What is the fetal period of development?

  1. Introduction: development from embryo to fetus is not abrupt, but the embryo changes to a recognizable human being and develops all the basic outlines of its organs and is then called a fetus. This long (7-month) fetal period is concerned with growth and differentiation of tissues and organs that began to develop in the embryonic period, maturation of the primordia, reorganization of spatial relationships of primordia, and the embryo begins to make functional use of its organs for part of its needs. Its volume and weight increase proportionally, and it grows considerably, from about 30 mm (CR) to about 330 mm (CR). Fetal growth is complex and is really a phenomenon which results from the sum of very asynchronous growth of different organs and parts even at the histologic level (histogenesis). Body proportions at term are very different from the fetus of 2 or 3 months
  2. Fetal age is best expressed in weeks. Most uncertainty comes from the use of both calendar months (28-31 days) or lunar months (28 days). Most use calendar months
    1. GESTATIONAL PERIOD is divided into 3 trimesters or parts of 3 calendar months each
      1. By the end of the first trimester, all major systems are developed, and CR length is about as wide as one's palm
      2. At the end of the second trimester (26 weeks according to LMP but only 24 weeks related to time of fertilization), the fetus is too immature to live independently and is about the size of a handspan
  3. Fetal period changes
    1. WEEKS 9 TO 12 (STAGE OF INITIAL FETAL ACTIVITY)
      1. Beginning of week 9: the head is about half the fetal size, but growth of the body in CR length more than doubles by the end of week 12
      2. One sees a broad face, eyes widely separated, ears low set, and eyelids fused so that the conjunctival sacs are closed
      3. Beginning of week 9, the legs are short and thighs relatively small, but by the end of week 12, the upper limbs reach relatively normal lengths, even though the lower limbs are not well developed and are relatively shorter than normal
      4. The external genitalia of male and female appear similar until end of week 9
      5. Intestinal loops are clearly seen in the proximal end of the umbilical cord until the middle of week 10 when they return to the abdomen
      6. By the end of week 12, the fetus will react to stimuli (seen in aborted fetuses)
    2. WEEKS 13 TO 16 (PERIOD OF RAPID FETAL GROWTH)
      1. By end of week 16, the head is relatively small compared to a 12-week fetus
      2. Legs have become longer
      3. Skeletal ossification progresses rapidly and is seen on x-ray by week 16
      4. Scalp hair pattern gives some clue to early brain development
    3. WEEKS 17 TO 20
      1. Growth slows, but fetal CR length increases by 50 mm and lower limbs reach their final relative proportions
      2. Fetal movements (quickening) are generally felt by mother
      3. Skin is covered by the vernix caseosa (greasy, cheeselike material) by week 20 due to fetal sebaceous gland secretion and dead epithelial cells
        1. Protects fetal skin from chapping, abrasions, and hardening due to amniotic fluid around it
      4. By week 20, the fetus is covered by lanugo, a fine downy hair
      5. The eyebrows and head hair are visible
      6. Brown fat forms and is the site of heat production (in the newborn)
        1. Brown fat is specialized adipose tissue that produces heat by oxidizing fatty acids and is chiefly found in the floor of the anterior triangle of the neck surrounded by the subclavian and carotid vessels, behind the sternum, and in the perirenal areas

What is the fetal period of development?

Feigelman S, Finkelstein LH. Assessment of fetal growth and development. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 20.

Ross MG, Desai M, Ervin MG. Fetal development, physiology, and effects on long-term health. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 2.


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Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Growth and nutrition. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Siedel's Guide to Physical Examination. 9th ed. St Louis, MO: Elsevier; 2019:chap 8.

Benson CB, Doubilet PM. Fetal measurements: normal and abnormal fetal growth and assessment of fetal well-being. In: Rumack CM, Levine D, eds. Diagnostic Ultrasound. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 42.

Graham GM, Park JS, Norwitz ER. Antepartum fetal assessment and therapy. In: Chestnut DH, Wong CA, Tsen LC, et al, eds. Chestnut's Obstetric Anesthesia: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 6.

Goyal NK. The newborn infant. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 113.

Nock ML, Olicker AL. Tables of normal values. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 11th ed. Philadelphia, PA: Elsevier; 2020:Appendix B, 2028-2066.

Walker VP. Newborn evaluation. In: Gleason CA, Juul SE, eds. Avery's Diseases of the Newborn. 10th ed. Philadelphia, PA: Elsevier; 2018:chap 25.


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Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Growth and nutrition. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Siedel's Guide to Physical Examination. 9th ed. St Louis, MO: Elsevier; 2019:chap 8.

Bamba V, Kelly A. Assessment of growth. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 27.

Riddell A. Children and adolescents. In: Glynn M, Drake WM, eds. Hutchison's Clinical Methods. 24th ed. Philadelphia, PA: Elsevier; 2018:chap 6.


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Antoniou E, Orovou E, Sarella A, et al. Zika virus and the risk of developing microcephaly in infants: a systematic review. Int J Environ Res Public Health. 2020;17(11):3806. PMID: 32471131 pubmed.ncbi.nlm.nih.gov/32471131/.

Centers for Disease Control and Prevention website. Zika virus. www.cdc.gov/zika/index.html. Updated September 20, 2021. Accessed January 19, 2022.

Kinsman SL, Johnston MV. Congenital anomalies of the central nervous system. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 609.

Mizaa GM, Dobyns WB. Disorders of brain size. In: Swaiman KF, Ashwal S, Ferriero DM, et al, eds. Swaiman's Pediatric Neurology: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2017:chap 28.


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Bacino CA, Lee B. Cytogenetics. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 98.

Madan-Khetarpal S, Arnold G, Ortiz D. Genetic disorders and dysmorphic conditions. In: Zitelli BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 1.


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Updated by: Charles I. Schwartz MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.


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Updated by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Home Health & Medicine Anatomy & Physiology

prenatal development, also called antenatal development, in humans, the process encompassing the period from the formation of an embryo, through the development of a fetus, to birth (or parturition).

The human body, like that of most animals, develops from a single cell produced by the union of a male and a female gamete (or sex cell). This union marks the beginning of the prenatal period, which in humans encompasses three distinct stages: (1) the pre-embryonic stage, the first two weeks of development, which is a period of cell division and initial differentiation (cell maturation), (2) the embryonic period, or period of organogenesis, which lasts from the third to the eighth week of development, and (3) the fetal period, which is characterized by the maturation of tissues and organs and rapid growth of the body. The prenatal period ends with parturition and is followed by a long postnatal period. Only at about age 25 years are the last progressive changes completed.

embryos of different animals

Much of the embryonic developmental machinery (the cellular apparatus) used in human development is similar to that used by other vertebrates as well as some invertebrates. The machinery is essential for four processes: cell proliferation, cell specialization, cell interaction, and cell movement. During these processes, the approximately 20,000–25,000 genes in the human genome give rise to as many as 100,000 different proteins, which give the conceptus form and substance.

sperm

The development and liberation of the male and female gametes are steps preparatory to their union through the process of fertilization. Active movements first bring some spermatozoa into contact with follicle cells adhering to the secondary oocyte (immature egg), which still lies high in the uterine tube. The sperm then propel themselves past the follicle cells and attach to the surface of the gelatinous zona pellucida enclosing the oocyte. Some sperm heads successfully penetrate this capsule by means of an enzyme they secrete, hyaluronidase, but only one sperm makes contact with the cell membrane and cytoplasm of the oocyte and proceeds farther. This is because the invading sperm head releases a substance that initiates surface changes in the oocyte that render its membrane impermeable to other spermatozoa.

The successful sperm is engulfed by a conical protrusion of the oocyte cytoplasm and is drawn inward. Once within the periphery of the oocyte, the sperm advances toward the centre of the cytoplasm; the head swells and converts into a typical nucleus, now called the male pronucleus, and the tail detaches. It is during the progress of these events that the oocyte initiates its final maturation division. Following the separation of the second polar body (one or two polar bodies are produced during division), the oocyte nucleus typically reconstitutes and is then called the female pronucleus of the ripe egg. It is now ready to unite with its male counterpart and thereby consummate the total events of fertilization.

The two pronuclei next approach, meet midway in the egg cytoplasm, and lose their nuclear membranes. Each resolves its diffuse chromatin material into a complete single set of 23 chromosomes. Each chromosome is composed of two chromatids held together by a centromere. During mitosis (ordinary cell proliferation by division), the centromeres attach to a bundle of microtubules known as the mitotic spindle, which is formed by centrioles (cylindrical cell structures). This climax in the events of fertilization creates a joint product known as the zygote, which contains all the factors essential for the development of a new individual.

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The fundamental results of fertilization are the following: (1) reassociation of a male and female set of chromosomes, thus restoring the full number and providing the basis for biparental inheritance and for variation), (2) establishment of the mechanism of sex determination for the new individual (this depending on whether the male set of chromosomes included the X or the Y chromosome), and (3) activation of the zygote, initiating further development.

first stages of human development

Through the process of mitosis, the relatively enormous zygote directly subdivides into many smaller cells of conventional size, suitable as early building units for the future organism. This process is called cleavage and the resulting cells are blastomeres. The tendency for the progressive increase in cell numbers to follow a doubling sequence is soon disturbed and then lost. Each blastomere receives the full complement of paternal and maternal chromosomes.

Subdivision of the zygote into blastomeres begins while it is still high in the uterine tube. The cohering blastomeres are transported downward chiefly, at least, by muscular contractions of the tubal wall. Such transport is relatively rapid until the lower end of the tube is reached, and here cleavage continues for about two days before the multicellular cluster is expelled into the uterus. The full reason for this delay is not clear, but it serves to retain the cleaving blastomeres until the uterine lining is suitably prepared to receive its prospective guest.

Since the human egg contains little inert yolk material and since this is distributed rather evenly throughout the cytoplasm, the daughter cells of each mitosis are practically equal in size and composition. This type of cleavage is known as total, equal cleavage. The sticky blastomeres adhere, and the cluster is still retained for a time within the gelatinous capsule—the zona pellucida—that had enclosed the growing and ovulated oocyte. There is no growth in the rapidly dividing blastomeres, so that the total mass of living substance does not increase during the cleavage period.

By the fourth day after fertilization, a cluster of about 12 blastomeres passes from the uterine tube into the uterus. At this stage the cluster is called a morula. By the time some 30 blastomeres have been produced, pools of clear fluid accumulate between some of the internal cells, and these spaces soon coalesce into a common subcentral cavity. The resulting hollow cellular ball is a blastula of a particular type that occurs in mammals and is called a blastocyst; its cavity is the blastocoel.

An internal cellular cluster, eccentric in position and now named the inner cell mass, will develop into the embryo. The external capsule of smaller cells, enveloping the segregated internal cluster, constitutes the trophoblast. It will contribute to the formation of a placenta and fetal membranes. During its stay within the uterine cavity, the blastocyst loses its gelatinous capsule, imbibes fluid, and expands to a diameter of 0.2 mm (0.008 inch); this is nearly twice the diameter of the zygote at the start of cleavage. Probably several hundred blastomeres have formed before the blastocyst attaches to the uterine lining.