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KP 1.5.3.1 - Perkembangan Janin Intrauterin Dan Gangguan Yang Mungkin Timbul PDF
KP 1.5.3.1 - Perkembangan Janin Intrauterin Dan Gangguan Yang Mungkin Timbul PDF
INTRA-UTERIN
DAN
GANGGUAN YANG MUNGKIN TIMBUL
Rahmatina B. Herman
Bagian Fisiologi
Fakultas Kedokteran Unand
Introduction
Initial development of placenta and fetal membranes
occurs far more rapidly than development of fetus itself
Until 2-3 weeks after implantation of the blastocyst, the
fetus remains almost microscopic
After 3 weeks of implantation, the length of fetus
increases almost in proportion to age
At 12 weeks: 10 cm; at 20 weeks: 25 cm; at term (40
weeks): 53 cm
The weight of fetus is approximately proportional to the
cube of length → the weight increases almost in
proportion to the cube of fetus age
Growth of fetus
Stages and Events of Human Prenatal Development
STAGE TIME PERIOD PRINCIPAL EVENTS
Fertilized 12-24 hours Secondary oocyte fertilized;
egg following ovulation zygote has 23 pairs of chr
Cleavage 30 hours – 3rd day Mitosis increases cell number
Morula 3rd to 4th day Solid ball of cells
Blastocyst 5th day through 2nd Hollowed ball forms trophoblast
week (outside) and inner cell mass,
which implants to form
embryonic disc
Gastrula End of 2nd week Primary germ layers formed
- The embryonic stages extends until the 8th week of prenatal
development: placenta forms, the main internal organ develops,
and the major external body structures appear
- The fetal stage begins at the end of the 8th week - lasts until birth
Fertilization
Definition: the union of male and female gametes
Can take place during fertile period in each cycle
Normally occurs in ampulla
Thus, both ovum and sperm must be transported
from their site of production to the ampulla
During first 3-4 days following fertilization, zygote
remains within ampulla, because of constriction
between ampulla and remainder oviduct canal
prevents further movement of zygote into uterus
A number mitotic cell divisions of zygote to form morula
during in ampulla
Parents with diploid (46 chr) somatic cells
Mother Father
Meiotic division Meiotic division
of germ cells of germ cells
Mitosis
Converted to
Dihydrotestosterone Degeneration of
(DHT) Mullerian ducts
Phenotype
sex
Ovaries does not secrete hormone and factor
Absence of testosterone Absence of Mullerian-
inhibiting factor
Degeneration of
Wolfian ducts
Phenotype
sex
Descent of Morula to Uterus
± 3-4 days after ovulation, progesterone produce is
sufficient to relax oviduct contraction morula
rapidly propelled into uterus by oviductal peristaltic
and ciliary activity
Temporary delay of descending embryo into uterus,
lets enough nutrients accumulate in uterine lumen
to support embryo until implantation can take place
Morula will die, if it arrives prematurely
Descent of Morula to Uterus……
Morula floats freely within uterine cavity for 3-4
days, living on endometrial:
- secretions and continuing to divide
- being prepared for implantation under
influence of luteal-phase progesterone
- storing up glycogen
- becoming richly vascularized
Morula which fails to descend into uterus will lead
to ectopic tubal pregnancy (95% of ectopic
pregnancy)
Implantation
± 1 week after ovulation, morula has descended into
uterus and continued to proliferate and differentiate
into blastocyst which capable to implantation
Blastocyst is consisted of 2 parts: inner cell mass
(which become fetus) and trophoblast (outermost
layer of blastocyst)
Trophoblast accomplish implantation, after which
develops into fetal portion of placenta
When blastocyst is ready to implant, its surface
becomes sticky, by the time endometrium is ready to
accept the early embryo
Formation of Placenta and Amniotic Sac
By day 12:
- embryo is completely embedded in decidua
- trophoblastic layer (2 cell layers) thick chorion
Chorion continues to release enzymes and expand
- forms extensive network of cavities within decidua
- erodes decidual capillary walls maternal blood
leaks and fills the cavities
- produces anticoagulant to keep blood clotting
Developing embryo sends out capillaries into
chorionic projections to form placental villi
…..Formation of Placenta and Amniotic Sac
Theory II:
• Fetal portion of placenta which derived from
trophoblast produce enzyme indoleamine 2,3-
dioxygenase (IDO) which destroy tryptophan (critical
factor in activation of maternal cytotoxic T cells)
Theory III:
• In pregnancy production of regulatory T cells is
doubled or tripled which suppress maternal
cytotoxic T cells
Growth and Functional Development of Fetus