MODULE #2 PRENATAL DEVELOPMENT way from the vagina into the uterus and subsequently into the

fallopian tube where the ovum has been released. This process can
Introduction
take up to ten hours after ejaculation. For fertilization to occur, a
Life is a phenomenon based on the strictly regulated
sperm must penetrate the tough outer membrane of the egg called
alternation of selective and nonselective transcription of dna and
the zona pellucida. When one sperm successfully binds with the
rna.
zona pellucida, a series of chemical reactions occurs to allow only
Different cultures have different beliefs and practices. A
that sperm to penetrate. Fertilization occurs when the sperm
woman’s cultural background can affect their needs and
successfully enters the ovum's membrane. The genetic material of
expectations during pregnancy and childbirth, as well as how they
the sperm and egg then combine to form a single cell called a
and their family raise children. These beliefs represent a cultural
zygote and the germinal stage of prenatal development
ideology or a superstition, which are oftentimes baseless.
commences.
Nevertheless, the truth is that the life in the mother’s womb is a
The zygote soon begins to divide rapidly in a process called
living fetus in the process of growth and development.
cleavage, first into two identical cells called blastomeres, which
Today there is extensive evidence to show how conditions
further divide to four cells, then into eight, and so on. The group of
in the prenatal environment can and do affect development before
dividing cells begins to move along the fallopian tube toward the
birth.
uterus. About sixty hours after fertilization, approximately sixteen
Prenatal development refers to the process in which a baby
cells have formed to what is called a morula, still enclosed by the
develops from a single cell after conception into an embryo and
zona pellucida; three days after fertilization, the morula enters the
later a fetus.
uterus. As cell division continues, a fluid-filled cavity called a
The average length of time for prenatal development to
blastocoele forms in the center of the group of cells, with the outer
complete is 38 weeks from the date of conception. During this
shell of cells called trophoblasts and an inner mass of cells called
time, a single-celled zygote develops in a series of stages into a full-
embryoblasts. The zona pellucida disappears and the morula
term baby. The three primary stages of prenatal development are
becomes a blastocyst. At this stage the blastocyst consists of 200 to
the germinal stage, the embryonic stage, and the fetal stage
300 cells and is ready for implantation.
Implantation, the process in which the blastocyst implants
Germinal stage
into the uterine wall, occurs approximately six days after
Conception occurs when the female egg (ovum) is fertilized
conception. Hormones secreted from the mother's ovaries and a
by the male sperm. Under normal circumstances, one egg is
chemical secreted by the trophoblasts begin to prepare the uterine
released approximately once a month from a woman's ovary
wall. The blastocyst first adheres to the wall then moves into the
during a process called ovulation. The egg makes its way into a
uterine tissue. Implantation marks the end of the germinal stage
fallopian tube, a structure that guides the egg away from the ovary
and the beginning of the embryonic stage.
toward the uterus. For fertilization to occur, sperm ejaculated
during sexual intercourse (or introduced during artificial
insemination) in a substance called semen must have made their
Embryonic stage Week 8: facial features more distinct, internal organs well
The embryonic stage begins after implantation and lasts developed, the brain can signal for muscles to move, heart
until eight weeks after conception. Soon after implantation, the development ends, external sex organs begin to form.
cells continue to rapidly divide and clusters of cells begin to take By the end of the embryonic stage, all essential external and
on different functions (called differentiation). A process internal structures have been formed. The embryo is now referred
(gastrulation) leads to the formation of three distinct layers called to as a fetus.
germ layers: the ectoderm (outer layer), the mesoderm (middle
layer), and the endoderm (inner layer). As the embryo develops,
each germ layer differentiates into different tissues and structures.
For example, the ectoderm eventually forms skin, nails, hair, brain,
nervous tissue and cells, nose, sinuses, mouth, anus, tooth enamel,
and other tissues. The mesoderm develops into muscles, bones,
heart tissue, lungs, reproductive organs, lymphatic tissue, and
other tissues. The endoderm forms the lining of lungs, bladder,
digestive tract, tongue, tonsils, and other organs. Fetal stage
The process of differentiation takes place over a period of Prenatal development is most dramatic during the fetal
weeks with different structures forming simultaneously. Some of stage. When an embryo becomes a fetus at eight weeks, it is
the major events that occur during the embryonic stage are as approximately 3 centimeters (1.2 inches) in length from crown to
follows: rump and weighs about 3 grams (0.1 ounce). By the time the fetus
Week 3: beginning development of the brain, heart, blood cells, is considered full-term at 38 weeks gestation, he or she may be 50
circulatory system, spinal cord, and digestive system. centimeters (20 inches) or 3.3 kilograms (7.3 pounds). Although
Week 4: beginning development of bones, facial structures, and all of the organ systems were formed during embryonic
limbs (presence of arm and leg buds); continuing development of development, they continue to develop and grow during the fetal
the heart (which begins to beat), brain, and nervous tissue. stage.
Week 5: beginning development of eyes, nose, kidneys, lungs;
continuing development of the heart (formation of valves), brain,
nervous tissue, and digestive tract.
Week 6: beginning development of hands, feet, and digits;
continuing development of brain, heart, and circulation system.
Week 7: beginning development of hair follicles, nipples, eyelids,
and sex organs (testes or ovaries); first formation of urine in the
kidneys and first evidence of brain waves
Examples of some of the major features of fetal development by Weeks 29–32: the fetus reaches approximately 38–43 cm. (15–17
week are as follows: in.) In length and weighs approximately 2 kg (4 lb. 6 oz.). Fat
Weeks 9–12: the fetus reaches approximately 8 cm. (3.2 in.) In deposits become more pronounced under the skin. The lungs
length; the head is approximately half the size of the fetus. External remain immature but breathing movements begin. The fetus's
features such as the face, neck, eyelids, limbs, digits, and genitals bones are developed but not yet hardened.
are well formed. The beginnings of teeth appear, and red blood Weeks 33–36: the fetus reaches approximately 41–48 cm. (16–19
cells begin to be produced in the liver. The fetus is able to make a in.) In length and weighs 2.6–3.0 kg (5 lb. 12 oz. To 6 lb. 12 oz.).
fist. Body fat continues to increase, lanugo begins to disappear, and
Weeks 13–15: the fetus reaches approximately 15 cm. (6 in.) In fingernails are fully grown. The fetus has gained a high degree of
length. Fine hair called lanugo first develops on the head; control over body functions.
structures such as the lungs, sweat glands, muscles, and bones Weeks 36–38: the fetus reaches 48–53 cm. (19–21 in.) In length is
continue to develop. The fetus is able to swallow and make sucking considered to be full-term by the end of this period. Lanugo has
motions. mostly disappeared and is replaced with thicker hair on the head.
Weeks 16–20: the fetus reaches approximately 20 cm. (8 in.) In Fingernails have grown past the tips of the fingers. In a healthy
length. Lanugo begins to cover all skin surfaces, and fat begins to fetus, all organ systems are functioning.
develop under the skin. Features such as finger and toenails,
eyebrows, and eyelashes appear. The fetus becomes more active, CONGENITAL ABNORMALITIES
and the mother can sometimes begin to feel fetal movements at In some cases, abnormalities may arise during prenatal
this stage. development that cause physical malformations or developmental
Weeks 21–24: the fetus reaches approximately 28.5 cm. (11.2 in.) delays or affect various parts of the body after the child is born.
In length and weighs approximately 0.7 kg (1 lb. 10 oz.). Hair The cause may be a small mutation in or damage to the genetic
grows longer on the head, and the eyebrows and eyelashes finish material of cells, or a major chromosomal abnormality (each
forming. The lungs continue to develop with the formation of air normal cell has two copies each of 23 strands [called
sac (alveoli); the eyes finish developing. A startle reflex develops at chromosomes] of genetic material, and abnormalities can arise if
this time. there are three copies of a strand or only one). Sometimes the
Weeks 25–28: the fetus reaches approximately 38 cm. (15 in.) In abnormality is inherited from one or both parents; in other cases,
length and weighs approximately 1.2 kg (2 lb. 11 oz.). The next few the defect occurs because of an error in prenatal development.
weeks mark a period of rapid brain and nervous system Maternal derived abnormalities
development. The fetus gains greater control over movements The age, health status, nutritional status, and environment of the
such as opening and closing eyelids and certain body functions. mother are all closely tied to the health of a growing embryo or
The lungs have developed sufficiently that air breathing is fetus. Some examples of environmental factors that may lead to
possible. developmental abnormalities include:
Age: as of 2004, research showed that babies born to mothers prenatal visits to an obstetrician, a pregnant mother should be
between the ages of seventeen and thirty-five tend to be healthier. educated in proper nutrition and prenatal care; often, prenatal
One reason is that the risk of certain congenital abnormalities such vitamins are prescribed to avoid nutritional deficiencies. Prenatal
as down syndrome increases with mother's age (particularly testing is often recommended to parents-to-be as a means of
mothers over forty). Another reason is that the risk of having assessing the fetus's health and the risk of developing certain
pregnancy or birth complications is greater with women over the conditions. Some common prenatal tests that relate to prenatal
age of thirty-five. development are as follows: blood tests to check for diseases that
Health status: in some cases, a mother may pass a viral or could affect the fetus, such as HIV, hepatitis b , or other sexually
bacterial infection to the fetus, such as in human transmitted diseases blood tests to check if the mother carries a
immunodeficiency virus (hiv). In other cases, a mother's illness protein called rh factor on her red blood cells; if she does not and
may cause congenital malformations; an example is rubella , which her baby does (determined by whether the father is Rh-positive or
can cause heart defects, deafness, developmental delays, and other not), she will require treatment to prevent a potentially damaging
problems in a fetus if the mother contracts it during pregnancy. reaction to the baby chorionic villus sampling, a prenatal test that
Nutritional status: a well-balanced diet rich in nutrients such as takes a tiny sample of the placenta with a needle to test for
folic acid , calcium, iron, zinc, vitamin d, and the b vitamins is chromosomal abnormalities nuchal fold or nuchal translucency
recommended for pregnant women. Certain vitamin and mineral screening test, which measures a small space at the back of the
deficiencies can interfere with normal prenatal development. For fetus's neck using ultrasound; fetuses with larger nuchal folds have
example, a deficiency in folic acid during the early stages of a greater risk of having a chromosomal abnormality
pregnancy may lead to neural tube defects such as spina bifida . amniocentesis, a test that takes a sample of the fluid that
Mothers are recommended to eat approximately 300 additional surrounds the fetus in the uterus to identify certain genetic
calories a day (above and beyond a normal non-pregnancy diet) to disorders, congenital malformations, or the maturity of the fetus's
support the fetus's growth and development. lungs
Other environmental factors: exposure to certain substances
called teratogens (agents that may interfere with prenatal TERATOLOGY
development) during pregnancy may cause embryonic or fetal Good prenatal care is essential. The developing child is
malformations. Examples of teratogens include alcohol, most at risk for some of the most severe problems during the first
thalidomide, cocaine, certain seizure medications, three months of development. Unfortunately, this is a time at
diethylstilbestrol (des), and the anti-acne drug Accutane. which most mothers are unaware that they are pregnant. It is
estimated that 10% of all birth defects are caused by prenatal
PARENTAL CONCERNS exposure or teratogen. Teratogens are factors that can contribute
Many parents have questions or concerns about the to birth defects which include some maternal diseases, drugs,
prenatal development of an existing or anticipated child and what alcohol, and stress. These exposures can also include
steps they should take to ensure their child's health. During environmental and occupational exposures. Today, we know many
of the factors that can jeopardize the health of the developing developmental delays, and behavioral problems. Those with fasd
child. Teratogen-caused birth defects are potentially preventable. are more at risk for lifelong problems such as criminal behavior,
The study of factors that contribute to birth defects is called psychiatric problems, and unemployment (cdc, 2006).
teratology. Teratogens are usually discovered after an increased The terms alcohol-related neurological disorder (arnd) and
prevalence of a particular birth defect. For example, in the early alcohol-related birth defects (arbd) have replaced the term fetal
1960’s, a drug known as thalidomide was used to treat morning alcohol effects to refer to those with less extreme symptoms of
sickness. Exposure of the fetus during this early stage of fasd. Arbd includes kidney, bone and heart problems. Some
development resulted in cases of phocomelia, a congenital distinguishing characteristics of fetal alcohol spectrum disorders
malformation in which the hands and feet are attached to include more narrow eye openings. A smooth philtrum, meaning a
abbreviated arms and legs. smooth area between the upper lip and the nose, and a thin upper
ALCOHOL lip.
One of the most commonly used teratogens is alcohol.
Alcohol consumption, particularly during the second month of TOBACCO
prenatal development, but at any point during pregnancy, may lead Smoking is also considered a teratogen because nicotine
to neurocognitive and behavioral difficulties that can last a travels through the placenta to the fetus. When the mother
lifetime. In extreme cases, alcohol consumption can lead to fetal smokes, the developing baby experiences a reduction in blood
death, but more frequently it can result in fetal alcohol spectrum oxygen levels. Tobacco use during pregnancy has been associated
disorders (fasd). This terminology is now used when looking at the with low birth weight, placenta previa, birth defects, preterm
effects of exposure and delivery, fetal growth restriction, and sudden infant death
replaces the term fetal syndrome. Smoking in the month before getting pregnant and
alcohol syndrome. It is throughout pregnancy increases the chances of these risks.
preferred because it Quitting smoking before getting pregnant is best. However, for
recognizes that women who are already pregnant, quitting as early as possible can
symptoms occur on a still help protect against some health problems for the mother and
spectrum and that all baby.
individuals do not have DRUGS
the same characteristics. Prescription, over-the-counter, or recreational drugs can
Children with fasd have serious teratogenic effects. In general, if medication is
share certain physical required, the lowest dose possible should be used. Combination
features such as flattened drug therapies and first trimester exposures should be avoided.
noses, small eye Almost three percent of pregnant women use illicit drugs such as
openings, small heads, marijuana, cocaine, ecstasy and other amphetamines, and heroin.
intellectual These drugs can cause low birth-weight, withdrawal symptoms,
birth defects, or learning or behavioral problems. Babies born with stis, and early detection is important. Stis, such as chlamydia,
a heroin addiction need heroin just like an adult addict. The child gonorrhea, syphilis, trichomoniasis and bacterial vaginosis can all
will need to be gradually weaned from the heroin under medical be treated and cured with antibiotics that are safe to take during
supervision; otherwise, the child could have seizures and die. pregnancy. Stis that are caused by viruses, like genital herpes,
ENVIRONMENTAL CHEMICALS hepatitis b, or HIV cannot be cured. However, in some cases these
Environmental chemicals can include an exposure to a wide infections can be treated with antiviral medications or other
array of agents including pollution, organic mercury compounds, preventive measures can be taken to reduce the risk of passing the
herbicides, and industrial solvents. Some environmental pollutants infection to the baby.
of major concern include lead poisoning, which is connected with MATERNAL DISEASES
low birth weight and slowed neurological development. Children Maternal illnesses increase the chance that a baby will be
who live in older housing in which lead-based paints have been born with a birth defect or have a chronic health problem. Some of
used have been known to eat peeling paint chips thus being the diseases that are known to potentially have an adverse effect
exposed to lead. The chemicals in certain herbicides are also on the fetus include: diabetes, cytomegalovirus, toxoplasmosis,
potentially damaging. Radiation is another environmental hazard rubella, varicella, hypothyroidism, and strep b. If the mother
that a pregnant woman must be aware of. If a mother is exposed to contracts rubella during the first three months of pregnancy,
radiation, particularly during the first three months of pregnancy, damage can occur in the eyes, ears, heart, or brain of the unborn
the child may suffer some congenital deformities. There is also an child. On a positive note, rubella has been nearly eliminated in the
increased risk of miscarriage and stillbirth. Mercury leads to industrial world due to the vaccine created in 1969. Diagnosing
physical deformities and intellectual disabilities (dietrich, 1999). these diseases early and receiving appropriate medical care can
The hot tubs and saunas help improve the outcomes. Routine prenatal care now includes
can produce neural tube screening for gestational diabetes and strep b.
defects. The type of birth Maternal stress
defects that might arise Stress represents the effects of any factor able to threaten
affect the brain the homeostasis of an organism; these either real or perceived
and spine. These are threats are referred to as the “stressors” and comprise a long list of
called neural tube potentially adverse factors, which can be emotional or physical.
defects ( ntd ). Spina bifida Because of a link in blood supply between a mother and fetus, it
is an example of ntd. has been found that stress can leave lasting effects on a developing
SEXUALLY fetus, even before a child is born. The best-studied outcomes of
TRANSMITTED DISEASES fetal exposure to maternal prenatal stress are preterm birth and
Sexually transmitted infections (stis) can complicate low birth weight. Maternal prenatal stress is also considered
pregnancy and may have serious effects on both the mother and responsible for a variety of changes of the child’s brain, and a risk
the developing baby. Most prenatal care today includes testing for factor for conditions such as behavioral problems, learning
disorders, high levels of anxiety, attention deficit hyperactivity to certain substances during this period, the arms and ears may be
disorder, autism, and schizophrenia. Furthermore, maternal malformed.
prenatal stress has been associated with a higher risk for a variety The amount of exposure: some substances are not harmful
of immune and metabolic changes in the child such as asthma, unless the amounts reach a certain level. The critical level depends
allergic disorders, cardiovascular diseases, hypertension, in part on the size and metabolism of the mother.
hyperlipidemia, diabetes, and obesity. Genetics: genetic make-up also plays a role on the impact a
particular teratogen might have on the child. This is suggested by
CRITICAL PERIODS OF PRENATAL DEVELOPMENT. fraternal twin studies who are exposed to the same prenatal
this image summarizes the three developmental environment, yet do not experience the same teratogenic effects.
periods in prenatal development. The blue images The genetic make-up of the mother can also have an effect; some
indicate where major development is happening mothers may be more resistant to teratogenic effects than others.
And the aqua indicates where refinement is Being male or female: males are more likely to experience
Happening. As shown, the majority organs are damage due to teratogens than are females. It is believed that the y
Particularly susceptible during embryonic period. chromosome, which contains fewer genes than the x, may have an
The central nervous impact.
system still
continues to
develop in major
ways through the
fetal period as well.
Factors influencing
prenatal risks
There are several
considerations in
determining the type and amount of damage that might result
from exposure to a particular teratogen (Berger, 2004). These
include:
The timing of the exposure: structures in the body are
vulnerable to the most severe damage when they are forming. If a
substance is introduced during a particular structure’s critical
period (time of development), the damage to that structure may be
greater. For example, the ears and arms reach their critical periods
at about 6 weeks after conception. If a mother exposes the embryo