344 Chapter 17
Disorders: miscarriages, stillbirths,
and Birth Defects
carbohydrates, lipids, and proteins it needs. Vitamins and
minerals are a different story, however. Physicians recom-
mend that a pregnant woman take supplemental vitamins
and minerals, not only for her own benefit but also to meet
the needs of her fetus. This is particularly true for the nutri-
ent folic acid (folate), which is required for the neural tube
to develop properly. If too little folic acid is available, a birth
Miscarriage is the death and spontaneous expulsion of an
embryo or fetus before 20 weeks of gestation. It occurs in
more than 20 percent of all conceptions, usually during the
first trimester. Many factors can trigger a miscarriage (also
called spontaneous abortion), but in up to half of cases the
embryo (or the fetus) has one or more genetic disorders that
prevent normal development.
Death of a fetus after 20 weeks is called a stillbirth.
Some stillbirths result from complications during delivery,
but most occur before labor begins. The risk is greatest for
twins (or other multiples) who share a placenta and for the
fetuses of women who are diabetic, smokers, have a history
of drug abuse, or who are of African descent.
Poor maternal nutrition puts a fetus at risk
A pregnant woman must nourish her unborn child as well
as herself. In general, the same balanced diet that is good
for her should also provide her developing baby with all the
period of dividing
zygote, implantation,
and early embryo
1
CNS
heart eye
eye ear palate
brain
central nervous system
external genitals
upper limbs
lower limbs
eyes
ear
teeth
palate
ear
external genitals
teeth
limbs
heart
indicates common site of action of teratogen
not
vulnerable to
teratogens
prenatal death major structural abnormalities
age of embryo (in weeks) fetal period (in weeks) full term
2345 678916 20–36 38
functional defects and
minor structural abnormalities
heart
F i g u r e 17.19 Many factors can cause birth defects. Light blue bars indicate periods when developing organs are most sensitive to
damage from alcohol, viral infection, and so on. Dark blue bars indicate the time when major structural abnormalities due to other
causes become apparent. Numbers signify the week of development. (© Cengage Learning)
1 7. 1 0
An exposed spinal cord due to spina bifida
Biophoto Associates/Science Source
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