CACHOLA, ALLIAH A.

BSN-2101

MILESTONES OF FETAL GROWTH AND DEVELOPMENT

Both ovulation and gestational age are typically reported in lunar months (4-week periods) or in
trimesters (3-month periods) rather than in weeks
In lunar months, a total pregnancy is 10 months (40 weeks or 280 days) long; a fetus grows in
uterus for 9.5 lunar months or three full trimesters (38 weeks or 266 days)
End of Fourth Gestational Week
 The length of the embryo is about 0.75 cm; weight is about 400 mg
 The spinal cord is formed and fused at the midpoint
 The head is large in proportion and represents about one third of the entire structure
 The 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 Eighth Gestational Week
 The length of the fetus is about 2.5 cm (1 inch); weight is about 20 g
 Organogenesis is complete
 The heart, with a septum and valves, beats rhythmically
 Facial features are definitely discernible; arms and legs have developed
 External genitalia are forming, but sex is not yet distinguishable by simple observation
 The abdomen bulges forward because of the fetal intestine is growing so rapidly
 A sonogram shows a gestational sac, which is diagnostic of pregnancy
End of 12th Gestational Week (First Trimester)
 The length of the fetus is 7-8 cm; weight is about 45 g
 Nail beds are forming on fingers and toes
 Spontaneous movements are possible, although they are usually too faint to be felt by
the mother
 Some reflexes, such as Babinski reflex, are present
 Bone ossification centers begin to form
 Tooth buds are present
 Sex is distinguishable on outward appearance
 Urine secretion begins but may not yet be evident in amniotic fluid
 The heartbeat is audible through Doppler technology
End of 16th Gestational Week
 The length of the fetus is 10-17 cm; weight is 55-120 g
 Feta heart sounds are audible by and ordinary stethoscope
 Lanugo is well formed
 Both the liver and pancreas are functioning
 The fetus actively swallows amniotic fluid, demonstrating an intact but uncoordinated
swallowing reflex; urine is present in amniotic fluid
  Sex can be determined by ultrasonography
End of 20th Gestational Week
 The length of the fetus is 25 cm; weight is 223 g
 Spontaneous fetal movements can be sensed by the mother
 Antibody production is possible
 Hair, including eyebrows, forms on the head; vernix caseosa begins to cover the skin
 Meconium is present in the upper intestine
 Brown fat, a special fat that aids in temperature regulation begins to form behind the
kidneys, sternum and posterior neck
 Passive antibody transfer from mother to fetus begins
 Definite sleeping and activity patterns are distinguishable as the fetus develops
biorhythms that will guide sleep/wake patterns throughout life
End of 24th Gestational Week (Second Trimester)
 The length of the fetus is 28-36 cm; weight is 550 g
 Meconium is present as far as the rectum
 Active production of lung surfactant begins
 Eyelids, previously fused since the 12th week, now open; pupils react to light
 Hearing can be demonstrated by response to sudden sound
 When fetuses reach 24 weeks, or 500-600 g, they have achieved a practical low-end age
of viability if they are cared for after birth in a modern intensive care nursery
End of 28th Gestational Week
 The length of the fetus is 35-38 cm; weight is 1200 g
 Lung alveoli are almost mature; 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 formed but thin and extremely susceptible to
damage from high oxygen concentrations (an important consideration when caring from
preterm infants who need oxygen)
End of 32nd Gestational Week
 The length of the fetus is 38-43 cm; weight is 1600 g
 Subcutaneous fat begins to be deposited (the former stringy, “little old man”
appearance is lost)
 Fetus responds by movement to sounds outside the mother’s body
 An active Moro reflex is present
 Iron stores, which provide iron for the time during which the neonate will ingest only
breast milk after birth, are beginning to be built
 Fingernails reach the end of fingertips
End of 36th Gestational Week
 The length of the fetus is 42-48 cm; weight is 1800-2700 g (5-6 lb)
 Body stores of glycogen, iron, CHO, and calcium are deposited
 Additional amounts of subcutaneous fat are deposited
  Sole of the foot has only one or two crisscross creases compared with a full crisscross
pattern evident at term
 Amount of lanugo begins to diminish
 Most foetuses turn into vertex (head down) presentation during this month
End of 40th Gestational Week
 The length of fetus is 48-52 cm (crown to rump, 35-37 cm); weight is 3000 g (7-7.5 lb)
 Fetus kicks actively, sometimes hard enough to cause the mother considerable
discomfort
 Fetal hemoglobin begin its conversion to adult hemoglobin
 Vernix caseosa starts to decrease after the infant reaches 37 weeks gestation and may
be more apparent in the creases than the covering of the body as the infant approaches
40 weeks or more gestational age
 Fingernails extend over the fingertips
 Creases on the soles of the feet cover at least two thirds of the surface

FETAL CIRCULATION
 Blood arriving at the fetus from the placenta is highly oxygenated. This blood enters the
fetus through the umbilical vein
 Specialized structures present in the fetus then shunt blood flow to first supply the most
important organs of the body: liver, heart, kidneys, and brain
 Blood flows from the umbilical vein to the ductus venosus (an accessory vessel that
discharges oxygenated blood into the fetal liver) and then connects to the fetal inferior
vena cava so oxygenated blood is directed to the right side of the heart
 Blood enters the right atrium into the left atrium through an opening in the atrial
septum called foramen ovale
 From the left atrium, it follows the course of adult circulation into the left ventricle, then
into the aorta, and out to the body parts.
 A small amount of blood that returns to the heart via the vena cava does leave the right
atrium by the adult circulatory route; through the tricuspid valve into the right ventricle
and then into the pulmonary artery and lungs to service the lung tissue. However, the
larger portion of even this blood is shunted away from the lungs through an additional
structure, ductus arteriosus, directly into the descending aorta.
 As the majority of blood cells in the aorta become deoxygenated, blood is transported
from the descending aorta through the umbilical arteries back to the placental villi,
where new oxygen takes place.

Reference: Maternal and Child Health Nursing

Care of the Childbearing and Childrearing Family
Eight Edition
Volume 1
JoAnne Silbert-Flagg
Adele Pillitteri