Fetal Development

MODULE 1.4.2

From the beginning of fetal growth, development proceeds in a cephalocaudal (head-to-tail)

direction; that is, head development occurs first and is followed by development of the middle
and, finally, the lower body parts.

- DEVELOPMENT OCCUR IN SYSTEMATIC MANNER FROM HEAD TO TOE

- from proximal to distal and from general to specific

- or described in general term of trimester

(1st trimester -12 wks, 2nd trimester-13 to
27 weeks, 3rd trimester-28 to 40 weeks)

Fetal development: (3 Stages)

1. preembryonic or germinal stage:
• week 1 and 2 - rapid cell division and differentiation
- germinal layers form
- FIRST 14 DAYS AFTER FERTILIZATION

2. embryonic stage:
• week 3 - primitive nervous system, eyes, ears, RBC present, heart begins to beat day 21

3. FETAL STAGE:
-FROM WEEK 9 UNTIL 38 TO 40 WEEK / FULLTERM

Origin of Body Tissue

Germ Layer Body Portions Formed
A. Ectoderm
- Central nervous system (brain and spinal cord)
- Peripheral nervous system
- Skin, hair, and nails
- Sebaceous glands
- Sense organs
 - Mucous membranes of the anus, mouth, and nose
- Tooth enamel
- Mammary glands
Origin of Body Tissue
Germ Layer Body Portions Formed
B. Mesoderm
- Supporting structures of the body
(connective tissue, bones,cartilage, muscle, ligaments,and tendons)
- Dentin of teeth
- Upper portion of the urinary system
(kidneys and ureters)
- Reproductive system
- Heart
- Circulatory system
- Blood cells
- Lymph vessels
- Entoderm Lining of pericardial, pleura, and
- peritoneal cavities
- Lining of the gastrointestinal tract,
- respiratory tract, tonsils, parathyroid,
- thyroid, thymus glands
- Lower urinary system (bladder and
- urethra)
C. Endoderm
- Lining of pericardial, pleura, and peritoneal cavities
- Lining of the gastrointestinal tract, respiratory tract, tonsils, parathyroid,

- thyroid, thymus glands

- Lower urinary system (bladder and urethra)

Milestones of Fetal Growth and Development

• life of the fetus is typically measured from the time of ovulation or fertilization (ovulation age),
• but the length of a pregnancy is more commonly measured from the first day of the last
menstrual period (gestational age).
Age of Embryo and Fetus in weeks

End of 4th Gestational Week

• Length: 0.75–1 cm
• Weight: 400 mg
• The spinal cord is formed and fused at the midpoint.
• Lateral wings that will form the body are folded forward
to fuse at the midline.
• The head folds forward and becomes prominent, representing about one-
third of the entire
structure.
• The back is bent so that the head almost touches the tip of the tail.
• The rudimentary heart appears as a prominent bulge on the anterior surface.
• Arms and legs are budlike structures.
• Rudimentary eyes, ears, and nose are discernible.
End of 8th Gestational Week
• Length: 2.5 cm (1 in)
• Weight: 20 g
• Organogenesis is complete.
• The heart, with a septum and valves, is beating rhythmically.
• Facial features are definitely discernible.
• Arms and legs have developed.
• External genitalia are forming, but sex is not yet distinguishable by simple
observation.
• The primitive tail is regressing.
• The abdomen bulges forward because the fetal intestine is growing so rapidly.
• An ultrasound shows a gestational sac, diagnostic of pregnancy

End of 12th Gestational Week (First Trimester)

• Length: 7–8 cm
• Weight: 45 g
• Nail beds are forming on fingers and toes.
• Spontaneous movements are possible, although they are usually too faint to be felt by the
mother.
• Some reflexes, such as the Babinski reflex, are present.
• Bone ossification centers begin to form.
• Tooth buds are present.
• Sex is distinguishable by outward appearance.
• Urine secretion begins but may not yet be evident in amniotic fluid.
• The heartbeat is audible through Doppler technology.

End of 16th Gestational Week

• Length: 10–17 cm
• Weight: 55–120 g
• Fetal heart sounds are audible by an ordinary stethoscope.
• Lanugo is well formed.
• Liver and pancreas are functioning.
• Fetus actively swallows amniotic fluid, demonstrating an intact but uncoordinated
swallowing reflex;
urine is present in amniotic fluid.
• Sex can be determined by ultrasound.

End of 20th Gestational Week

• Length: 25 cm
• Weight: 223 g
• Spontaneous fetal movements can be sensed by the mother.
• Antibody production is possible.
• The hair forms on the head, extending to include eyebrows.
• Meconium is present in the upper intestine.
 • Brown fat, a special fat that will aid in temperature regulation at birth, begins to be formed
behind the kidneys, sternum, and posterior neck.
• Vernix caseosa begins to form and cover the skin.
• Passive antibody transfer from mother to fetus begins.
• Definite sleeping and activity patterns are distinguishable (the fetus has developed biorhythms
that will guide sleep/wake patterns throughout life).

End of 24th Gestational Week (Second Trimester)

• Length: 28–36 cm
• Weight: 550 g
• Meconium is present as far as the rectum.
• Active production of lung surfactant begins.
• Eyebrows and eyelashes become well defined.
• Eyelids, previously fused since the 12th week, now open.
• Pupils are capable of reacting to light.
• When fetuses reach 24 weeks, or 601 g, they have achieved a practical low-end age of viability
(earliest age at which fetuses could survive if born at that time), if they are cared for after birth in
a modern intensive care facility.
• Hearing can be demonstrated by response to sudden sound.

End of 28th Gestational Week

• Length: 35–38 cm
• Weight: 1200 g
• Lung alveoli begin to mature, and surfactant can be demonstrated in amniotic fluid.
• Testes begin to descend into the scrotal sac from the lower abdominal cavity.
• The blood vessels of the retina are formed but thin and extremely susceptible to damage from
high oxygen concentrations (an important consideration when caring for preterm infants who
need oxygen).

End of 32nd Gestational Week

• Length: 38–43 cm
• Weight: 1600 g
• Subcutaneous fat begins to be deposited (the former stringy, “little old man” appearance is
lost).
• Fetus responds by movement to sounds outside the mother’s body.
• Active Moro reflex is present.
• Iron stores, which provide iron for the time during which the neonate will ingest only milk after
birth, are beginning to be developed.
• Fingernails grow to reach the end of fingertips.

End of 36th Gestational Week

• Length: 42–48 cm
• Weight: 1800–2700 g (5–6 lb)
• Body stores of glycogen, iron, carbohydrate, and calcium are deposited.
• Additional amounts of subcutaneous fat are deposited.
• Sole of the foot has only one or two crisscross creases, compared with the full crisscross pattern
that will be evident at term.
• Amount of lanugo begins to diminish.
 • Most babies turn into a vertex (head down) presentation during this month.

End of 40th Gestational Week (Third Trimester)

• Length: 48–52 cm (crown to rump, 35–37 cm)
• Weight: 3000 g (7–7.5 lb)
• Fetus kicks actively, hard enough to cause the mother considerable discomfort.
• Fetal hemoglobin begins its conversion to adult hemoglobin.
The conversion is so rapid that, at birth, about 20% of hemoglobin will be adult in character.
• Vernix caseosa is fully formed.
• Fingernails extend over the fingertips.
• Creases on the soles of the feet cover at least two thirds of the surface.