Anhis Tumkem Farmasi 2012

We cannot teach people anything; we can only help them discover it within themselves.

Galileo Galilei

dr.Indriati Dwi R, M.Kes Lab. Anatomi-Histologi FKUB

Fertilization

Development Before Birth

Development of Male and Female Sex

Birth

Development After Birth

Fertilization

sperma vs ovum

AMPULLA

(1)Sperm penetration of corona radiata

(2) Sperm binding and penetration of the

zona pellucida

(3) one sperm enters the egg Fuse zygote

Clinical Correlates Contraceptive methods :

Barrier technique, ex : condom, diaphragm, cervical cap, contraceptive

sponges.

Hormonal contraceptive :pills, Depo-provera, cyclofem, morning-after

The intra uterine device(IUD).

Vasectomy and tubal ligation

Infertility :

= problem for 15%-30% couples :

Males : insufficient number of sperm and/or poor motility

Females : occluded oviduct, hostile cervical mucus,immunity

spermatozoa, absence of ovulation.

Fertilization



Birth



Processes of Development

Cleavage

Morphogenesis : start at blastula

Differentiation organogenesis

Growth : in size

developmental stages

- pre-embryonic : fertilisasi s.d menjelang implantasi

- embryonic : mulai implantasi

- fetal

Approximately 6 days after fertilization, the cell mass is termed a blastocyst. Human chorionic gonadotropin now is produced in amounts that may be detected by commercial laboratories.

zygote

embryoblast

Inner cell mass = embryo Outer cell mass = trophoblast

Pre-embyonic developmental stages

Implantation = kontak fisik & fisiologis pertama;

antara blastocyst vs mucosa uterus (6th -8th day),

3 phase : Preparation of the uterus for adhesion and

implantation

Trophoblast-uterus adhesion

Blastocyst movement into the uterus (mid portion of the posterior/anterior)

HLA-G

Tcell Bcell NKcell APC

Th1Th2

Apoptosis

Inhibisi cytitoxic

Ab anti HLA-G Inhibisi toxicitas

Sekresi :

PgE2, IL-10, TGF

Resistensi trophoblast

Eliminasi - Supresi Supresi

Clinical corellation 3

Abnormal implantation : Immunorejection Placenta praevia Ectopic pregnancy

Organogenesis

Embyonic developmental stages

2 to 2

What happened?

4 to 8 week of development (organogenesis)

Differentiation of ectoderm: CNS

Differentiation of mesoderm: dermis, bone, cartilage, CT, muscles, pleura, peritoneum and pericardium, cardiovascular and lymph system

Differentiation of endoderm: digestive, respiratory and urinary system

Extraembryonic Membranes

1. Chorion. The chorion develops into the fetal half of the placenta,

2. Yolk sac. The yolk sac has little yolk and is the rst site of blood cell formation.

3. Allantois. The allantois blood vessels become the umbilical blood vessels.

4. Amnion. The amnion contains uid to cushion and protect the embryo.

embryonic period lasts from approximately 2 weeks after fertilization until 8 weeks after fertilization, THEN FETUS

!!! Most body structures are formed during the embryonic period Continue to grow and mature during the fetal period.

PLACENTA : - Mulai akhir mgg I

- 100 % : akhir embryo, awal fetal

The placental membrane separates maternal blood from fetal blood. Some substances that cross can be either benecial or harmful.

Some substances do not cross the placental membrane. The composition of the placental membrane changes during

pregnancy. A. In early pregnancy, the placental membrane has four layers:

syncytiotrophoblast, cytotrophoblast (Langhans cells), connective tissue, and endothelium of fetal capillaries. Hofbauer cells (large, sometimes pigmented, elliptical cells found in the connective tissue), are most numerous in early pregnancy and have characteristics similar to those of macrophages.

B. In late pregnancy, the placental membrane has two layers: the syncytiotrophoblast and the endothelium of fetal capillaries.

TRANSPLACENTAL DRUG TRANSFER Most drugs move from the maternal circulation to the fetal

circulation by diffusion.

Drugs with molecular weights less than 500 Da readily cross the placenta, whereas larger molecules (6001,000 Da) cross more slowly.

Drugs with molecular weights greater than 1,000 Da, such as insulin and heparin, do not cross the placenta in significant amounts.

Lipophilic drugs, such as opiates and antibiotics, cross the placenta more easily than do water-soluble drugs.

Maternal plasma albumin progressively decreases while fetal albumin increases during the course of pregnancy, higher concentrations of certain protein-bound drugs in the fetus.

Fetal pH is slightly more acidic than maternal pH, permitting weak bases to more easily cross the placenta.

Fetal Development During fetal development, the fetus has a human appearance, but refinements are still taking place.

Fetal developmental stages

Path of Fetal Blood

A teratogen is any infectious agent, drug, chemical, or irradiation that alters fetal morphology or fetal function if the

fetus is exposed during a critical stage of development.

1. The resistant period (week 1 of development)

the all-or-none phenomenon (i.e., the conceptus will either

die as a result of the teratogen or survive unaffected).

2. The maximum susceptibility period (weeks 38; 18 to 60 days

postconception = embryonic period). All organ

morphogenesis occurs at this time. Teratogenic exposures

may result in structural anomalies.

3. The lowered susceptibility period (weeks 938; fetal period)

All organs systems have already formed;

Teratogen exposure at this period generally results in a

functional derangement of an organ system. may result in

structural anomalies.

MATERNAL PHARMACOKINETIC CHANGES

maternal plasma volume, cardiac output, and glomerular filtration increase by 30% to 50%, potentially lowering the concentration of renally cleared drugs

body fat increases during pregnancy, the volume of distribution of fat-soluble drugs may increase

Plasma albumin concentration decreases, which increases the volume of distribution of drugs that are highly protein bound. However, these unbound drugs are more rapidly cleared by the liver and kidney during pregnancy, resulting in little change in concentration

Fertilization



Birth


During weeks 16, the embryo remains in a sexually indifferent or undifferentiated stage.

genetically female embryos and male embryos are phenotypically indistinguishable.

During week 7, the indifferent embryo begins phenotypic sexual differentiation.

By week 12, female or male characteristics of the external genitalia can be recognized.


Development of Sex organs

Phenotypic sexual differentiation is determined by the SRY gene (di kromosom Y)

The SRY gene encodes testes-determining factor [TDF]

In the presence of TDF, testosterone, and MIF

Fertilization



Birth


Time of birth

The length of pregnancy is considered to be 280 days or

40 weeks after the onset of last normal menstrual period

or more accurately 266 days or 38 weeks after fertilization

The age of embryo determined by combining data of the

onset last menstrual period with fetal length, weight, and

morphological characteristic

Birth

Fertilization



Birth


Development After Birth Early life stages in humans

Neonatus : s.d 30 hari (*) Bayi 1-3 tahun Batita Balita Anak Pubertas Adolescence : puberty to reproduction

Abortion:

Interruption of pregnancy before pregnancy 28 weeks with the death of her fetus

Perinatal period:

The period since pregnancy 28 -7 mgg days after birth.

Neonatal period:

The period from birth until the age of 4 weeks (28 days) after birth.

Preterm:

Babies born with a gestation

Gratias.....

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Anhis Tumkem Farmasi 2012