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Conception,
Implantation and
Fetal Development
Thursday, April 5, 2018 1Dr. Soad Abd El salam Ramdan
‫الرحيم‬ ‫الرمحن‬ ‫هللا‬ ‫بسم‬
َ‫ك‬َ‫ن‬‫ا‬َ‫ح‬ْ‫ب‬ُ‫س‬ ْ‫ا‬‫و‬ُ‫ل‬‫ا‬َ‫ق‬َ‫ل‬ َ‫م‬ْ‫ل‬ِ‫ع‬ َ‫ال‬ّ‫ال‬ِ‫إ‬ ‫آ‬َ‫ن‬
ّ‫ن‬ِ‫إ‬ ‫آ‬َ‫ن‬َ‫ت‬ْ‫م‬ّ‫َل‬‫ع‬ ‫ا‬َ‫م‬َ‫ع‬ْ‫ال‬ َ‫ت‬ْ‫ن‬َ‫أ‬ َ‫ك‬ُ‫م‬‫ي‬ِ‫ل‬
ُ‫م‬‫ي‬ِ‫ك‬َ‫ح‬ْ‫ال‬
‫العظيم‬ ‫اهلل‬ ‫صدق‬
‫سورة‬‫البقرة‬‫أية‬32
Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan 2
3
• Chairman of obstetrics &woman health
nursing department
• Pre. Vice dean for students &Education
Affairs
Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan
Fertilization conception fetal development
Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan 5
▪ Discuss concepts related to
fertilization (conception).
▪ Explore the process of
fertilization, implantation.
▪ Identify the process of fetal
development.
Objectives
FERTILIZATION
It is the process during which a male
gamete (sperm) unites with a female
gamete (oocyte) to form a single cell
(ZYGOTE).
Site
• Usually in the ampulla of the uterine
tube.
• Ampulla is the longest and widest part.
• Does not occur in the uterine cavity.
• Chemical signals from oocyte attract
the sperms.
FERTILIZATION & IMPLANTATION
Chromosomes in zygote
- Sex determination from the mature ovum carries 22 autosomes and one
x chromosome. while sperm carries 22 autosomes and either an x or y
chromosome. If the fertilizing sperm is carrying x chromosome the fetus
will be female(46xx), if it is carrying y chromosome the fetus will be
male(46xy).
- Half of its chromosomes come from the father and the other half
comes from the mother.
-Zygote is genetically unique. zygote contains 46 chromosomes
Sex of the Embryo
• Embryo's chromosomal
sex is determined at the
time of fertilization.
• Sex is determined by the
type of sperm
(X or Y) that fertilizes the
oocyte.
• So, it is the father whose
gamete decides the sex.
Gametogenesis
Cells are produced in two different methods:
mitosis and meiosis.
• Meiosis: is the process by which gametes are
produced
• Mitosis: is the process by which the cells
replicate to yield same genetic make up-
• Oogenesis: Cyclical
• Spermatogenesis: Continuous
Thursday, April 5, 2018 11Dr. Soad Abd El salam Ramdan
Oogenesis
• Occurs in females , is the creation of an ovum in the
ovary
• Oogenesis is regulated by hormones- Follicle
stimulating hormone (FSH) and LH.
• Only one oocyte is selected to continue meiosis each
month.
Thursday, April 5, 2018 12Dr. Soad Abd El salam Ramdan
Ovum
Thursday, April 5, 2018 13Dr. Soad Abd El salam Ramdan
Thursday, April 5, 2018 14Dr. Soad Abd El salam Ramdan
Spermatogenesis
• Spermatogenesis is the process by which male
gametogonia develop into mature spermatozoa
• It occurs in the male testes and epididymis and takes
approximately 64 day.
• Sperm can live 72 hrs but more fertile for 48 hrs.
• The maturation of the male gamets, start at puberty
Thursday, April 5, 2018 15Dr. Soad Abd El salam Ramdan
Sperms
Thursday, April 5, 2018 16Dr. Soad Abd El salam Ramdan
Thursday, April 5, 2018 17Dr. Soad Abd El salam Ramdan
Fertilization Process- Ovum
• The ovum is expelled from the mature follicle (graafian )
of the ovary and picked up by the fimbria.
• The ovum is surrounded by a ring of
mucopolysaccharide fluid (the zona pellucida) and outer
layer a circle of cells (the corona radiata)
• The lifespan of the oocyte is thought to be 6-24 hours.
• After fertilization the zygote undergoes cleavage
divisions whilst traveling through the uterine tube to the
uterus where it implants in the uterine wall.
Thursday, April 5, 2018 18Dr. Soad Abd El salam Ramdan
corona
radiata
Thursday, April 5, 2018 19Dr. Soad Abd El salam Ramdan
Thursday, April 5, 2018 20Dr. Soad Abd El salam Ramdan
Sperm & Ovum
Thursday, April 5, 2018 21Dr. Soad Abd El salam Ramdan
Fertilization
Thursday, April 5, 2018 22Dr. Soad Abd El salam Ramdan
Fertilization
• Depends on key points
– Equal maturation of both ova and sperm
– Ability of sperm to reach ova
– Ability of sperm to penetrate the zona pellucida and
corona radiata
Thursday, April 5, 2018 23Dr. Soad Abd El salam Ramdan
Schema of ovulation, fertilization, and implantation
Thursday, April 5, 2018 24Dr. Soad Abd El salam Ramdan
Intra Uterine Life
• The development of the fetus (female and the male) is
initially the same until the 4th week.
• The zygote moves through the fallopian tube to the uterus
within 3-4 days.
• During this time (3-4) days the zygote continues to divide.
• Within 3 days a solid ball of cells, the Morula continues to
develop to form a central cavity or blastocyst
• Even at this early stage of development, cells begin to
differentiate in structure and function.
Thursday, April 5, 2018 25Dr. Soad Abd El salam Ramdan
Intra Uterine Life
• A fluid filled cavity in : morula which now becomes known as
blastocyst
• Blastocyst is the stage at which it embeds after 3rd or 4th free floating
in the uterus .
• about 8 days from ovulation. It attaches to the surface of
endometrium
• Endometrium after implantation is called deciduas
• Deciduas can be differentiated into 3 layes
• Decidus basalis under site of implantation.
• Decidus capsularis covering the ovum
decidua vera lining rest of uterine cavity
Thursday, April 5, 2018 26Dr. Soad Abd El salam Ramdan
Decidua
Thursday, April 5, 2018 27Dr. Soad Abd El salam Ramdan
Intra Uterine Life
• Small projection begin to appear over the
surface of blastocyst
• Called choronic villi the fluid filled cavity
pushes some of cells to one side and two
layers are formed :
• Outer cell mass (trophoblast) this is orgin
of placenta
• Inner cell mass become fetus(embroyblast )Thursday, April 5, 2018 28Dr. Soad Abd El salam Ramdan
After implanation 2 cavities appear in the inner
cell mass(embroyblast ) (ammiot sac
and yolk sac) in between them 3 main
layers which will form fetus developed :
Ectoderm , mesoderm , endoderm
Primary Germ Layers
Germ
Layer Body Portions Formed
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
Mammary glands
Mesoderm Supporting structures of the body (connective tissue, bones, cartilage, muscle,
ligaments, and tendons)
Upper portion of the urinary system (kidneys and ureters)
Reproductive system Heart Circulatory system Blood cells Lymph vessels
Entoderm Lining of pericardial, and peritoneal cavities
Lining of the gastrointestinal tract, respiratory tract, tonsils, parathyroid, thyroid
glands
Lower urinary system (bladder and urethra)
Thursday, April 5, 2018 30Dr. Soad Abd El salam Ramdan
Intra Uterine Life
• ectoderm mainly forms : skin and
nervous system.
• Mesoderm: forms bones and muscles
and heart & blood vessels
• Endoderm : forms mucous membranes
and glands
Thursday, April 5, 2018 31Dr. Soad Abd El salam Ramdan
Intra Uterine Life
• Implantation point is usually high of uterus (upper uterine
segment)
• If point of implantation is low in uterus growing placenta
may occlude cervix make birth of child difficult ( placenta
previa )
• 2/3 cases implanted in posterior surface of upper uterine
segment .
• 1/3 cases implanted in anterior surface of upper uterine
segment.
• After fertilization corpus luteum in the ovary continues to
function until the placenta formed (12 ws).
Thursday, April 5, 2018 32Dr. Soad Abd El salam Ramdan
Intra Uterine Life
The placenta :
• It is discoid in shape about 15-20 cm , 2.5 cm in thickness at
the center and weighting about 500 gm
• Has two surface .
• Fetal surface :- umbilical cord inserted at center of this
surface
• Maternal surface:- divided into 15-20 .cotyledons .
• The structure of the placenta is complete by the 12th week.
• At term, one-sixth the weight of the baby.
Thursday, April 5, 2018 33Dr. Soad Abd El salam Ramdan
Intra Uterine Life
Function of placenta :
• Exchange of gases (as lung ) respiration
• Execration (as urinary tract)
• Nutrition (as G.I.T)
• Secretion of hormones (as endocrine system)
• As (H.P.L). HGC
• Barrier action as protection
• As Storage
Thursday, April 5, 2018 34Dr. Soad Abd El salam Ramdan
Intra Uterine Life
Amniotic fluid:-
• One litre average if 2 litre or more called polyhydromenis if
less called Oligo hydromeris
• The volume reach to its peak at 38 w than slightly up to
term and rapidly decrase there after
• Is alkaline in reaction (PH.is 7 to 7.4)
•Composition 99 % water 1% solid as waste product Urea
enzymes , hormones lingua hairy Deed skin, verneix
casueasa
Thursday, April 5, 2018 35Dr. Soad Abd El salam Ramdan
Normal Amounts of Fluid
• 30 ml @ 10 weeks
• 350 ml @ 20 weeks
• 500 to 1000 ml after 20 weeks
• At Term 800-1200 ml
• Oligohydramnios=Too little <300ml pocket <1cm”
• Poly or Hydraminios=Too much >2L“pocket >8cm
• Genetic testing at 16 wks
Thursday, April 5, 2018 36Dr. Soad Abd El salam Ramdan
Intra Uterine Life
Function :
• Protection of fetus from external trauma.
• Facilitate the movement of the fetus.
• Execration of fetal urine
• Keeps fetal temperature constant
• Bag of water help to dilate cervix
• After rupture of membranes act as antiseptic
Thursday, April 5, 2018 37Dr. Soad Abd El salam Ramdan
Intra Uterine Life
• Umbilical cord :
• Development from mesoderm
• Length : 50 cm
• Insertion : centeral
• Content : 2 arteries & one vien surrounded by Wharton’s jelly
• Abnormality :
• Too long lead to prolapsed cord
• Coiling around the neck
• Too short lead to prolonged labour
or Premature separation of placenta
• Knots:
• True knote cause fetal death
Thursday, April 5, 2018 38Dr. Soad Abd El salam Ramdan
• Cephalocaudal (Brain before lungs)
• Proximodistal (Arms before fingers)
• Differentiation (Organs formed)
– All major organs are formed by day 17
to 56
Fetal Development Principles
Thursday, April 5, 2018 39Dr. Soad Abd El salam Ramdan
Thursday, April 5, 2018 40Dr. Soad Abd El salam Ramdan
An early gestational sac prior to the appearance of a yolk sac
or other embryonic structure
Thursday, April 5, 2018 41Dr. Soad Abd El salam Ramdan
Terms Used to Denote Fetal Growth
Time PeriodName
From ovulation to fertilizationOvum
From fertilization to implantationZygote
From implantation to 5–8 weeksEmbryo
From 5–8 weeks until termFetus
Developing embryo or fetus and placental structures
throughout pregnancy
Conceptus
Thursday, April 5, 2018 42Dr. Soad Abd El salam Ramdan
– Viruses can cross the placenta and infect the fetus
– Some bacteria and protozoa first infect the placenta
then infect the fetus
– Drugs, caffeine, alcohol, nicotine, cocaine,
marijuana all cross the placenta to the fetus
Mechanisms of Placental
transportation:
Thursday, April 5, 2018 43Dr. Soad Abd El salam Ramdan
Placental Hormones
1. Human Chorionic Gonadotrophin (hCG): peak
at 50-70days then decrease detected in blood
serum by 8 to 10 days after conception.
– hCG maintain the function of ovarian corpus
luteum to ensure a continuous supply of
oestrogen and progesterone.
Thursday, April 5, 2018 44Dr. Soad Abd El salam Ramdan
2. human Placental Lactogen (hPL):
• A growth hormone like-substance
• Stimulate maternal metabolism,
• Facilitate glucose transport across placental membrane,
• Stimulate breast development to prepare for lactation
3. Progesterone:
• Maintain the endometrial
• Decrease the contractility of uterus,
• Stimulate the breast alveoli development
• Assist in maternal metabolism
Placental Hormones
Thursday, April 5, 2018 45Dr. Soad Abd El salam Ramdan
4. Estrogen
• At week 7 most of maternal oestrogen
from the placenta
• It stimulates uterine growth, cause
proliferation of breast glandular tissue,
• It stimulates myometrial contractility
Placental Hormones
Thursday, April 5, 2018 46Dr. Soad Abd El salam Ramdan
Placental function
Placental Function depends on maternal blood pressure:
1. Vasoconstriction _such that caused by hypertension-
diminish uterine blood flow
2. Decreased maternal blood pressure or cardiac output
diminish uterine blood flow- supine position
3. Excessive maternal exercise derives blood away from
uterus to muscles
4. Prolonged contraction and decreased interval between
them reduce blood flow to placenta
Thursday, April 5, 2018 47Dr. Soad Abd El salam Ramdan
Arrangement of the placental layers &
part
Thursday, April 5, 2018 48Dr. Soad Abd El salam Ramdan
Placenta & Membranes
Thursday, April 5, 2018 49Dr. Soad Abd El salam Ramdan
Landmarks in Fetal Development
• 4 weeks-Fetal heart begins to beat
• 8 weeks-All organs are formed
• 8-12 weeks- Heartbeat heard with Doppler
• 16 weeks-Baby’s sex can be seen
• 20 weeks-Mother feels movement
• 24 weeks-Respiratory movements
• 28 weeks-can breathe in extra uterine life
Thursday, April 5, 2018 50Dr. Soad Abd El salam Ramdan
Critical Periods/Development
Thursday, April 5, 2018 51Dr. Soad Abd El salam Ramdan
Embryo at Four Weeks
Thursday, April 5, 2018 52Dr. Soad Abd El salam Ramdan
Embryo at Five Weeks
Thursday, April 5, 2018 53Dr. Soad Abd El salam Ramdan
7 Weeks
Thursday, April 5, 2018 54Dr. Soad Abd El salam Ramdan
Embryo at Seven Weeks
Thursday, April 5, 2018 55Dr. Soad Abd El salam Ramdan
Week 8
The embryo is reactive to its environment inside the amniotic
sac where it swims and moves. Hands and feet can be
seen. At the end of week 8, the embryonic period is over and
the fetal stage begins.
Thursday, April 5, 2018 56Dr. Soad Abd El salam Ramdan
Embryo at Eight Weeks
Thursday, April 5, 2018 57Dr. Soad Abd El salam Ramdan
Fetus at 9 Weeks
Thursday, April 5, 2018 58Dr. Soad Abd El salam Ramdan
16 weeks
Thursday, April 5, 2018 59Dr. Soad Abd El salam Ramdan
18 weeks
Thursday, April 5, 2018 60Dr. Soad Abd El salam Ramdan
Fetus at 20 Weeks
Thursday, April 5, 2018 61Dr. Soad Abd El salam Ramdan
Hazards to Fetal Development
• Teratogens are……………………………
• Tissues are most vulnerable during the
embryonic stage when tissues are differentiating
into essential organs.
• Critical time: Day 16 to 56.
• Most women do not know they are even
pregnant (Preconceptual counseling)
Thursday, April 5, 2018 62Dr. Soad Abd El salam Ramdan
Week 20
• “Quickening” (when the mother can feel the
fetus moving) usually occurs around this time.
• Finger and toenails appear.
• Lanugo, a fine hair now covers the entire body.
• The fetus can hear and recognize the mother’s
voice.
• Sex organs are visible on ultrasound devices.
Thursday, April 5, 2018 63Dr. Soad Abd El salam Ramdan
20 weeks girl
Thursday, April 5, 2018 64Dr. Soad Abd El salam Ramdan
20weeks
Thursday, April 5, 2018 65Dr. Soad Abd El salam Ramdan
Third Trimester
Week 24
A protective waxy substance called Vernix covers the skin. By birth,
most of the vernix will be gone but any that is left is quickly
absorbed. Fetus has a hand and startle reflex. Footprints and
fingerprints are forming. Fetus practices breathing by inhaling
amniotic fluid into its developing lungs.
Thursday, April 5, 2018 66Dr. Soad Abd El salam Ramdan
32 weeks
Thursday, April 5, 2018 67Dr. Soad Abd El salam Ramdan
Congratulations
Thursday, April 5, 2018 68Dr. Soad Abd El salam Ramdan
Choose the best name
Thursday, April 5, 2018 69Dr. Soad Abd El salam Ramdan
704/5/2018 Dr. Soad Abd El Salam Ramadan

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Fertilization conception fetal development

  • 1. Conception, Implantation and Fetal Development Thursday, April 5, 2018 1Dr. Soad Abd El salam Ramdan
  • 2. ‫الرحيم‬ ‫الرمحن‬ ‫هللا‬ ‫بسم‬ َ‫ك‬َ‫ن‬‫ا‬َ‫ح‬ْ‫ب‬ُ‫س‬ ْ‫ا‬‫و‬ُ‫ل‬‫ا‬َ‫ق‬َ‫ل‬ َ‫م‬ْ‫ل‬ِ‫ع‬ َ‫ال‬ّ‫ال‬ِ‫إ‬ ‫آ‬َ‫ن‬ ّ‫ن‬ِ‫إ‬ ‫آ‬َ‫ن‬َ‫ت‬ْ‫م‬ّ‫َل‬‫ع‬ ‫ا‬َ‫م‬َ‫ع‬ْ‫ال‬ َ‫ت‬ْ‫ن‬َ‫أ‬ َ‫ك‬ُ‫م‬‫ي‬ِ‫ل‬ ُ‫م‬‫ي‬ِ‫ك‬َ‫ح‬ْ‫ال‬ ‫العظيم‬ ‫اهلل‬ ‫صدق‬ ‫سورة‬‫البقرة‬‫أية‬32 Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan 2
  • 3. 3 • Chairman of obstetrics &woman health nursing department • Pre. Vice dean for students &Education Affairs Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan
  • 5. Thursday, April 5, 2018 Dr. Soad Abd El salam Ramdan 5 ▪ Discuss concepts related to fertilization (conception). ▪ Explore the process of fertilization, implantation. ▪ Identify the process of fetal development. Objectives
  • 6. FERTILIZATION It is the process during which a male gamete (sperm) unites with a female gamete (oocyte) to form a single cell (ZYGOTE).
  • 7. Site • Usually in the ampulla of the uterine tube. • Ampulla is the longest and widest part. • Does not occur in the uterine cavity. • Chemical signals from oocyte attract the sperms.
  • 9. Chromosomes in zygote - Sex determination from the mature ovum carries 22 autosomes and one x chromosome. while sperm carries 22 autosomes and either an x or y chromosome. If the fertilizing sperm is carrying x chromosome the fetus will be female(46xx), if it is carrying y chromosome the fetus will be male(46xy). - Half of its chromosomes come from the father and the other half comes from the mother. -Zygote is genetically unique. zygote contains 46 chromosomes
  • 10. Sex of the Embryo • Embryo's chromosomal sex is determined at the time of fertilization. • Sex is determined by the type of sperm (X or Y) that fertilizes the oocyte. • So, it is the father whose gamete decides the sex.
  • 11. Gametogenesis Cells are produced in two different methods: mitosis and meiosis. • Meiosis: is the process by which gametes are produced • Mitosis: is the process by which the cells replicate to yield same genetic make up- • Oogenesis: Cyclical • Spermatogenesis: Continuous Thursday, April 5, 2018 11Dr. Soad Abd El salam Ramdan
  • 12. Oogenesis • Occurs in females , is the creation of an ovum in the ovary • Oogenesis is regulated by hormones- Follicle stimulating hormone (FSH) and LH. • Only one oocyte is selected to continue meiosis each month. Thursday, April 5, 2018 12Dr. Soad Abd El salam Ramdan
  • 13. Ovum Thursday, April 5, 2018 13Dr. Soad Abd El salam Ramdan
  • 14. Thursday, April 5, 2018 14Dr. Soad Abd El salam Ramdan
  • 15. Spermatogenesis • Spermatogenesis is the process by which male gametogonia develop into mature spermatozoa • It occurs in the male testes and epididymis and takes approximately 64 day. • Sperm can live 72 hrs but more fertile for 48 hrs. • The maturation of the male gamets, start at puberty Thursday, April 5, 2018 15Dr. Soad Abd El salam Ramdan
  • 16. Sperms Thursday, April 5, 2018 16Dr. Soad Abd El salam Ramdan
  • 17. Thursday, April 5, 2018 17Dr. Soad Abd El salam Ramdan
  • 18. Fertilization Process- Ovum • The ovum is expelled from the mature follicle (graafian ) of the ovary and picked up by the fimbria. • The ovum is surrounded by a ring of mucopolysaccharide fluid (the zona pellucida) and outer layer a circle of cells (the corona radiata) • The lifespan of the oocyte is thought to be 6-24 hours. • After fertilization the zygote undergoes cleavage divisions whilst traveling through the uterine tube to the uterus where it implants in the uterine wall. Thursday, April 5, 2018 18Dr. Soad Abd El salam Ramdan
  • 19. corona radiata Thursday, April 5, 2018 19Dr. Soad Abd El salam Ramdan
  • 20. Thursday, April 5, 2018 20Dr. Soad Abd El salam Ramdan
  • 21. Sperm & Ovum Thursday, April 5, 2018 21Dr. Soad Abd El salam Ramdan
  • 22. Fertilization Thursday, April 5, 2018 22Dr. Soad Abd El salam Ramdan
  • 23. Fertilization • Depends on key points – Equal maturation of both ova and sperm – Ability of sperm to reach ova – Ability of sperm to penetrate the zona pellucida and corona radiata Thursday, April 5, 2018 23Dr. Soad Abd El salam Ramdan
  • 24. Schema of ovulation, fertilization, and implantation Thursday, April 5, 2018 24Dr. Soad Abd El salam Ramdan
  • 25. Intra Uterine Life • The development of the fetus (female and the male) is initially the same until the 4th week. • The zygote moves through the fallopian tube to the uterus within 3-4 days. • During this time (3-4) days the zygote continues to divide. • Within 3 days a solid ball of cells, the Morula continues to develop to form a central cavity or blastocyst • Even at this early stage of development, cells begin to differentiate in structure and function. Thursday, April 5, 2018 25Dr. Soad Abd El salam Ramdan
  • 26. Intra Uterine Life • A fluid filled cavity in : morula which now becomes known as blastocyst • Blastocyst is the stage at which it embeds after 3rd or 4th free floating in the uterus . • about 8 days from ovulation. It attaches to the surface of endometrium • Endometrium after implantation is called deciduas • Deciduas can be differentiated into 3 layes • Decidus basalis under site of implantation. • Decidus capsularis covering the ovum decidua vera lining rest of uterine cavity Thursday, April 5, 2018 26Dr. Soad Abd El salam Ramdan
  • 27. Decidua Thursday, April 5, 2018 27Dr. Soad Abd El salam Ramdan
  • 28. Intra Uterine Life • Small projection begin to appear over the surface of blastocyst • Called choronic villi the fluid filled cavity pushes some of cells to one side and two layers are formed : • Outer cell mass (trophoblast) this is orgin of placenta • Inner cell mass become fetus(embroyblast )Thursday, April 5, 2018 28Dr. Soad Abd El salam Ramdan
  • 29. After implanation 2 cavities appear in the inner cell mass(embroyblast ) (ammiot sac and yolk sac) in between them 3 main layers which will form fetus developed : Ectoderm , mesoderm , endoderm
  • 30. Primary Germ Layers Germ Layer Body Portions Formed 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 Mammary glands Mesoderm Supporting structures of the body (connective tissue, bones, cartilage, muscle, ligaments, and tendons) Upper portion of the urinary system (kidneys and ureters) Reproductive system Heart Circulatory system Blood cells Lymph vessels Entoderm Lining of pericardial, and peritoneal cavities Lining of the gastrointestinal tract, respiratory tract, tonsils, parathyroid, thyroid glands Lower urinary system (bladder and urethra) Thursday, April 5, 2018 30Dr. Soad Abd El salam Ramdan
  • 31. Intra Uterine Life • ectoderm mainly forms : skin and nervous system. • Mesoderm: forms bones and muscles and heart & blood vessels • Endoderm : forms mucous membranes and glands Thursday, April 5, 2018 31Dr. Soad Abd El salam Ramdan
  • 32. Intra Uterine Life • Implantation point is usually high of uterus (upper uterine segment) • If point of implantation is low in uterus growing placenta may occlude cervix make birth of child difficult ( placenta previa ) • 2/3 cases implanted in posterior surface of upper uterine segment . • 1/3 cases implanted in anterior surface of upper uterine segment. • After fertilization corpus luteum in the ovary continues to function until the placenta formed (12 ws). Thursday, April 5, 2018 32Dr. Soad Abd El salam Ramdan
  • 33. Intra Uterine Life The placenta : • It is discoid in shape about 15-20 cm , 2.5 cm in thickness at the center and weighting about 500 gm • Has two surface . • Fetal surface :- umbilical cord inserted at center of this surface • Maternal surface:- divided into 15-20 .cotyledons . • The structure of the placenta is complete by the 12th week. • At term, one-sixth the weight of the baby. Thursday, April 5, 2018 33Dr. Soad Abd El salam Ramdan
  • 34. Intra Uterine Life Function of placenta : • Exchange of gases (as lung ) respiration • Execration (as urinary tract) • Nutrition (as G.I.T) • Secretion of hormones (as endocrine system) • As (H.P.L). HGC • Barrier action as protection • As Storage Thursday, April 5, 2018 34Dr. Soad Abd El salam Ramdan
  • 35. Intra Uterine Life Amniotic fluid:- • One litre average if 2 litre or more called polyhydromenis if less called Oligo hydromeris • The volume reach to its peak at 38 w than slightly up to term and rapidly decrase there after • Is alkaline in reaction (PH.is 7 to 7.4) •Composition 99 % water 1% solid as waste product Urea enzymes , hormones lingua hairy Deed skin, verneix casueasa Thursday, April 5, 2018 35Dr. Soad Abd El salam Ramdan
  • 36. Normal Amounts of Fluid • 30 ml @ 10 weeks • 350 ml @ 20 weeks • 500 to 1000 ml after 20 weeks • At Term 800-1200 ml • Oligohydramnios=Too little <300ml pocket <1cm” • Poly or Hydraminios=Too much >2L“pocket >8cm • Genetic testing at 16 wks Thursday, April 5, 2018 36Dr. Soad Abd El salam Ramdan
  • 37. Intra Uterine Life Function : • Protection of fetus from external trauma. • Facilitate the movement of the fetus. • Execration of fetal urine • Keeps fetal temperature constant • Bag of water help to dilate cervix • After rupture of membranes act as antiseptic Thursday, April 5, 2018 37Dr. Soad Abd El salam Ramdan
  • 38. Intra Uterine Life • Umbilical cord : • Development from mesoderm • Length : 50 cm • Insertion : centeral • Content : 2 arteries & one vien surrounded by Wharton’s jelly • Abnormality : • Too long lead to prolapsed cord • Coiling around the neck • Too short lead to prolonged labour or Premature separation of placenta • Knots: • True knote cause fetal death Thursday, April 5, 2018 38Dr. Soad Abd El salam Ramdan
  • 39. • Cephalocaudal (Brain before lungs) • Proximodistal (Arms before fingers) • Differentiation (Organs formed) – All major organs are formed by day 17 to 56 Fetal Development Principles Thursday, April 5, 2018 39Dr. Soad Abd El salam Ramdan
  • 40. Thursday, April 5, 2018 40Dr. Soad Abd El salam Ramdan
  • 41. An early gestational sac prior to the appearance of a yolk sac or other embryonic structure Thursday, April 5, 2018 41Dr. Soad Abd El salam Ramdan
  • 42. Terms Used to Denote Fetal Growth Time PeriodName From ovulation to fertilizationOvum From fertilization to implantationZygote From implantation to 5–8 weeksEmbryo From 5–8 weeks until termFetus Developing embryo or fetus and placental structures throughout pregnancy Conceptus Thursday, April 5, 2018 42Dr. Soad Abd El salam Ramdan
  • 43. – Viruses can cross the placenta and infect the fetus – Some bacteria and protozoa first infect the placenta then infect the fetus – Drugs, caffeine, alcohol, nicotine, cocaine, marijuana all cross the placenta to the fetus Mechanisms of Placental transportation: Thursday, April 5, 2018 43Dr. Soad Abd El salam Ramdan
  • 44. Placental Hormones 1. Human Chorionic Gonadotrophin (hCG): peak at 50-70days then decrease detected in blood serum by 8 to 10 days after conception. – hCG maintain the function of ovarian corpus luteum to ensure a continuous supply of oestrogen and progesterone. Thursday, April 5, 2018 44Dr. Soad Abd El salam Ramdan
  • 45. 2. human Placental Lactogen (hPL): • A growth hormone like-substance • Stimulate maternal metabolism, • Facilitate glucose transport across placental membrane, • Stimulate breast development to prepare for lactation 3. Progesterone: • Maintain the endometrial • Decrease the contractility of uterus, • Stimulate the breast alveoli development • Assist in maternal metabolism Placental Hormones Thursday, April 5, 2018 45Dr. Soad Abd El salam Ramdan
  • 46. 4. Estrogen • At week 7 most of maternal oestrogen from the placenta • It stimulates uterine growth, cause proliferation of breast glandular tissue, • It stimulates myometrial contractility Placental Hormones Thursday, April 5, 2018 46Dr. Soad Abd El salam Ramdan
  • 47. Placental function Placental Function depends on maternal blood pressure: 1. Vasoconstriction _such that caused by hypertension- diminish uterine blood flow 2. Decreased maternal blood pressure or cardiac output diminish uterine blood flow- supine position 3. Excessive maternal exercise derives blood away from uterus to muscles 4. Prolonged contraction and decreased interval between them reduce blood flow to placenta Thursday, April 5, 2018 47Dr. Soad Abd El salam Ramdan
  • 48. Arrangement of the placental layers & part Thursday, April 5, 2018 48Dr. Soad Abd El salam Ramdan
  • 49. Placenta & Membranes Thursday, April 5, 2018 49Dr. Soad Abd El salam Ramdan
  • 50. Landmarks in Fetal Development • 4 weeks-Fetal heart begins to beat • 8 weeks-All organs are formed • 8-12 weeks- Heartbeat heard with Doppler • 16 weeks-Baby’s sex can be seen • 20 weeks-Mother feels movement • 24 weeks-Respiratory movements • 28 weeks-can breathe in extra uterine life Thursday, April 5, 2018 50Dr. Soad Abd El salam Ramdan
  • 51. Critical Periods/Development Thursday, April 5, 2018 51Dr. Soad Abd El salam Ramdan
  • 52. Embryo at Four Weeks Thursday, April 5, 2018 52Dr. Soad Abd El salam Ramdan
  • 53. Embryo at Five Weeks Thursday, April 5, 2018 53Dr. Soad Abd El salam Ramdan
  • 54. 7 Weeks Thursday, April 5, 2018 54Dr. Soad Abd El salam Ramdan
  • 55. Embryo at Seven Weeks Thursday, April 5, 2018 55Dr. Soad Abd El salam Ramdan
  • 56. Week 8 The embryo is reactive to its environment inside the amniotic sac where it swims and moves. Hands and feet can be seen. At the end of week 8, the embryonic period is over and the fetal stage begins. Thursday, April 5, 2018 56Dr. Soad Abd El salam Ramdan
  • 57. Embryo at Eight Weeks Thursday, April 5, 2018 57Dr. Soad Abd El salam Ramdan
  • 58. Fetus at 9 Weeks Thursday, April 5, 2018 58Dr. Soad Abd El salam Ramdan
  • 59. 16 weeks Thursday, April 5, 2018 59Dr. Soad Abd El salam Ramdan
  • 60. 18 weeks Thursday, April 5, 2018 60Dr. Soad Abd El salam Ramdan
  • 61. Fetus at 20 Weeks Thursday, April 5, 2018 61Dr. Soad Abd El salam Ramdan
  • 62. Hazards to Fetal Development • Teratogens are…………………………… • Tissues are most vulnerable during the embryonic stage when tissues are differentiating into essential organs. • Critical time: Day 16 to 56. • Most women do not know they are even pregnant (Preconceptual counseling) Thursday, April 5, 2018 62Dr. Soad Abd El salam Ramdan
  • 63. Week 20 • “Quickening” (when the mother can feel the fetus moving) usually occurs around this time. • Finger and toenails appear. • Lanugo, a fine hair now covers the entire body. • The fetus can hear and recognize the mother’s voice. • Sex organs are visible on ultrasound devices. Thursday, April 5, 2018 63Dr. Soad Abd El salam Ramdan
  • 64. 20 weeks girl Thursday, April 5, 2018 64Dr. Soad Abd El salam Ramdan
  • 65. 20weeks Thursday, April 5, 2018 65Dr. Soad Abd El salam Ramdan
  • 66. Third Trimester Week 24 A protective waxy substance called Vernix covers the skin. By birth, most of the vernix will be gone but any that is left is quickly absorbed. Fetus has a hand and startle reflex. Footprints and fingerprints are forming. Fetus practices breathing by inhaling amniotic fluid into its developing lungs. Thursday, April 5, 2018 66Dr. Soad Abd El salam Ramdan
  • 67. 32 weeks Thursday, April 5, 2018 67Dr. Soad Abd El salam Ramdan
  • 68. Congratulations Thursday, April 5, 2018 68Dr. Soad Abd El salam Ramdan
  • 69. Choose the best name Thursday, April 5, 2018 69Dr. Soad Abd El salam Ramdan
  • 70. 704/5/2018 Dr. Soad Abd El Salam Ramadan