FETAL PERIOD

GENERAL EMBRYOLOGY
S. A ADELAKUN

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OVERVEIW OF THE FETAL PERIOD

• The fetal period begins 8 weeks after fertilization

(10 weeks after the LNMP) and ends at birth.
• It is characterized by rapid body growth and
differentiation of tissues and organ systems.
• An obvious change in the fetal period is the relative
slowing of head growth compared with that of the
rest of the body.
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OVERVIEW OF THE FETAL PERIOD
• At the beginning of the 20th week, lanugo (fine
downy hair) and head hair appear and the skin is
coated with vernix caseosa (a fatty cheesy
substance).
• The eyelids are closed during most of the fetal
period, but they begin to reopen at approximately
26 weeks.
• At this time, the fetus is usually capable of
extrauterine existence, mainly because of the 3

maturity of its respiratory system.

OVERVIEW OF THE FETAL PERIOD

• Up to 30 weeks, the fetus appears reddish and

wizened (wrinkled) because of the thinness of its
skin and the relative absence of subcutaneous fat.
• Fat usually develops rapidly at 26 to 29 weeks,
giving the fetus a smooth, healthy appearance

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 NINE TO TWELVE WEEKS

• At the beginning of 9th week head is still about half

of the CRL of the fetus
• By the end of 12th week, the CRL has almost
doubled with the rest of the body now growing
faster than the head
• At 9 weeks, the face is broad, the eyes are widely
separated, the ears are low set, and the eyelids are
fused
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 NINE TO TWELVE WEEKS
• By the end of 12 weeks, primary ossification
centers appear in the skeleton, especially in the
cranium (skull) and long bones.
• Early in the ninth week, the legs are short and the
thighs are relatively small
• By the end of 12 weeks, the upper limbs have
almost reached their final relative lengths but the
lower limbs are still not so well developed, and
they are slightly shorter than their final relative
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lengths.
 NINE TO TWELVE WEEKS
• The external genitalia of males and females
appear similar until the end of the ninth week.
Their mature form is not established until the 12th
week
• By the 11th week, the intestines have returned to
the abdomen
• At 9 weeks, the beginning of the fetal period, the
liver is the major site of erythropoiesis (formation
of red blood cells).
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• By the end of 12 weeks, this activity has decreased

 NINE TO TWELVE WEEKS

• Urine formation begins between the 9th and 12th

weeks, and urine is discharged through the urethra
into the amniotic fluid in the amnionic cavity.
• Fetal waste products are transferred to the maternal
circulation by passage across the placental
membrane

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 THIRTEEN TO SIXTEEN WEEKS
• By 16 weeks, the head is relatively smaller than the
head of a 12-week fetus and the lower limbs have
lengthened
• Ossification of the fetal skeleton is active during
this period, and the developing bones are clearly
visible on ultrasound images by the beginning of
the 16th week
• By 16 weeks, the ovaries are differentiated and
contain primordial ovarian follicles, which 9

contain oogonia, or primordial germ cells

 THIRTEEN TO SIXTEEN WEEKS

• The genitalia of male and female fetuses can be

recognized by 12 to 14 weeks. By 16 weeks, the
eyes face anteriorly rather than anterolaterally

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 SEVENTEEN TO TWENTY WEEKS
• Fetal movements (quickening) are commonly felt
by the mother
• The skin is now covered with a greasy, cheese-like
material, the vernix caseosa.
• Eyebrows and head hair are visible at 20 weeks.
• By 18 weeks, the fetal uterus is formed and
canalization of the vagina has begun.
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 TWENTY-ONE TO TWENTY-FIVE
WEEKS
• Substantial weight gain occurs during this period,
and the fetus is better proportioned
• The skin is pink to red because blood in the
capillaries is visible.
• The secretory epithelial cells (type ii pneumocytes)
in the interalveolar walls of the lung have begun to
secrete surfactant, a surface-active lipid that
maintains the patency of the developing alveoli of 12

the lungs
 TWENTY-ONE TO TWENTY-FIVE
WEEKS
• Fingernails are present by 24 weeks.
• Although a 22- to 25-week fetus born prematurely
may survive if given intensive care, there is also a
chance that it may die because its respiratory
system is still immature.
• The risk for neurodevelopmental disability (e.G.,
Mental deficiency) is high in fetuses born before
26 weeks. 13
 TWENTY-SIX TO TWENTY-NINE
WEEKS
• The lungs and pulmonary vasculature have
developed sufficiently to provide adequate gas
exchange
• The central nervous system has matured to the
stage where it can direct rhythmic breathing
movements and control body temperature.
• The eyelids are open at 26 weeks, and lanugo (fine
downy hair) and head hair are well developed.
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 TWENTY-SIX TO TWENTY-NINE
WEEKS

• The fetal spleen has been an important site of

erythropoiesis (formation of red blood cells).
• This ends at 28 weeks, by which time bone marrow
has become the major site of erythropoiesis.

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 THIRTY TO THIRTY-FOUR WEEKS

• The pupillary reflex can be elicited at 30 weeks.

• Usually by the end of this period, the skin is pink
and smooth and the upper and lower limbs have a
chubby appearance.
• At this age, the quantity of white fat is
approximately 8% of the body weight.
• Fetuses 32 weeks and older usually survive if born
prematurely.
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 THIRTY-FIVE TO THIRTY-EIGHT
WEEKS
• As term approaches, the nervous system is
sufficiently mature to carry out some integrative
functions.
• By 36 weeks, the circumferences of the head and
abdomen are approximately equal.
• The foot length of fetuses is usually slightly larger
than the femoral length (long bone of the thigh) at
37 weeks, and is an alternative parameter for
confirmation of fetal age 17
 THIRTY-FIVE TO THIRTY-EIGHT
WEEKS
• At full term (38 weeks), most fetuses usually reach
a CRL of 360 mm and weigh approximately 3400 g
• The thorax (chest) is prominent and the breasts
often protrude slightly in both sexes.
• The testes are usually in the scrotum in full-term
male neonates; premature male neonates
commonly have undescended testes.
• In general, male fetuses are longer and weigh more
at birth than females. 18
 ESTIMATION OF FETAL AGE

• Ultrasound measurements of the crown−rump

length (CRL) of the fetus are taken to determine its
size and probable age and to provide a prediction of
the expected date of delivery.
• Fetal head measurements and femur length are also
used to evaluate age.

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 ESTIMATION OF FETAL AGE

• Clinically, the gestational period is divided into

three trimesters, each lasting 3 months.
• By the end of the first trimester, one third of the
length of the pregnancy, major systems have been
developed.
• In the second trimester, the fetus grows sufficiently
in size so that good anatomical detail can be
visualized during ultrasonography. 20
 ESTIMATION OF FETAL AGE

• By the beginning of the third trimester, the fetus

may survive if born prematurely. The fetus reaches
a major developmental landmark at 35 weeks and
weighs approximately 2500 g.
• At 35 weeks, fetuses usually survive if born
prematurely.

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ESTIMATION OF FETAL AGE

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 ESTIMATED DELIVERY DATE

• The expected date of delivery of a fetus is 266 days

or 38 weeks after fertilization, that is, 280 days or
40 weeks after the LNMP. Approximately 12% of
fetuses are born 1 to 2 weeks after the expected
time of birth.

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 FACTORS INFLUENCING
FETAL GROWTH

• CIGARETTE SMOKING
• MULTIPLE PREGNANCY
• ALCOHOL AND ILLICIT DRUGS
• IMPAIRED UTEROPLACENTAL AND
FETOPLACENTAL BLOOD FLOW
• GENETIC ABNORMALITY
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 PROCEDURES FOR ASSESSING
FETAL STATUS

• ULTRASONOGRAPHY
• AMNIOCENTESIS
• ALPHA-FETOPROTEIN ASSAY
• CHORIONIC VILLUS SAMPLING
• SPECTROPHOTOMETRIC STUDIES
• CELL CULTURES AND CHROMOSOMAL ANALYSIS
• NONINVASIVE PRENATAL DIAGNOSIS
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 PROCEDURES FOR ASSESSING
FETAL STATUS

• FETOSCOPY
• FETAL MONITORING
• PERCUTANEOUS UMBILICAL CORD
SAMPLING
• MAGNETIC RESONANCE IMAGING

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 FETAL ABNORMALITY
• PREMATURITY
• LOW BIRTH WEIGHT
• VERY LOW BIRTH WEIGHT
• EXTREMELY LOW BIRTH WEIGHT
• SMALL FOR GESTATIONAL AGE
• DOWN SYNDROME
• HEMOLYTIC DISEASE OF THE NEW BORN
• RESPIRATORY DISTRESS SYNDROME
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• VACTERL
THANKS FOR LISTENING

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