INTRODUCTION

The Stages of Human Embryonic Development

Human prenatal development is divided into an embryonic period and a fetal

period. The embryonic period begins with fertilization and ends eight weeks later.
The staging of human embryos was introduced in 1914 by Franklin P. Mall at the
Department of Embryology of the Carnegie Institution of Washington. Mall's
sucessor, George L. Streeter, later refined the classification of human embryos
into 23 stages, or "developmental horizons".

It is important to note that each of the 23 Carnegie stages represents an arbitary

point along the time-line of development, akin to a "freeze-frame" in a movie. The
stages are based on a variety of morphological features and are independant of
chronological age or size. As implied by the original term, "horizon", the stages
are not definitive steps, that when combined lead to a fully formed human fetus,
but rather they are a series of events that must be completed during
development. As the description of each stage is based on the features seen in
an "average" embryo individual embryos may not fit exactly into a particular
stage. There may also be considerable variation within a stage and overlap
between stages.
The Form of the Embryo at Different Stages of Its Growth

First Week.—During this period the ovum is in the uterine tube.

Having been fertilized in the upper part of the tube, it slowly passes
down, undergoing segmentation, and reaches the uterus. Peters
described a specimen, the age of which he reckoned as from three to
four days. It was imbedded in the decidua on the posterior wall of the
uterus and enveloped by a decidua capsularis, the central part of
which, however, consisted merely of a layer of fibrin. The ovum was
in the form of a sac, the outer wall of which consisted of a layer of
trophoblast; inside this was a thin layer of mesoderm composed of
round, oval, and spindle-shaped cells. Numerous villous processes—
some consisting of trophoblast only, others possessing a core of
mesoderm—projected from the surface of the ovum into the
surrounding decidua. Inside this sac the rudiment of the embryo was
found in the form of a patch of ectoderm, covered by a small but
completely closed amnion. It possessed a minute yolk-sac and was
surrounded by mesoderm, which was connected by a band to that
lining the trophoblast .
Second Week.—By the end of this week the ovum has increased
considerably in size, and the majority of its villi are vascularized. The
embryo has assumed a definite form, and its cephalic and caudal
extremities are easily distinguished. The neural folds are partly united.
The embryo is more completely separated from the yolk-sac, and the
paraxial mesoderm is being divided into the primitive segments .
Fourth Week.—The embryo is markedly curved on itself, and when
viewed in profile is almost circular in outline. The cerebral
hemispheres appear as hollow buds, and the elevations which form the
rudiments of the auricula are visible. The limbs now appear as oval
flattened projections.
Fifth Week.—The embryo is less curved and the head is relatively of
large size. Differentiation of the limbs into their segments occurs. The
nose forms a short, flattened projection. The cloacal tubercle is evident
.
Sixth Week.—The curvature of the embryo is further diminished. The
branchial grooves—except the first—have disappeared, and the
rudiments of the fingers and toes can be recognized .
Seventh and Eighth Weeks.—The flexure of the head is gradually
reduced and the neck is somewhat lengthened. The upper lip is
completed and the nose is more prominent. The nostrils are directed
forward and the palate is not completely developed. The eyelids are
present in the shape of folds above and below the eye, and the
different parts of the auricula are distinguishable. By the end of the
second month the fetus measures from 28 to 30 mm. in length .
Third Month.—The head is extended and the neck is lengthened. The
eyelids meet and fuse, remaining closed until the end of the sixth
month. The limbs are well-developed and nails appear on the digits.
The external generative organs are so far differentiated that it is
possible to distinguish the sex. By the end of this month the length of
the fetus is about 7 cm., but if the legs be included it is from 9 to 10
cm.
Fourth Month.—The loop of gut which projected into the umbilical
cord is withdrawn within the fetus. The hairs begin to make their
appearance. There is a general increase in size so that by the end of the
fourth month the fetus is from 12 to 13 cm. in length, but if the legs be
included it is from 16 to 20 cm.
Fifth Month.
—It is during this month that the first movements of the fetus are
usually observed. The eruption of hair on the head commences, and
the vernix caseosa begins to be deposited. By the end of this month the
total length of the fetus, including the legs, is from 25 to 27 cm.
Sixth Month.—The body is covered by fine hairs (lanugo) and the
deposit of vernix caseosa is considerable. The papillæ of the skin are
developed and the free border of the nail projects from the corium of
the dermis. Measured from vertex to heels, the total length of the fetus
at the end of this month is from 30 to 32 cm.
Seventh Month.—The pupillary membrane atrophies and the eyelids
are open. The testis descends with the vaginal sac of the peritoneum.
From vertex to heels the total length at the end of the seventh month is
from 35 to 36 cm. The weight is a little over three pounds.
Eighth Month.—The skin assumes a pink color and is now entirely
coated with vernix caseosa, and the lanugo begins to disappear.
Subcutaneous fat has been developed to a considerable extent, and the
fetus presents a plump appearance. The total length, i. e., from head to
heels, at the end of the eighth month is about 40 cm., and the weight
varies between four and one-half and five and one-half pounds.
Ninth Month.—The lanugo has largely disappeared from the trunk.
The umbilicus is almost in the middle of the body and the testes are in
the scrotum. At full time the fetus weighs from six and one-half to
eight pounds, and measures from head to heels about 50 cm.