> CASE 4 Normal Infant Development
Jasmine and Richard had mixed emotions when the pregnancy test came back positive. Their previous pregnancy was not successful because of chromosomal abnormalities. This had been devastating for them both, and they planted a tree in the backyard in honor of that child not meant to be. A human karyotype consists of 22 pairs of autosomal chromosomes and one pair of allosomes for gender. Fetal development often ends prior to the first trimester of a pregnancy, primarily due to karyotype deficiencies such as an extra chromosome, XXY, or a missing chromosome, X only. They were relieved when the chorionic villi sampling (CVS) test in the first trimester was negative for chromosomal abnormalities. CVS is a common prenatal test performed in high-risk pregnancies; the physician extracts tissue from the placenta for fetal genetic testing.
Jasmine was careful with her diet, eating healthy foods and taking prenatal vitamins. She was very fit, and her physician supported her decision to remain active, with modifications as needed, as long as she felt good and the baby was doing well. She worked as a physical therapist at the hospital until her 39th week of pregnancy. Additionally, visitors to the local health club were surprised to meet a vibrant and very pregnant woman teaching both Zumba and spinning up until her ninth month!
Jasmine worked Friday and went into labor over the weekend, giving birth to Miles on a Monday evening in October, after 39 weeks of gestation. At 8 pounds 5 ounces, Miles was full term; however, a complication developed during delivery when the umbilical cord wrapped around his neck. The obstetrician asked Jasmine to hold off on pushing while he unwound the cord, and Miles was delivered. He was a little blue, with a hearty cry and an Apgar score of 9/10 (he lost one point for color), which increased to a 10/10 at five minutes. Infant health is assessed at one minute and five minutes after delivery, using the Apgar scale, which evaluates infant status for cardiovascular and neurologic function, indicating need for resuscitation support to thrive. The one-minute score offers a glimpse of how the infant tolerated delivery, and the five-minute score relates to postpartum tolerance. It does not correlate to long-term infant health, nor can it predict morbidity or mortality. Miles’ Apgar reflected the minimal amount of time he had the cord wrapped around his neck, thus saving him from potentially damaging events such as anoxia.
Miles is a very fortunate baby, with many loving caregivers in his life, offering a supportive and varied environment. From day one, Miles enjoyed multisensory enrichments including sound, touch, and varied postures. His parents sang to him daily, and he would listen as they read to Fiona, his older sister. Each bath ended with infant massage, and he came to appreciate daily “tummy time,” to promote head extension and development of motor milestones. His grandparents were bilingual ...