Prenatal Development Stages

I Nyoman Mangku Karmaya

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 The Three Main Stages
1. The Germinal Stage: from conception two
weeks
2. The Embryonic Stage: the third  the eighth
week
3. The Fetal Stage: from the ninth week until
birth
 The Germinal Stage
• 1st week : fertilization-zygote-cleavage-blastomeres-
morula-blastocyst
• 2nd week: bilaminar germ disc
– Embryoblast  hypoblast + epiblast
– Trophoblast  cytotrophoblast + syncitiotrophoblast
• 3rd week: trilaminar germ disc (gastrulation process)
– The ectoderm (which will become the skin and nervous system)
– The endoderm (which will become the digestive and respiratory
systems)
– The mesoderm (which will become the muscle and skeletal
systems).
All of these layers originated from epiblast
1st
Week

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• Conception/fertilization is the beginning of life

• Implantation/nidation is the beginning of

pregnancy
 2nd Week (DAY 8)
BILAMINAR GERM
DISC

• 1. EMBRYOBLAST
DIFFERENTIATED INTO
– HYPOBLAST LAYER, ADJACENT
TO BLASTOCYST CAVITY,
SMALL CUBOIDAL CELLS
– EPIBLAST LAYER, ADJACENT
TO AMNIOTIC CAVITY, HIGH
COLUMNAR CELLS
(AMNIOBLAST)

• 2. TROPHOBLAST
DIFFERENTIATED INTO
CYTOTROPHOBLAST (MONO
NUCLEATD, INNER), MITOTIC
+
SYNCYTIOTROPHOBLAST,
MITOTIC (–)

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Figure 47.8x Cleavage in a frog embryo
 CLEAVAGE
• TWO-CELL STAGE
• BLASTOMERES
• COMPACTION
• MORULA (16 CELLS: INNER/EMBRYOBLAST
AND OUTER/TROPHOBLAST CELL MASS)
• BLASTOCYST
Human blastula
 The Embryonic Stage
Epiblast diferentiate into 3 layers (gastrulation
process)
– The ectoderm (which will become the skin and
nervous system)
– The endoderm (which will become the digestive
and respiratory systems)
– The mesoderm (which will become the muscle
and skeletal systems).
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THIRD MONTH TO BIRTH

THE FETAL PERIOD

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 THE LENGTH OF PREGNANCY

• 280 DAYS
• 40 WEEKS AFTER LNMP
• 266 DAYS/38 WEEKS AFTER FERTILIZATION

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 The clinical stages by trimester

• First trimester (0-13 weeks)

– The body is going through enormous changes as it
accommodates a growing fetus.
– hormone levels change significantly
– uterus begins to support the growth of the placenta
and the fetus,
– Increase of blood supply to carry oxygen and nutrients
to the developing baby, so the heart rate increases.
– Accompanied by pregnancy symptoms, such as
fatigue, morning sickness, headaches, and
constipation.
 The clinical stages by semester

• Second trimester (13-27 weeks)

– the most comfortable period of time for the
majority of pregnant women (pregnancy
symptoms will gradually disappear).
– The abdomen will start to look pregnant,
– Common complaints include leg cramps and
heartburn.
 The clinical stages by trimester

• Third trimester (28th week –baby birth)

– The baby position
1 month 3 month 5 month 9 month

26 40
weeks weeks
 Usia kehamilan
• HTA dengan rumus Naegle
• Mengukur tingi fundus uteri
• Gerakan pertama janin
• Menentukan denyut jantung janin
• USG
• Usia dan panjang janin dalam cm
– 1 – 5 bulan = kuadrat
– 6 bulan dst = usia dalam bulan x 5
 Lamanya kehamilan
• EDD (expecting date of delivery) = 40 minggu
dihitung sesudah LNMP (last normal menstrual
period)
• Kelahiran biasanya terjadi antara minggu ke 37- 42
(gunakan rumus Naegele)
• At term (aterm) = jika kehamilan mencapai usia 37-
42 minggu (antara hari 259 -294 sejak LNMP)
• Preterm = kelahiran sebelum minggu 37
• Postterm = lebih minggu 42
 MONTHLY CHANGES DURING FETAL PERIOD

• 3RD MONTH : HUMAN LOOKING FACE

• 4TH MONTH : OSSIFICATION CENTERS APPEAR
• 4TH MONTH INTESTINAL LOOPS CAUSE A LARGE SWELLING IN THE UMBILICAL
CORD WITHDRAW
• 4TH AND 5TH MONTH FETUS LENGTHENS RAPIDLY, COVERED BY LANUGO
• 5TH MONTH: MOVEMENT OF THE FETUS RECOGNIZED
• SECOND HALF OF I.U. LIFE: WEIGHT INCREASES
• 6TH MONTH: REDDISH SKIN, WRINKLE APPEARANCE
• THE LAST 2 MONTH (7TH MONTH): WELL-ROUNDED CONTOURS
• THE END OF I.U.LIFE: VERNIX CASEOSA
• THE END OF 9TH MONTH: SKULL HAS THE LARGEST CIRCUMFERENCE
• AT BIRTH: WEIGHT: 3000-3400 G, CRL 36 CM, CHL 50 CM, SEXUAL CHARACTERISTIC
PRONOUNCED, TESTES IN THE SCROTUM

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Problems With Prenatal Development

Genetic Problems
• Down Syndrome - Also known as trisomy 21,
approximately 1 out of every 1,000 infants. The risk of
having a child with Down syndrome increases with
maternal age.
• Inherited diseases Sickle-cell anemia, Cystic fibrosis,
and Tay-Sachs disease. Genetic tests can often
determine if a parent is a carrier of genes for a specific
disease.
• Sex-Chromosome Problems - Klinefelter's syndrome
(an extra X-chromsome) and Turner syndrome (a single
X-chromosome).
Problems With Prenatal Development
Environmental Problems
• teratogens. There a number of teratogens that can harm the fetus,
including:
• Maternal Drug Use –
– Smoking is linked to low birth weight, which can result in a weakened immune
system, poor respiration, and neurological impairment.
– Alcohol use can lead to fetal alcohol syndrome, which is linked to heart
defects, body malformations, and mental retardation.
– psychoactive drugs such as cocaine and methamphetamine is also linked to
low birth weight and neurological impairment.
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Maternal Disease - herpes, rubella, and AIDS. Herpes virus is one of the
most common maternal diseases and can be transmitted in the fetus,
leading to deafness, brain swelling, or mental retardation. Women with
herpes virus are often encouraged to deliver via cesarean to avoid
transmission of the virus.
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Terimakasih