Dr.B.B.

Gosai
Professor in Anatomy
Ojvensha e-learning resources
 At the end of the lecture students should be
able to:
 Define fetal period and identify major changes
which occur during various stages of fetal period.
 Identify major milestones of fetal period and define
major changes which occur during various stages of
fetal period.
 Langman’s Medical Embryology by T.W.Sadler

 Other reference text book:

 Keith Moore’s Developing Human
 Pre-embryonic:
 Weeks :1-2
 Embryonic:
 Weeks :3-8
 Fetal:
 Weeks :9-birth(38-42
week)
 The period from the beginning of the ninth week to birth.
 Characterized by maturation of tissues & organs and rapid
growth of body.
 Important parameters:
 Crown-rump length (CRL) (Sitting height): the
measurement from the vertex of the skull to the buttocks.
 Crown-heel length (CHL) (Standing height): the
measurement from the vertex of the skull to the heel.
 Length of pregnancy is considered to be 280 days or 40
weeks after the onset of the last normal menstrual
period(LNMP). More accurately, 266 days or 38 weeks after
fertilization. For the fetal period discussion, age is
calculated from the time of fertilization and expressed in
weeks or calendar months.
 3rd Month:
 Size of head is half of the CRL.
 Face becomes human like.
 Eyes moves to ventral aspect.
 Ear comes to definitive position.
 Limbs reach relative length in comparison to the rest
of the body.
 Primary ossification centers seen in long bones &
skull.
 External genitalia develop
 Intestinal loops withdraw into the abdominal cavity
 4th & 5th Months:
 Crown-rump length up to approximately 15 cm.
 Weight less than 500gms.
 Fetus covered with fine hair: Lanugo hair.
 Eyebrows and head hairs are visible.
 During the fifth month movements of the fetus can
be felt by the mother.
 6th Month:
 Skin become reddish and wrinkled.
 Several organ systems are able to function.
 Respiratory system and central nervous system not
well differentiated.
 If born during this period difficult to survive.
 6.5th to 7th Months:
 Length: 25 cms.
 Weight: 1100gms.
 If born during this period 90% chance of survival.
 7th to 9th Months:
 CRL: 36 cms.
 CHL: 50 cms.
 Weight: 3000 -3400 gms.
 Skin covered by whitish fatty substance (Vernix
caseosa) composed of secretory material from
sebaceous glands.
 Skull has largest circumference of all parts of body.
 Sexual characteristics prominent.
 Testes in male fetus in the scrotum.
Age (Weeks) CRL (cm) Weight (g)
9-12 5-8 10-45
13-16 9-14 60-200
17-20 15-19 250-450
21-24 20-23 500-820
25-28 24-27 900-1300
29-32 28-30 1400-2100
33-36 31-34 2200-2900
37-38 35-36 3000-3400
Event Age (Weeks)
Tastebuds appear 7
Swallowing 10
Respiratory movements 14-16
Sucking movements 24
Some sounds can be heard 24-26
Eyes sensitive to light 28
 Date of birth is most accurately indicated as 266
days or 38 weeks after fertilization.
 But to know exact time of fertilization is difficult.
Hence date of birth is calculated by obstetricians
by following method.
 Date of Birth = First day of Last Normal Menstrual
Period (LNMP) + 280 days/40 weeks.
 Example: If a female has last bleeding on 1st
December the Date of birth will be as follows:
 1st December + 280 days/40 weeks = 8th September
 Calculation from LNMP.
 Fetal length
 Fetal weight
 Biparietal diameter (BPD) of the skull
 Head & abdominal circumference
 Femur length
 ULTRASOUND – A valuable tool for the
determination of fetal age.
 Low Birth Weight:
 Intrauterine growth restriction (IUGR) : Infants who are
at or below the 10th percentile for their expected birth
weight at a given gestational age. Also known as Small
for gestational age (SGA).
 It leads to neurological deficiencies, congenital
malformations, meconium aspiration, hypoglycemia,
respiratory distress syndrome.
 Causes: chromosomal anomalies, teratogens, congenital
infections, poor maternal health, use of cigarettes, alcohol
or drugs
 Weight less 500 gms: do not survive
 Weight 500-1000 gms: may survive with expert care