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PERTUMBUHAN JANIN
DAN FAKTOR
YANG MEMPENGARUHI
Rahmatina B. Herman
Bagian Fisiologi
Fakultas Kedokteran Universitas Andalas
TIME PERIOD
PRINCIPAL EVENTS
Fertilized
egg
12-24 hours
Secondary oocyte fertilized;
following ovulation zygote has 23 pairs of chr
Cleavage
Morula
Blastocyst
Gastrula
Fertilization
Definition: the union of male and female gametes
Can take place during fertile period in each cycle
Normally occurs in ampulla
Thus, both ovum and sperm must be transported
from their site of production to the ampulla
During first 3-4 days following fertilization, zygote
remains within ampulla, because of constriction
between ampulla and remainder oviduct canal
prevents further movement of zygote into uterus
A number mitotic cell divisions of zygote to form
morula during in ampulla
Implantation
1 week after ovulation, morula has descended into
uterus and continued to proliferate and differentiate
into blastocyst which capable to implantation
Blastocyst is consisted of 2 parts: inner cell mass
(which become fetus) and trophoblast (outermost
layer of blastocyst)
Trophoblast accomplish implantation, after which
develops into fetal portion of placenta
When blastocyst is ready to implant, its surface becomes
sticky, by the time endometrium is ready to accept the
early embryo
Placenta
Specialized organ of exchange between
maternal and fetal blood
Derived from:
- trophoblastic tissue, and
- decidual tissue
Function: to sustain the growing embryo / fetus
during intrauterine life
Functions of Placenta
Transport system between maternal blood and
fetal blood:
- Nutrition & O2 and metabolic wastes & CO2
- Drugs, pollutants, cigarette smokes,
chemical agents, microorganisms harmful
(thalidomide, AIDS, drug abuse)
Temporary endocrine organ:
Fetally derived portion has remarkable capacity to
secrete peptide and streoid hormones for
maintaining pregnancy
Placental Hormones
HORMONES
FUNCTION
1. Human chorionic
gonadotropin
(hCG)
2. Estrogen
3. Progesterone
..Placental Hormones
HORMONES
FUNCTION
6. Placental PTHrp
(Parathyroid
Hormone-related
peptide)
Theory III:
In pregnancy production of regulatory T cells is
doubled or tripled which suppress maternal
cytotoxic T cells
Circulatory System
Heart:
Begins beating during the 4th week after fertilization
65 bpm and increases to 140 bpm before birth
Blood cells:
- During the midportion of fetal life:
Extra marrow areas are the major sources of blood cells
Respiratory System
Respiration cannot occur during fetal life
At the end of 1st trimester of pregnancy: respiratory
movements caused by tactile stimuli or fetal asphyxia
During the latter 3-4 months of pregnancy for unclearly
reasons:
- Respiratory movements are inhibited
- Lungs remain almost completely deflated
- It prevents filling of lungs with debris from meconium
- Fluid is secreted into the lungs by alveolar epithelium
up until birth keeping only clean fluid in the lungs
Nervous System
Most of skin reflexes are present by 3rd 4th
month of pregnancy
However, functions of central nervous system
that involve cerebral cortex are still mainly
undeveloped, even at birth
Myelinization of some major tracts of central
nervous system becomes complete only after
1 year of postnatal life
Gastrointestinal Tract
By midpregnancy: fetus ingests and absorbs large
quantities of amniotic fluid
During the last 2-3 months: gastrointestinal
function approaches that of normal neonate
Small quantities of meconium are continually
formed in gastrointestinal tract and excreted from
bowel into amniotic fluid
Meconium is composed of:
- Residue from amniotic fluid
- Excretory products from gastrointestinal mucosa and
glands
The Kidneys
Fetal kidneys are capable of excreting urine
during at least the latter half of pregnancy and
urination occurs normally in utero
However, renal control systems for regulating:
- Extracellular fluid electrolytes balances
- Acid-base balance
are almost nonexistent until after midfetal life
and do not reach full development until a few
months after birth
Representative Changes
0.6 cm
3 cm / 1 g
Representative Changes
7.5 cm / 30 g
18 cm / 100 g
Representative Changes
25 - 30 cm /
200 - 450 g
27 - 35 cm /
550 - 800 g
Representative Changes
32 - 42 cm /
1100 - 1350 g
41 - 45 cm /
2000 - 2300 g
Fetal Metabolism
Fetal uses mainly glucose for energy
Fetal has a high rate of storage of fat and protein
Most of fat being synthesized from glucose, rather
than being absorbed from mothers blood
Metabolism of Iron
Iron accumulates in fetus more rapidly than
calcium and phosphates
Most of iron is in the form of Hb, which begin to be
formed at 3rd week after fertilization
Metabolism of Vitamins
Fetus needs vitamins equally as much as adult and in
some instances to a far greater extent
Vitamins function the same in fetus as in adult:
- Vit B: especially B12 and folic acid for formation of
RBC and nervous tissue as well as for overall growth
- Vit C: for appropriate formation of intercellular
substances, especially bone matrix and fibers of
connective tissue
- Vit D: probably for normal bone growth in fetus
But more important for adequate absorption of
calcium from mothers gastrointestinal tract large
quantities will be stored by fetal liver to be used for
several months after birth
..Metabolism of Vitamins
- Vit E: necessary for normal development of early embryo
although the mechanisms are not clear
In its absence in laboratory animals: spontaneous abortion
usually occurs at an early age
- Vit K: for formation of Factor VII, pro-thrombin, and several
other blood coagulation factors
When vit K is insufficient in mother: Factor VII and prothrombin become deficient in fetus as well as in mother
Because most vit K is formed by bacterial action in colon,
neonate has no adequate source of vit K prenatal storage
in fetal liver derived from mother is helpful in preventing
hemorrhage, particularly when head is traumatized by
squeezing through birth canal