PRENATAL DEVELOPMENT

Module 2: Prenatal Development

Fertilization- Germinal Period, Embryonic Period, Fetal Period- Effect
of long term & short term use of Teratogens, Birth Process: Types,
methods- prenatal and perinatal diagnostic tests. Birth complication
and their effects. Post partum period- physical, emotional adjustment.
PRENATAL DEVELOPMENT
● Prenatal development refers to the process in which a baby develops
from a single cell after conception into an embryo and later a fetus.
● Typical prenatal development begins with fertilization and ends with
birth, lasting between 266 and 280 days (from 38 to 40 weeks).
● It can be divided into three periods: germinal, embryonic, and fetal.
FERTILIZATION
● Fertilization occurs when a sperm and an oocyte (egg) combine and
their nuclei fuse.ie., fusion of haploid gametes, egg and sperm.
● This new single cell, called a zygote, contains all of the genetic material
needed to form a human—half from the mother and half from the father.
1. GERMINAL PERIOD
● The germinal period (the period of zygote) of prenatal development takes place in the
first two weeks after conception.
● It includes the creation of the fertilized egg, called a zygote, followed by cell division
and attachment of the zygote to the uterine wall.
● Rapid cell division (mitosis) by the zygote continues throughout the germinal period.
The zygote’s first cell duplication is long and is not complete until about 30 hours after
conception. Gradually, new cells are added at a faster rate.
● At this stage, the group of cells form a hollow, fluid-filled ball called the blastocyst.
● Blastocyst consists of
Ø An inner mass of cells (embryonic disk) that will eventually develop into
the embryo.
Ø Trophoblast an outer layer of cells that later provides nutrition and
support for the embryo.
Therefore, the period of the zygote lasts about 2 weeks, from fertilization
until the tiny mass of cells drifts down and out of the fallopian tube and
attaches itself to the wall of the uterus.
2.EMBRYONIC PERIOD (2-8 week)
● This period begins as the blastocyst attaches to the uterine wall.
● During the embryonic period, the rate of cell differentiation intensifies,
support systems for cells form, and organs appear.
● By the end of the 2nd week, cells of the trophoblast form another
protective membrane – the chorion, which surrounds the amnion. From
the chorion, the hair like villi, or blood vessels emerge. As these villi
burrow into the uterine wall, placenta develops.
● The mass of cells is now called an embryo, and three layers of cells form.
a) Endoderm - The inner layer of cells, which will develop into the digestive system,
respiratory system, urinary tract and glands – primarily produces internal body parts.
b) Mesoderm - The middle layer, which will become the circulatory system, bones, muscles,
excretory system, and reproductive system – primarily produces parts that surround the
internal areas.
c) Ectoderm - The outermost layer, which will become the nervous system and brain,
sensory receptors (ears, nose, and eyes, for example), and skin parts (hair and nails, for
example) – primarily produces surface parts.
● Every body part eventually develops from these three layers.
● As the embryo’s three layers form, life-support systems for the embryo
develop rapidly. These life-support systems include the amnion, the
umbilical cord (both of which develop from the fertilized egg, not the
mother’s body), and the placenta.
● Amnion - Like a bag or an envelope and contains a clear fluid in which the
developing embryo floats. The amniotic fluid provides an environment that is
temperature and humidity controlled. It provides a cushion against any jolts
caused by the woman’s movements as well as shockproof.
● Placenta - A temporary fetal organ that begins developing from the blastocyst shortly after
implantation. It plays critical roles in facilitating nutrient, gas and waste exchange between
the physically separate maternal and fetal circulations, and is an important endocrine organ
producing hormones that regulate both maternal and fetal physiology during pregnancy. It
consists of a disk-shaped group of tissues in which small blood vessels from the mother and
the offspring intertwine but do not join.
● Umbilical cord – It contains two arteries and one vein, and connects the baby to the
placenta.
● A yolksac emerges that produces blood cells until the liver, spleen and bone marrow are
mature enough to take over this situation.
● Organogenesis - Organ formation that takes place during the first two
months of prenatal development.
● Growth in the embryonic period follows 2 important principles: \
a) Cephalocaudal principle: The sequence in which the earliest growth always
occurs at the top—the head—with physical growth in size, weight, and
feature differentiation gradually working from top to bottom.
First the head develops before the rest of the body.
i.e. growth from head to the base of the spine.
Motor development generally proceeds according to the cephalocaudal
principle. For example, infants see objects before they can control their body.
b) Proximodistal principle: The sequence in which growth starts at the
center of the body and moves toward the extremities.
Growth of parts near the centre of the body before those that are more
distant .i.e. arms and legs develop before hands and feet.
3.FETAL PERIOD (8-38 WEEKS)
● The fetal period, lasting about seven months, is the prenatal period
between two months after conception and birth in typical pregnancies.
● Is the longest prenatal period.
● During this “growth and finishing” phase, the organism increases
rapidly in size.
Three months after conception
● The fetus is about 3 inches long and weighs about 3 ounces.
● The face, forehead, eyelids, nose, and chin are distinguishable, as are the
upper arms, lower arms, hands, and lower limbs.
● In the 3rd month, the organs, muscles and nervous system start to
become organized and connected. When the brain signals, the fetus kicks,
bends its arms, forms a fist, curls its toes, opens its mouth and even sucks its
thumb.
● The tiny lungs expand and contract in an early rehearsal of breathing
movements.
● The heartbeat can now be heard through a stethoscope
By the end of the fourth month of pregnancy
● The fetus has grown to 6 inches in length and weighs 4 to 7 ounces.
● At this time, a growth spurt occurs in the body’s lower parts.
● For the first time, the mother can feel arm and leg movements.
By the end of the fifth month
● The fetus is about 12 inches long and weighs close to a pound.
Structures of the skin have formed—toenails and fingernails.
● The fetus is more active, showing a preference for a particular position
in the womb.
By the end of the sixth month
● The fetus is about 14 inches long and has gained another half pound
to a pound.
● The eyes and eyelids are completely formed, and a fine layer of hair
covers the head.
● A grasping reflex is present and irregular breathing movements occur.
Early seven months of pregnancy
● The fetus for the first time has a chance of surviving outside of the
womb, that is, viable.
● Infants who are born early, or between 24 and 37 weeks of pregnancy,
usually need help breathing because their lungs are not yet fully
mature.
By the end of the seventh month
● The fetus is about 16 inches long and weights about 3 pounds.
During the last two months of prenatal development
● Fatty tissues develop, and the functioning of various organ systems,
heart and kidneys steps up.
During the eighth and ninth months
● The fetus grows longer and gains substantial weight about another 4 (7
pounds)
Effect of long term & short term use of Teratogens
TERATOGENS
● Refers to any environmental agent that causes damage during the
prenatal period.
● A teratogen is any agent that can potentially cause a birth defect or
negatively alter cognitive and behavioral outcomes.
● So many teratogens exist that practically every fetus is exposed to at least
some teratogens. For this reason, it is difficult to determine which teratogen
causes which problem. In addition, it may take a long time for the effects of a
teratogen to show up. Only about half of all potential effects appear at birth.
● The harm done by teratogens is not always straightforward. it depends on the
following factors:
● Dose. larger doses over longer time periods usually have more negative effects.
● Heredity. the genetic makeups of the mother and the developing organism play an
important role. some individuals are better able to withstand harmful
environments.
● Other negative influences. the presence of several negative factors at once, such
as poor nutrition, lack of medical care, and additional teratogens, can worsen the
impact of a single harmful agent.
● Age. The effects of teratogens vary with the age of the organism at time of exposure. We can

best understand this last idea if we think of the sensitive period concept- a limited time span,

in which a part of the body or a behavior is biologically prepared to develop rapidly and,

therefore, is especially sensitive to its surroundings. If the environment is harmful, then

damage occurs, and recovery is difficult and sometimes impossible.

● Time of exposure. Teratogens do more damage when they occur at some points in

development than at others. Damage during the germinal period may even prevent

implantation. In general, the embryonic period is more vulnerable than the fetal period.
● After organogenesis is complete, teratogens are less likely to cause
anatomical defects. Instead, exposure during the fetal period is more
likely instead stunt growth or to create problems in the way organs
function.
1. Prescription and non-prescription drugs:
● Prescription as well as nonprescription drugs, however, may have effects on
the embryo or fetus.
● prescription drugs that can function as teratogens include antibiotics, such
as streptomycin and tetracycline; some antidepressants; certain hormones,
such as progestin and synthetic estrogen; and accutane.
o Accutane, a vitamin A derivative used to treat severe acne, is the most widely
used potent teratogenic drug. Exposure during the first trimester results in
eye, ear, skull, brain, heart, and immune system abnormalities.
● Non prescription drugs that can be harmful include diet pills and high
dosages of aspirin.
o Recent studies indicated that low doses of aspirin pose no harm for the
fetus but that high doses can contribute to maternal and fetal bleeding.
2. Psychoactive drugs : psychoactive drugs are drugs that act on the nervous system to alter
states of consciousness, modify perceptions, and change moods. examples include caffeine,
alcohol, and nicotine, as well as illicit drugs such as cocaine, methamphetamine, marijuana,
and heroin.
q Alcohol - heavy drinking by pregnant women can be devastating to offspring. Fetal Alcohol
Spectrum Disorders (FASD) are a cluster of abnormalities and problems that appear in the
offspring of mothers who drink alcohol heavily during pregnancy. the abnormalities include
facial deformities and defective limbs, face, and heart. most children with FASD have
learning problems and many are below average in intelligence with some that are mentally
retarded.
q Nicotine - cigarette smoking by pregnant women can also adversely influence
prenatal development, birth, and postnatal development. Preterm births and low
birth weights, fetal and neonatal deaths, respiratory problems, sudden infant
death syndrome and ADHD.
q Cocaine - cocaine exposure during prenatal development is associated with
reduced birth weight, length, and head circumference, lower levels of arousal
and impaired physical growth. And lower quality of reflexes at 1 month of
age, impaired motor development at 2 years of age and a slower rate of
growth through 10 years of age.
● Methamphetamine - mothers who use methamphetamine, or “meth,” during pregnancy are

at risk for a number of problems, including high infant mortality, low birth weight, and

developmental and behavioral problems and memory deficits.

● Marijuana - the most widely used illegal drug, has been linked to low birth weight and

smaller head size (a measure of brain growth); to attention, memory, and academic

achievement difficulties and to depression in childhood; and to poorer problem solving

performance in adolescence.

● Heroin - usage of heroin show several behavioral difficulties at birth like withdrawal

symptoms, such as tremors, irritability, abnormal crying, disturbed sleep, and impaired

motor control and attention deficits may appear later in development.

3. Incompatible blood types- incompatibility between the mother’s and father’s
blood types poses another risk to prenatal development. if a pregnant woman is Rh-
negative and her partner is Rh-positive, the fetus may be Rh-positive. if the fetus’
blood is Rh-positive and the mother’s is Rh-negative, the mother’s immune system
may produce antibodies that will attack the fetus. This can result in any number of
problems, including miscarriage or stillbirth, anemia, jaundice, heart defects,
brain damage, or death soon after birth. generally, the first Rh-positive baby of an
Rh-negative mother is not at risk, but with each subsequent pregnancy the risk
increases. A vaccine (rho gam) may be given to the mother within three days of the
first child’s birth to prevent her body from making antibodies that will attack any
future Rh-positive fetuses in subsequent pregnancies.
4. Environmental hazards - many aspects of our modern industrial world can
endanger the embryo or fetus. some specific hazards to the embryo or fetus include
radiation, toxic wastes, and other chemical pollutants.
o Radiation- X-ray radiation can affect the developing embryo or fetus, especially in
the first several weeks after conception, low-level radiation, medical X-rays, can
increase the risk of childhood cancer.
o Environmental pollutants and toxic wastes- In industrialized nations, an astounding
number of potentially dangerous chemicals are released into the environment.
These are also sources of danger to unborn children. Among the dangerous
pollutants are carbon monoxide, mercury, and lead, as well as certain
fertilizers and pesticides.
5. Maternal diseases - maternal diseases and infections can produce defects in offspring by

crossing the placental barrier, or they can cause damage during birth. rubella (german measles)

is one disease that can cause prenatal defects (Congenital deafness). others include, syphilis,

herpes, HIV.

q AIDS is a sexually transmitted infection that is caused by the human immunodeficiency virus

(HIV), which destroys the body's immune system. A mother can infect her offspring with

HIV/AIDS.

q The more widespread disease of diabetes, characterized by high levels of sugar in the blood.

Women who have gestational diabetes also may deliver very large infants(weighing 10

pounds or more), and the infants are at risk for diabetes themselves.
q Syphilis (a sexually transmitted infection) is more damaging later in prenatal
development-four months or more after conception. Damage includes eye
lesions, which can cause blindness, and skin lesions.
q Another infection that has received widespread attention is genital herpes.
Newborns contract this virus when they are delivered through the birth canal
of a mother with genital herpes.

6. Other parental factors like maternal nutrition, maternal age, stress and
emotional problems.
BIRTH PROCESS
● The birth process occurs in different contexts, and in most cases involves
one or more attendance.
STAGES OF BIRTH
● The birth process occurs in three stages.
1. Dilation and effacement of the cervix. The first stage is the longest of the three stages.
Uterine contractions are 15 to 20 minutes apart at the beginning and last up to a minute.
These contractions cause the woman's cervix to stretch and open. As the first stage
progresses, the contractions come closer together, appearing every two to five minutes.
Their intensity increases. By the end of the first birth stage, contractions dilate the cervix to
an opening of about 10 centimeters (4 inches), so that the baby can move from the uterus
to the birth canal. For a woman having her first child, the first stage lasts an average of 6 to
12 hours; for subsequent children, this stage typically is much shorter.
2.Delivery of the baby. The second birth stage begins when the baby's
head starts to move through the cervix and the birth canal (vagina). It
terminates when the baby completely emerges from the mother's body. With
each contraction, the mother bears down hard to push the baby out of her
body. By the time the baby's head is out of the mother's body, the
contractions come almost every minute and last for about a minute. This
stage typically lasts approximately 45 minutes to an hour.
3.Delivery of the placenta (Afterbirth) is the third stage, at which time the
placenta, umbilical cord, and other membranes are detached and expelled.
This final stage the shortest of the three birth stages, lasting only 5 to 10
minutes.
TYPES OF CHILD BIRTH
In the world most of births take place in hospitals. Who helps a mother
during birth varies across cultures. In hospitals, it has become the norm for
fathers or birth coaches to be with the mother throughout labor and delivery.
In some culture, men are completely excluded from the childbirth process.
When a woman is ready to give birth, female relatives move into the
woman's hut and the husband leaves, taking his belongings (clothes, tools,
weapons, and so on) with him. He is not permitted to return until after the
baby is born. In some other cultures, childbirth is an open, community affair.
A. Medication Three basic kinds of drugs that are used for labor are analgesia, anesthesia,
and oxytocin/pitocin.
1. Analgesia is used to relieve pain. Analgesics include tranquilizers, barbiturates, and
narcotics (such as Demerol).
2. Anesthesia is used in late first-stage labor and during delivery to block sensation in
an area of the body or to block consciousness. There is a trend toward not using general
anesthesia, which blocks consciousness, in normal births because general anesthesia
can be transmitted through the placenta to the fetus (Lieberman & others, 2005). An
epidural block is regional anesthesia that numbs the woman's body from the waist down.
Researchers are continuing to explore safer drug mixtures for use at lower doses to
improve the effectiveness and safety of epidural anesthesia (Balaji, Dhillon, & Russell,
2009).