Organogenetic Period:

The third to Eight Weeks

Phase of Embryonic Development

Folding of the Embryo
Germ Layer Derivatives
Control of Embryonic Development
Highlights of the Fourth to Eight Weeks
Estimation of Embryonic Age
Summary of the Fourth to Eight Weeks
Clinically Oriented Problems
Organogenesis / embryonic period

3rd 8th week

Ectoderm, mesoderm and endoderm
specific organ
Ectoderm

3rd week
Notocohord and prechordal mesoderm
induced ectoderm to thicken and form
neural plate
The end of 3rd week neural folds and
neural groove fused C5 (5th somite)
cranially and caudally
Cranial closure : day 25 (18-20 somite),
posterior : day 27 (25 somite)
As neural fold fused, lateral cell neural
crest :
Dorsal pathway : form melanocyte
Ventral pathway : become sensory ganglia,
sympathetic and enteric neurons, schwann
cells, cells of adrenal medulla

By the time neural tube is closed, ectodermal

thickenings otic placodes and lens placodes
invaginate form vesicles n(5th week)
So..
Ectoderm become :
Central nervous system
Peripheral nervous system
Sensory epithelium of the ear, nose and eye
Epidermis (hair and nail)
Add : subcutaneous glands, mamary gland,
pituitary gland and enamel of the teeth
Mesoderm

17th day midline proliferate then thicken

= paraxial mesoderm, more lateral =
lateral plate, middle = intermediate
mesoderm
2 layer :
Continuous covering amnion parietal
mesoderm layer
Continuous covering yolk salk viceral
mesoderm layer
Paraxial mesoderm

3rd week, called somitomeres

Appear 1st at cephalic region,
cephalocaudally
Become segmented with neural plate
neuromeres
Somitomeres become somites
Somite :1st pair at the occipital region, day
20, 3 pairs per day, until 5th week become
42 to 44 pairs (become axial skeleteon):
4 occipital
8 cervical
12 thoracic
5 lumbar
5 sacral
8-10 coccygeal
4th week form ventral and medial walls,
surround notochord sclerotome (form
vertebral column)
Sclerotome at dorsomedial portion
myotome, dorsal epithelium dermatome
Intermediate mesoderm

Differentiate into urogenital structure,

gonad system
Lateral plate

Parietal and visceral layer

Parietal Peritoneal, pleural and
pericardial cavities & serous fluid
membrane
Visceral thin serous membrane around
each organ
Blood and blood vessels

Vasculogenesis, angiogenesis at lateral

plate of mesoderm
Endoderm

GI tract
Cephalocaudally, head and tail fold
Anterior : foregut, middle : midgut, tail :
hindgut
Midgut connect to yolk salk from broad
stalk (vitelline duct)
At cephalic, foregut bounded with
buccopharyngeal membrane and rupture
(4th week) open to amnion cavity
At tail, hindgut bounded with cloacal
membraneanus
At 5th week : umbilical ring : yolk sac duct,
umbilical vessel and alantois
Further development :
Epithelial lining of respiratory tract
Parenchyma of the thyroid, parathyroid, liver
and pancreas
Reticular stroma of the tonsils and thymus
Epithelial lining of the urinary bladder and
urethra
Epithelial lining of the tympanic cavity and
auditory tube
External apperance during 2nd month

At the end of 4th week counting somites

difficult using CRL (crown-rump Length,
vertex of the skull to the midpoint between
the apices of the buttocks))
2nd month : increase size of head and
formation of the limbs, face, ear, nose and
eyes
Start 5th week : forelimb and hindlimbs
appear as paddle shaped buds
Birth defect : during 3rd to 8th week
(malformation)
 The Fetal Period
Nine Week to Birth

Estimation of Fetal Age

Highlights of Fetal Period
Expected Date of Delivery
Procedures for Assessing Fetal Status
Summary of Fetal Period
Clinically Oriented Problems
9th week

Fetal period
Maturation of the tissue, organ and rapid
growth
Using CRL
Growth striking at 3rd, 4th and 5th months
Increase weight at last 2 months
Length pregnancy : 280 days/40 weeks
after last normal menstrual period or 266
days/38 weeks after fertilization
Start 3rd months, head = CRL, face
become more human, eyes laterally, ears
side of the head, primary ossification at
long bones, external genitalia present
Start 5th months, head = 1/3 CRL, during
5th months, movement can be felt, lanugo
hair, eyebrow and head hair appear,
weight <500 g
6th months : skin fetus reddish, wrinkled
(lack of underlying connective tissue),
respiratory system have not differentiate
sufficiently
6.5 7 month 90% surviving
7th months : subcutaneous fat ++, vernix
caseosa (product from sebaceous gland)
Birth , head = CRL (36 cm), normal
weight : 3000-3400 gr, testes should be in
the scrotum
7-14th week CRL
16 30th week BPD biparietal diameter,
head and abdominal circumference, femur
length
\
Lamanya Kehamilan Berat Anak Istilah

< 22 minggu < 500 g Abortus

22 28 minggu 500 g 1000 g Partus immaturus
28 37 minggu 1000 g 2500 g Partus praematurus
37 42 minggu > 2500 Partus aterme
(sampai 4500 g) (maturus)
> 42 minggu Partus serotinus
 Placenta and Fetal Maembranes

The Placenta
Parturition (Childbirth)
Amniotic Fluid
Multiple Pregnancies
Summary of Placenta and Fetal Membranes
Clinically Oriented Problems
Changes in trophoblast
Structure of the placenta
Placental function

Gas exchange
Nutrients and electrolytes exchange
Transmission of maternal antibodies
Hormone production
Placental changes at the end of
pregnancy
Increase in fibrous tissue
Thickening of basement membrane in fetal
capillaries
Obliterative changes in small capillaries of
the villi
Deposition of fibrinoid on the surface of
the villi in the junctional zone and in the
chorionic plate
Amniotic fluid

10th week : 30 cc
20th week : 450 cc
37th week : 800 1000 cc
Swalow 400 cc per day at 5th months
Function :
Absorb jolts
Prevents adherence of the embryo to the
amnion
Allow fetal movement
Multiple pregnancy

Dizigot
Monozigot
phase pertama ( phase dilatasi )
phase kedua ( phase pengeluaran )
phase ketiga ( phase placental )
phase keempat ( phase pemulihan )
 Human Birth Defects

Teratology Study of Abnormal Development

Anomalies Caused by Genetic Factors
Anomalies Caused by Environmental Factors
Anomalies Caused by Multifactorial
Inheritance
Summary of Human Birth Defect
Clinically Oriented Problems
Type of abnormalities

Malformation : 3rd to 8th week

Disruption: already formed, destructive
process
Deformation : caused by mechanical
forces
Syndrome : CHARGE, VACTERL
Principles of teratology

Genotype of the conceptus

Embryogenesis
Duration of exposure to a teratogen
Mechanism
Manifestation death, malformation,
growth retardation and functional disorders
Etiology

Infectious agent
Radiation
Chemical agent
Hormones
Maternal disease
Mal nutrisi
Hypoxia
Heavy metals
Prenatal diagnosis

USG
Amniocentesis
Maternal serum screening (AFP, hCG)
Chorionic villus sampling
Fetal therapy

Fetal transfusion
Fetal surgery
Stem cell transplant and gene therapy
Fetal medical treatment
 The End
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