Conception and Fetal

Development
NUR 324.60 Nursing Management of Childbearing
Families
October 10, 2014
Nancy Murphy, RN, MSN
PhD Candidate

Objectives
At the end of the student will be able to:
Describe the process of fertilization and implantation.
Describe the development, structure, and functions of the
placenta during intrauterine life.
Discuss key concepts related to fetal development.
Describe in order of increasing complexity the structures
that form during the cellular multiplication and
differentiation stages of intrauterine development.
Summarize the significant changes in growth and
development of the embryo and fetus at 4, 6, 12, 16, 20, 24,
28, 32, 36, and 38 weeks after conception.
Identify the vulnerable periods during fetal development in
which malformations of the various organ systems may
occur, and describe the resulting congenital malformations.

Key Concepts and Terms

Chromosomes (Genetics)

Mitosis

Development and Functions of the

Placenta

Placental Circulation
Placental Functions

Meiosis

Function of Amniotic Fluid

The Process of Fertilization

Preparation for Fertilization
The Moment of Fertilization

Embryonic and Fetal Development

Embryonic Stage

Fetal Stage

Pre-embryonic Stage
Cellular Multiplication
Implantation
Cellular Differentiation

Factors Influencing Embryonic and

Fetal Development

Gametogenesis, Oogenesis,
Spermatogenesis

Setting the Stage: Female

Reproductive Cycle
MATURATION OF OVARIAN FOLLICLE
OVULATION
CORPUS LUTEUM
NEUROHUMORAL RESPONSE
HYPOTHALMUS RELEASES GONADATROPINRELEASING HORMONE TO PITUITARY FROM
RESPONES FROM CNS
ANTERIOR PITUITARY THEN SECRETES FSH
AND LH

Setting the Stage: Female

Reproductive Cycle
FEMALE REPRODUCTIVE CYCLE
OVARIAN CYCLE
FOLLICULAR PHASE
LUTEAL PHASE
FEMALE HORMONES
ESTROGEN
PROGESTERONE
PROSTAGLANDINS
UTERINE CYCLE (MENSTRUAL)

Figure32aSpermpenetrationofanovum.Thesequentialstepsofoocytepenetrationbyaspermaredepicted
movingfromtoptobottom.Source:ScanningelectronmicrographfromNilsson,L.(1990).Achildisborn.
NewYork:DellPublishing.

Setting the Stage: the Cellular

Level

CELLULAR DIVISION
MITOSIS
MEIOSIS
OOGENESIS
SPERMATOGENESIS

Figure31bEachspermatogoniumproducesfourhaploidspermatozoa.

Conception
A sequential process: Gamete formation,
Ovulation, Fertilization
Following ovulation, fertilization occurs in
fallopian tube
Cell division occurs in the zygote
Flows into uterus

Intrauterine Development:
Three
Stages
Stage I: Pre-Embryonic: Fertilization ---14 days
CELLULAR MULTIPLICATION
CLEAVAGE
MORULA
BLASTOCYST
TROPHOBLAST

Stage II: Embryonic: Day 15 ---- 8 weeks

Basic structures of all major body organs complete

Cellular differentiation begins
Most vulnerable to teratogens

Stage III: Fetal: 9 weeks until end of pregnancy

All organs/body systems in place.

Characterized by rapid body growth and differentiation of body
tissues.

Intrauterine Development

Pre-Embryonic Stage
Fertilized egg not yet implanted in the uterus
Upon initial cell division the fertilized egg
becomes a zygote
At approximately 12-14 days following
fertilization, zygote is implanted in the lining
of the uterus
Cells specialize into what will become organs

Pre-Embryonic Stage
Morula

Blastocyst

IMPLANTATION
6-10 DAYS after
Fertilization

IMPLANTATION
CHANGES IN ENDOMETRIUM
- DECIDUA CAPSULARIS
- DECIDUA BASALIS
- DICIDUA PARIETALIS

Figure37Earlydevelopmentofprimaryembryonicmembranes.At412weeks,thedeciduacapsularis(placental
portionenclosingtheembryoontheuterinesurface)anddeciduabasalis(placentalportionencompassingthe
elaboratechorionicvilliandmaternalendometrium)arewellformed.Thechorionicvillilieinbloodfilled
intervillousspaceswithintheendometrium.Theamnionandyolksacarewelldeveloped.Source:Adaptedfrom
Marieb,E.N.(1998).

Embryonic Stage
Differentiation of tissues into what will
become organs (organogenesis)
Critical period of pregnancy in that as
organogenesis occurs, anomalies can
result in miscarriage
Umbilical cord and placenta develop and
provide nutrition and oxygen to and
remove waste from the embryo
Developmental patterns:
Cephalocaudal Patterns
Proximodistal Patterns

Fetal Stage
All organs/body systems in place
(Organogenesis is complete).
Characterized by rapid body growth and
differentiation of body tissues.
At approximately 3 months, genitalia can be
identified
At approximately 4 months, movements can be felt
by the mother
At approximately 7 months fetus may be viable
(can survive outside the womb with nutrition and
temperature regulation support).

Age
Fertilization age
VERSUS
Gestational age (commonly used in practice): Fertilization
Age + 2 Weeks
Full term = 36 to 40 weeks of fertilization age or 38 to 42
weeks of gestational age (after last menstrual period)

Critical Periods during

Development
Points at which key transitions occur tend to
be the most critical
Attachment to the uterine wall
Organogenesis tends to most vulnerable to
major malformations. (Pre-Embryonic
into early Embryonic Stages)
Chronic exposure to toxins during fetal
stage linked to delay in fetal growth and
deficits in intellectual potential (fetal stage)

Periods of Critical
Developments (based on
Fertilization Age)

Factors Influencing Fetal

Development
Circulation
Teratogens
Maternal Risk factors
Pre-existing medical conditions
Infections
Gestational disorders
Maternal Nutrition
Family history

The Fathers Role in Fetal

Development
Health of Spermtoxins, radiation,
drugs and alcohol
Supportive partneremotional
support, support for alcohol & tobacco
free pregnancy
Support and encourage access to
health care

PLACENTA

PLACENTA

Figure310Vasculararrangementoftheplacenta.Arrowsindicatethedirectionofbloodflow.Maternalbloodflows
throughtheuterinearteriestotheintervillousspacesoftheplacentaandreturnsthroughtheuterineveinstomaternal
circulation.Fetalbloodflowsthroughtheumbilicalarteriesintothevillouscapillariesoftheplacentaandreturns
throughtheumbilicalveintothefetalcirculation.

PLACENTA AT DELIVERY
FETAL SIDE

MATERNAL SIDE

AMMNIOTIC FLUID
FUNCTION

AMMNIOTIC FLUID
ABNORMALITIES

UMBILICAL CORD
By the fifth week of embryonic development, the
umbilical cord has formed.
Two arteries and one vein A-V-A
Whartons Jelly

UMBILICAL CORD ABNORMALITY

Velamentous insertion of umbilical cord

FETAL CIRCULATION
High pulmonary vascular resistance
Transient structures
Ductus venosus
Foramen ovale
Ductus arteriosus
https://www.youtube.com/watch?v=uwswhoKfkmM

MULTIFETAL PREGNANCIES
MONOZYGOTIC

DYZYGOTIC

MULTIFETAL PREGNANCIES
https://www.youtube.com/watch?v=9ZetwC3wdnI