The document discusses fetal physiology, including growth and development from conception to term. It covers the characteristic indicators of fetal maturity, such as nutrition, amniotic fluid, and the cardiovascular, respiratory, gastrointestinal, renal, immunological and endocrine systems. The fetus develops most organs by 8 weeks, with continued growth and nutritional dependence on the placenta. Fetal circulation differs from adult circulation prior to birth through structures like the ductus arteriosus and foramen ovale.

1. FETAL PHYSIOLOGY
Age conception of the week commonly used to indicate the status
of development of the embryo. Age conception can be determined by
measuring the fetus and is generally determined by measuring CROWN
LENGTH Rump via ultrasound.
A. GROWTH AND DEVELOPMENT :
Growth and development during the first 8 weeks, the terminology
used for the development of organisms embryos after 8 weeks, the
terminology used by the fetus because most organs have been formed
and have entered into the stage of growth and development continued.
Fetus weighing 500 - 1000 g (22-23 weeks) called immature. From weeks
28-36 are called preterm and full-term fetus when the pregnancy is over
37 weeks.
B. CHARACTERISTIC INDICATING MATURITY OF THE FETUS :
1. Nutrition intrauterine :
Nutrition intrauterine fetal growth and placental function defined
perfusion. Chronic malnutrition can cause anemia and low birth
weight - low birth weight case of hypoxia, fetal obtain energy
through anaerobic glycolysis, which originated from the reserve in
the heart muscle and placenta. The fetus produces a specific
protein called Alfafetoprotein - AFP from liver. The protein is
secreted by the fetal kidneys and swallowed back to experience
degradation in the gut. If the fetus is swallowing disorders (eg fetal
abnormalities Anensepalus or another NTD's) the serum AFP levels
increased.
2. Amniotic fluid :
Amniotic fluid amniotic fluid volume at term about - about 800 ml
and pH 7.2 polyhydramnios (hydramnios): amniotic fluid volume>
2000 ml, can occur in normal pregnancy but 50% of the state is
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2. accompanied
by
abnormalities
in
the
mother
or
fetus.
Oligohydramnios objectively determined by measuring the largest
bag with ultrasound that shows the number of less than 2 cm x 2
cm or 4 quadrant total amount of less than 5 cm (amniotic fluid
index).
SOLUTE AND WATER EXCHANGE IN THE AMNIOTIC FLUID :
1. Cardiovascular system :
The cardiovascular system is an abrupt change from intrauterine
life to extrauterine circulation neonates require adjustment include:
diversion of blood flow from the lungs, Bottali closure of the ductus
arteriosus and foramen ovale and ductus venosus obliteration
Arantii and vasa umbilical. Dilatation vasa formation of pulmonary
and pulmonary sirkluasi
2. Cardiovascular system :
Cardiovascular system infant circulation consists of 3 phases:
Phase intrauterine where the fetus depends on the placental phase
transition that begins shortly after birth and the first cry adult phase
generally lasts in full in the first month of life
3. Fetal circulation :
Fetal circulation circulation adult: a series circuit where the blood
flow through the right heart - lungs - left ventricle - the systemic
circulation - fetal circulation right heart: a parallel circuit in which the
cardiac output from the left ventricle and the right directly to
different vascular tangle. Fetal circulation is characterized by a
'shunt': ductus arteriosus ductus venosus Arantii Botali
4. Phase intrauterine :
Phase intrauterine umbilical vein brings oxygenated blood from the
placenta to the fetus is more than 50% of cardiac out - put walked
to the placenta through the umbilical artery. Red blood cells,
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3. hemoglobin and "packed cell volume" continued to increase during
pregnancy. Most of the erythrocytes containing HbF
5. Phase transition :
Transition phase During labor, there are two events that alter fetal
hemodynamic Ligation cord leading to the rise of CO2 levels
increase in arterial pressure and a decrease in PO2 leading to early
neonatal respiratory fetal circulation to be perfect after the closing
ductus and foramen ovale ongoing arteriousus
6. Phase extrauterine :
Phase extrauterine hemodynamically normal adults differ with the
fetus in terms of: venous and arterial blood does not mix in the
atrium Vena cava carries only deoxygenated blood into the right
atrium, right ventricle and then into the blood and then pumped into
the pulmonary artery and pulmonary capillary blood carries only
Aorta oxygenated from the heart through the pulmonary vein to the
left further distributed throughout the body of the fetus.
7. Respiratory function :
Pregnancy 22 weeks respiratory function, pulmonary capillary
system formed and already has the ability to exchange gases.
Aterm, has formed 3-4 generations alveoli. Epithelium that originally
shaped cabbage change a flat at the first breath. Gas exchange
takes place in the placenta to the fetus. O2 partial pressure (PO2)
of fetal blood <maternal blood, but because it contains a lot of HbF
fetal blood oxygen saturation, then the fetus is able to make ends
meet.
8. Gastrointestinal function :
Function gastrointestinal partially swallowed amniotic fluid following
cellular material contained therein through the enzymatic activity of
bacteria and converted into meconium. Meconium remains in the
intestine unless there is severe hypoxia that causes contraction of
intestinal muscles so that meconium out and mixes with the
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4. amniotic fluid. Gluconeogenesis from amino acids and glucose
accumulation in the liver is sufficient when the neonate has not
happened yet.
9. Renal function :
Kidney function placenta, lung, and kidney maternal normally would
regulate water and electrolyte balance in the fetus. Formation of
urine begins the week of 9-12. At 32 weeks, urine production
reached 12 ml/hour, at term 28 ml/hr. Fetal urine is a major
component of the amniotic fluid.
10. Systems immunology :
Systems immunology in early pregnancy fetal capacity to produce
antibodies against the antigen maternal or very bad bacterial
invasion. Since week 20 the immunological response of the fetus is
expected to start happening. Fetal Response assisted with the
transfer of maternal antibodies in the form of passive protection that
persisted until some time after delivery. IgM is mainly derived from
the fetus so that it can be used to determine the presence of
intrauterine infection.
11. Endocrine :
Thyroid is an endocrine gland endocrine first formed in the fetus.
Pancreas formed at week 12 and the insulin produced by the
pancreatic B cells. Maternal insulin can not cross the placenta so
the fetus must form its own insulin for glucose metabolism interests.
The fetus produces TSH - thyroid stimulating hormone since week
14 which causes the release of T3 and T4.
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