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Life in Utero

Life in Utero 12 NOVEMBER 2015

Dr. Luis Emmanuel Esguerra

OUTLINE 3. Human Life

I. Human Life Characteristics: all of the above, plus:
A. Beginning of Human Life Rationality conscious awareness
B. Levels of Life o Superior intellect
1. Plant life o Abstract thinking
2. Animal life Capable of abstract, as opposed to merely
3. Human life concrete thinking
C. Human Person at Conception Free will (free choice)
II. Stages of Life in Embryo o Deliberate behavior can override your instincts
A. Embryonic period o Goal directed, logical use of both will and
B. Fetal period intellect in decision-making
III. Factors Affecting Fetal Growth and Development Personhood
A. Intrinsic o Capacity to form meaningful relationships with
B. Extrinsic other human beings
1. Maternal factors
2. Environmental factors *** RATIONALITY, FREE WILL, and PERSONHOOD reflect
IV. Developmental Origins of Health and Diseases the spiritual dimension, which is unique for humans
(DOHAD) compared to other forms of life
V. Adaptation of Birth
OBJECTIVES The human being is a person because of its spiritual
1. Describe the characteristics of human life in utero. dimension.
2. Describe the periods of human development in utero The embryo is a living being whose development,
(from conception until birth guided by the genome that is present and active from
3. Describe the intrinsic and extrinsic factors that affect conception onwards, takes place in an autonomous,
the development of the embryo and the fetus. coordinated, continuous and gradual way.
4. Describe how conditions experienced in utero may The reality of the human being for the entire span of
influence ones susceptibility to adult disease life, both before and after birth, does not allow us by
(Developmental Origins of Health & Disease reason to consider that the embryo as a human
(DOHAD)). individual not be a human person.
5. Describe the adaptation to extra-uterine life at birth. ! There is a continuum of life. Its still the same
life, the same organism. It just so happened that
I. Human Life the embryo is not (yet) able to manifest its
A. BEGINNING OF HUMAN LIFE spiritual dimension, but it is programmed to
Birth may be a grand occasion but it is a trivial event eventually be able to manifest it as the human
in development. person develops after birth. It is human life; it is
Life starts at fertilization or conception. not going to be another animal or plant.

B. LEVELS OF LIFE **"The human embryo has, therefore, from the very beginning,
1. Plant Life (Vegetative Life) the dignity proper to a person." (from Dignitas Personae, 2008)
Characteristics common to all living beings:
Organism II. Stages of Life in Embryo
o Individual can distinguish a certain organism as A. EMBRYONIC PERIOD (from conception to 8 week)
different from another 1. Early embryo: Pre-organogenic Phase (1 2 weeks)
o Integrated
Responsiveness Week 1:
o Responds to external stimuli Includes fertilization, cleavage & morulation, blastocyst
o Easy to see in animals but less apparent in plants formation, implantation
but still present (ex. sunlight heliotropism) Ovulation
Growth not stagnant, there is an ongoing process o Ovum comes out of the ovary and is caught by the
Reproduction for the continuation of species fallopian tube.
2. Animal Life o Occurs at the fallopian tube during the first 12-24
Characteristics: all of the above, plus: hours
Mobility ability to move Cleavage/mitosis
Moderate intellect, concrete thinking o Form morula by the time the fertilized zygote reaches
o Can determine that a particular experience is opening to the fallopian tube towards cavity of the
harmful or pleasurable uterus.
Instinctive Behavior
Transcribers: Pagtalunan, Palacio, Pangilinan, Parado, Paypa
2 Tolentino, D.
[HLC][Life in Utero]
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Once it enters the uterine cavity, it further differentiates to Figure 2. A. Implantation site at the end of the second week. B.
form a blastocyst Representative view of the germ disc at the end of the second week of
o Has fluid inside development. The amniotic cavity has been opened to permit a view of
the dorsal side of the epiblast. The hypoblast and epiblast are in
o Preparing itself to be implanted on the wall of the contact with each other, and the primitive streak forms a shallow
endometrial lining of the uterus by the end of the 1st groove in the caudal region of the embryo. (Langmans)
rd th
2. Late Embryo: Organogenesis (3 -8 week)
Week 3:
Embryonic period proper
Gastrulation: Formation of the 3 definitive germ layers "
trilaminar germ disc
o Migration of epiblast cells via primitive streak to form:
# Endoderm (Lining of GIT and Respiratory Tract)
# Mesoderm (Musculoskeletal, Cardiovascular and
Urogential System)
# Ectoderm (Epidermis and CNS)

Figure 1. Events during the first week of human development. 1,

oocyte immediately after ovulation; 2, fertilization, approximately 12 to
24 hours after ovulation; 3, stage of the male and female pronuclei; 4,
spindle of the first mitotic division; 5, two-cell stage (approximately 30
hours of age); 6, morula containing 12 to 16 blastomeres
(approximately 3 days of age); 7, advanced morula stage reaching the
uterine lumen (approximately 4 days of age); 8, early blastocyst stage
(approximately 4.5 days of age; the zona pellucida has disappeared);
and 9, early phase of implantation (blastocyst approximately 6 days of
age). The ovary shows stages of transformation between a primary
follicle and a preovulatory follicle as well as a corpus luteum. The
uterine endometrium is shown in the progestational stage. (Langmans)

Week 2: "Week of Twos"

Blastocyst form 2 main layers " bilaminar germ disc Figure 3. Events at Week 3.
o Trophoblast layer (outer cell mass) divides into
cytotrophoblast and syncytiotrophoblast Trophoblast further develop to form the placenta
o Embryoblast layer (inner cell mass) divides into Establishment of the main organ systems and major
epiblast and hypoblast features of the body form
Extraembryonic mesoderm Key Changes in Embryo Form:
o Outer layer of developing embryo o Flat embryonic disc with notochord
o Divides into somatic and splanchnic extraembryonic ! Notochord comes in via primitive streak
mesoderm (which forms the definitive yolk sac from ! Its presence stimulates the differentiation of the
the primitive blastocyst cavity) axis
By the end of second week, two cavities are formed: o Neural tube formation
amniotic cavity (dorsal to the epiblast) and yolk sac. ! Nervous system will develop first
o Somites formation and differentiation
! Will form beside the notochord then differentiate
to form the axial skeleton & skin
o Cephalocaudal folding (C-shape form of embryo)
! Head and tail part will approach each other to one
site " where the umbilical cord will be
o Humanoid form: enlarging head and development of
appendages (upper & lower limbs)
o By 8 week, embryo with completed organogenesis.
# Establishment of main organ systems, main
features of body form
th rd
B. Fetal Period (9 week/ 3 month to birth)
! Full term: 40 weeks
! Term: 37 weeks
! Pre-term: <37 weeks; at least 24-25 weeks can
survive (depending on technology) though some may need
support later on for chronic problems
Maturation of the tissues and organs
Rapid growth of the body
Preparation for birth (extra-uterine life)

Transcribers: Pagtalunan, Palacio, Pangilinan, Parado, Paypa

Editors: Tolentino, D.
[HLC][Life in Utero] page 2 of 5
4 month: the embryo that was inside the wall of the Hearing and vision
endometrium of the uterus has enlarged to occupy the o 16 week: reactive listening
whole cavity of the uterus with the fetus inside, suspended # Behavioral responses when pure tone is
in amniotic fluid and connected with its umbilical cord to transmitted over the abdomen of the mother to
the placenta the fetus.
Change of body proportions: # Ear apparatus is not yet complete. However, the
o Proportion of the head to the body " faster growth of fetus can already hear beyond 16 weeks.
the rest of the body compared to the head o 24 week
3 month: 1/2 (50%) head-to-body ratio # Ears structurally complete.
5 month: 1/3 (33%) head-to-body ration # Skin and skeleton as receptors for the vibrations
# Birth: 1/4 (25%) head-to-body ratio to cochlear and vestibular systems in the fetus.
# Adult: 1/8 (12.5%) head-to body ratio o Eyelids are fused before 26 weeks (limited vision)
o 28 week: eyes sensitive to light
Touch o When babies are born at term, able to recognize form,
o First sense to develop color, light and shadows, bright light and dark colors.
o Withdrawal to hair stroke on its cheek/face as early as o At birth, baby can focus to distance of 8-12 inches
8 week (lanugo: fine hairs of skin) (distance to mothers face to the face of the baby
o 10 week: genital area when breastfeeding).
o 11 week: palms
o 12 week: soles Fetal learning
th o Mothers voice
o 17 week: abdomen and buttocks
o Order of development also corresponds to the # Fetus first learns the mothers voice
sensitivity/abundance of nerve endings in each area, # Sound travels to the fetus through the mothers
with the face being with the most and the abdomen amniotic fluid and abdominal tissue.
and buttocks having less # Moms own voice reverberates throughout her
o Pain responses body reaching the fetus more readily since fetus
# Withdrawal is with her 24/7.
# Vigorous body and breathing movements # Recognition and preference: Study among
# Hormonal rushes (e.g. Epinephrine and cortisol newborn babies presented with 2 rubber nipples
elevation) with milk, each accompanied with recording of
either mom's or strangers voice " baby quickly
Fetal Movement chooses nipple accompanied with recording of
o Second sense to develop mom's voice
o 6 to 10 week
# Familiarity with passags read or theme song:
# Graceful stretching & rotational movements of the Researchers discovered that, after women
head, arms and legs repeatedly read aloud a section of Dr. Seuss "Cat
# Important for development of the musculoskeletal in the Hat" while pregnant, their newborns
system recognize that passage when they hear it outside
# If it doesnt move that limb will not develop the womb. They even recognize the theme song
o 10 week
th the mom's favorite telenovela
# Hand to head, hand to face, hand to mouth, # Intonation of mothers language: Intonation of
opening closing of mouth and swallowing crying imitates intonation of mother's language
o 14 week
th (French end on a rising note vs. German end on
# Spontaneous endogenous cycles of activity and a falling note) " as the baby cries sounding like
rest the mother to further endear the baby to mother,
# Regular breathing and jaw movements the person most likely to care for it; gives it head
o 4 month start into learning its native language
# quickening (start of sensation of fetal o Flavors of Food
movement by mother) # Babies are able to taste and smell depending on
# can be mistakenly described as kabag or colic what the mother is exposed to.
by first time mothers (primagravids); may also # Flavors reach fetus taste buds via amniotic fluid
occur later fort hem compared to those whove # Moms smell and taste preferences teach fetus
been pregnant more than once (multigravids) what is safe and good to eat
# Study with women drinking plenty of carrot juice
Taste and smell during pregnancy, 6 month old infants babies
o 7 week: taste buds appear with moms whose diet consists of a cereal +
o 10 week: swallowing carrot juice diet enjoy it more (facial expressions)
o 11-15 week: nose development than 6 month old infants whose mothers did not
o 24 week: sucking movements take carrot juice during pregnancy
o By breathing and sucking movements, fetus exposed # Introduction into the culture they would be born
to tastes/flavors and odors (from the mother via through food (one of the major expressions of
placenta) via amniotic fluid (produced by fetal uterine) culture)

Transcribers: Pagtalunan, Palacio, Pangilinan, Parado, Paypa

Editors: Tolentino, D.
[HLC][Life in Utero] page 3 of 5
Fetal Behavior o Congenital Infections
o Makes presence felt to the mother: quickening and # Rubella during the 1 trimester; can cause
kicking (to hand of the father placed upon the mental retardation, deafness, cardiac
mothers belly) anomalies and microcephaly
o Responds to sounds (music and especially mothers # CMV (Cytomegalovirus) small head
voice) # Toxoplasma head enlargement
# Changes in heart rate and breathing movements # Syphilis multiple organs are affected
with specific sounds o Hormonal Imbalance
o Reacts to pain and some vision # E.g thyroid deficiency associated with
# E.g. withdrawal or hitting amniocentesis needle congenital hypothyroidism
with fist o Maternal Malnutrition
o Develops inborn reflexes for survival # intrauterine growth restriction (IUGR)
# Sucking, rooting , Moro, extensor # most common manifestation: low birth weight
o Reflection of consciousness, free wil land relationship
with others (mother) Drug Intake
o Androgens vs. miscarriage
III. Factors Affecting Fetal Growth &Development # Masculinized female infants
A. Intrinsic (Fetal) # May have ambiguous genital
Primarily genetic o Diethylstilbestrol for threatened abortion
Determined by fetus DNA/ genome # Cervical dysplasia in female newborn

B. Extrinsic Maternal Stress

Can either be maternal or environmental to which the o Increase adrenal hormones affect newborns
baby is exposed through the mother o Chronic anxiety can make a child hyperactive,
irritable, with sleep disturbance and poor feeding

Narcotic Addiction (Morphine)

o Newborn with acute withdrawal at birth (may
have seizures)

2. Environmental Factors
o Slight intake (2 shots/ day) " can lower IQ by 7
o Binge drink (>5 per sitting) " increased risk for
orofacial defects
o Fetal Alcohol Syndrome delayed growth,
mental retardation, facial deformities; most
common preventable

o Reduced oxygen, CO " fetal circulation of
nicotine & other toxins " fetal RR & fetal HR
o (if chronic) risk of miscarriage, infant mortality,
Figure 4. Exposure to harmful substances and event during specific IUGR, mental retardation & developmental delay
periods could increase risk for the development of particular
deformities and malformations. Exposure during the embryonic period Radiation
when the organ systems are still being developed (red bars) would o Birth defects depending on dose and stage of
increase risk for major morphological abnormalities. After the organ development at time of exposure
systems are formed, exposure to maturation (yellow bars) may lead to
o Exposure during the embryonic period does not
functional defects and minor morphological abnormalities. Note that a
woman may be exposed to harmful substances and events at a time automatically lead to major malformations.
when she may not even know she is pregnant (before 6 week) and
may produce major malformations in the embryo and fetus. IV. Developmental Origins of Health and Diseases
1. Maternal Factors David Barker, MD, PhD
Maternal Illness British physician
o Diabetes congenital defects and neonatal 1989: reported relationship between birth weight & death
hypoglycemia rates from coronary heart disease in both men & women in
# Baby is exposed to too much glucose while a poor district in Birmingham, UK
inside the mother " adjusts the insulin level Hypothesized that poor prenatal nutrition led to diversion
to maintain normal levels " when born, of nutrients to the brain, while skimping on other parts of
there is a drop in glucose levels due to the body, predisposing them to weakened heart
disconnection of glucose supply from mother Met with ridicule (heart disease perceived as due to
" baby still has high level of insulin " genetics and affluent lifestyle)
hypoglycemia Subsequent studies, even by detractors, replicated his

Transcribers: Pagtalunan, Palacio, Pangilinan, Parado, Paypa

Editors: Tolentino, D.
[HLC][Life in Utero] page 4 of 5
Developmental Origins of Health and Disease (DOHAD) Nourishment by oral feeding: from placenta to oral feeding
Formerly called Barkers hypothesis (e.g. breastfeeding)
Also known as Fetal origins Elimination: from placenta to functional genitourinary and
Thrifty phenotype gastrointestinal tracts
o An adverse fetal environment, followed by plentiful
food in adulthood may be a recipe for adult chronic VI. Mini Quiz
! The fetus is used to shortage " adjust metabolism, 1. Which of the following characteristics distinguish human
then at birth, you gave too much " baby cannot life from other forms of life?
metabolize properly " lodged into arteries " metabolic a. Concrete thinking
syndrome b. Deliberate behavior
Studies have expanded beyond effects of nutrition c. Mobility
restriction (i.e., other intrauterine environmental d. Responsiveness
exposures, maternal diseases, overnutrition)
Related to the field of epigenetics 2. Which of the following determines individuality of each
Stresses experienced in the womb alter the structure of human life at its beginning?
organs in the fetus, thus changing the expression of a. Birth
regulatory genes throughout the lifetime, leading to b. Fetus
vulnerability for disease later in life. c. Genome
d. Implantation
Dutch Hunger Winter (1944-45) 3. Which of the following events BEST reflects the spiritual
o WW II Nazi blockade of Western Holland dimension of the human fetus?
o Killed 10,000 and weakened thousands a. Hitting amniocentesis needle with fist
o 40,000 fetuses in utero also affected b. Quickening felt by the mother
# Immediate effects: stillbirth, birth defects, infant c. Reactive listening to pure tone
mortality d. Sucking and swallowing movements
# Others not discovered for many years
o Prenatal starvation " obesity, high BP, poor 4. Which of the following events occur during the late
cholesterol profiles, impaired OGT & diabetes, heart embryonic period?
disease later in life a. Formation of the C-shaped embryo
Chinese Great Famine (1958-1961) b. Maturation of the tissues and organs
o Due to Maos Great Leap Forward c. Rapid growth of the body
# No private property, farmers made to work in d. Implantation into the endometrial wall
steel factories, planting seeds too close together,
flood 1959 followed by drought 5. Major morphological abnormalities are more likely with
o By 1962, 43 million Chinese died due to famine exposure to harmful conditions during which stage of
o Increased risk of hyperglycemia, high blood pressure intrauterine development?
(1st trimester exposure), schizophrenia a. Preorganogenic
o By starvation during fetal life, the mother may be b. Fetal
telling the fetus that the world they are going to be c. Organogenic
born into is a world of scarcity such that fetus is made d. Birth
to adapt to that scenario, changing their way of
metabolizing nutrients 6. Which of the following adaptations at birth DOES NOT
September 11, 2001 involve transition from the placenta to extrauterine life?
o At 8:46 am September 11, 2001, tens of thousands a. Breathing
were in the vicinity of the WTC in New York, b. Nourishment
commuters/waitresses/stock brokers c. Elimination
o 1,700 pregnant women around the vicinity d. Temperature regulation
o 50% of them developed Post-Traumatic Stress 7.
Disorder (PTSD), found to have low cortisol levels Answers: BCAACD
(considered a biological marker for the development
of PTSD) VII. Reference
o Pregnant women exposed at 3rd trimester with PTSD
had infants also with low cortisol levels " pass on to 2018 trans
child the increased risk of developing PTSD Dr. Esguerra handout/ppt
o Mother's way to transmit hyper-awareness of one's
surroundings, enable a quick response to danger " Video links:
warning the child "Danger" From conception to birth:
V. Adaptation of Birth h_visualized.html
Transition from intra-uterine to extra-uterine life
Breathing: switch from placenta to lungs as respiratory Maternal-infant bonding
Temperature regulation: constant intrauterine
temperature to variable outside temperature

Transcribers: Pagtalunan, Palacio, Pangilinan, Parado, Paypa

Editors: Tolentino, D.
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