Perkembangan Fetus dr. Richardi., Sp.OG

8/10/2019 Perkembangan Fetus dr. Richardi., Sp.OG

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PERKEMBANGAN JANIN

RICARDI W. ALIBASJAH

BAGIAN

OBSTETRI GINEKOLOGIFAKULTAS KEDOKTERAN

UNSWAGATI


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3/43

Implantation isbeginning. Trophoblast

cells proliferate andbegin to invade theuterine epithelium.Invasion is eected

through digestion of theuterine cells bysecretions of thetrophoblast cells. Upon

contact with theendometrium thecytotrophoblast formsthe syncytiotrophoblast

and HCG (humanchorionic gonadotropin

!th day

"#$u ($."#mm


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%yncytiotrophoblast cellsfurther invade the

&ndometrium by secretinghydrolytic en'ymes.

th day


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Implantation continues. Thesynctiotrophoblast nearlycompletely surrounds thecytotrophoblast cells of theblastocyst. The primary yol)sac is (probably formed as the

hypoblast cells move aroundthe blastocyst cavity.

"$th day


6/43

Gastrulation begins when theprimitive pit forms* though it cannot be seen in this picture.

Gastrulation is the process bywhich the third germ layer* theintraembryonic mesoderm* isformed. It involves ingression andmigration of cells from theepiblast through the primitive pit

and primitive strea). This resultsin a trilaminar embryo with thethree basic germ layers+ectoderm* mesoderm* andendoderm.

,ndwee)


7/43

A very signi!"n# $ee% &'r #(ee)*ry'. I# ("s !("nge+ &r') ","# #ri-")in"r +is! in#' "#*-"r e)*ry' "n+ ("s n'$"!/ire+ " #(ree0+i)ensi'n"-&'r). T(e e)*ry' "n+ ")ni'n("ve gr'$n vig'r's-y1 *##(e y'-% s"! ("s n'#. T(e-"#er"- e+ges &'-+ n+er "n+

*e!')e #(e ven#r"- sr&"!e '(e e)*ry'. Ner-"#i'n is"-)'s# !')2-e#e+ "n+ #(e"n#eri'r 3r's#"-4 "n+ 2's#eri'r3!"+"-4 ner'2'res "re

!-'sing. S')e#i)es "re s#i--&'r)ing. T$' 2"irs '&*r"n!(i"- 32("rynge"-4 "r!(es("ve &'r)e+ 3*eginning "*'#+"y 554.

U22er -i)* *+s "22e"r"r'n+ +"y 56. T(e 2ri)'r+i"

-th wee)


8/43

T(e si7e '& #(e e)*ry' isn'$ 3"22r'8i)"#e-y4 9.6 0:.; )). Cr"ni"- "n+ !"+"-

ner'2'res ("ve re!en#-y!-'se+1 "n+ #(e *!!"-3'r'2("rynge"-4 )e)*r"neis '2ening. U22er 3"n#eri'r4"n+ -'$er 32's#eri'r4 -i)*

*+s "re 2resen#. L'$er-i)* *+ "22e"rs "r'n++"y 5


9/43

The si'e of the embryo is now(approimately /$mmC01(Crown20ump 1ength. Theembryo trun) is elongatingand the cervical region is

straightening* raising thehead. Genital ridges areambiseual gonads.

!thwee)

/$mmC01


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T(e si7e '& #(e e)*ry' is n'$3"22r'8i)"#e-y4 960:;))CRL3Cr'$n0R)2 Leng#(4. T(is)"r%s #(e en+ '& #(e E)*ry'ni!

Peri'+ "n+ #(e *eginning '& #(eFe#"- Peri'+. T(e rs# eig(#$ee%s is " #i)e '&e)*ry'genesis1 $(en )">'r'rg"n +eve-'2)en# *egins. T(e

*eginnings '& "-- essen#i"-s#r!#res "re n'$ 2resen#. T(eeye-i+s )ee# "n+ ?!-'se@ in #(is$ee%. T(e (e"+ is -"rge1 )'s#ere!#1 "n+ )'re r'n+e+.

E8#ern"- geni#"-i" s#i-- n'#+is#ingis("*-e "s )"-e 'r&e)"-e. I& )"-e ('r)'nes "re2resen#1 #(e ")*ise8"- g'n"+$i-- n'$ *egin #' +i=eren#i"#ein#' " #es#is. T(e in#es#ines "rein #(e 2r'8i)"- 2"r# '& #(e

thwee)

/#mmC01


11/43

The head is now erect and theeyes face anteriorly. The earsare still lowset* but very closeto their de3nitive position. The

lower limbs are now welldeveloped. &arly toenaildevelopment.

"#thwee)

"/$mmC01


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Head and body hair (lanugo arevisible. &ternal ears stand out from

the head. 4t this point the motherhas felt movements of the fetus.

,$thwee)

"#mmC01


13/43

The fetus has now been viable

since ,$2,, wee)s* i.e.* survival ispossible in the outside worldwithout etraordinary measures.5ingernails* toenails* andeyelashes are present. The fetusmay now have a good head of

hair. The body is 3lling out. Testesare descending. The eyelids haveparted and the eyes are open.

/$thwee)

,!#mmC01


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Aver"ge +r"#i'n '& 2regn"n!y

5


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4bortus 6 7 #$$ gr. 7

,,wee)s

8artus Imaturus 6 #$$ 2 "$$$gr ,, 2 , wee)

8artus 8rematurus 6 "$$$ 2,#$$gr

(8reterm labor , 2 /! wee)8artus 9aturus 6 : ,#$$ gr(Term labor /! 2 -, wee)8artus %erotinus 6 : -, wee)

(8rolonged;8ostdate 8regnancy


16/43

" month < " cm , month < - cm < "gr

/ month < = cm < "-*,

gr - month < "> cm < "$gr

# month < ,# cm < /">gr

> month < /$ cm < >/$gr

! month < /# cm < "$-#


17/43

5 5; 5: 5< 95 9 9


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Weig(# 9;;; g)

9 $ee%s


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,. 4GI@4 and DUT1&T Increased vascularity 2 Chadwic)?s

sign

Increase in thic)ness of themucosa K smooth muscle

aginal secretion

/. D40IU9 Corpus luteum graviditatum


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-. 4bdominal wall and s)in %triae gravidarum livid albicans due to hyperfunction gl.

suprarenal#. %)in hyperpigmentation 6 linea nigra

chloasma

>. Breast Hypertrophy Colostrum Hyperpigmentation


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!. Eeight Gain "stTrimester 6 " )g ,ndTrimester 6 # )g /rdTrimester 6 #*# )g

5etus 6 / )g 8lancenta 6 $*#)g 4mnionic Luid 6 " )g

Uterus 6 " )g 5at 6 $*# )g 8rotein 6 , )g

Eater 6 "*# )g

In!re"se )iner"-re/ire)en#3Fe1C"1Mg4


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. H&94TD1DGIC CH4@G&% Blood volume increase M -#N Increase 8lasma K &rythrocyte (M//N

Hydraemia D,aAnity decrease

Hematocrit decrease @ormal value 6

Hb 6 "" grN &ry 6 /* million ;mm/

1euco 6 ",$$$;mm/


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=. Dthers Cardiovascular system

0espiratory tract

Urinary system

Gastrointestinal tract

1iver K Gallbladder

&ndocrine glands 9usculo2s)eletal system

8sychological

disturbances


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Perkembangan Fetus dr. Richardi., Sp.OG