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Please refer to Chapter 5: Nursing Care During Normal Pregnancy and Care of the Developing Fetus-Milestones of Fetal
Growth and Development p. 185

I. MILESTONES OF FETAL GROWTH AND DEVELOPMENT
 Ovulation age- measured from the time of END OF 4TH GESTATIONAL WEEK
ovulation  Length: 0.75 to 1 cm
st  Weight: 400 mg
 Length of pregnancy- from 1 day of the last  Spinal cord formed & fused at midpoint
menstrual period (LMP) is the gestational age  Lateral wings forming body are folded
forward to fuse at midline
 Ovulation & fertilization takes place about 2  Head folds forward, prominent, 1/3 of
weeks after LMP so ovulation age of fetus is entire structure
always 2 weeks less than the length of  Back is bent so head almost touches tip of
pregnancy or gestational age tail
 Rudimentary heart bulges on anterior
surface
 Arm and leg buds
 Ovulation age & gestational age are measured
in lunar months (4-week periods) or trimesters  Rudimentary eyes, ears, nose are discernible
(3-month periods)
 Pregnancy- 10 lunar months (40 weeks or 280

days)
 Fetus grows in utero for 9.5 lunar months

or 3 full trimesters (38 weeks or 266 days)
END OF 8TH GESTATIONAL WEEK END OF 12TH GESTATIONAL WEEK (1ST
 Length: 1 inch TRIMESTER)
 Weight: 20g • Length: 7 to 8 cm
 Organogenesis complete • Weight: 45 g
 Heart, with septum & valves, beats • Nail beds on fingers & toes forming
 Discernible facial features • Spontaneous movements possible but too
 Arms and legs developed faint to be felt
 External genitalia present but can’t be • Bone ossification centers forming
discerned by simple observation • Tooth buds present
 Primitive tail regressing • Sex distinguishable by outward appearance
 Abdomen is large because fetal • Kidney secretion begins but urine not yet
intestines are growing rapidly evident in the amniotic fluid
 Ultrasound shows gestational sac • Heartbeat audible through DOPPLER
(diagnostic of pregnancy) technology
• Some reflexes present like the Babinski
reflex
END OF 16TH GESTATIONAL WEEK END OF 20TH GESTATIONAL WEEK
 Length: 10 to 17 cm  Length: 25 cm
 Weight: 55 to 120 g  Weight: 223 g
 Fetal heart sounds audible with ordinary  Spontaneous movements felt by the mother
stethoscope  Antibody production possible
 LANUGO is well formed  Hair forms, including eyebrows and hair
 Liver & pancreas functioning on the head
 Actively swallows amniotic fluid  Meconium present in the upper intestine
demonstrating intact though  BROWN FAT, a special fat insulator
uncoordinated swallowing reflex deposits behind the kidneys, sternum &
 Urine is present in amniotic fluid posterior neck
 Sex can be determined by ultrasound  Vernix caseosa begins to form
 Definite sleep/wake patterns
(developed biorhythms)
END OF 24TH GESTATIONAL WEEK (2ND END OF 28TH WEEK OF GESTATION
TRIMESTER) • Length: 35 to 38 cm
 Length: 28 to 36 cm • Weight: 1,200 g
 Weight: 550 g • Lung alveoli begin to mature, surfactant
 Passive ab transfer begins by 20th present in Amniotic fluid
week, established by 24th week • Testes begin to descend in scrotal sac
 Meconium is present as far as the rectum from the lower abdominal cavity
 Active production of lung surfactants begins • Blood volume of retina are thin &
 Eyebrows/eyelashes well-defined susceptible to damage from high O2
 Eyelids now open
 Pupils capable of reacting to light
 24 weeks or 601 g- low-end age of
viability if cared for in a modern NICU
 Hearing can be demonstrated by response
to
sudden sound
END OF 32ND WEEK OF GESTATION END OF 36TH GESTATIONAL WEEK
 Length: 38 to 43 cm • Length: 42 TO 48 CM
 Weight: 1,600 g • Weight: 1,800 to 2,700 g (5 to 6 lbs)
 Subcutaneous fat begins to be deposited • Body stores of glycogen, iron,
(the former stringy, “little old man” carbohydrates & calcium are deposited
appearance is lost) • Additional amount of subcutaneous
 Fetus responds by movement to sounds fat are deposited
outside mother’s body • Sole of foot has only 1 or 2 crisscross
 Active Moro Reflex creases (full crisscross pattern at term)
 Birth position (breech or vertex) is assumed • Lanugo begins to diminish
 Iron stores beginning to be developed • Most babies turn into a vertex or
 Fingernails grow to reach end of fingertips head-down position during this month
END OF 40TH GESTATIONAL WEEK (3RD TRIMESTER)
 Length: 48 TO 52 CM (CROWN TO RUMP, 35 to 37 cm)
 Weight: 3,000 g (7 to 7.5 lbs)
 Fetus kicks actively, causing discomfort
 Fetal hemoglobin begins conversion to adult hemoglobin
 Vernix caseosa is fully formed
 Fingernails extend over fingertips
 Creases on foot soles cover at least 2/3 of surface
*In primiparas, fetus sinks into the birth canal during the last 2 weeks, giving the mother a feeling that the
load she is carrying is less (LIGHTENING), an announcement that the third trimester has ended and birth
is at hand
II. FETOPLACENTAL CIRCULATION

A. Shunts or Bypasses
 Foramen ovale- between R atrium & L atrium
 Ductus venosus- bypasses the liver
 Ductus arteriosus- bypasses the lungs
 Umbilical Vein- carries oxygenated blood & nutrients to fetus
 Umbilical arteries- carries Carbon dioxide and other wastes from fetus to maternal
circulation
 *Pressure is higher on the R side of the heart before birth

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Please refer to Chapter 5: Nursing Care During Normal Pregnancy and Care of the Developing Fetus-Milestones of Fetal

Growth and Development p. 185

 Pregnancy- 10 lunar months (40 weeks or 280

 Fetus grows in utero for 9.5 lunar months

II. FETOPLACENTAL CIRCULATION

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