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function\tpreconceptually\timproves\tperinatal\toutcomes.\tInterpregnancy\tintervention\tto\tlower\nweight\timproves\tplacental\tfunction\tand\tfetal\tdevelopment.\nPCOS\taffects\tup\tto\t10%\tof\twomen\tof\treproductive\tage\tbut\tprevalence\tvaries\twidely\tbetween\npopulations\t(\nBellver\tet\tal,\t2018\n).\tWhether\tPCOS\taffects\toocyte\tquality\tis\tunknown.\tThe\ttestosterone-
|
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] |
).\tWhether\tPCOS\taffects\toocyte\tquality\tis\tunknown.\tThe\ttestosterone-\nestrogen\tbalance\tis\taltered,\tresulting\tin\tinsulin\tresistance\tand\tinfertility.\tSome\tresearch\tsuggests\nthat\t5%\tto\t10%\tweight\tloss\tis\tpreferred\tto\tthe\tuse\tof\tmetformin\tfor\tovulation\tinduction\tin\tpatients\nwith\tPCOS\t(\nUsadi\tand\tLegro,\t2012\n;\tsee\t\nChapter\t30
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] |
with\tPCOS\t(\nUsadi\tand\tLegro,\t2012\n;\tsee\t\nChapter\t30\n).\tBoth\tmetabolic\tsyndrome\tand\tPCOS\tare\nassociated\twith\tlower\tfertility\trates,\talong\n\twith\tincreased\tpregnancy\tand\tneonatal\trisks,\teven\twhen\ncontrolling\tfor\tthe\tobesity.\tThese\tproblems\tare\tlikely\tthe\tresult\tof\tmultiple\tmechanisms,\tincluding
|
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] |
inflammation,\tsome\tof\twhich\tmay\toverlap\twith\tthe\ttwo\tconditions,\tand\tsome\tof\twhich\thave\tnot\tyet\nbeen\tidentified.\tObesity\tis\toften\ta\tcomorbidity\tthat\tmay\tamplify\tthe\teffects\tof\tPCOS\tbut\tit\tis\tnot\ta\ndiagnostic\tcriterion\t(\nACOG,\t2018a\n).\tWeight\tloss\n\tfor\tboth\tmetabolic\tsyndrome\tand\tPCOS\tis
|
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ACOG,\t2018a\n).\tWeight\tloss\n\tfor\tboth\tmetabolic\tsyndrome\tand\tPCOS\tis\nrecommended\tas\ta\tfirst\tcourse\tof\ttreatment\tbecause\tobesity\tis,\tin\titself,\tassociated\twith\tdecreased\nfertility.\tHowever,\tin\tthe\tcase\tof\tPCOS,\tweight\tloss\twill\tnot\taddress\tthe\tunderlying
|
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hyperandrogenemia\tand\tlikely\twill\tnot\tbe\thelpful\tif\tthe\tpatient\tis\tnot\toverweight\tor\tobese.\tBecause\n50%\tto\t70%\tof\tpeople\twith\tPCOS\thave\tinsulin\tresistance\tregardless\tof\tBMI,\n\toptimizing\tglucose\ncontrol\tmay\tbe\tbeneficial\t(\nBellver\tet\tal,\t2018\n).\tA\tmale\tequivalent\tof\tPCOS\tmay\talso\texist\tbut\tthe
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] |
and\ndietary\tsupplements\tare\tpromoted\tfor\tPCOS\ttreatment\t(see\t\nFocus\tOn:\n\tHerbal\tand\tDietary\nSupplements\n).\n\t\nFOCUS\tON\nHerbal\tand\tDietary\tSupplements\nSome\therbal\tand\tdietary\tsupplements\tare\tpromoted\tfor\tPCOS\tand/or\tmetabolic\tsyndrome\ntreatment.\tHowever,\tfor\tmany,\tthe\tsupporting\tevidence\tis\tinsufficiently\treliable\tto\trate\n\ttheir
|
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0.10697191953659058,
0.05731156840920448,
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] |
their\neffectiveness.\tFor\tothers,\tthere\tis\tconcern\teven\tif\tthe\therbal\tsupplements\tare\tthought\tto\tbe\neffective,\tbecause\tof\tthe\tpotential\tnegative\teffect\ton\ta\tpregnancy.\tSpecifically,\tberberine\tis\tlikely\nunsafe\tin\tpregnancy\tbecause\tit\tcrosses\tthe\tplacenta\tand\tmay\tharm\tthe\tfetus.\tIt\tmay\talso
|
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] |
stimulate\tuterine\tcontractions.\tN-acetyl\tcysteine\tis\talso\tmentioned\tas\tuseful\tin\ttreating\tPCOS.\nHowever,\tit\talso\n\tcrosses\tthe\tplacenta.\tMelatonin\tmay\tinhibit\tovulation\tbut\tthe\tcritical\tdose\tis\nunknown\tand\tit\tis\tnot\trecommended.\tInositol\t(myo-inositol,\tD-chiro-inositol)\tappears\tto\tbe\tsafe\tfor
|
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use\tin\tpregnancy.\tIts\tuse\twith\tfolic\tacid\tappears\tto\tlower\ttriglycerides\tand/or\ttestosterone\tand\nimprove\tovarian\tfunction,\tincluding\tovulation\trates\tin\toverweight\twomen\twith\tPCOS,\tworking\tas\nwell\tas\tmetformin\t(\nJellin\tand\tGregory,\t2018\n).\tA\tcombination\tof\tthe\ttwo\tforms\tof\tinositol\tmay\tbe
|
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).\tA\tcombination\tof\tthe\ttwo\tforms\tof\tinositol\tmay\tbe\nmore\teffective\tthan\ta\tsingle\tform.\tHowever,\ta\tCochrane\tsystematic\treview\tfound\tno\tdifferences\nbetween\tinositol\tand\tplacebo\ton\tBMI,\twaist-hip\tratio,\tthe\tnumber\tof\tpeople\twho\tovulated,\tserum\ntestosterone,\ttriglycerides,\tcholesterol,\tfasting\tglucose,\tor\tfasting\tinsulin\t(\nMonash\tUniversity,\n2018
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] |
Monash\tUniversity,\n2018\n).\tData\tis\tstill\tlimited\tand\tinositol\tuse\tshould\tbe\tconsidered\n\texperimental.\tDosage\tappears\ncritical\tand\tthere\tare\tpotential\tadverse\teffects\tamong\tnonobese\twomen,\tso\tcaution\tis\tadvised\n(\nNoventa\tet\tal,\t2016\n).\nAs\tin\tthe\tgeneral\tpopulation,\tthe\tuse\tof\therbal\tand\tdietary\tsupplements\tfor\tmany\tconditions\tis
|
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] |
common\tduring\tpregnancy.\tFor\tmany\therbs,\tthe\tsupporting\tevidence\tis\tinsufficiently\treliable\tto\nrate\ttheir\teffectiveness\tor\tsafety,\tespecially\tin\tthe\tfirst\n\ttrimester.\tCommon\tlocal\therbs\tshould\tbe\ninvestigated\tcarefully\tfor\ttheir\tsafety\tduring\tpregnancy.\tEven\tthose\twith\tthe\tsame\tnames\tcan
|
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] |
have\tdifferent\teffects.\tFor\texample,\tGerman\tchamomile\tappears\tto\tbe\tof\tlittle\tconcern\tduring\npregnancy,\twhile\tRoman\tchamomile\tappears\tto\tincrease\tthe\trisk\tfor\tpreterm\tdelivery\tand\tLBW\n(\nTrabace\tet\tal,\t2015\n)\tand\tmay\tbe\tan\tabortifacient\t(\nJellin\tand\tGregory,\t2018\n).\tMany\n\therbs\tmay
|
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] |
Jellin\tand\tGregory,\t2018\n).\tMany\n\therbs\tmay\ncause\tuterine\tcontractions\tand/or\tbleeding\tand\tare\tcontraindicated\tin\tpregnancy,\tincluding\ningested\taloe\tvera\tlatex,\tcat’s\tclaw,\tcinnamon\tvolatile\toil,\toregano\ttea,\tavocado\tleaf\ttea,\true,\tsage\ntea,\tdamiana,\tand\tlarge\tamounts\tof\tparsley\tor\tcelery\tseeds\t(\nKennedy\tet\tal,\t2016\n;\t\nRivera\tet\tal,\n2006\n).
|
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] |
Caution\tis\tadvised\twith\tthe\tuse\tof\tall\therbal\tand\tdietary\tsupplements\tbecause\tsafety,\tpurity,\n\tand\neffectiveness\tcannot\talways\tbe\tguaranteed\tdue\tto\tthe\tway\tthey\tare\tregulated\tby\tthe\tFood\tand\nDrug\tAdministration\t(FDA).\tInteractions\twith\tprescribed\tmedications\tcan\toccur,\taffecting\ntreatment\tdecisions\t(\nKennedy\tet\tal,\t2016
|
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] |
treatment\tdecisions\t(\nKennedy\tet\tal,\t2016\n).\tEven\tsome\therbs\tconsidered\thelpful\tduring\tpregnancy\ncan\thave\tunexpected\tconsequences.\tFor\texample,\traspberry\tleaf\tand\tblackberry\tleaf\ttea\tcan\ncause\thypoglycemia\tin\tpatients\n\twith\tgestational\tdiabetes\t(\nCheang\tet\tal,\t2016\n).\tWomen\tshould
|
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] |
with\tgestational\tdiabetes\t(\nCheang\tet\tal,\t2016\n).\tWomen\tshould\nadvise\ttheir\thealth\tcare\tprovider\tabout\tany\tmedication\tuse,\tincluding\tdietary\tand\therbal\nsupplements,\tand\tthe\trisk\tvs.\tbenefit\tshould\tbe\tcarefully\tconsidered.\tSee\tNatural\tMedicines\nComprehensive\tDatabase\tfor\tspecific\tdetailed\tinformation.\tAlso\tsee\t\nChapter\t11\n.
|
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] |
Chapter\t11\n.\nA\thealthy\tdiet\tand\texercise\tprogram\thelps\tparents\tprepare\tfor\tan\toptimal\n\tpregnancy\toutcome,\nwith\tthe\tgoal\tof\tachieving\tnormal\tweight\tbefore\tconception.\tHowever,\talthough\tpreconceptual\nintervention\tis\trecommended,\tit\tis\tseldom\tachieved\tbecause\thalf\tof\tpregnancies\tin\tthe\tUnited\tStates\nare\tunplanned.\tIn\taddition,\tadvances\tin
|
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] |
are\tunplanned.\tIn\taddition,\tadvances\tin\t\nassisted\treproductive\ttechnology\t(ART)\n\tmean\tthat\n“parents”\tmay\tbe\tegg\tor\tsperm\tdonors\tor\tsurrogate\tmothers.\tThe\tpreconceptual\thealth\tof\tthese\n“parents”\n\tis\tlikely\talso\timportant\tbut\tthe\timpact\tis\tunknown.\nConception\nConception
|
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] |
Conception\nConception\n\tinvolves\ta\tcomplex\tseries\tof\tendocrine\tevents\tin\twhich\ta\thealthy\tsperm\tfertilizes\ta\nhealthy\tovum\t(egg)\twithin\t24\thours\tof\tovulation.\tConception\tdoes\tnot\tguarantee\tsuccessful\npregnancy\toutcome.\tOccult\tloss\trates\tare\testimated\tto\tbe\t41%\tto\t70%,\tdepending\ton\tthe\ttiming\tand\nsensitivity\tof\tthe\tpregnancy\ttest\t(
|
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0.0777016207575798,
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] |
sensitivity\tof\tthe\tpregnancy\ttest\t(\nKwak-Kim\tet\tal,\t2010\n).\tAmong\tclinically\trecognized\tpregnancies,\nthe\toverall\tearly\tpregnancy\tloss\trate\tis\t10%\tbut\tvaries\twidely\tby\tthe\tage\tof\tthe\tmother\t(\nACOG,\n2015e\n).\nThe\tCarnegie\tStages\tare\ta\tsystem\tused\tto\tdescribe\tpredictable\tembryonic\tchanges\tand\ndevelopmental\tmilestones.\tAs\tnoted\tin\t\nTable\t14.3
|
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] |
developmental\tmilestones.\tAs\tnoted\tin\t\nTable\t14.3\n,\tas\twell\tas\tin\t\nTable\t14.1\n\tand\t\nBox\t14.1\n,\toptimal\nconditions,\tincluding\tthe\tabsence\tof\thostile\tfactors\tand\toptimal\tstatus\n\tof\tmany\tnutrients,\tare\tthought\nto\tbe\tcritical\tpreconceptually\tand\tduring\tfetal\torganogenesis.\nTABLE\t14.3
|
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0.07102296501398087,
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0.0026389078702777624,
0.07459424436092377,
0.06033211201429367,
0.1083240658044815,
-0.004241341724991798
] |
TABLE\t14.3\nThe\tCarnegie\tStages\tof\tHuman\tGestation\tThrough\t16\tWeeks\tPostovulation\nCarnegie\tStage\n(time\npostovulation)\nStructure\tSize\nHighlighted\tDevelopmental\tEvents\twith\tSelected\nPotential\tNutrient\tImplications\nStage\t1\nFertilization\n(1\tday)\n0.1-0.15\nmillimeters\n(mm);\tsmaller\nthan\tthe\tsize\nof\ta\tpencil\npoint
|
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0.0026777368038892746
] |
0.1-0.15\nmillimeters\n(mm);\tsmaller\nthan\tthe\tsize\nof\ta\tpencil\npoint\nFertilization\tbegins\twhen\tthe\tsperm\tpenetrates\tthe\noocyte.\tThis\trequires\tthe\tsperm,\twhich\tcan\tsurvive\tup\nto\t48\thours,\tto\ttravel\t10\thours\tup\tthe\tfemale\nreproductive\ttract.\tThen\tthe\tsperm\tmust\tsuccessfully\npenetrate\tthe\tzona\tpellucida,\ta\ttough\tmembrane
|
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] |
penetrate\tthe\tzona\tpellucida,\ta\ttough\tmembrane\nsurrounding\tthe\tegg,\ta\tprocess\tthat\ttakes\napproximately\t20\tminutes.\tOnce\tthe\tfertilization\tis\nsuccessful,\tthe\tstructure\tnow\tbecomes\n\ta\tzygote.\tThis\nis\tthe\tend\tof\tthe\tfertilization\tprocess.\nOptimal\tamounts\tof\tfolate\n\tare\tneeded\tfor\tcell\tdivision\nand\tformation\tof\tDNA.\nStage\t2\nFirst\tCell\tDivision
|
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] |
and\tformation\tof\tDNA.\nStage\t2\nFirst\tCell\tDivision\n(1.5-3\tdays)\n0.1-0.2\tmm\nZygote\tbegins\tto\tdivide.\tDivision\tbegins\tto\toccur\napproximately\tevery\t20\thours.\nWhen\tcell\tdivision\tgenerates\ta\tmass\tof\tapproximately\t16\ncells,\tthe\tzygote\tnow\tbecomes\ta\tmorula,\ta\tmulberry\nshaped\tstructure.\n\tThe\tnewly\tcreated\tmorula\tleaves
|
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shaped\tstructure.\n\tThe\tnewly\tcreated\tmorula\tleaves\nthe\tfallopian\ttube\tand\tenters\tthe\tuterine\tcavity\t3-4\ndays\tafter\tfertilization.\nStage\t3\nEarly\tBlastocyst\n(4\tdays)\n0.1-0.2\tmm\nThe\tmorula\tenters\tthe\tuterus\tand\tcell\tdivision\tcontinues.\nA\tcavity\t(hole),\tknown\tas\ta\tblastocele,\tforms\tin\tthe\nmiddle\tof\tthe\tmorula.\tCells\tare\tflattening\tand
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] |
middle\tof\tthe\tmorula.\tCells\tare\tflattening\tand\ncompacting\tinside\tthis\tcavity.\tThe\tzona\tpellucida\nremains\tthe\tsame\tsize\tas\n\tit\twas\tafter\tfertilization,\nwith\tthe\tcavity\tin\tthe\tcenter.\tThe\tentire\tstructure\tis\nnow\tcalled\ta\tblastocyst.\tTwo\tcell\ttypes\tare\tforming:\nembryoblasts,\ton\tthe\tinside\tof\tthe\tblastocele,\tand
|
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] |
embryoblasts,\ton\tthe\tinside\tof\tthe\tblastocele,\tand\ntrophoblasts,\ton\tthe\toutside\tportion\tof\tthe\tblastocele.\nStage\t4\nImplantation\nBegins\n(5-6\tdays)\n0.1-0.2\tmm\nPressure\tfrom\tthe\tblastocele\texpanding\tin\tthe\tmiddle\tof\nthe\tblastocyst\tagainst\tthe\trigid\twall\tof\n\tthe\tzona\npellucida\tcreates\ta\t“hatching”\tof\tthe\tblastocyst\tfrom
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the\tzona\npellucida\tcreates\ta\t“hatching”\tof\tthe\tblastocyst\tfrom\nthis\tzona\tpellucida.\tSeparation\tof\tthe\tembryoblasts\nand\ttrophoblasts\tis\tcomplete.\nThe\touter\tlayer\tof\ttrophoblast\tcells\tsecretes\tan\tenzyme\nthat\terodes\tthe\tepithelial\tlining\tof\tthe\tuterus\tso\tthe\nblastocyst\tcan\timplant.\tTrophoblast\tcells\talso\tsecrete
|
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] |
blastocyst\tcan\timplant.\tTrophoblast\tcells\talso\tsecrete\nhCG,\twhich\tstimulates\tthe\tcorpus\tluteum\t(the\tyellow\nglandular\tmass\tin\tthe\tovary\tformed\n\tby\tan\tovarian\nfollicle\tthat\thas\tmatured\tand\tdischarged\tits\tovum)\tto\ncontinue\tprogesterone\tproduction,\timportant\tin
|
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] |
maintaining\tthe\tblood-rich\tuterine\tlining.\nProgesterone\tis\talso\tlater\tproduced\tby\tthe\tplacenta.\nFive\tdays\tis\tthe\tlatest\tthat\tan\tIVF\tembryo\twould\tbe\ntransferred.\nConsider\tvitamin\tD.\nStage\t5\nImplantation\nComplete\n(7-12\tdays)\n0.1-0.2\tmm\nTrophoblast\tcells\tcontinue\tto\tdestroy\n\tcells\tof\tthe\tuterine\nlining,\tcreating\tblood\tpools\tand\tstimulating\tnew
|
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] |
lining,\tcreating\tblood\tpools\tand\tstimulating\tnew\ncapillaries\tto\tgrow.\tThis\tbegins\tthe\tgrowth\tof\tthe\nplacenta.\nThe\tblastocyst\tinner\tcell\tmass\tdifferentiates\tinto\tthe\nepiblast\t(top\tlayer\tof\tcells,\tbecoming\tthe\tembryo\tand\nthe\tamniotic\tcavity)\tand\tthe\thypoblast\t(lower\tlayer\tof\ncells,\tbecoming\tthe\tyolk\tsac).
|
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] |
cells,\tbecoming\tthe\tyolk\tsac).\nEctopic\tpregnancies\tare\tthose\tthat\tdo\tnot\timplant\tin\tthe\nuterus\tat\tthis\n\ttime,\teventually\tbecoming\ta\tlife-\nthreatening\tproblem.\nStage\t6\nPrimitive\tStreak\n(13\tdays)\n0.2\tmm\nPlacental\tformation:\tChorionic\tvilli\t“fingers”\tform,\nanchoring\tthe\tembryo\tto\tthe\tuterus.\tBlood\tvessels\nbegin\tappearing.
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anchoring\tthe\tembryo\tto\tthe\tuterus.\tBlood\tvessels\nbegin\tappearing.\nStalk\tformation:\tThe\tembryo\tis\tattached\tto\tthe\ndeveloping\tplacenta\tby\ta\tstalk,\twhich\tlater\tbecomes\npart\tof\tthe\tumbilical\tcord.\nGastrulation:\tA\tnarrow\tline\tof\tcells,\tcalled\n\tthe\t\nprimitive\nstreak,\n\tappears\ton\tthe\tsurface\tof\tthe\ttwo-layered
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] |
lymphatic\ttissue,\tspleen,\tblood\tcells,\theart,\tlungs,\tand\nreproductive\tand\texcretory\tsystems),\tand\tthe\nendoderm\t(inner\tcell\tlayer\tthat\twill\tlater\tform\tthe\nlining\tof\tthe\tlungs,\tthe\ttongue,\tthe\ttonsils,\tthe\turethra\nand\tassociated\tglands,\tthe\tbladder,\tand\tthe\tdigestive\ntract).\nConsider\tvitamins\tA,\tE,\tC,\tcopper,\tand\tDHA.\nStage\t7\nNeurulation\n(16\tdays)
|
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] |
Stage\t7\nNeurulation\n(16\tdays)\n0.4\tmm\nGastrulation\tcontinues,\tforming\tthe\tthree-layered\nembryonic\tdisc.\nNeural\tcrest\tcells\toriginate\tat\tthe\ttop\tof\tthe\tneural\ttube\nand\tmigrate\textensively\tthroughout\tthe\tembryo,\ndifferentiating\tinto\tmany\tcell\ttypes,\tincluding\nneurons,\tglial\tcells,\tpigmented\tcells\tof\tthe\tepidermis,\nepinephrine-producing
|
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] |
epinephrine-producing\n\tcells\tof\tthe\tadrenal\tglands,\nand\tvarious\tskeletal\tand\tconnective\ttissues\tof\tthe\nhead.\nFetal\talcohol\tsyndrome\tresults\tfrom\tdisruption\tof\tthe\nmigration\tof\tneural\tcrest\tcells.\nConsider\tvitamins\tA,\tE,\tfolic\tacid,\tcholine,\tzinc,\nselenium,\tDHA,\tand\tantioxidants.\nStage\t8\n(17-19\tdays)\n1-1.5\tmm
|
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] |
selenium,\tDHA,\tand\tantioxidants.\nStage\t8\n(17-19\tdays)\n1-1.5\tmm\nThe\tembryonic\tarea\tis\tnow\tshaped\tlike\ta\tpear,\twith\tthe\nhead\tregion\tbroader\tthan\tthe\ttail.\tThe\tectoderm\n\thas\nthickened\tto\tform\tthe\tneural\tplate.\tThe\tedges\trise,\nforming\tthe\tconcave\tneural\tgroove.\tThis\tgroove\tis\tthe\nprecursor\tof\tthe\tembryo’s\tnervous\tsystem,\tone\tof\tthe
|
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] |
precursor\tof\tthe\tembryo’s\tnervous\tsystem,\tone\tof\tthe\nfirst\torgans\tto\tdevelop.\nBlood\tcells\tare\talready\tdeveloped\tand\tbegin\tto\tform\nchannels\talongside\tthe\tepithelial\tcells\tthat\tare\talso\nforming.\nSonic\thedgehog\t(Shh)\n\tis\tone\tof\tthree\tgenes\tthat\tare\tnow\nsecreted\tfrom\tthe\tnotochord\t(rod-shaped\n\tbody\ncomposed\tof\tmesoderm\tcells).\tThese\tgenes\tencode\tfor
|
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] |
development.\tA\trepression\tof\tShh\tby\tthe\tnotochord\ninitiates\tpancreatic\tdevelopment.\nConsider\tvitamin\tB\n12\n,\tomega-3\tfatty\tacids,\tfolate,\ncholesterol,\tand\tcholine.\nStage\t9\nAppearance\tof\nSomites\n(19-21\tdays)\n1.5-2.5\tmm\nEmbryo\tlooks\tlike\ta\tpeanut\twith\ta\tlarger\thead\tend\ncompared\twith\tthe\ttail\tend.\nOne\tto\tthree\tpairs\tof\tsomites\t(mesoderm\ttissue\tthat
|
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] |
One\tto\tthree\tpairs\tof\tsomites\t(mesoderm\ttissue\tthat\nlooks\tlike\t“bumps”)\tare\tnow\tpresent,\twith\tevery\tridge,
|
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bump,\tand\trecess\tindicating\tcellular\tdifferentiation.\nThe\thead\tfold\trises\ton\teither\tside\tof\tthe\tprimitive\tstreak.\nEndocardial\n\t(muscle)\tcells\tbegin\tto\tfuse\tand\tform\tinto\nthe\tearly\tembryo’s\ttwo\theart\ttubes.\nSecondary\tblood\tvessels\tnow\tappear\tin\tthe\nchorion/placenta.\tHematopoietic\tcells\t(forming\tblood
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chorion/placenta.\tHematopoietic\tcells\t(forming\tblood\ncells)\tand\tendothelial\tcells\t(forming\tblood\tvessels)\nappear\ton\tthe\tyolk\tsac\tsimultaneously.\nConsider\tfolic\tacid,\tcopper,\tand\tiron.\nStage\t10\n(21-23\tdays)\n1.5-3.0\tmm\nAt\tthis\ttime,\tthe\tembryo\tlooks\tlike\tan\told\tfashioned\n\tkey-\nhole\twith\ta\tbig\toval\ttop,\twith\tan\tear\tof\tcorn\tin\tthe
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] |
key-\nhole\twith\ta\tbig\toval\ttop,\twith\tan\tear\tof\tcorn\tin\tthe\nbottom\ttwo\tthirds\tof\tthe\tstructure.\nRapid\tcell\tgrowth\telongates\tthe\tembryo\tand\texpands\tthe\nyolk\tsac.\tBy\tthe\tend\tof\tthis\tstage,\t4-12\tsomite\tpairs\ncan\texist.\tCells\tthat\twill\tbecome\tthe\teyes\tand\tears\nappear.\nNeural\tfolds\tbegin\tto\trise\tand\tfuse,\t“zippering”\tthe
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appear.\nNeural\tfolds\tbegin\tto\trise\tand\tfuse,\t“zippering”\tthe\nneural\ttube\tclosed.\tFailure\tof\tthis\tclosure\tresults\tin\ta\nneural\ttube\tdefect,\tincluding\n\tanencephaly\tand\tspina\nbifida,\twhich\tvaries\tin\tseverity\tdepending\ton\tlocation\nand\textent\tof\tthe\tarea\tleft\topen.\nThe\ttwo\tendocardial\ttubes\tfuse\tinto\tone.\tThis\theart\ttube
|
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The\ttwo\tendocardial\ttubes\tfuse\tinto\tone.\tThis\theart\ttube\ntakes\ton\tan\tS-shaped\tform\tand\tcardiac\tmuscle\ncontraction\tbegins.\nConsider\tfolate,\tB\n6\n,\tB\n12\n,\tcholine,\tvitamin\tA,\tzinc,\ncopper,\tand\tmethionine.\nStage\t11\n(23-25\tdays)\n2.5-3.0\tmm\nEmbryo\thas\ta\tmodified\tS-curve\tshape\twith\ta\tbulb-like\ntail\tand\ta\tstalk\tconnecting\tto\tthe\tdeveloping\tplacenta.
|
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tail\tand\ta\tstalk\tconnecting\tto\tthe\tdeveloping\tplacenta.\nSomites\tincrease\tto\t20\tpairs,\tat\twhich\tpoint\tthe\nforebrain\tis\tcompletely\tclosed.\tThe\tprimitive\ttubal\nheart\tis\tbeating\tand\tperistalsis\tbegins.\nConsider\tVitamin\tA.\nStage\t12\n(25-27\tdays)\n3-5\tmm\nEmbryo\tnow\thas\ta\tC-shape.\tBrain\tand\tspinal\tcord\tare\tthe\nlargest\ttissue\tin\tthe\tembryo.
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] |
largest\ttissue\tin\tthe\tembryo.\nFace\tis\tbecoming\tapparent;\teyes\tand\tears\tare\tbeginning\nto\tform.\tHeart\tvalves\tand\tsepta\tmay\tbecome\napparent.\tBlood\tsystem\tis\tdeveloping.\tBlood\tcells\nfollow\tthe\tsurface\tof\tthe\tyolk\tsac\t(where\tthey\noriginated),\tthen\tmove\talong\tthe\tcentral\tnervous\nsystem\tto\tthe\tchorionic\tvilli,\tpart\tof\tthe\tmaternal
|
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] |
system\tto\tthe\tchorionic\tvilli,\tpart\tof\tthe\tmaternal\nblood\tsystem.\tLiver\tcells\tare\tbeginning\tto\tform,\nbefore\tthe\trest\tof\tthe\tdigestive\tsystem.\tUpper\tlimb\nbuds\tappear.\nConsider\tvitamin\tA,\tfolic\tacid,\tcholine,\n\tmethionine,\nand\tzinc.\nStage\t13\n(26-30\tdays)\n4-6\tmm;\tsize\tof\nthe\thead\tof\ta\npencil\teraser\nMore\tthan\t30\tsomite\tpairs\tare\tnow\tevident,\tprecursors
|
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pencil\teraser\nMore\tthan\t30\tsomite\tpairs\tare\tnow\tevident,\tprecursors\nof\tmultiple\torgan\tsystems.\nFirst\tthin\tsurface\tlayer\tof\tskin\tappears\tto\tcover\tthe\nembryo.\tBack\tmuscles\tand\tribs\tbegin\tto\tform.\tThe\ndigestive\tepithelium\tlayer\tbegins\tto\tdifferentiate,\neventually\tdeveloping\tinto\tthe\tliver,\tlung,\tstomach,\nand\tpancreas.\nStage\t14\n(31-35\tdays)\n5-7\tmm
|
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] |
and\tpancreas.\nStage\t14\n(31-35\tdays)\n5-7\tmm\nBrain\tand\thead\tare\tgrowing\trapidly,\tsections\tof\tthe\tbrain\nand\tspinal\tcord\twall\tare\tbecoming\tdifferentiated.\tThe\neye\tis\tdeveloping\tand\tthe\tnasal\tplate\tcan\tbe\tdetected.\nThe\tadenohypophyseal\tpouch,\tlater\tdeveloping\tinto\nthe\tanterior\tpituitary,\tis\tdefined.\tThe\tesophagus\tis
|
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] |
the\tanterior\tpituitary,\tis\tdefined.\tThe\tesophagus\tis\nforming\tand\tlung\tsacs\tappear.\tUreteric\tbuds\tand\tthe\nmetanephros,\tlater\tdeveloping\tinto\tthe\tkidney,\n\tappear.\nUpper\tlimbs\telongate\tand\tinnervation\tbegins.\nConsider\tLCPUFA\t(especially\tDHA\tand\tAA),\tprotein,\nzinc,\tiron,\tcholine,\tcopper,\tiodine,\tvitamin\tA,\tand\nfolate.\nStage\t15\n(35-38\tdays)\n7-9\tmm
|
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] |
folate.\nStage\t15\n(35-38\tdays)\n7-9\tmm\nBrain\tis\tstill\tlarger\tthan\tthe\ttrunk.\nMaxillary\tand\tmandibular\tarches\tare\tmore\tprominent.\nThe\tstomodeum,\tthe\tdepression\tin\tthe\tectoderm\tthat\nwill\tdevelop\tinto\tthe\tmouth\tand\toral\tcavity,\tappears.\nRetinal\n\tpigment\tmay\tappear\tin\tthe\toptic\tcup.\nSymmetric\tand\tseparate\tnasal\tpits\tappear\tas
|
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0.03715689480304718,
0.04069289565086365,
0.07303831726312637,
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] |
Symmetric\tand\tseparate\tnasal\tpits\tappear\tas\ndepressions\tin\tthe\tnasal\tdisc.\tFuture\tcerebral\nhemispheres\tare\tdistinct.\nBlood\tflowing\tthrough\tthe\tatrioventricular\tcanal\tis\tnow\ndivided\tinto\tleft\tand\tright\tstreams.\nHandplate,\tforearm,\tarm,\tand\tshoulder\tmay\tnow\tbe\ndiscerned\tin\tthe\tupper\tlimb\tbud.\tLower\tlimb\tbud\nbegins\tto\tdevelop\tand\tinnervation\tbegins.
|
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] |
begins\tto\tdevelop\tand\tinnervation\tbegins.\nStage\n\t16\n9-11\tmm\nHindbrain,\tresponsible\tfor\theart\tregulation,\tbreathing,
|
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] |
(37-42\tdays)\nand\tmuscle\tmovements,\tbegins\tto\tdevelop.\tFuture\nlower\tjaw\tis\tnow\tvisible.\tNasal\tpits\trotate\tto\tface\nventrally\tas\thead\twidens.\nCardiac\ttube\tbegins\tto\tdevelop.\tMammary\tgland\ttissue\nbegins\tto\tmature.\tMesentery,\tthe\ttissue\tthat\tattaches\nthe\tintestines\tto\tthe\trear\tabdominal\twall\tand\tsupplies\nthem\twith\tblood,\tnerves,\n\tand\tlymphatics,\tis\tnow
|
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] |
them\twith\tblood,\tnerves,\n\tand\tlymphatics,\tis\tnow\ndefined.\nHands\tbegin\tto\tdevelop.\tThigh,\tleg,\tand\tfoot\tareas\tcan\nnow\tbe\tdistinguished.\nConsider\tvitamin\tA.\nStage\t17\n(42-44\tdays)\n10-13\tmm\nJaw\tand\tfacial\tmuscles\tare\tdeveloping.\tThe\tnasofrontal\ngroove\tbecomes\tdistinct.\tAn\tolfactory\tbulb\t(sense\tof\nsmell)\tforms\tin\tthe\tbrain.\tTeeth\tbuds\t(without\ta\tclear
|
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smell)\tforms\tin\tthe\tbrain.\tTeeth\tbuds\t(without\ta\tclear\ncell\tarrangement)\tbegin\tto\tform.\nHeart\tseparates\tinto\tfour\tdistinct\n\tchambers.\tThe\ndiaphragm\tforms\tand\tthe\tpituitary\tgland,\ttrachea,\nlarynx,\tand\tbronchi\tbegin\tto\tform.\tIntestines\tbegin\tto\ndevelop\twithin\tthe\tumbilical\tcord,\tlater\tmigrating\tto\nthe\tabdomen\twhen\tthere\tis\tspace.\tPrimitive\tgerm
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] |
the\tabdomen\twhen\tthere\tis\tspace.\tPrimitive\tgerm\ncells\tarrive\tat\tthe\tgenital\tarea,\tresponding\tto\tgenetic\ninstructions\ton\twhether\tthey\tdevelop\tinto\tfemale\tor\nmale\tgenitals.\tDigital\trays\tare\tapparent\ton\tfeet\tand\nhands.\nConsider\n\tvitamin\tK.\nStage\t18\n(44-48\tdays)\n11-14\tmm\nBody\tappears\tmore\tlike\ta\tcube.
|
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] |
Stage\t18\n(44-48\tdays)\n11-14\tmm\nBody\tappears\tmore\tlike\ta\tcube.\nEyelids\tbegin\tto\tdevelop,\teyes\tare\tpigmented.\tNipples\nappear\ton\tthe\tchest.\tKidneys\tbegin\tto\tproduce\turine.\nOssification\tof\tthe\tskeleton\tbegins.\nConsider\tcalcium,\tphosphorus,\tmagnesium,\nvitamins\tA,\tD,\tand\tK.\n\tSee\t\nChapter\t23\n.\nStage\t19\n(48-51\tdays)\n13-18\tmm
|
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] |
See\t\nChapter\t23\n.\nStage\t19\n(48-51\tdays)\n13-18\tmm\nSemicircular\tcanals\tare\tforming\tin\tthe\tinner\tear,\nenabling\n\ta\tsense\tof\tbalance\tand\tbody\tposition.\tGonads\nare\tforming.\tKnee\tand\tankle\tlocations\tare\tnow\napparent,\tjoints\tare\tmore\tdistinct.\tToes\tare\tnearly\ncompletely\tnotched\tand\ttoenails\tbegin\tto\tappear.
|
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] |
completely\tnotched\tand\ttoenails\tbegin\tto\tappear.\nBone\tcartilage\tbegins\tto\tform\ta\tmore\tsolid\tstructure.\nMuscles\tdevelop\tand\tstrengthen.\nStage\t20\n(51-53\tdays)\n15-20\tmm\nSpontaneous\tmovement\tbegins.\nNose\tis\tfully\tformed.\tAnal\tmembrane\tis\tperforated.\nTestes\tor\tovaries,\tas\twell\tas\ttoes,\tare\tdistinguishable.\nStage\t21\n(53-54\tdays)\n17-22\tmm
|
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] |
Stage\t21\n(53-54\tdays)\n17-22\tmm\nEyes\tare\twell\tdeveloped\tbut\thave\tnot\tyet\tmigrated\nforward\tfrom\tthe\tside\tof\tthe\thead.\tExternal\tears\thave\nnot\tyet\tmigrated\tup.\tTongue\tis\tdeveloping.\nIntestines\tbegin\tto\trecede\tinto\tthe\tabdominal\tcavity.\nFailure\tto\trecede\tmay\tresult\tin\teither\t\ngastroschisis\n\tor\nomphalocele\n.\nStage\t22\n(54-56\tdays)\n19-24\n\tmm
|
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] |
gastroschisis\n\tor\nomphalocele\n.\nStage\t22\n(54-56\tdays)\n19-24\n\tmm\nDevelopment\tof\tmultiple\torgans\tcontinues.\tUpper\tlip\nnow\tfully\tformed.\nThe\tbrain\tcan\tsignal\tmuscle\tmovement.\nLimbs\tbegin\tto\tossify\t(replacing\tcartilage\twith\tbone),\nstarting\tin\tthe\tupper\tlimbs.\nConsider\tthe\tbone\tnutrients.\n\tSee\t\nChapter\t23\n.\nStage\t23\nEmbryonic\tPeriod\nEnds\n(56-60\tdays)
|
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] |
See\t\nChapter\t23\n.\nStage\t23\nEmbryonic\tPeriod\nEnds\n(56-60\tdays)\n23-26\tmm\nHead\tis\terect\tand\tround.\tExternal\tear\tis\tcompletely\ndeveloped.\tRetina\tis\tfully\tpigmented.\tEyelids\n\tbegin\tto\nunite\tand\tare\thalf\tclosed.\tTaste\tbuds\tbegin\tto\tform.\nBones\tof\tthe\tpalate\tbegin\tto\tfuse.\tPrimary\tteeth\tare\tat\ncap\tstate\t(cells\tare\tnow\tarranged\tand\tlook\tlike\ta\tcap).
|
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] |
cap\tstate\t(cells\tare\tnow\tarranged\tand\tlook\tlike\ta\tcap).\nUpper\tand\tlower\tlimbs\tare\twell\tformed;\tfingers\tand\ntoes\tno\tlonger\twebbed.\nIntestines\tcontinue\tto\tmigrate\tfrom\tthe\tumbilical\tcord\ninto\tthe\tbody\tcavity.\nLayers\tof\trather\tflattened\tcells\t(precursors\tto\tthe\tsurface\nlayer\tof\n\tskin)\treplace\tthe\tthin\tectoderm.\nConsider\tvitamins\tA,\tD,\tand\tK,\tcalcium,
|
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] |
Consider\tvitamins\tA,\tD,\tand\tK,\tcalcium,\nphosphorus,\tmagnesium,\tprotein,\tand\tomega-3\nfatty\tacids.\n(61-68\tdays,\napproximately\n10\tweeks)\n31-42\tmm\nBasic\tbrain\tstructure\tis\tcomplete\tand\tthe\tbrain\tmass\tis\nrapidly\tgrowing.\tSockets\tfor\tall\t20\tteeth\tare\tformed\tin\nthe\tgum\tline.\tFace\thas\thuman\tappearance.\tVocal\ncords\tform\tand\tthe\tfetus\tcan\tmake\tsounds.\tFetus
|
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] |
cords\tform\tand\tthe\tfetus\tcan\tmake\tsounds.\tFetus\ndevelops\n\treflexes.\nDigestive\ttract\tmuscles\tcan\tfunction\tand\tpractice\ncontraction.\tNutrient-extracting\tvilli\tline\tthe\tfolded\nintestines.\tThe\tliver\tbegins\tto\tsecrete\tbile\t(thick,
|
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] |
brown-green\tliquid\tcontaining\tbile\tsalts,\tbile\npigments,\tcholesterol,\tand\tinorganic\tsalts),\twhich\tis\nstored\tin\tthe\tgallbladder.\nThe\tthyroid\tand\tpancreas\tare\tfully\tdeveloped.\tThe\npancreas\tproduces\tinsulin.\tGenitalia\tare\tnot\tyet\n\tfully\nformed.\tFingernails\tbegin\tgrowing.\tSkin\tis\tvery\nsensitive.\nConsider\tfolate,\tomega-3\tfatty\tacids,\tvitamins\tD,\tA,
|
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] |
sensitive.\nConsider\tfolate,\tomega-3\tfatty\tacids,\tvitamins\tD,\tA,\ncholine,\tBs,\tprotein,\tzinc,\tiron,\tcopper,\nmagnesium,\tand\tiodine.\n(12\tweeks)\nLength:\tcrown-\nrump\tlength\n61\tmm\t(almost\n2.5\tinches)\nWeight:\t8-14\tg\n(0.3-0.5\toz)\nFetus\tbegins\tto\tmove\taround\tas\tmuscle\tand\tnervous\nsystems\tcontinue\tto\tdevelop.\nHeartbeat\tcan\tbe\tdetected.\tSucking
|
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] |
systems\tcontinue\tto\tdevelop.\nHeartbeat\tcan\tbe\tdetected.\tSucking\n\tmuscles\tdevelop,\nsalivary\tglands\tbegin\tto\tfunction.\tSweat\tglands\tand\nbody\thair\tbegin\tto\tgrow.\tScalp\thair\tpattern\tis\ndiscernible.\tFetus\tinhales\tand\texhales\tamniotic\tfluid,\nessential\tfor\tthe\tdevelopment\tof\tthe\tair\tsacs\tin\tthe\nlungs.
|
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] |
essential\tfor\tthe\tdevelopment\tof\tthe\tair\tsacs\tin\tthe\nlungs.\nSpleen\tis\tfully\tfunctional,\tremoving\told\tred\tblood\tcells\nand\tproducing\tantibodies.\n(Approximately\t14\nWeeks)\nLength:\t80-104\nmm\t(3.2-4.1\ninches)\nWeight:\t25\tg\n(almost\n\t1\toz)\nBones\tcontinue\tto\tform,\tmuscles\tstrengthen.\tEyes\tface\nmore\tforward\tand\tears\tare\tnear\ttheir\tfinal\tposition.
|
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] |
more\tforward\tand\tears\tare\tnear\ttheir\tfinal\tposition.\nTorso\tis\tgrowing\trapidly,\tincreasing\tits\tproportion\tto\nthe\thead.\tLimbs\tare\twell\tdeveloped.\tToenails\tbegin\tto\ngrow.\nHeart\tpumps\t25\tquarts\tof\tblood/day\t(by\tthe\ttime\tof\ndelivery\tit\twill\tbe\t300\tquarts/day).\tBreathing,\nswallowing,\tand\tsucking\tare\tall\tbecoming\tmore\ndeveloped.\nConsider
|
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] |
swallowing,\tand\tsucking\tare\tall\tbecoming\tmore\ndeveloped.\nConsider\n\tvitamin\tA,\tprotein,\tand\tthe\tbone\nnutrients.\n\tSee\t\nChapter\t23\n.\n(16\tweeks)\nLength:\t109-117\nmm\t(4.3-4.6\ninches)\nWeight:\t80\tg\n(approximately\n2.8\toz)\nThe\tplacenta\tis\tnow\tthe\tsize\tof\tthe\tfetus.\tThe\tumbilical\ncord\tsystem\tgrows\tand\tthickens,\twith\tthe\tblood
|
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] |
cord\tsystem\tgrows\tand\tthickens,\twith\tthe\tblood\nproviding\tnourishment\tto\tthe\tfetus\tthrough\nconsiderable\tforce.\t7.5\toz\t(250\tmL)\tof\tamniotic\tfluid\nsurround\tthe\tconceptus.\nEyes\tand\tears\tare\tin\n\tcorrect\tpositions.\tFetus\tcan\tblink,\nears\tstand\tout\tfrom\thead.\tFingerprints\tand\ttoe\tprints\ndevelop.\nCirculation\tis\tcompletely\tfunctional.\tMeconium,\tthe
|
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] |
develop.\nCirculation\tis\tcompletely\tfunctional.\tMeconium,\tthe\nproduct\tof\tcell\tloss,\tdigestive\tsecretions,\tand\nswallowed\tamniotic\tfluid,\tbegins\tto\taccumulate\tin\tthe\nintestines.\tNerves\tare\tbeing\tcoated\twith\tmyelin,\ta\nfatty\tsubstance\tthat\tspeeds\tnerve\tcell\ttransmission\nand\tinsulates\tthem\tfor\tuninterrupted\timpulses.
|
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] |
and\tinsulates\tthem\tfor\tuninterrupted\timpulses.\nConsider\tomega-3\tfatty\tacids,\tiron,\tvitamin\tA,\tand\ncholesterol.\nAdapted\tfrom\t\nThe\tVisible\tEmbryo\n\t(website):\t\nhttp://www.visembryo.com/\n.\t\nAA,\n\tArachidonic\tacid;\t\nDNA,\n\tdeoxyribonucleic\tacid;\t\nhCG,\n\thuman\tchorionic\ngonadotropin;\t\nLCPUFA,\n\tlong-chain\tpolyunsaturated\tfatty\tacids,\t\nDHA,
|
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0.0162839125841856
] |
gonadotropin;\t\nLCPUFA,\n\tlong-chain\tpolyunsaturated\tfatty\tacids,\t\nDHA,\n\tdocosahexaenoic\tacid.\nBOX\t14.1\nPotential\tRisk\tFactors\tfor\tDevelopment\tof\tBirth\tDefects\nAssisted\treproductive\n\ttechnologies\t(ART)\nGenetic\talterations\nGene-environmental\tinteractions,\tsuch\tas\tmaternal\tsmoking\nHypoxia\tduring\tpregnancy
|
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0.010362130589783192
] |
Hypoxia\tduring\tpregnancy\nInfection\tduring\tpregnancy\t(bacterial,\tparasitic,\tviral)\nIn\tutero\texposure\tto\ttoxins\tor\theavy\tmetals\t(lawn\tchemicals,\tformaldehyde,\tendocrine\ndisruptors,\tagricultural\tproducts,\tpesticides,\tcarbon\tmonoxide,\tradiation,\tmercury,\tlead)\nMaternal\tmedical\tconditions\t(diabetes,\n\thypothyroidism,\tphenylketonuria)
|
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] |
hypothyroidism,\tphenylketonuria)\nMaternal\tmedication\tor\tsubstance\texposure\t(including\tbut\tnot\trestricted\tto\tisotretinoin,\nphenytoin,\tcarbamazepine,\ttriamterene,\ttrimethoprim,\twarfarin,\tand\tradioactive\tiodine),\nillicit\trecreational\tsubstances,\talcohol\nNutrient\tdeficits\tduring\tearly\tpregnancy\t(iodine,\tvitamin\tB\n12\n,\tvitamin\tD,\tvitamin\tA\t[also
|
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] |
12\n,\tvitamin\tD,\tvitamin\tA\t[also\nexcess],\tvitamin\tK,\tcopper,\tzinc,\tfolic\tacid,\tcholine)\nObesity\nOlder\tmother\tor\tfather\nPregnancy
|
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Physiologic\tchanges\tof\tpregnancy\nBlood\tvolume\tand\tcomposition\nBlood\tvolume\texpands\tby\tnearly\t50%\tby\tthe\tend\tof\tpregnancy,\twith\twide\tvariability\tamong\twomen.\nThis\tincreased\tblood\tvolume\tresults\tin\tdecreased\tlevels\tof\themoglobin,\tserum\talbumin,\tother\tserum\nproteins,\tand\twater-soluble\tvitamins,\tprimarily\tafter\tthe\tend\tof\tthe\tfirst\ttrimester.
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0.06437807530164719,
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0.01628647744655609,
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0.01224781945347786,
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0.05414889007806778,
0.05193965137004852,
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0.015056571923196316,
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0.07568872720003128,
0.07082445919513702,
-4.407803189110382e-8,
0.0284389890730381,
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0.004945885390043259,
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0.04714054986834526,
0.004957484547048807,
0.023891815915703773,
0.06347319483757019,
0.023056503385305405,
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0.015057201497256756,
0.11776438355445862,
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0.07429932802915573,
0.03551211953163147,
0.001199907623231411,
0.11129987239837646,
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0.04749215766787529,
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0.015115354210138321,
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0.018478427082300186,
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0.020505446940660477,
0.02944023162126541,
0.08136383444070816,
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0.05246661603450775,
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0.0005230739479884505,
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0.09434504061937332,
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-0.036937445402145386,
0.08820532262325287,
0.09974829107522964,
-0.0888819694519043,
0.00897824577987194,
0.11214651167392731,
0.03393443301320076,
-0.06734221428632736,
-0.041365861892700195,
0.06883953511714935,
0.01094689778983593,
-0.06760742515325546,
-0.060637861490249634,
0.06307364255189896,
0.06506551057100296,
-0.007859943434596062,
-0.04188238084316254,
-0.017406612634658813,
0.04625558480620384,
0.10487135499715805,
0.08973169326782227,
-0.0007479350897483528
] |
In\tcontrast,\tserum\nconcentrations\tof\tfat-soluble\tvitamins\tand\tother\tlipid\tfractions\tsuch\tas\ttriglycerides,\tcholesterol,\tand\nfree\tfatty\tacids\tincrease\tto\tensure\tsufficient\ttransport\tto\tthe\tfetus.\tA\tcompilation\tof\tlaboratory\nvalues\tby\ttrimester\tis\tavailable,\tand\tselected\tvalues\tare\tlisted\tin\t\nTable\t14.4\n.\tHowever,\twide
|
[
0.002334347227588296,
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0.02559240534901619,
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0.04821806401014328,
0.025036795064806938,
0.0052541205659508705,
0.03449002653360367,
0.0369989387691021,
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0.043499656021595,
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0.12372814863920212,
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0.09024311602115631,
0.08436019718647003,
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0.08365791290998459,
0.029846929013729095,
0.052002567797899246,
0.0004289858916308731,
0.05019380897283554,
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0.04527708888053894,
0.0004169154854025692,
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0.02367490343749523,
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0.0002815092448145151,
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0.021566713228821754,
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0.0009309282759204507,
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0.04475720599293709,
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0.05416075885295868,
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0.01259598508477211,
0.08466725796461105,
0.02832399681210518,
0.006933568511158228,
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0.0394786037504673,
0.0557347871363163,
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2.837220184918706e-33,
0.04080707207322121,
0.0795711949467659,
0.006342671345919371,
0.053109411150217056,
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0.08090764284133911,
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0.043668437749147415,
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0.07330633699893951,
0.03683776035904884,
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0.07164686173200607,
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0.16521625220775604,
0.01354435458779335,
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0.01977715454995632,
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0.017799559980630875,
0.037060339003801346,
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0.016457531601190567,
0.007405588403344154,
0.014623365364968777,
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0.001348618185147643,
0.023988284170627594,
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0.04638262838125229,
0.06408493965864182,
0.06755296885967255,
0.009343364275991917,
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0.010738018900156021,
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0.02632763981819153,
0.06678793579339981,
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0.005350553430616856,
0.0347757562994957,
0.045754846185445786,
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0.023511581122875214,
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0.0204167477786541,
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0.07691200077533722,
0.013462665490806103,
0.08390316367149353,
0.09780284017324448,
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0.06705287843942642,
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0.0015500482404604554,
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0.02122459001839161,
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0.04928475245833397,
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-3.417883537498207e-33,
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0.017430922016501427,
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0.07736469805240631,
0.0940561443567276,
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0.10660459101200104,
0.03879819065332413,
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0.04724310338497162,
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0.058599915355443954,
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0.05667790398001671,
0.017986614257097244,
0.06799622625112534,
0.013643085956573486,
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0.044968802481889725,
0.08941458910703659,
0.06170904263854027,
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0.049763087183237076,
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0.04567918926477432,
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0.022529758512973785,
0.001266221865080297,
0.023006368428468704,
0.09205149859189987,
0.03752480819821358,
0.034875594079494476,
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0.02507100999355316,
0.08091696351766586,
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0.03631793335080147,
0.03564785420894623,
0.0549568347632885,
0.030955720692873,
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0.01477157510817051,
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0.041386380791664124,
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0.06848358362913132,
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-0.0054514650255441666,
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0.03151649981737137,
0.008006295189261436,
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0.05286821350455284,
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0.07210108637809753,
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0.05263805761933327,
0.0012499012518674135,
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0.02742072567343712,
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0.07573236525058746,
0.07577744871377945,
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0.028249183669686317,
0.026997826993465424,
0.07732798159122467,
0.0827081948518753,
-4.887302651468417e-8,
0.029681801795959473,
-0.04587356001138687,
-0.011386818252503872,
-0.0462551973760128,
-0.01725171133875847,
0.008513439446687698,
0.03291913866996765,
0.01785997301340103,
0.0007811872055754066,
-0.03970164805650711,
0.01296423003077507,
0.10168559104204178,
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0.093231700360775,
0.033647436648607254,
-0.03270844742655754,
0.07494112104177475,
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-0.035144004970788956,
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0.08610061556100845,
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0.0030232667922973633,
0.000942255137488246,
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-0.029337575659155846,
0.017365969717502594,
0.07160069048404694,
0.013093029148876667,
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0.024391623213887215,
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0.015270179137587547,
0.0906679555773735,
-0.03548511490225792,
-0.02311100997030735,
-0.05375514179468155,
0.14534391462802887,
-0.023636851459741592,
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0.06578467041254044,
0.10836955904960632,
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-0.029730796813964844,
0.1135343387722969,
0.03873974457383156,
-0.05920197814702988,
-0.03278908133506775,
0.11657022684812546,
-0.048758987337350845,
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-0.06778517365455627,
0.023039136081933975,
-0.0062089706771075726,
0.03585125133395195,
-0.010564632713794708,
-0.03464249148964882,
0.07321173697710037,
0.03408755734562874,
0.15696175396442413,
0.007741390261799097
] |
Table\t14.4\n.\tHowever,\twide\nindividual\tvariability\tmakes\tdetermination\tof\tan\tinadequate\tintake\tor\ta\tdeficient\n\tnutrient\tstate\ndifficult.\tNormal\thematocrit\tand\themoglobin\tvalues\tchange\tby\ttrimester\tand\tcutpoints\tincrease\twith\naltitude\tand\tsmoking\tstatus,\tas\tshown\tin\t\nTable\t14.5\n.\nTABLE\t14.4
|
[
0.02448543719947338,
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0.019422311335802078,
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0.016716590151190758,
0.0730191096663475,
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0.06415386497974396,
0.09094968438148499,
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0.07072566449642181,
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0.05763060972094536,
0.018540002405643463,
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0.02253580093383789,
0.045465607196092606,
0.075783371925354,
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0.008828237652778625,
0.0370095819234848,
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0.03345659747719765,
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0.10066637396812439,
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0.02286648564040661,
0.04146928712725639,
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0.04038790240883827,
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0.11605187505483627,
0.014147666282951832,
0.06485733389854431,
0.015443320386111736,
0.015539740212261677,
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0.02303117886185646,
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] |
altitude\tand\tsmoking\tstatus,\tas\tshown\tin\t\nTable\t14.5\n.\nTABLE\t14.4\nSelected\tReference\tRanges\tfor\tNutrient\tLevels\tin\tNonpregnant\tand\tPregnant\tWomen,\tby\tTrimester\nComponent\nNonpregnant\nAdult\nFirst\nTrimester\nSecond\nTrimester\nThird\nTrimester\nAlbumin,\tg/dL\n4.1-5.3\n3.1-5.1\n2.6-4.5\n2.3-4.2\nProtein,\ttotal,\tg/dL\n6.7-8.6\n6.2-7.6\n5.7-6.9\n5.6-6.7
|
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0.05388738960027695,
0.009346445091068745,
-0.019317520782351494,
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0.02051803097128868,
0.050426285713911057,
-0.01215197890996933,
0.02638757787644863,
0.0319502130150795
] |
2.6-4.5\n2.3-4.2\nProtein,\ttotal,\tg/dL\n6.7-8.6\n6.2-7.6\n5.7-6.9\n5.6-6.7\nCholesterol,\ttotal,\tmg/dL\n<\t200\n141-210\n176-299\n219-349\nTriglycerides,\tmg/dL\n<\t150\n40-159\n75-382\n131-453\nVitamin\tA\n\t(retinol),\tmcg/dL\n20-100\n32-47\n35-44\n29-42\nVitamin\tB\n12\n,\tpg/mL\n279-966\n118-438\n130-656\n99-526\nVitamin\tC,\tmg/dL\n0.4-1.0\nNot\treported\nNot\treported\n0.9-1.3
|
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0.029660023748874664,
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] |
99-526\nVitamin\tC,\tmg/dL\n0.4-1.0\nNot\treported\nNot\treported\n0.9-1.3\nVitamin\tD,\t25\thydroxy,\nng/mL\n14-80\n18-27\n10-22\n10-18\nVitamin\tE,\tmcg/mL\n5-18\n7-13\n10-16\n13-23\nFolate,\tred\tblood\tcell,\tng/mL\n150-450\n137-589\n94-828\n109-663\nCalcium,\ttotal,\tmg/dL\n8.7-10.2\n8.8-10.6\n8.2-9.0\n8.2-9.7\nCopper,\tmcg/dL\n70-140\n112-199\n165-221\n130-240\nFerritin,\tng/mL\n10-150
|
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] |
Copper,\tmcg/dL\n70-140\n112-199\n165-221\n130-240\nFerritin,\tng/mL\n10-150\n6-130\n2-230\n0-116\nHemoglobin,\tg/dL\n12-15.8\n11.6-13.9\n9.7-14.8\n9.5-15.0\nHematocrit,\t%\n35.4-44.4\n31.0-41.0\n30.0-39.0\n28.0-40.0\nMagnesium,\tmg/dL\n1.5-2.3\n1.6-2.2\n1.5-2.2\n1.1-2.2\nSelenium,\tmcg/L\n63-160\n116-146\n75-145\n71-133\nZinc,\tmcg/dL\n75-120\n57-88\n51-80\n50-77
|
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-0.013385197147727013,
-0.012880779802799225,
-0.05389003828167915,
-0.04680265858769417
] |
63-160\n116-146\n75-145\n71-133\nZinc,\tmcg/dL\n75-120\n57-88\n51-80\n50-77\nAdapted\tfrom\tAbbassi-Ghanavati\tM\tet\tal:\tPregnancy\tand\tlaboratory\tstudies:\ta\n\treference\ttable\tfor\tclinicians,\t\nObstet\tGynecol\n\t114:1326,\t2009.
|
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] |
TABLE\t14.5\nMaximum\tHemoglobin\tand\tHematocrit\tValues\tfor\tPrenatal\tAnemia\tDiagnosis\nTrimester\nHemoglobin\tCutpoints\tat\tSea\nLevel\nHematocrit\tCutpoints\tat\tSea\nLevel\nFirst\n<\t11.0\tg/dL\n<\t33.0%\nSecond\n<\t10.5\n<\t32.0\nThird\n<\t11.0\n<\t33.0\nAltitude\tadjustments:\tmust\tbe\tadded\tto\tthe\tabove\tcutpoints\tfor\taccurate\tdiagnosis\n3000-3999\tfeet\tabove\tsea\nlevel
|
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+2.0\n+6.0\n3500\tmeters\n+2.7\n+8.0\n4000\tmeters\n+3.5\n+10.5\n4500\tmeters\n+4.5\n+13.5\nCigarette\tsmoking:\tmay\tbe\tadded\tto\tthe\tabove\tcutpoints\tfor\taccurate\tdiagnosis\n0.5\tto\t<\t1.0\tpack\tper\tday\n+0.3\tg/dL\n+1.0\t%\n1.0\tto\t<\t2.0\tpacks\n\tper\tday\n+0.5\n+1.5\n≥\t2.0\tpacks\tper\tday\n+0.7\n+2.0\nAll\tsmokers\n+0.3\tg/dL\n+1.0\t%
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+0.5\n+1.5\n≥\t2.0\tpacks\tper\tday\n+0.7\n+2.0\nAll\tsmokers\n+0.3\tg/dL\n+1.0\t%\nAdapted\tfrom\tCenters\tfor\tDisease\tControl\tand\tPrevention:\tRecommendations\tto\tprevent\tand\tcontrol\tiron\tdeficiency\tin\tthe\tUnited\tStates,\t\nMMWR\nRecomm\tRep\n\t47:1,\t1998;\tWorld\tHealth\tOrganization\t(WHO):
|
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0.010080669075250626
] |
MMWR\nRecomm\tRep\n\t47:1,\t1998;\tWorld\tHealth\tOrganization\t(WHO):\t\nHaemoglobin\tconcentrations\tfor\tthe\tdiagnosis\tof\tanaemia\tand\tassessment\tof\tseverity.\nVitamin\tand\tMineral\tNutrition\n\tInformation\tSystem.\tWHO/NMH/NHD/MNM/11.1,\t2011.\t\nhttp://www.who.int/vmnis/indicators/haemoglobin.pdf\n.\nCardiovascular\tand\tpulmonary\tfunction
|
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] |
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