.00 / Lecture 16: Detection of Developmental Deviation In Children (Screening & Stimulation)
Individual Learning + Learning Task
Break
SGD 2 (LO 6-8)
Individual Learning + Learning Task / Trisna
Facilitator
8
Wednesday
27 Jan 16 / LEARNING OUTCOMES 9: AWARENESS OF THE NORMAL SEXUAL DEVELOPMENT SEQUENCE IN CHILDREN AND ADOLESCENT
09.00 – 10.00
10.00 – 12.30
12.30 – 13.30 / Lecture 17: Sexual
Developmental Sequence in Children and Adolescent
Independent Learning + Learning Task
Break / Arimbawa
LEARNING OUTCOMES 10: AWARENESS OF COMMON DEVELOPMENTAL DISORDERS IN CHILDREN
13.30 – 14.00
14.00 – 14.30
14.30 – 16.00 / Lecture 18: Visual Impairment
Lecture 19: Hearing Impairment
Independent Learning + Learning Task / Eka Sutyawan
Eka Putra
9
Thusday
28 Jan 16 / 09.00 – 09.30
09.30 – 10.00
10.00 – 12.30
12.30 – 13.30
13.30 – 14.00
14.00 – 14.30
14.30 – 16.00 / Lecture 20: Learning Disorders
Lecture 21: Down Syndrome and Mental Retardation
Independent Learning + Learning Task
Break
Lecture 22: Attention Deficit/Hyperactivity Disorders
Lecture 23: Autism Spectrum Disorders
Independent Learning + Learning Task / Endah
Endah
Trisna/Endah
Sugitha
10
Friday
29 Jan 16 / 09.00 –10.00
10.00 – 10.30
12.30 – 13.30
13.30 – 15.30
15.30 – 16.00 / Lecture 24: Cerebral Palsy
Break
Independent Learning + Learning Task
SGD 3 (LO 9-10)
Independent Learning + Learning Task / D. Sutrini
Facilitators
11
Monday
1 Feb 16 / LEARNING OUTCOMES 11: AGING AND ITS CLINICAL IMPLICATIONS
09.00 – 10.00
10.00 – 12.30
12.30 – 13.30
13.30 – 14.30
14.30 – 16.00 / Lecture 25: Aging Process
Independent Learning + Learning Task
Break
Lecture 26: Clinical Implication of Aging Process
Independent Learning + Learning Task / Tuty K
N Astika
12
Tuesday
2 Feb 16 / 09.00 – 10.00
10.00 – 12.00
12.00 – 13.00
13.00 – 14.00
14.00 – 15.00
15.00 – 16.00 / SGD 3 (LO 11)
SP Presentation
Break
Lecture: General Principles of Physical Examination
Lecture: Vital Sign Measurement
Individual Learning / Facilitators
Tim
Ratna S
Ratna S
13
Wednesday
3 Feb 16 / SILENT DAY
14
Thursday
4 Feb 16 / EXAMINATION

Venue: 402 (4th Floor)

~LEARNING PROGRAMS~

LECTURE

Prof. dr. Soetjiningsih, SpAK, IBCLC

Learning outcomes

-To describe the general concept of growth and development

-To describe the stages in lifespan development

-To understand the conceptual differences between growth and development

-To describe the factors that may affectgrowth and development

Abstract

Lifespan development is a field of study that examines patterns of growth, change, and stability in behavior that occur throughout the entire lifespan. The lifespan is usually divided into broad age ranges: the prenatal period (the period from conception to birth); infancy and toddler hood (birth to age 3); the preschool period (ages 3 to 6); middle childhood (ages 6 to 12); adolescence (ages 12 to 20); young adulthood (ages 20 to 40); middle age (ages 40 to 60); and late adulthood (age 60 to death).

Lifespan development specialists discuss development in several topics: physical development (development involving the body’s physical make up, including the brain, nervous system, muscles, senses, and the need for food, drink and sleep); cognitive development (development involving the ways that growth and change in intellectual capabilities influence a person’s behavior); personality development (development involving the ways that enduring characteristics that differentiate one person from another change over the life span); and social development ( the way in which individuals’ interactions with others and their social relationships grow, change, and remain stable over the course of life).

Growth and development are an integral process. Growth refer to the metabolic change by which an organism increases in size and changes shape. Growth refers to quantitative changes. Changes in physical size and appearance are visible manifestations of the complex morphologic, biochemical and physiologic changes taking place during childhood.

Child development is a process, a continuous series of purposeful changes, consisting of many aspects, moving together at differing paces. Development refers to qualitative and quantitative changes. There are 10 fundamental principles of development:

Development involves change
Early development is more critical than later development
Development is the product of maturation and learning
The developmental pattern is predictable
The developmental pattern has predictable characteristics
There are individual differences in development
There are periods in the developmental pattern
There are social expectations for every developmental period
Every area of development has potential hazards
Happiness varies at different periods in development

Environmental and genetic factors influence growth and development. In Bronfenbrenner’s ecological system theory, development is influenced at four levels: the microsystem, mesosystem, exosystem and macrosystem.

Prof. dr. Soetjiningsih, SpAK, IBCLC

Learning outcomes

-Describe the clinical importance of study physical growth

-Describe the normal patterns of the physical growth

-Understand factors that affecting physical growth

-Use of common growth parameter

Abstract

Physical growth usually refers to changes in size or mass. The most people usually think of growth at the level of the whole child, the cells and internal structures that make up the child, primarily by increasing in number or size.

Growth assessment is essential because almost any problems within the physiologic, interpersonal and social domains can adversely affect growth. Anthropometry is an effective and frequently performed child health screening procedure. The value of physical growth data depends on their accuracy and reliability, how they are recorded and interpreted, and what follow-up efforts are made after identification of growth abnormality.

The most powerful tool in growth assessment is the growth chart. Whenever possible, growth should be assessed by plotting accurate measurements on growth charts and comparing each set of measurements with previous measurements. The CDC Growth Charts 2000 are used to measure growth, consist of 16 charts including “Body mass index (BMI) for-age percentile” for boys and girls aged 2-20 years.

Normal growth patterns have spurts and plateaus, but some shifting on the percentile graphs can be expected; however, large shifts warrant attention. Large discrepancies among height, weight, and head circumference percentiles also diserve attention. Deviation in growth patterns are nonspecific but important indicators of serious medical disorders. Deviations often provide the first clue that something is wrong, occasionally even when the parents do not suspect a problem. An accurate measurement of height, weight, and head circumference should be obtained at every health supervision visit. Serial measurements are much more useful than single measurements because they can help detect deviations from a particular child’s growth pattern even if the value remains within statistically defined normal limits.

Factors affecting physical growth and health in infancy and toddlerhood continue to be influential in early childhood. Heredity affects physical growth by regulating the production of hormones. Extreme emotional deprivation can interfere with the production of growth hormone, thereby stunting children's growth. Sleep difficulties, in the form of night waking and nightmares, are common during the preschool years. Appetite decline is associated with a slower rate of physical growth. Disease can lead to malnutrition, seriously undermining children's growth, an effect that is especially common in developing countries.

NymMangkuKarmaya

Learning outcomes

Describe the main stages of embryonic development for use to estimate the gestational age of embryo.

Abstract

Early embryonic development is describe in stages because of the variable period it takes for embryos to develop certain morphological characteristics. Stage 1 of development begins at fertilization and embryonic development ends at stages 23, which occur on day 57 and ends when he fetus is completely outside the mother. The stages of embryonic development can be assessed by ultrasonography. In general the period of prenatal development is as follows:

1st week: zygote-blastomeres-morula-blastocyst.
2nd week: bilaminar germ disc
3rd week: trilaminar germ disc
3rd - 8th week: embryonic period/organogenesis
8th week-BIRTH: fetal period

Mangku Karmaya

Learning outcomes

-~ soon will be added ~

Abstract

In a low-risk pregnancy, the abdomen is measured at prenatal visits to assess the baby's growth. The measurement in centimeters from the top of your pubic bone to the top of your uterus (the fundus) should be about the same as the number of weeks you are pregnant, with an allowance of up to 2 cm either way. For example, if you are 26 weeks' pregnant, you should measure between 24 and 28 cm. Your fundal height can be measured between 24 and 36-37 weeks, since once your baby "drops" into the pelvis in late pregnancy, the measurement may not reflect his or her true size. If there is a variation of 3 cm or more, your doctor will arrange for an ultrasound to check your baby's growth and the amount of amniotic fluid. If the scan indicates a problem, the doctor will arrange for scans every two weeks since analyzing growth patterns over time gives a more accurate assessment of whether your baby's growth is normal.

Dharma Artana

Learning outcomes

-Apply the New Ballard Score to assess the gestational age of infant: the small for gestational age (SGA), appropriate for gestational age (AGA), or large for gestational age (LGA).

Abstract

Since the late 1960s, a variety of methods for assessing the gestational age of the newborn infant have been developed. Currently, the most widely use system for the postnatal assessment of gestational age is the New Ballard Score (NBS). This system includes both physical and neurologic characteristics. The score spans from 10 (correlating with 20 weeks’ gestation) to 50 (correlating with 44 weeks gestation). The examination consists of six neuromuscular criteria and six physical criteria. The neuromuscular criteria are based on the understanding that passive tone is more useful than active tone in indicating gestational age. The neuromuscular maturity includes: posture, square window, arm recoll, popliteal angel, scarf sign, and heal to ear. The physical maturity includes: skin, lanugo hair, plantar surface, breast, ear and ear, and genitalia. The examination of NBS is administered twice by two different examiners to ensure objective, and the data entered on the chart.