MILESTONES OF FETAL GROWTH AND DEVELOPMENT

By: Cymil Paul O. MontoyaBSN IV-3

AKLAN STATE UNIVERSITY

BACHELOR OF SCIENCE IN NURSING

Banga, Aklan

OBJECTIVESGeneral Objective:

After 30 minutes of clear and comprehensive discussion, about 80% of

the students would be able to develop skills, knowledge and proper attitude in

preparing them to apply the nursing process in actual situations in relation to

fetal growth and development.

Specific Objectives:

After 30 minutes of clear and comprehensive discussion, about 80% of the students would be able to:

Skills:Apply learned concepts to future actual situation.

Knowledge:

Identify the different fetal characteristics in different gestational week.

Anticipate in actual situations the different developmental status and image of the growing fetus in different gestational week.

Visualize and compare the different size and appearance of human fetuses at different stages.

Attitude:Develop a sense to confidence in dealing with pregnant patients and in imparting teachings to patients and significant others.

The following discussion of fetal development milestones is based on gestational weeks.

*END OF 4th GESTATIONAL WEEK

Is a rapidly growing formation of cells but does not yet resemble a human being.Length: 0.75 – 1 cmWeight: 400 mgThe spinal cord is formed Head folds forward and becomes prominentThe back is bent so that the head almost touches the tail.The heart appears as a prominent bulge on the anterior surface.Arms and legs are budlike structures.Rudimentary eyes, ears, and nose are discernable.

*END OF 8th GESTATIONAL WEEK

Length: 2.5 cm (1in)Weight: 20 gOrganogenesis is complete.The heart with septum and valves is beating rhythmically.Facial features are definitely discernible.Arms and legs have developed.External genitalia are present, but sex is not yet distinguishable by simple observation.The primitive tail is regressing.Abdomen appears large because the fetal intestine is growing rapidly.Sonogram shows a gestational sac, diagnosing of pregnancy.

8 week old fetus

:-DEow Pow!

Can you see my gestational sac? It can be detected

through a sonogram by now to diagnose my mother’s

pregnancy.

Gestational sac as seen on a

sonogram

*END OF 12th GESTATIONAL WEEK (FIRST TRIMESTER) Length: 7 – 8 cmWeight: 45 kgNail beds are forming fingers and toes.Spontaneous movements are possible, although they are usually too faint to be felt by the mother.Bone ossification centers are forming.Tooth buds are present.Sex is distinguishable by outward appearance.Kidney secretion has begun, although urine may not yet be evident in amniotic fluid.Heartbeat is audible through Doppler technology 

12 week old fetus on ultrasound

;-)

*END OF 16th GESTATIONAL WEEK

Length: 10 – 17 cmWeight: 55 – 120 gFetal heart sounds are audible with an ordinary stethoscope.Lanugo (the fine, downy hair on the back and arms of newborns, which apparently serves as a source of insulation for body heat) is well formed.Liver and pancreas are functioning.Fetus actively swallows amniotic fluid. Demonstrating an intact but uncoordinated swallowing reflex; urine is present in the amniotic fluid.Sex can be determined by ultrasonography

*END OF 20th GESTATIONAL WEEK

Length: 25 cmWeight: 223 gSpontaneous fetal movements can be sensed by the mother.Antibody production is possible.Hair forms, extending to include eyebrows and hair on the head.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, which serves as a protective skin covering during intrauterine life, begins to form.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 cmWeight: 550 gPassive antibody transfer from mother to fetus probably begins as early as the 20th week of gestation, certainly by the 24th week. Meconium is present as far as the rectum.Active production of lung surfactant begins.Eyebrows and eyelashes are well defined. Vernix Casseosa

Eyelids, previously fused since the 12th week, are 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 if they are cared for after birth in a modern intensive care facility.Hearing can be demonstrated by response to sudden sound.

Sino mas cute?Ako o imaw?

*END OF 28th GESTATIONAL WEEK

Length: 35 – 38 cm Weight: 1200 gLung 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 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 cmWeight: 1600 gSubcutaneous fat begins to be deposited (the former stringy appearance “little old man” appearance is lost). Fetus responds by movement to sounds outside the mother’s body.Active Moro Reflex is present.Birth position (vertex or breech) may be assumed.Iron stores, which provide iron for the time during which the neonate ingests only milk after birth, are beginning to be developed.Fingernails grow to reach the end of fingertips.

*END OF 36th GESTATIONAL WEEKLength: 42 – 48 cmWeight: 1800 – 2700 gBody stores of glycogen, iron and carbohydrate and calcium are deposited.Additional amounts of subcutaneous fats 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 or head down presentation during this month.

*END OF 40th GESTATIONAL WEEK

Length: 28 – 36 cmWeight: 3000 gFetus 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 is adult in character.Fingernails extend over the fingertips.Creases on the soles of the feet cover at least two thirds of surface.

In primiparas, the fetus often sinks into the birth canal during the last two weeks, giving the mother a feeling that the load she is carrying is less. This event, termed lightening, is a fetal announcement that the third trimester of pregnancy has ended and birth is at hand.

Thank you for your cooperation!!

SOURCE: 5th Edition Maternal and Child Health Nursing: Care of the Childbearing and Childrearing Family by Adele Pillitteri. Volume 1.

Quiz:

1. Organogenesis can be expected to be complete at the end of what gestational week?

a. 4th gestational week b. 12th gestational week

c. 8th gestational week d. 40th gestational week

2. The substance that increases pulmonary compliance and prevents alveolar collapse is?

3. “________” is the collapse of the alveoli.

4. What is the cheese like substance that serves as a protective skin during intrauterine life?

4. What do you call the fine, downy hair on the back and arms of newborns, which apparently serves as a source of insulation for body heat?

5. At the end of what week can the fetal heart sound be heard using a doppler?

6. The only available intrauterine structure used to diagnose pregnancy until the embryo is identified and can be detected using a sonogram at the end of 8th gestational week. _________________

7. _________ is the earliest stools of an infant.

8. _________ is the increase in size or the quantitative changes over time.

9. Also called maturation or the qualitative changes that occur over time.

10. At the end of what gestational week does active surfactant production begins?

a. End of 24th gestational week c. End of 8th gestational week

b. End of 30th gestational week d. End of 4th gestational week

SAEAMAT KINYO TANAN!