Julkipli, Hassan S.

September 8, 2022
BSN 2-A
NCM 107
Week 4 Assignment
Fetal growth and development
Assessment of Fetal Well-being (Typewritten or Handwritten)

Answer the following: 

1. Identify the highlights of fetal growth across the 40 weeks gestation.

Fertilization- Beginning of pregnancy, union of ovum and a spermatozoon.

Implantation- In this stage, fertilization is complete. This is a contract between the

growing structure and the uterine endometrium. This occurs 8 to 10 days after
fertilization. Implantation usually occurs high in the uterus on the posterior surface.
Once implanted, the zygote is now called an embryo.

End of 4th gestational week- length of embryo is about 0.75cm, weight is about 400
mgThe spinal cord is formed; the head is large and represents about one third of the
entire structure, rudimentary heart appears as a prominent bulge on the anterior
surface, arms and legs are bud-like structures; rudimentary eyes, ears, and nose are
discernible.

End of 8th gestational week- length of the fetus is about 2.5 cm and its weight is about
20 grams. Organogenesis is complete at this stage, the heart beats rhythmically, arms
and legs have developed, external genitalia is forming but not yet distinguishable, the
abdomen bulges forward because the fetal intestine is growing rapidly.

End of 12th gestational week (first trimester)- length of the fetus is 7 to 8 cm and the
weight is about 45 grams. Nail beds are forming, spontaneous movements are possible
but cannot be felt by mother, babinski reflex is present, bone ossification centers begin
to form, tooth buds are present, sex is distungishable on outward appearance, urine
secretion begins but may not yet be evident in amniotic fluid, and the heartbeat is
audible through doppler technology.

End of 16th gestational week- length of the fetus is 10 to 17cm, weight is 55 to 120
grams, fetal heart sounds are audible with a normal stethoscope, lanugo is well formed,
liver and pancreas are functioning, fetus actively swallows amniotic fluid, urine is
present in amniotic fluid, sex can be determined by ultrasonography.

End of 20th gestational week-. Spontaneous fetal movements can be felt by the
mother, antibody production is possible, hair including the eyebrows are forming in the
head, vernix caseosa begins to cover the skin, meconium is present in the upper
intestine, brown fat begins to form behind the kidneys, sternum, and posterior neck to
regulate the temperature.
Julkipli, Hassan S. September 8, 2022
BSN 2-A
End of 24th gestational week (second trimester)- length of fetus is 28 to 36 cm,
weight is 550 grams, meconium is present as far as the rectum, active production of
lung surfactant begins, eyelids is now open and pupils can react to light, and hearing
can be demonstrated by response to sudden sound.

End of 28th gestational week- length of fetus is 35 to 38cm, weight is 1,200 grams,
lung alveoli are almost mature; surfactant can be demonstrated in amniotic fluid, tested
begin to descend into the scrotal sac from the lower abdominal cavity, the blood vessels
of the retina are formed but thin extremely susceptible to damage from high oxygen
concentrations.

End of 32nd gestational week- length of the fetus is 38 to 43cm, weight is 1,600
grams, subcutaneous fat begins to be deposited, fetus responds by movement to
sounds outside the mother’s body, active moro reflex is present, iron stores, and
fingernails reach the end of fingertips.

End of 36th gestational week- length of the fetus is 42 to 48cm, weight is 1,800 to
2,700 grams, body stores of glycogen, iron, carbohydrate, and calcium are deposited,
additional amount of subcutaneous fat are deposited, sole of the foot has only one or
two crisscross creases, amount of lanugo begins to diminish, most fetuses turn into a
vertex presentation during this month.

End of 40th gestational week (third trimester)- length of fetus is 48 to 52 cm, weight
is 3,000 grams, fetus kicks actively, fetal hemoglobin begin its conversion to adult
hemoglobin, vernix caseosa starts to decrease after the infant reaches 37 weeks
gestation, fingernails extend over the fingertips, creases on the soles of the feet cover at
least two thirds of the surface.
Julkipli, Hassan S. September 8, 2022
BSN 2-A

2. Draw and trace the pathway of fetal circulation (HAND DRAW)

3. Give at least 5 assessment of fetal well-being:

Julkipli, Hassan S. September 8, 2022
BSN 2-A
1. Fetal Movement Counts - Fetal movement counting, also known as kick counting,
Pregnant mothers use this approach to measure the frequency of their unborn
child's kicks over time. By 20 weeks of pregnancy, the majority of women can
feel their baby's movements. Pregnant women who notice fetal movements can
determine that their fetus is growing and developing. These movements are often
sensed initially by the mother, after which they may be noticed by others. Women
are routinely instructed by health care providers on how to keep an eye on or be
aware of the fetus' movements. A normal fetal movement consists of 10 kicks,
flutters, or rolls in one hour. Don't be frightened if you don't experience 10
movements in an hour. Less than 10 kicks may or may not signal a problem.
Furthermore, it may take more than an hour to observe ten moves.

2. The nonstress test - a typical prenatal test to check on the health of the unborn
child. During a non-stress test, the baby's heart rate is monitored to see how it
responds to the baby's movements. Nonstress refers to the fact that no efforts
are made to stress the newborn throughout the exam. A non-stress test is used
to evaluate a baby's health before to birth. A non-stress test seeks to provide you
with critical information about your baby's oxygenation by monitoring his or her
heart rate and how it responds to activity. The test might identify the need for
more monitoring, testing, or delivery. The results of a non-stress test are reactive.
Before week 32 of pregnancy, if your baby's heartbeat accelerates to a certain
level above the baseline twice or more for at least 10 seconds each within a 20-
minute interval, the results are considered normal (reactive).

3. Biophysical profile - After the 28th week of pregnancy, a test called the
biophysical profile is performed. This non-invasive diagnostic approach aids in
the evaluation of the fetus. The quantity of amniotic fluid around the fetus, as well
as respiratory activity, muscle tone, and body mobility, are all measured. The
biophysical profile is conducted after the 28th week of pregnancy. This non-
invasive diagnostic approach aids in the evaluation of the fetus. The quantity of
amniotic fluid around the fetus, as well as respiratory activity, muscle tone, and
body mobility, are all measured. If the biophysical profile yields a score of four or
less, delivery should be induced. If the gestational period is less than 32 weeks
and the score is 4, the pregnancy may require additional evaluation and
monitoring. A low total score indicates a greater likelihood of fetal hypoxia and
stillbirth.

4. Contraction stress test - A contraction stress test reveals whether your baby's
heart rate goes down after a contraction: Normal (negative) results indicate that
this does not happen (late decelerations). If the results are abnormal (positive), it
means that your baby's heart rate slowed after a contraction and stayed that way.
A contraction stress test reveals whether your baby's heart rate goes down after
Julkipli, Hassan S. September 8, 2022
BSN 2-A
a contraction: Normal (negative) results indicate that this does not happen (late
decelerations). If the results are abnormal (positive), it means that your baby's
heart rate slowed after a contraction and stayed that way.

5. Doppler ultrasound exam of the umbilical artery - Umbilical arterial (UA) Doppler
examination is used to check the health of the fetus throughout the third trimester
of pregnancy. A symptom of placental insufficiency and the resultant intrauterine
growth restriction (IUGR) or likely pre-eclampsia is faulty umbilical artery
Doppler. Doppler ultrasonography tests use reflected sound waves to monitor
blood flow through blood vessels. It can tell you how well the major arteries and
veins in your foot are flowing blood. It might show diminished or interrupted blood
flow due to narrowing of the main arteries. A normal result means that the
arteries have normal blood flow and that the blood vessels show no symptoms of
constriction, clotting, or closure.