What is Mild Hyperphe?

Mild Hyperphe is an inherited condition in which a person's body is unable to properly utilize one part of protein found in food. This condition causes mildly increased levels of phenylalanine in the blood. There are no known problems associated with having Mild Hyperphe as a child so dietary treatment is usually not required then. However, research suggests special attention might be needed for the woman with Mild Hyperphe during pregnancy to protect her babies from birth defects.
Hyperphe is an abbreviation of the medical term Hyperphenylalaninemia (pronounced hyper-fenel-al-ah-ninemia). This long medical term can be divided into three parts and defined as follows:

Hyper: means high
Phenylalnine: is an amino acid (a part of protein) found in food
Emia: refers to the blood

How Did I Get Mild Hyperphe?

Genes are responsible for your characteristics, such as eye color and height. Genes are also responsible for instructing the cells in the liver to make the enzyme that changes PHE to tyrosine. When the gene responsible for making this enzyme is altered, Mild Hyperphe occurs. Below is a simple illustration of how the altered gene was passed from your grandparents to your parents and to you.

Genes are units of inheritance found in body cells. Genes come in pairs in your cells with each parent contributing one gene to the pair in each cell. A person who has one "normal" gene and one altered Mild Hyperphe gene is called a carrier.

Generation I represents the possible genetic makeup of your grandparents. One of your maternal grandparents and one of your paternal grandparents are carriers of the Mild Hyperphe gene. One in 70 persons are carriers of the Mild Hyperphe gene.

What Are the Effects of Mild Hyperphe on an Unborn Child During Pregnancy?

There are no known problems associated with having Mild Hyperphe as a child so treatment is not needed then. However, research suggests special attention may be needed for the woman with Mild Hyperphe during pregnancy to prevent birth defects.

In 1984, the Maternal PKU Collaborative Study began collecting information on Hyperphe during pregnancy. Women with various types of Hyperphe, including Mild Hyperphe, were enrolled and followed during pregnancy by the Study. The results show that women with Mild Hyperphe should be followed by a PKU center before and during pregnancy. The center monitors the woman's diet and blood PHE levels and, if necessary, puts her on a diet to avoid possible damage to the baby.
The potential damage for the unborn baby during pregnancy works this way. As blood flows from the mother through the placenta during pregnancy, nutrients, including PHE, are transferred to the baby. The placenta concentrates some nutrients, like PHE, to help the baby grow. The blood PHE level may increase 1½ times in the baby. For example, a mother's blood level of 7 mg/dL (420 mmol/L) may be concentrated by the placenta to 11 mg/dL (660 mmol/L) before passing on to the baby as illustrated in Figure 4. Blood PHE levels that are too high place the baby at risk for birth defects.

Fetus Support Manipulator with Flexible Balloon-based Stabilizer for Endoscopic Intrauterine Surgery

A novel manipulator is described for stabilizing fetus and preventing it from free-floating during the endoscopic intrauterine surgery. Minimally invasive endoscopic fetal surgery enables intrauterine intervention with reduced risk to the mother and fetus. We designed and fabricated a prototype of a fetus supporting manipulator equipped with a flexible bending/curving mechanisms and a soft balloon-based stabilizer. The flexible bending and curving mechanisms enable the stabilizer to reach the target sites within the uterus under an ultrasound-guidance. The balloon-based stabilizer could be inserted into the uterus with a small incision for entry. The accuracy evaluation showed that the maximum error of the curving mechanism was as small as 7 mm and the standard deviation of the bending mechanism was 1.6 degree. In the experiments using a fetus model, the manipulator could be well controlled under ultrasound guidance and its curving mechanism with the balloon-based stabilizer could be clearly visualized during the implementation of fetus model supporting. The manipulator has the potential to be used in minimally invasive intrauterine surgery, though further improvements and experiments remain to be carried out.


1. Fetus stabilizing mechanism and manipulator system for intrauterine surgery
In recent years, endoscopic technology has provided a less invasive approach to surgical treatment. Minimally invasive endoscopic fetal surgery enables intrauterine intervention with reduced risks to the mother and fetus. The problem is that the fetus is floating in the amniotic fluid and its movement will disturbe the surgical treatment. Then, it is necessary to develop a fetus-holding device to support the fetus within the uterus. In a previous research, we attempted to develop a stainless steel fetal stabilizer. The outcome of this research was unfavorable although the fetus was fixed well. Other device was a suction type silicone tube stabilizer equipped with small holes to apply negative pressures on the fetal skin. However, this device was likely to cause fetal tissue congestion during a long time surgery. To overcome these issues, we propose a newly-developed manipulator with a flexible mechanism and a balloon-based supporting stabilizer. The outcome of mechanical performance tests and surgical practice tests using a fetal model under ultrasound guidance will be also described.
The prototype of the fetal support manipulator is comprised of three units: the flexible manipulator unit with a balloon-based stabilizer and a curving mechanism; the PC for controlling the bending mechanism and the syringe; the ultrasonic device for viewing the intra-operative situation of the fetus and the instrument．In general endoscopic surgery, since the viewing zone of endoscope is small and sometime the endoscope can not reach the narrow area, an ultrasonic image is used for assisting the endoscope surgery. The ultrasound is an ideal imaging modality for the diagnosis in obstetrics and gynecology. We use ultrasound to acquire the real-time intra-operative information. The position of the fetus and the umbilical cord could be identified when we insert the stabilizer into the uterus.
Fig.1 Fetus support manipulator system for intrauterine surgery．

2. Mechanism of the manipulator and stabilizing procedure
The procedure of inserting the balloon-based stabilizer to the uterus and stabilizing the fetus with the ultrasound guidance. 1) We insert the instrument with a shrunk balloon according to the position of the fetus. The spatial relationship of the fetus, the uterine wall and the instrument is observed using an ultrasonic diagnosis device. 2) The bending angle of the link part and the curving part of the manipulator are controlled by a PC according to position of the fetus. The bending and curving mechanisms are crooked and inserted into the required position with the guidance of intra-operative ultrasonic image.3) When the silicon covered curving part arrive the abdomen of the fetus, we inject the physiological saline into the balloon and adjust the balloon to optimal position for stabilizing the fetus.

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Fetal pain

The subject of fetal pain and suffering is controversial. The ability of a fetus to feel pain is often part of the abortion debate. However, according to Arthur Caplan, "there is no consensus among the medical and scientific experts about precisely when a fetus becomes pain-capable."[21] Different sources have estimated that the earliest point for pain sensation may be during the first trimester, or after 20, 24, or 26 weeks gestation, or after the second trimester, or months after birth.

Circulatory system

Diagram of the human fetal circulatory system.
The circulatory system of a human fetus works differently from that of born humans, mainly because the lungs are not in use: the fetus obtains oxygen and nutrients from the woman through the placenta and the umbilical cord.
Blood from the placenta is carried by the umbilical vein. About half of this enters the ductus venosus and is carried to the inferior vena cava, while the other half enters the liver proper from the inferior border of the liver. The branch of the umbilical vein that supplies the right lobe of the liver first joins with the portal vein. The blood then moves to the right atrium of the heart. In the fetus, there is an opening between the right and left atrium (the foramen ovale), and most of the blood flows from the right into the left atrium, thus bypassing pulmonary circulation. The majority of blood flow is into the left ventricle from where it is pumped through the aorta into the body. Some of the blood moves from the aorta through the internal iliac arteries to the umbilical arteries, and re-enters the placenta, where carbon dioxide and other waste products from the fetus are taken up and enter the woman's circulation.
Some of the blood from the right atrium does not enter the left atrium, but enters the right ventricle and is pumped into the pulmonary artery. In the fetus, there is a special connection between the pulmonary artery and the aorta, called the ductus arteriosus, which directs most of this blood away from the lungs (which aren't being used for respiration at this point as the fetus is suspended in amniotic fluid).

Postnatal development

With the first breath after birth, the system changes suddenly. The pulmonary resistance is dramatically reduced ("pulmo" is from the Latin for "lung"). More blood moves from the right atrium to the right ventricle and into the pulmonary arteries, and less flows through the foramen ovale to the left atrium. The blood from the lungs travels through the pulmonary veins to the left atrium, increasing the pressure there. The decreased right atrial pressure and the increased left atrial pressure pushes the septum primum against the septum secundum, closing the foramen ovale, which now becomes the fossa ovalis. This completes the separation of the circulatory system into two halves, the left and the right.
The ductus arteriosus normally closes off within one or two days of birth, leaving behind the ligamentum arteriosum. The umbilical vein and the ductus venosus closes off within two to five days after birth, leaving behind the ligamentum teres and the ligamentum venosus of the liver respectively.

Differences from the adult circulatory system
Remnants of the fetal circulation can be found in adults:
Fetal
Adult
foramen ovale
fossa ovalis
ductus arteriosus
ligamentum arteriosum
extra-hepatic portion of the fetal left umbilical vein
ligamentum teres hepatis (the "round ligament of the liver").
intra-hepatic portion of the fetal left umbilical vein (the ductus venosus)
ligamentum venosum
proximal portions of the fetal left and right umbilical arteries
umbilical branches of the internal iliac arteries
distal portions of the fetal left and right umbilical arteries
medial umbilical ligaments (urachus)

In addition to differences in circulation, the developing fetus also employs a different type of oxygen transport molecule than adults (adults use adult hemoglobin). Fetal hemoglobin enhances the fetus' ability to draw oxygen from the placenta. Its association curve to oxygen is shifted to the left, meaning that it will take up oxygen at a lower concentration than adult hemoglobin will. This enables fetal hemoglobin to absorb oxygen from adult hemoglobin in the placenta, which has a lower pressure of oxygen than at the lungs.

Developmental problems

Congenital anomalies are anomalies that are acquired before birth. Infants with certain congenital anomalies of the heart can survive only as long as the ductus remains open: in such cases the closure of the ductus can be delayed by the administration of prostaglandins to permit sufficient time for the surgical correction of the anomalies. Conversely, in cases of patent ductus arteriosus, where the ductus does not properly close, drugs that inhibit prostaglandin synthesis can be used to encourage its closure, so that surgery can be avoided.
A developing fetus is highly susceptible to anomalies in its growth and metabolism, increasing the risk of birth defects. One area of concern is the mother's lifestyle choices made during pregnancy. Diet is especially important during the first trimester of development. Studies show that supplementation of the mother's diet with folic acid reduces the risk of spina bifida and other neural tube defects. Another dietary concern is the consumption of breakfast by the mother. This one factor could lead to extended periods of lower than normal nutrients in the mother's blood, leading to a higher risk of prematurity, or other birth defects in the fetus. During this time alcohol consumption may increase the risk of the development of Fetal alcohol syndrome, a condition leading to mental retardation in some infants.[25] Smoking during pregnancy may also lead to a low birth weight infant, with a weight of <2500 grams, or 5.5 lbs. Low birth weight is a concern for medical providers due to the tendency of these infants, described as premature by weight, to have a higher risk of secondary medical problems.

Legal issues
Fetal rights
Especially since the 1970s, there has been continuing debate over the "personhood" of the human fetus. Although abortion of a fetus before viability is generally legal in the United States following the case of Roe v. Wade, the third-party-killing of a fetus can be punishable as feticide or homicide throughout the pregnancy, depending on jurisdiction.

I found this quote on Human Consciousness.

A human being’s physical body can be considered as a ‘quantum system,’ and it does grow from a ‘zero-point source’–a fertilized ovum, a barely visible point source–which is a whole inner world on another dimension of scale. From a point source, the body forms from within/without, and there are varied subtle fields of energies within the inner human being. Again, the One is divided by three any gives seven, and there is an inner circulation of light and electromagnetic forces, and generations of causes and effects within the living being. If a person is considered as a quantum system, then the heart and not the head is the most dominant ‘electromagnetic centre.’ In this illustration of the fetus, the heart is the primary centre of being, for an emerging
being.

Fetal Development

Week 1:The story of your baby's life begins when a sperm fertilizes an egg. Within half an hour, the fertilized egg begins dividing at a furious rate while traveling down the Fallopian tube to the uterus.Once in the uterus, the developing embryo, implants beneath the surface of the uterus. The unborn child is only one-sixth of an inch long, but is rapidly developing.

Week 2:The embryo produces hormones which stop the mother's menstrual cycle

Week 3:At three weeks, the bundle of cells can now be called an "embryo" and the tiny heart begins to beat.





Week 4:The baby is now an embryo and is about 1/17 of an inch long. The neural tube enlarges into three parts, soon to become a very complex brain. The placenta begins functioning. The umbilical cord develops. The eyes and ears begin to form as well as an opening for the mouth. The heart has begun to pump blood. Buds form on the body that will become the arms and legs.

Week 5:The baby is about 1/3 of an inch. The brain is growing. Facial features are visible, including a mouth and tongue. The eyes have a retina and lens. The major muscle system is developed, and the unborn child practices moving. The part of the nervous system that deals with equilibrium and spatial relations also begins to develop. That means that whenever the mother moves, the baby can feel the change in spatial orientation and will try to change her position accordingly in order to re-stabilize herself. She can also respond to tactile stimulation as her coordination improves.Week 6:Development between third and eighth weeks is highly important since the outlines of all internal and external structures are developed. During the second month, the mother's total volume of blood increases to accommodate the growing fetus. Week 7:The fingers and thumb have appeared but are short and webbed.Week 8:Most of the joints are formed now. Ears, ankles and wrists are formed. At the end of the second month the fetus is a little over 1 inch long and weighs less than an ounce


Week 9:As we go into the third month, the embryo is now called a fetus. The heart is beating more strongly, she can turn her head, open her mouth, and swallow amniotic fluid. She is growing rapidly. Fingers and toes of the fetus have soft nails.Week 10:Nearly all of the organs of the fetus are formed. They will continue to grow and develop until delivery. Vocal chords are complete, and the child can and cry (silently). The brain is fully formed, and he is able to feel pain. The fetus may even suck his thumb. The eyelids now cover the eyes, and will remain shut until the seventh month to protect the delicate optical nerve fibers. Week 11:The face is looking more and more human each day as the eyes begin to move closer together. The face is looking more and more human each day as the eyes begin to move closer togetherIt would be possible now to determine the baby's sex by looking at the genitals. Hair is beginning to appear on the fetus' head.





Week 12:Remember that the baby can now experience many sensations and is now able to begin communicating with you. She has immense potential waiting to be stimulated and developed.Your baby is intimately connected to you emotionally as well as physically. Not only are the substances you intake transmitted to your baby, but your emotions and feelings are transmitted to her as well. Since she shares your endorphins, which are chemical substances that produce an enormous sense of well-being, your child can also sense and share your emotional sensations. It is therefore very important to be happy, peaceful and serene. Your happiness and positive feelings can induce equally pleasant feelings in your child. By the end of the third month the fetus is 4 inches long and from now on, the organs will mature and the fetus will gain weight.


Week 13:Muscles lengthen and become organized. The mother will soon start feeling the first flutters of the unborn child kicking and moving within. the skin is pink and transparent. Week 14:In the second trimester the head is developing more actively than the rest of the body: the eyes, mouth, nose, and ears are almost completely formed, creating a well-defined face. The fetus has an adult's taste buds and may be able to savorWeek 15:The legs are now longer than the arms, and she is moving those arms and legs frequently.




Week 16:The internal organs are maturing. The fetus sleeps and wakes at regular intervals


Week 17:The fetus is much more active turning from side to side and your baby can grasp with his hands, kick, or even somersault. Week 18:Meconium, the baby's first bowel movement, is accumulating within the bowelWeek 19:At the fifth month, something extraordinary occurs: she can actually begin to hear! The child can hear and recognize her mother's voice.





Week 20:She hears the sounds coming from your body: your voice, and the voices of other people who are speaking close by -perhaps her father's-. She can also hear environmental sounds. Rhythmic music calms her and strident sounds excite her.


Week 21:The sensory organs continue their development. She is able to react to sweet and sour tastes as well as bitter ones. She hears and learns and the ability to react to stimuli is already presentWeek 22:The body is becoming better proportioned each day, and the bones of the middle ear begin to hardenWeek 23:Baby makes breathing movements with the chest muscles and sometimes amniotic fluid gets into the windpipe and gives the fetus hiccupsWeek 24:At six months, the unborn child is covered with a fine hair called lanugo and his/her is protected by a waxy substance called vernix caseosa.




Week 25:The brain continues its rapid growth, and the lungs continue to grow


Week 26:The eyelids open, and the eyes are completely formedWeek 27:Fat continues to accumulate under the skin. The brain can control primitive breathing and body temperature control, and the eyes can move in the sockets. The baby is becoming sensitive to light, sound, taste and smellWeek 28:By the 7th month, her key organs are already developed: The nervous system has matured to the point that it controls respiratory functions and body temperature, the lungs would be capable of breathing if she were to be born at this point. Her movements are more organized, and her muscles stronger. She exercises by kicking and stretching. Calcium is being stored and fetal bones are hardening. Now the baby weighs about 3 pounds and she is about 15 inches longWeek 29:The brain goes through a period of rapid development. The only major organ left to fully develop is the lungs.



Week 30:The baby is up to four pounds now and all five senses are functional. The toenails are completely formed and the hair on the head continues to grow.


Week 31:Fat continues to accumulate which turns the baby's skin color from red to pink. During this month, she begins to show signs of personality and intentional behavior. Not only does she move to the rhythm of music, but she also prefers some types of music to others. By the end of this month, she can see! She reacts to changes in lighting and can follow a flashing light.Week 32:She is developing immunities to fight mild infection. Her skin is smooth, her legs and arms are chubby by the eight month. The nervous system is fully formed and ready to operate through a complex mass of neurons. The signals they emit turn into messages, ideas, decisions, memory. She doesn't move as often, but her movements are stronger when she does. The baby is about 18 inches long and weighs about 5 poundsWeek 33:The baby has gotten big enough to take up most of the uterus, and there's less room to move aroundWeek 34:With four weeks to go, our baby is almost ready. She could drop into the birth canal at any time now. This week, the fat is dimpling on the elbows and knees as well as forming creases in the neck and wrists. The baby's gums are very rigid.Week 35:Average size is around 6.5 pounds now! The baby practices breathing movements preparing for life outside the womb. His/her grasp becomes firm, and she will turn toward light.Week 36:The circumference of the head and the baby's abdomen are about the same size. The bones of the baby's head are soft and flexible for delivery. She will continue growing and developing until birth. The fetus is gaining about half pound per week.Week 37:The lungs are maturing and surfactant production is increasing. The baby can't move too much anymore, and the average size is over seven poundsWeek 38:The baby is ready for life outside its mother's womb. Toward the end of the ninth month, when the baby drops into a lower position, you will breath easier and you may have an increased need to urinate.



Your baby, now approximately seven and a half pounds, is ready to be born.