FETAL GROWTH AND

DEVELOPMENT
By S.R. Muheriwa
3rd Feb.2011
 

INTRODUCTION

 Understanding of the fetal

development is a constructive step
towards achieving a positive
pregnancy outcome.

 It provides prospective parents with

opportunity to make conscious
decisions about their health and
lifestyle.
 

INTRODUCTI
INTRODUCTION
ON CONT’D 

 The midwife’s role in fetal

development is focused on health
education for maternal and fetal well
being.

 This involves providing parents with

information about the effects of
maternal lifestyle such as diet,
smoking, alcohol, drugs and exercise
on fetal growth and development
 

 
OBJECTIVES
 Explain the overview of fetal
growth and development

 Describe the developmental

changes that take place in the
following systems:
 Cardiovascular system
 

OBJECTIVES CONT’D 

 Respiratory system
 Urogenital system
 Endocrine system


Digestive system
 

OBJECTIVES CONT’D 

 Nervous system
 Integumentary
Integumentary,, skeletal and

muscular system

 Explain factors that influence fetal

growth and development
 

OVERVIEW OF FETAL GROWTH &

DEVELOPMENT 

FETUS
- This name is used during the

period
th from the beginning of the
9  week after fertilization to term
(end of 38th week - 40th week).
 

OVERVIEW CONT’D 

 By the beginning of the 9th 

fertilization, the human embryo

has developed into a recognizable

human being and most of the
body structures have commenced
development.
 

OVERVIEW CONT’D 

 The fetal period is mainly

concerned with differentiation and
growth of tissues and organs
which have already appeared.
 

OVERVIEW CONT’D 

 The fetus is less vulnerable

than the embryo, to the harmful
and deforming effects of
teratogenic agents.
 

OVERVIEW CONT’D 

 Tissues grow by cell proliferation,

cell enlargement and accretion

(building
material. up) of extracellular

 On average, the baby at term

weighs 3400 grams (3.4 kg) and is
500mm long.
 

DEVELOPMENTAL CHANGES IN THE

SYSTEMS

The cardiovascular system

 Is the first to function in the

embryo.
 The heart and the vascular

system commences development

in the 3rd week
th
 By 4   week a primitive heart is

visible and is beginning to

 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 Beating starts at around 22 days

but can not be heard until after 16-

20 weeks.

 Blood is pumped around the

vessels from the 4th week .
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

T h e r ed  
ed c e l l f o r m at i o n  
 There are three phases of red blood
cell formation.
rd  – 13
 York sac period :- from 3   –  13th 
week
 Hepatic /liver period:- from weeks 5-
36
 Born marrow period:- from week 12

throughout life.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 The red blood cells known as

 produced by the
 produced
erythrocytes 
York sac and the liver contain ffetal
etal
hemoglobin.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 Fetal hemoglobin (HbF) has a

much greater affinity for oxygen

and is found in greater

concentrations (18 -20g/dl at
term).

 This enhances the transfer of

oxygen across the placental site.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 Fetal erythrocytes have a life span

of 90 days which is shorter than

the adult erythrocytes

around 120 days. which is

 This short life span contributes to

neonatal physiological jaundice.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

The respiratory system 

system 
 Development of the respiratory

system begins in the 4th week.

 The lungs originate from the bud

growing out of the pharynx, which sub
divides to form the branching structure
of the brachial tree.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 Lung development occurs on

several levels and continues after

birth until about 8 years

when the full number of of age
bronchioles and alveoli will have
developed.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 


 At 20 weeks
weeks development
development of type
II alveolar commences.

 These cells are necessary for the

production of s u r f a c t a n t a
lipoprotein that reduces the
surface tension in the alveoli and
assist gaseous exchange.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 The amount of surfactant increases

until the lungs are mature at 30 –
30 – 34
 34
weeks.

 Babies born before 24 weeks’

gestation have a reduced chance of
survival due to immaturity of the
capillary system in the lungs and the
lack of surfactant.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 By 3rd month there is some

movement of the thorax and more

definite diaphragmatic
th
from the 6  month. movements

 This does not constitute breathing

as gaseous exchange is via the
placenta.
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

The urogenital system 

 This is divided into the

urinary/renal system and

genital/reproductive system.

 Both develop from the

intermediate mesoderm.
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 The kidneys develop from the 4th 

week and produce small amounts
th
of urine from the 9  week.

 They become more functional

around 15th week when more
urine is produced.
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 The urine does not constitute a

route for excretion as elimination
of the waste products is via the
placenta.

 The urine forms much of the

amniotic fluid and production
increases with maturity
maturity..
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 The sex of the fetus is determined

at fertilization. The gonads
develop in the 5th week.

 In the two sexes genital

development is the similar and is
referred a s i n d i ffer
ffe r e
enn t s ta
tate
te o f
s e x u a l d ev
e v e lo
lo p m en t  .
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 Differentiation occurs from 7th 

week, but female gonad
development occurs slowly and
the ovaries may not be identifiable
until the 10th week.
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 External genitalia in both sexes

th
develop in the 9  week, but males
and females are not
distinguishable until 12th week.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

The Endocrine system 

 The adrenal glands develop from
th
the 6  week, and grow to 10-20
times larger than the adult
adrenals.

 Their size regresses during the

first year of life.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 They produce the precursor s for

placental formation of oestriols


They influence
liver, the maturation
lungs and of the
the epithelium
of the digestive tract.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 It is also thought that they play a

part in the initiation of labour (the
exact mechanism not fully
established).
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

The digestive system 

 The primitive gut develops from
th
the endodemal layer in the 4  
week of life.
 It starts as a straight tube and

proceeds on several levels:

foregut, midgut and hindgut.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 By the 5th week, the foregut

(oesophagus, stomach and
duodenum) is visible.

 The midgut (small intestines,

caecum and appendix, ascending
colon and transverse colon)
undertakes much of its
development in the 6th week
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 The hindgut (rectum, and anal

canal ) th
completes its development
in the 7  week.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 The liver grows rapidly and from

the 5th -10th week, fills much of the
abdominal cavity.

  It is responsible for about 10% of

fetal weight by the 9th week.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 Around 12 weeks the d

 digestive
igestive
tract is well formed and the lumen

is patent.

 Most of the digestive juices are

present before birth and act on the
swallowed substances to form
.
meconium 
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 Meconium is normally retained in

the gut until after birth when it is

passed as the first stool of the

newborn.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

The nervous system 

 The brain begins to develop from

around day 19 and three

structures the fore brain; midbrain
and hind brain are visible.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 By 5th week, the major structures,

the thalamus and

hypothalamus arethe
differentiated.

 The neural tube is derived from

the ectoderm.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 This ectoderm folds in wards by a

complicated process to form the
neural tube which is then covered
over by the skin.

 This process is occasionally

incomplete, leading to a condition
called o p e n n e u r a l t u b e d e f ec
ec t
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 The development of the sensory

organs is associated with the
development of the head and
neck
which begin early in fetal life and
continues until the cessation of
growth in the late teens.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 Eyes develop from around 22

days and are complete by 20

weeks but theth eyelids are fused

up until the 6  month.

 The developing eyes are sensitive

to light.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 The inner ear which contains the

structures for hearing and balance

commences earlyth in life and are

completed by 25  week.

 The fetus is able to hear external

sound.
 

DEVELOPMENT
DEVELOPMENTAL
AL CHANGES CONT’D 

 Motor output in the form of

movement begins around 8
weeks.

 These movements are not usually

felt until around 16 weeks and are
usually referred to as quickening 
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

Integumentary, skeletal and

systems 
muscular systems 

 The epidermis is develops from a

single layer of ectoderm to which
other layers are added.
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 By the end of the first month, a

thin outer layer of flattened cells
covers the embryo.

 Further development continues

until the sixth month.
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 From 18 weeks, the fetus is

covered with a white creamy
substance called v e r n i x c a s e o s a .

 This protects the skin from the

amniotic fluid and any friction
against itself.
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 


 At 20 weeks,
weeks, the fetus is covered
covered
with a fine downy (silky, velvety)
hair called l a n u g o , at the same
time the head hair and eye brows
begin to form.

 Lanugo is shed from 36 weeks

and by term there is little left.
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 Fingernails develop from about 10

weeks but the toenails do not form
until 18 weeks.

 By term, the nails usually extend

beyond the fingertips.

 Length of the nails is unreliable

guide to maturity.
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 The skeleton first appears as

cartilage

 At specific
 specific periods the
the cartila
cartilage
ge is
replaced is replaced by the true
bone through a process of
ossification.
 

DEVELOPMENTAL
DEVELOPMENTAL CHANGES CONT’D 

 Nevertheless, the skull and the

facial bones develop from direct
ossification with no intermediate
cartilage stage.

 Skeletal, cardiac and smooth

muscles are formed during the
fetal period and continues into
 

 
childhood.
FACTORS NECESSARY FOR FETAL
DEVELOPMENT

Oxygen:
Necessary for all metabolic
processes

Nutrients:
 Glucose : The primary source of
energy for metabolism and
growth
 

FACTORS CONT’D 

 Aminoacids,

v i t am
a m i n s , m i n e r al
al s , i r o n an d
calcium  :
Necessary for metabolism and
growth.
 

FACTORS CONT’D 

 Insulin:
Necessary for the metabolism of
glucose but this later is secreted
by the fetal pancreas.
 

 
FACTORS ADVERSELY AFFECTING
FETAL GROWTH & DEVELOPMENT 

Placental insufficiency or impaired

utero placenta blood flow 
flow 

Maternal conditions such as
hypertension, chronic infections, and
cardiac disease have detrimental
effect upon the efficiency of the
placenta to transmit nutrients from
the mother to the fetus.
 

FACTORS CONT’D 

Genetic factors
 Babies born with abnormalities e.g

Downs’ syndrome and dwarf

syndromes are small for
gestational age at birth.
 

FACTORS CONT’D 

Alcohol and narcotic addiction 


This causes fetal growth
retardation. Besides this, babies
born to these mothers can also be
addicted and may have congenital
abnormalities.
 

FACTORS CONT’D 

Infections and hyperpyrexia of

the mother  
 Many viruses such as Rubella and

HIV
passand otherthe
through organisms
placentalcan
membrane and adversely affect
 fetal growth.
 

FACTORS CONT’D 

Multiple pregnancy 
pregnancy 
 Each placenta is usually reduced
in size and there is an increased

nutritional burden upon

for each additional fetus.the mother
 

FACTORS CONT’D 

Maternal malnutrition 
malnutrition 
 If the mother is lacking certain
necessary nutrients, the fetus will

also be deprived of them.