AKLAN STATE UNIVERSITY

BACHELOR OF SCIENCE IN NURSING

Banga, Aklan

MILESTONES OF FETAL GROWTH AND DEVELOPMENT

OBJECTIVES:

General Objective:

After 25 minutes of clear and comprehensive

discussion, about 80% of the students would be able to
develop skills, knowledge and proper attitude in preparing
them to apply the nursing process in actual situations in
relation to fetal growth and development.

Specific Objectives:

After 25 minutes of clear and comprehensive discussion

about 80% of the students would be able to:

SKILLS:
 Apply learned concepts to future actual
situation.

Knowledge:
 Identify the different fetal characteristics
in different gestational week.
 Anticipate in actual situations the
different developmental status and image of
the growing fetus in different gestational
week.
 Visualize and compare the different size and
appearance of human fetuses at different
stages.

Attitude:
 Develop a sense to confidence in dealing
with pregnant patients and in imparting
teachings to patients and significant others.
- The following discussion of fetal development milestones
is based on gestational weeks.

*END OF 4th GESTATIONAL WEEK

 At the end of the 4th week of gestation, the

human embryo is a rapidly growing formation
of cells but does not yet resemble a human
being.
 Lenth: 0.75 – 1 cm
 Weight: 400 mg
 The spinal cord is formed and fused at the
midpoint.
 Lateral wings that will form the body are
folded forward to fuse at the midline.
 Head folds forward and becomes prominent,
representing about one third of the entire
structure.
 The back is bent so that the head almost
touches the tail.
 The rudimentary heart appears as a prominent
bulge on the anterior surface.
 Arms and legs are budlike structures.
 Rudimentary eyes, ears, and nose are
discernable.

*END OF 8th GESTATIONAL WEEK

 Length: 2.5 cm (1in)

 Weight: 20 g
 Organogenesis is complete.
 The heart with septum and valves is beating
rhythmically.
 Facial features are definitely discernible.
 Arms and legs have developed.
 External genitalia are present, but sex is
not yet distinguishable by simple
observation.
 The primitive tail is regressing.
 Abdomen appears large because the fetal
intestine is growing rapidly.
 Sonogram shows a gestational sac, diagnosing
of pregnancy.

*END OF 12th GESTATIONAL WEEK (FIRST TRIMESTER)

 Length: 7 – 8 cm
 Weight: 45 kg
 Nail beds are forming fingers and toes.
 Spontaneous movements are possible, although
they are usually too faint to be felt by the
mother.
 Some reflexes, such as the Babinski reflex
are present.
 Bone ossification centers are forming.
  Tooth buds are present.
 Sex is distinguishable by outward
appearance.
 Kidney secretion has begun, although urine
may not yet be evident in amniotic fluid.
 Heartbeat is audible through Doppler
technology.

*END OF 16th GESTATIONAL WEEK

 Length: 10 – 17 cm
 Weight: 55 – 120 g
 Fetal heart sounds are audible with an
ordinary stethoscope.
 Lanugo (the fine, downy hair on the back and
arms of newborns, which apparently serves as
a source of insulation for body heat) is
well formed.
 Liver and pancreas are functioning.
 Fetus actively swallows amniotic fluid.
Demonstrating an intact but uncoordinated
swallowing reflex; urine is present in the
amniotic fluid.
 Sex can be determined by ultrasonography.

*END OF 20th GESTATIONAL WEEK

 Length: 25 cm
 Weight: 223 g
 Spontaneous fetal movements can be sensed by
the mother.
 Antibody production is possible.
 Hair forms, extending to include eyebrows
and hair on the head.
 Meconium is present in the upper intestine.
 Brown fat, a special fat that will aid in
temperature regulation at birth, begins to
be formed behind the kidneys, sternum, and
posterior neck.
 Vernix caseosa, which serves as a protective
skin covering during intrauterine life,
begins to form.
 Definite sleeping and activity patterns are
distinguishable (the fetus has developed
biorhythms that will guide sleep/wake
patterns throughout life).

*END OF 24th GESTATIONAL WEEK (SECOND TRIMESTER)

 Length: 28 – 36 cm
 Weight: 550 g
 Passive antibody transfer from mother to
fetus probably begins as early as the 20th
 week of gestation, certainly by the 24th
week. Infants born before antibody transfer
has taken place have no natural immunity and
need more than the usual protection against
infectious disease in the newborn period
until the infant’s own store of
immunoglobulins can build up.
 Meconium is present as far as the rectum.
 Active production of lung surfactant begins.
 Eyebrows and eyelashes are well defined.
 Eyelids, previously fused since the 12th
week, are now open.
 Pupils are capable of reacting to light.
 When fetuses reach 24 weeks or 601 g, they
have achieved a practical low-end age of
viability if they are cared for after birth
in a modern intensive care facility.
 Hearing can be demonstrated by response to
sudden sound.

*END OF 28th GESTATIONAL WEEK

 Length: 35 – 38 cm
 Weight: 1200 g
 Lung alveoli begin to mature, and surfactant
can be demonstrated in amniotic fluid.
 Testes begin to descend into the scrotal sac
from the lower abdominal cavity.
 The blood vessels of the retina are thin and
extremely susceptible to damage from high
oxygen concentrations (an important
consideration when caring for preterm
infants who need oxygen)

*END OF 32nd GESTATIONAL WEEK

 Length: 38 – 43 cm
 Weight: 1600 g
 Subcutaneous fat begins to be deposited (the
former stringy appearance “little old man”
appearance is lost).
 Fetus responds by movement to sounds
outside the mother’s body.
 Active Moro Reflex is present.
 Birth position (vertex or breech) may be
assumed.
 Iron stores, which provide iron for the time
during which the neonate ingests only milk
after birth, are beginning to be developed.\
 Fingernails grow to reach the end of
fingertips.

*END OF 36th GESTATIONAL WEEK

 Length: 42 – 48 cm
 Weight: 1800 – 2700 g
  Body stores of glycogen, iron and
carbohydrate and calcium are deposited.
 Additional amounts of subcutaneous fats are
deposited.

 Sole of the foot has only one or two

crisscross creases, compared with the full
crisscross pattern that will be evident at
term.
 Amount of lanugo begins to diminish.
 Most babies turn into a vertex or head down
presentation during this month.

*END OF 40th GESTATIONAL WEEK

 Length: 28 – 36 cm
 Weight: 3000 g
 Fetus kicks actively, hard enough to cause
the mother considerable discomfort.
 Fetal hemoglobin begins its conversion to
adult hemoglobin. The conversion is so rapid
that, at birth about 20% of hemoglobin is
adult in character.
 Fingernails extend over the fingertips.
 Creases on the soles of the feet cover at
least two thirds of surface.

- In primiparas, the fetus often sinks into the birth canal

during the last two weeks, giving the mother a feeling that
the load she is carrying is less. This event, termed
lightening, is a fetal announcement that the third
trimester of pregnancy has ended and birth is at hand.

SOURCE: 5th Edition Maternal and Child Health Nursing: Care

of the Childbearing and Childrearing Family by Adele
Pillitteri. Volume 1.