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RICARDI W. ALIBASJAH
BAGIAN
OBSTETRI GINEKOLOGI
FAKULTAS KEDOKTERAN
UNSWAGATI
7th day
150u (0.15mm)
Implantation is
beginning. Trophoblast
cells proliferate and
begin to invade the
uterine epithelium.
Invasion is effected
through digestion of the
uterine cells by
secretions of the
trophoblast cells. Upon
contact with the
endometrium the
cytotrophoblast forms
the syncytiotrophoblast
and HCG (human
chorionic gonadotropin)
8th day
Syncytiotrophoblast cells
further invade the
Endometrium by secreting
hydrolytic enzymes.
10th day
Implantation continues. The
synctiotrophoblast nearly
completely surrounds the
cytotrophoblast cells of the
blastocyst. The primary yolk
sac is (probably) formed as the
hypoblast cells move around
the blastocyst cavity.
2nd
week
4th week
5th
week
7th
week
30mmC
RL
8th
week
35mmC
RL
15th
week
130mm
CRL
20th
week
185mmC
RL
Head and body hair (lanugo) are
visible. External ears stand out from
the head. At this point the mother
has felt movements of the fetus.
30th
week
275mmC
RL
Abortus
22weeks
Partus Imaturus
: 500 - 1000gr
22 - 28 week
Partus Prematurus
: 1000 2500gr
(Preterm labor)
28 - 37 week
Partus Maturus : > 2500 gr
(Term labor)
37 - 42 week
Partus Serotinus : > 42 week
(Prolonged/Postdate Pregnancy)
1 month
2 month
3 month
gr
4 month
gr
5 month
gr
6 month
gr
7 month
=
=
=
1 cm
4 cm
9 cm
= 1gr
= 14,2
= 16 cm
= 108
= 25 cm
= 316
= 30 cm
= 630
= 35 cm
= 1045
11 12 16
20
PREGNANCY
24
28
32
36
TERM
38
Sutures : sagital
coronal
lambdoid
frontal
Anterior (Greater) Fontanel:
Lozenges shape/ Junction of :
sagital suture
coronal
frontal
lambdoid suture
1.
2.
3.
4.
5.
Diameters of the
fetal head at term
The
The
The
The
The
subocciput-bregmatic
suboccipito-frontal
occipito-frontal
occipito-mental
submento-bregmatic
Biparietalis
diameter
Bitemporal
diameter
Fetal Head
Circumference
2 Umbilical arteries
1 Umbilical vein
Umbilical vein carries oxygenated
blood
The difference from adult:
Ductus Arteriosus Botali
Foramen ovale
Duct. Venosus aranti
Aa umbilicales
Fetal
Circulati
on
Cardiovascul
ar
system of
fetus
FETAL BLOOD
Fetal Hb Adult Hb
Hematopoiesis: Yolk sac - Liver - Bone
marrow
Hb A & Hb F
Fetal Hb bind more oxygen
1. UTERUS
Hypertrophy and Dilatation
Arrangement of the Muscle Cells
Change in Size, Shape and Position
Change in Contractility
Change in the Cervix
week
6
24
12
16
20
week
40
28
32
36
Six
week
s
Fetus : + 2
Pregnant
cm
Pregnancy
12 weeks
Fetus : + 7
cm
Pregnancy
20 weeks
Fetus : + 18-27
cm
Weight : + 300
grm
Pregnancy
28 week
Fetus : + 25 - 38
cm
Weight : + 1000
grm
> 37 weeks
Weight : + 3000 gm
3. OVARIUM
Corpus luteum graviditatum
7. Weight Gain
1st Trimester : 1 kg
2nd Trimester : 5 kg
3rd Trimester : 5,5 kg
Fetus
: 3 kg
Plancenta
: 0,5kg
Amnionic fluid : 1 kg
Uterus
Fat
Protein
Water
:
:
:
:
1 kg
0,5 kg
2 kg
1,5 kg
Increase mineral
requirement
(Fe,Ca,Mg)
8. HEMATOLOGIC CHANGES
Blood volume increase ~ 45%
Increase Plasma & Erythrocyte (~33%)
Hydraemia
O2 affinity decrease
Hematocrit decrease
Normal value :
Hb
: 11 gr%
Ery
: 3,8 million /mm3
Leuco
: 12000/mm3
9.
Others
Cardiovascular system
Respiratory tract
Urinary system
Gastrointestinal tract
Liver & Gallbladder
Endocrine glands
Musculo-skeletal system
Psychological
disturbances