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How does intrauterine development of the fetus occur by week. Intrauterine development of the fetus: main stages

The human life cycle is a series of victories and defeats, joys and sorrows. And one of the most important achievements is the birth of a child. This is the moment when a person overflowing with happy emotions begins to feel significant and necessary. Children are the flowers of life that bring their part to the well-equipped life of their parents and make them relive the memories of their childhood.

The life of a baby begins from the moment of its conception, and, of course, it is very important for future parents to follow how the child develops in utero. The entire pregnancy consists of 40 weeks and is divided into 3 stages.

Stages of development

The stages of intrauterine development of a child in obstetric practice are usually called trimesters. This is a kind of division of the entire pregnancy into three identical periods, according to which the fetus is assessed, tests and ultrasounds are prescribed, and the pregnant woman is measured. The appearance of any physiological and psycho-emotional changes in the body of the expectant mother is typical for a certain trimester, and if they are not pathological, then they are considered the norm.

I trimester

It starts from 1 week and ends at 13. It is considered the most dangerous, since it is at this time that the fetal egg attaches to the wall of the uterus, if this does not happen, pregnancy does not occur.

Also at this time, the rudiments of future organs and tissues begin to form, so it is very important during this period to monitor your diet, take time to rest and be outdoors more often. At this stage, a woman can overtake such an unpleasant symptom as toxicosis. There is nothing to worry about if it is not very pronounced and protracted, in which case it is best to consult a doctor. Some women in the first trimester may experience the following changes:

  • violation of the taste perception of food;
  • frequent mood swings;
  • the appearance of drowsiness and headaches.

All this is often associated with a change in the hormonal background and the beginning of the preparation of the body for bearing and giving birth to a child.

II trimester

It starts at week 14 and ends at week 26. This trimester is characterized as the most calm and pleasant period of pregnancy. The intrauterine development of the child continues, and at the same time new sensations appear - this, of course, is the movement of the baby, which the expectant mother begins to clearly feel. In primiparas, this happens at a period of 18-24 weeks, and in multiparous ones, you can notice it starting at 13, because they have already given birth before and know what it is.

III trimester

It starts at 27 weeks and ends with childbirth. The safest intrauterine period of a child's development, but at the same time very hectic. The child is already almost formed and in case of premature birth is ready for independent existence. A pregnant woman begins to feel a sense of anxiety and fear, the frequent movements of the baby are more distinct and at some moments you can even notice how the stomach “walks with a shaker”. There are such unpleasant symptoms as heartburn and shortness of breath due to the pressure of the enlarged uterus on the stomach and diaphragm.

The physiological process of child development is usually divided into 3 periods:

ultrasound during pregnancy

Currently, ultrasound examination is necessary to assess

fetal life and detection of congenital malformations. In total, for the entire period of pregnancy, this procedure must be completed 3-4 times. The first time for a period of 12 weeks, the second - 21-24, the third time - at 32 weeks. During this procedure, the following is assessed:

  • intrauterine development of the child;
  • compliance with the gestational age;
  • weight and height of the baby;
  • its position in the uterine cavity;
  • the presence of congenital defects;
  • is there an entanglement with the umbilical cord;
  • the state of the placenta and amniotic fluid, as well as their number.

During pregnancy, there are no special changes in the body of a woman. During this period, the egg is fertilized by the sperm and the zygote is formed, which will actively divide and go into the uterine cavity.

2 month. The intrauterine development of a child in the second month is characterized by the fact that the baby is already forming legs and arms, and fingers on them. All internal systems develop and the heart begins to beat at a frequency of 140-150 beats per minute. The weight of the fetus is 4-5 grams, and the height is 2.4-3 cm.

3 month. This month ends The development of the child continues, and at the same time the vocal cords, tongue, hair and nails begin to form. The first rudiments of teeth appear in the oral cavity. The digestive and circulatory systems begin their work.

4 month. During this period, the baby becomes larger. All his organs and systems are actively working, and the child himself already knows how to bend and unbend his limbs, push with his legs. Of the special changes, one can note the development of the cerebral cortex, the auricles and the appearance of an individual pattern on the tips of small fingers, and the baby also becomes sensitive to external sounds.

5 month. All systems and organs continue to improve If we talk about the intrauterine development of a child by months, then the fifth month is perhaps the most memorable for a first-time pregnant woman. At this time, she can feel and feel the baby inside her. The lungs are still underdeveloped, so you should better monitor your health to avoid premature birth.

6 month. This month of pregnancy brings many changes in the development of the fetus. By this time, he had learned to open and close his eyes, on which cilia appeared, and on top of the eyebrows. The genitals are formed, and individual features are traced on the face. The baby weighs 750g at this time, and the height is approximately 30 cm.

7 month. During this period, the brain and lungs develop rapidly. There is more and more subcutaneous fat, so the skin is smoothed and there are less and less wrinkles on it. The growth of the baby this month is 33 cm, and the weight is about 1-1.2 kg.

8 month. During this period, the child significantly gains weight and increases in height. His skin is covered with thick hair, and the fat layer has become even larger. The baby begins to react violently to all external stimuli.

9 month. The final stage of the entire pregnancy. By this time, the child is fully formed and ready for independent existence. On his skin, the lanugo (fluff) completely disappeared, and she herself became smooth and pink.

During all periods of intrauterine development of the child, one should adhere to

A few rules and tips:

  • Review your diet and, if necessary, add foods rich in vitamins to it.
  • Do not overwork, sleep and rest is important for the full development of the child.
  • At the beginning of pregnancy, you should start taking folic acid, naturally, under the supervision of a doctor. Do not use other drugs without prescription.
  • If you have bad habits (alcohol, smoking), then you should give them up, because. they do not have a positive effect, rather the opposite.
  • Walk more often in the fresh air, but in no case be supercooled.
  • Sexual life with a partner can be continued if there are no contraindications.
  • Buy prenatal and postnatal bandage, it is very useful.
  • Clothing should be worn loose, not constraining anywhere, shoes should be with low heels.

Pregnancy is a very important period in the life of a woman and her significant other, so it is worth remembering every moment of this wonderful time and just enjoying it.

The human nervous system develops from the outer germinal lobe - the ectoderm. From the same part of the embryo, in the process of development, sensory organs, skin and sections of the digestive system are formed. Already on the 17-18th day of intrauterine development (gestation), a layer of nerve cells is released in the structure of the embryo - the neural plate, from which subsequently, by the 27th day of gestation, the neural tube is formed - the anatomical precursor of the central nervous system. The process of neural tube formation is called neurulation. During this period, the edges of the neural plate gradually fold upward, connect, and fuse with each other (Figure 1).

Figure 1. Stages of neural tube formation (in section).

When viewed from above, this movement may be associated with zippering (Figure 2).

Figure 2. Stages of neural tube formation (top view).

One "zipper" is fastened from the center to the head end of the embryo (rostral wave of neurulation), the other - from the center to the tail end (caudal wave of neurulation). There is also a third "zipper", which ensures the fusion of the lower edges of the neural plate, which "zips" towards the head end and meets the first wave there. All these changes happen very quickly, in just 2 weeks. By the time neurulation is completed (31-32 days of gestation), not all women even know that they will have a child.

However, by this time, the brain begins to form in the future person, the rudiment of two hemispheres appears. The hemispheres grow rapidly, and by the end of the 32nd day they make up ¼ of the entire brain! Then an attentive researcher will be able to see the rudiment of the cerebellum. During this period, the formation of the sense organs also begins.

Exposure to hazards during this period can lead to various malformations of the nervous system. One of the most common defects is a spinal hernia, which is formed as a result of improper “fastening” of the second “zipper” (impaired passage of the caudal wave of neurulation). Even erased, almost imperceptible variants of such spinal hernias sometimes reduce the child's quality of life, leading to various forms of incontinence (urinary and fecal incontinence). If a child has a problem such as enuresis (urinary incontinence) or encopresis (fecal incontinence), it is necessary to check if he has an erased form of spinal hernia. This can be found out by making an MRI of the child's lumbosacral spine. If a spinal hernia is detected, surgical treatment is indicated, which will lead to an improvement in pelvic functions.

In my practice, there was a case of a 9-year-old boy who suffered from encopresis. Only on the 6th attempt was it possible to make a high-quality MRI image, which showed the presence of a spinal hernia. Unfortunately, up to this point, the child had already been observed by a psychiatrist and received appropriate treatment, since neurologists disowned him, believing that he had mental problems. A simple operation allowed the boy to return to a normal lifestyle, to fully control his pelvic functions. Even more revealing was the story of a 16-year-old who suffered from encopresis all his life. Neurologists sent him to gastroenterologists, gastroenterologists to psychiatrists. By the time we met, he had already received psychiatric treatment for ten (!!!) years. No one ever ordered him an MRI scan. Due to the fact that our recommendations for additional examination were carried out, the guy was diagnosed with serious disorders in the lumbar spine, which led to compression of the nerves and a violation of the sensitivity of the pelvic organs. Obviously, psychiatric treatment, as well as psychotherapy or other methods of psychological influence in all these cases, are completely useless and perhaps even harmful.

To prevent the occurrence of such malformations as a spinal hernia, pregnant women are recommended to take folic acid already in the early stages of pregnancy. Folic acid plays the role of a protector of the cells of the nervous system (neuroprotector), and with its regular intake, the effect of various harmful factors is significantly weakened.

In order to minimize the risk of malformations, the expectant mother must also avoid various adverse effects on the body. Such effects include taking sedatives containing phenobarbital (including Valocordin and Corvalol), hypoxia (oxygen starvation), overheating of the mother's body. Unfortunately, certain anticonvulsant drugs also lead to adverse effects. Therefore, if a woman who is forced to take such drugs plans to become pregnant, she should consult with her doctor.

Throughout the first half of pregnancy, new nerve cells (neurons) are very actively born and develop in the future brain of the child. First of all, the processes of generation of new nerve cells occur in the area surrounding the cerebral ventricles. Another area of ​​the birth of new neurons is the hippocampus - the inner part of the cortex of the temporal regions of the right and left hemispheres. New nerve cells continue to appear after birth, but less intensively than in the prenatal period. Even in adults, young neurons have been found in the hippocampus. It is believed that this is one of the mechanisms due to which, if necessary, the human brain can plastically rebuild, restore damaged functions.

The newly born neurons do not stay in place, but "crawl" to the places of their permanent "deployment" in the cortex and deep structures of the brain. This process begins towards the end of the second month of pregnancy and actively continues up to 26-29 weeks of intrauterine development. By the 35th week, the fetal cerebral cortex already has a structure inherent in the adult cortex.

Each neuron has processes through which it interacts with other cells of the body.

Figure 3. Neuron. The long process is the axon. Short branched processes - dendrites.

Neurons that have taken their place in the brain try to establish new relationships with other nerve cells, as well as with cells in other tissues of the body (for example, with muscle cells). The place where one cell connects to another is called a synapse. Such connections are very important, because it is thanks to them that the brain forms complex systems in which information can be quickly transmitted from one cell to another. Inside the cell, information is transmitted in the direction from the body to the end in the form of an electrical impulse. This impulse provokes the release of specific chemicals (neurotransmitters) into the synaptic cleft, which are stored at the end of the neuron, and through which information is transmitted from the neuron to the next cell.

Figure 4. Synapse

The first synapses were found in embryos at the age of 5 weeks of intrauterine development. The formation of synaptic contacts between neurons is most active starting from 18 weeks of intrauterine development. New connections between nerve cells are formed almost throughout life. During the period of active formation of synapses, the child's brain is subject to the negative influence of narcotic substances and certain medications that affect the exchange of neurotransmitters. These substances include, in particular, antipsychotics, tranquilizers and antidepressants - drugs that treat mental disorders. If the expectant mother is forced to take such drugs, she should consult with her doctor. And, of course, a pregnant woman should avoid the use of psychoactive substances if she is concerned about the mental development of her child.

Neurotransmitters are specific chemical compounds that transmit information in the nervous system. Much of human behavior depends on their correct exchange. Including, his mood, activity, attention, memory. There are factors that can affect their exchange. One such adverse effect is maternal smoking during pregnancy. The impact of nicotine generates several effects at once. The brain recognizes nicotine as an activating agent and begins to develop systems that are sensitive to it. Simply, the number of elements perceiving nicotine in the brain increases, the transmission of information through nicotine improves. At the same time, there is a negative impact on the exchange of those neurotransmitters that should be produced by the brain itself. First of all, this applies to those substances that are related to the provision of attention and the regulation of emotions. Studies have shown that maternal smoking during pregnancy increases the risk of having a child with attention deficit hyperactivity disorder (ADHD) by several times. The second consequence of intrauterine nicotine use after ADHD is oppositional defiant disorder, which is characterized by such manifestations as irritability, anger, constantly changing, often negative, mood, vindictiveness. Another effect of smoking is a deterioration in the condition of blood vessels, malnutrition of the fetus. Children of smoking mothers are born with low birth weight, and low birth weight itself is a risk factor for the development of subsequent behavioral problems. Due to vasospasm caused by exposure to nicotine, the fetal brain is prone to ischemic strokes - impaired blood supply to certain parts of the brain, their hypoxia, which has a very detrimental effect on all subsequent mental development.

One of the most important processes occurring in the developing brain of an unborn child is the covering of the long endings of nerve cells (axons) with myelin (myelination). A myelinated axon is shown in one of the previous drawings (a drawing of a neuron). Myelin is a substance that is somewhat like the insulation that covers wires. Thanks to him, the electrical signal moves from the body of the neuron to the end of the axon very quickly. The first signs of myelination are found in the brain of 20-week-old fetuses. This process is uneven. The axons that form the visual and motor nerve pathways, which are primarily useful to a newborn baby, are the first to be covered with myelin. A little later (almost before birth), the auditory pathways begin to become covered with myelin.

The cells of one of the brain tissues - neuroglia, which produce myelin, are very sensitive to a lack of oxygen. Also, the myelination of the fetal brain can be affected by exposure to toxins, narcotic substances, a deficiency of the substances necessary for the brain from food (in particular, B vitamins, iron, copper and iodine), improper metabolism of certain hormones, such as thyroid hormones.

Alcohol is extremely harmful to the normal course of myelination processes. It interferes with myelination and, as a result, can cause severe mental development disorders, accompanied by mental retardation of the child. The impact of alcohol can also have a non-specific effect, leading to a variety of malformations.

About how intensively the brain of a child in the womb develops, at least the fact that in the period from 29 to 41 weeks, the brain increases almost 3 times! In many ways, this is due to myelination.

Relatively little is known about the mental development of a child in the prenatal period. At the same time, there are some interesting facts.

Starting from 10 weeks of fetal development, children suck their thumb (75% - right). It turns out that future right-handers, for the most part, prefer to suck their right thumb, and future left-handers prefer their left.

When exposed to sound on the abdomen of pregnant women (37-41 weeks of pregnancy) through headphones, significant activation was found in the temporal areas in four and in the frontal areas in one fetus - the same areas of the cerebral cortex that will subsequently take part in the processing of speech information. This suggests that the child's brain is actively preparing to exist in the environment that is intended for him.

Literature:

Nomura Y., Marks D.J., Halperin J.M. Prenatal Exposure to Maternal and Parental Smoking on Attention Deficit Hyperactivity Symptoms and Diagnosis in Offspring // J Nerv Ment Dis. September 2010; 198(9): 672-678.
Read original article >>

Tau G.Z., Peterson B.S. . Normal development of brain circuits // Neuropsychopharmacology reviews (2010) 35, 147-168
Read original article >>

Saveliev S.V. Embryonic pathology of the nervous system. - M.: VEDI, 2007. - 216 p.

Human intrauterine development lasts about 270 days. This is the time during which a child develops from a fertilized egg, ready for life outside the mother's body. Of course, a newborn baby is not yet independent - he needs constant mother's care, special food and conditions. However, during intrauterine development, a person reaches a certain level, which allows him to maintain his body temperature and the constancy of the internal environment.

Stages of intrauterine development

Prenatal development is a single process that goes according to the genetic program of our species. During this time, the future baby goes through several important stages of formation. The value of each of them is difficult to overestimate. Currently, scientists distinguish three stages of intrauterine development of a person.

The first of them is called preembryonic and lasts only about two weeks. The beginning of intrauterine development is the moment of fertilization of a mature egg. In the standard menstrual cycle, this event occurs the next day after ovulation, that is, on the 14th-15th day. Then, over the course of two weeks, the fertilized egg is repeatedly crushed, gradually moving along the fallopian tube to the uterine cavity and penetrating into the endometrium, the formation of fetal membranes. This stage of intrauterine development takes place separately from the mother's body. The embryo receives food from internal reserves. The fertilized egg receives the first nutrients only on the 6th-7th day of preembryonic development after implantation. This stage is critical for the embryo. In the first days, it becomes clear how genetically complete the fertilized egg turned out to be. More than a quarter of all pregnancies are interrupted at this time precisely because of the non-viability of the embryo itself or the unfavorable hormonal background of the mother's body.

The second stage of intrauterine development is called embryonic. Its duration is 7-9 weeks, starting from the 14th day after fertilization. During this time, the embryo from several cells turns into a complex multicellular organism. The baby in its intrauterine development repeats all the steps of the evolutionary formation of our species. During this period, the rudiments of all the most important organs and systems of the child are formed and even begin to function, the bones of the skeleton, trunk, head, upper and lower extremities are formed. In addition, the outer shells of the embryo also undergo changes. The most important organ of pregnancy, the placenta, is formed from the simplest trophoblast. Its role is to provide the baby with nutrients and oxygen from the mother's blood. A fully functioning placenta also performs a barrier function. It separates the blood flow of the mother and child, prevents the penetration of harmful substances, viruses, and many immune factors to the embryo. At the end of this stage of intrauterine development, the baby already has a silhouette similar to a newborn and begins to be called a fetus.

The next stage of intrauterine development is called fetal. It begins after 12-14 weeks of pregnancy and should end with the birth of a newborn baby. This time is characterized by the stable work of the placenta, the rapid growth of the baby, the further improvement of organs and tissues. The fetal stage should ensure the formation of functional systems that will support the independent life of the child after birth. In the last months before birth, adipose tissue accumulates especially intensively, the enzyme systems of the body mature, and the bones of the skeleton develop.

Intrauterine development normally ends in the period from 38 to 42 weeks of pregnancy. When exactly the baby is born depends both on its individual characteristics and on the mother's body.

Intrauterine development by week

Intrauterine development by weeks has been studied quite well. Obstetricians, ultrasound doctors, geneticists use the available information to control the development of the baby throughout the pregnancy. Intrauterine development by weeks is often of great interest to the expectant mother. Reading about the changes taking place with the child, a woman feels an even greater connection with him. Intrauterine development is very stable, especially in the early stages. This means that only after 28 weeks, the fetuses show significant differences in the size and degree of functional readiness of organs and systems. Before this period, babies of different mothers look and develop approximately the same. So, for example, at week 5, in all embryos, the laying of the liver, pancreas, heart and upper respiratory tract occurs. Already from the 6th week of intrauterine development, the baby's heart will beat. At week 9, the child's brain develops intensively. From the 10th week, milk teeth are laid and the external genitalia are formed. The genetic sex of the baby is determined even at conception, but only by the 3rd month the embryos begin to acquire obvious external differences. At the 11th week of intrauterine development, the fingers of the embryo actively develop, the iris of the eyes is laid, which determines their color. In a period of about 4 months, nails appear in the fetus, the bladder is actively functioning, intestinal peristalsis is going on. From the 26th week of intrauterine development, the baby begins to perfectly hear not only the sounds of the mother's body, but also the surrounding world. From 30 weeks, the child's pupils begin to respond correctly to light and darkness. By week 33, surfactant, a special substance that helps a person to breathe, should begin to actively form in the lungs. In the following weeks of intrauterine development, the nervous system is actively improved, and the child continues to prepare for the imminent birth.

Proper intrauterine development

Proper intrauterine development is provided by human genetics. This process is protected by a lot of mechanisms, but they sometimes fail. Not everything depends on future parents. However, preparation for pregnancy, adherence to the daily routine, proper nutrition of the expectant mother, a calm psychological background also largely determine the health of the baby. It is believed that, not yet born, the child perceives the emotions of the mother, reacts to them. The medical supervision of a woman is also important. The doctor can assess the intrauterine development of the child and give all the necessary recommendations.

Today we will discuss and show the intrauterine development of the fetus by weeks of pregnancy in the photo and video, we will analyze everything step by step and in great detail.

Pregnancy is a wonderful physiological process in the female body, which can be characterized by the development of an egg fertilized by a spermatozoon into an embryo, and then into a fetus.

The average pregnancy of a healthy woman lasts - about 9 calendar months or 10 obstetric. The development of any pregnancy is easier to view and track by trimester.

But it is no less interesting to consider in more detail and with a photo the intrauterine development of the fetus by weeks.

Embryo or fetus?

In obstetric practice, there are often two concepts that relate to the stages of bearing an unborn child - “embryo” and “fetus”. How are they different and what is the difference between them?

Intrauterine development of the fetus is divided into stages:

  1. Embryonic- which lasts for the first 8 weeks of pregnancy. Because of its small size and relatively unlike human appearance, the embryo in the womb is called an embryo.
  2. Fetal- lasts from the 9th week of pregnancy until the very moment of childbirth. The baby is already more formed and looks like a little man, it is called a fetus.

The genetic material laid down in the unborn child by the father and mother will directly affect the development of the embryo, and the first trimester of pregnancy and the condition of the mother will have a subsequent impact on the fetus.


baby development from embryo to fetus week by week

1-10 weeks

1 Week

If we talk about the first week of pregnancy, you need to clarify what is taken as the main reference point. In gynecology, however, more often they are guided by obstetric terms.

The first few days after conception, even with multiple pregnancies, the expectant mother does not feel any characteristic signs. This is the time when the menstrual cycle should begin.

The level of hCG is within the normal range and is (5 IU / ml for non-pregnant). In the first week, pregnancy tests are unlikely to show the coveted 2 strips. Since it is precisely by focusing on the level of hCG that pharmacy tests react.

2 weeks

The period is characterized by the maturation of the zygote in the uterus or fallopian tube. And if everything goes well, the pregnancy will take place.

After conception, the fertilized egg attaches to the wall of the uterus.

If the attachment has passed, then there may be discharge indicating this event and the appearance of the embryo. They are similar in texture to egg white, and can sometimes be bloody.

If the discharge at week 3 is similar in color and consistency to menstruation, then this is not the norm and you should consult a doctor.

3 week

The third week is the starting point in a woman's pregnancy, it is after her that one can say whether conception has occurred. The embryo is so small that its size does not exceed 0.15-0.2 mm in length, and weighs 2-3 micrograms.

If the sperm does not fertilize the egg, it is possible that menstruation will begin a couple of days ahead of schedule. This will be easy to notice if you keep a calendar.

Abundant discharge in the third week can be the cause of a miscarriage.

4 week

The fetus at the 4th week of pregnancy is actively developing and a pregnant woman can feel changes in her body. Many note a strong swelling of the breast, the nipples become bright and acquire special sensitivity. Menstruation does not occur, but sometimes some pregnant women may observe scanty discharge, which should not disturb her.

This time of fetal development is especially dangerous with excessive physical activity, weight lifting. There is also a risk of complications for the embryo in infectious diseases, which are most often accompanied by high fever. The abuse of alcohol and cigarettes is also dangerous. It is better to exclude them completely.

So far, the level of hCG increases only in the blood. And on ultrasound, you will most likely notice a yellow jelly-like body that provides nutrition to the embryo until the placenta begins to fully fulfill its protective functions. Progesterone, the hormone of pregnancy, is actively produced.

The size of the embryo in length is about 2-3 mm.

5 week

At this stage of pregnancy, the size of the uterus changes. At the stage of examination by ultrasound, a qualified specialist can tell about the presence or absence of a multiple pregnancy.

Changes in the body of the expectant mother become noticeable and even more tangible. Many women notice a slight increase in temperature and weakness. But if your condition is more like a cold, see your doctor immediately.

6 week

At this stage, the pregnant woman begins to actively show signs of future motherhood. The uterus of a pregnant woman at 6 weeks is the size of a plum. If you go to the gynecologist, he will already be able to probe it.

If you are pregnant with twins, then an ultrasound at this time will show the presence of two fetal and yolk sacs. At the 6th week of pregnancy, the examination will show small tubercles on the embryo - this is the place for the development of future limbs. It is already possible to listen to the heartbeat of the embryo on a special apparatus. The embryo is no more than 4-9 mm long, and weighs no more than 0.2 - 0.8 grams.

7 week

Important changes are taking place this week. The heart of the embryo becomes already four-chambered, and the main large blood vessels are also formed.

The first trimester can be characterized by the continuation of the development of vital internal organs and other systems of the embryo's body. It weighs about 1 g, and the size from the coccyx to the crown is no more than 13 mm.

The unborn child, although slowly, begins to straighten up. His brain begins to develop very rapidly.

The face of the crumbs is being improved, the upper limbs are being laid. The umbilical cord of the embryo completes its formation, a mucous plug forms.

8 week

The fetus begins to move and increase significantly. Its length is 14-20 mm. The face of the crumbs acquires every day more and more human features familiar to us.

The laying of the main vital organs and systems is gradually being completed. And some are already active. The optic nerve gradually emerges in the embryo, and the appearance of the rudiments of future genital organs can also be observed.

9 week

The embryo reaches a length of no more than 22-30 mm, and its weight is still so small, about 2 g. At this stage, the cerebellum and pituitary gland are actively forming, the middle layer of the adrenal glands is formed, the lymph nodes are born, as well as future genital organs.

Formed limbs begin to move slowly, learn to bend, the first muscle fibers appear. The embryo develops the ability to subsequently urinate.

10 week

The embryo weighs about 5 g, and its length is about 30-40 mm. A heart-born little man beats at a speed of 150 beats per minute. The limbs of the baby are formed, and sometimes fingers can already be seen on the ultrasound images. In the crumbs, most of the digestive tract organs have already formed.

At week 10, the foundation is laid for the formation of subsequent milk teeth. This obliges the expectant mother to keep her food calendar, as well as mark each consumption of a dairy product in it.

11-20 weeks

11 week

The fetus weighs about 8 g at week 11, and its “growth” is about 5 cm. Starting from this moment, the former embryo gradually grows and passes into the fetal stage.

His little heart is already working fully, the vessels and circulatory system are completing their formation. The placenta around the fetus becomes very strong and dense. The liver of the crumbs occupies about 10% of his body. The intestine is already trying to make the first movements, reminiscent of peristalsis.

genital organs are formed. The color of the eyes of the fetus is laid and the sense of smell already appears. The fingers and palms of the crumbs acquire sensitivity.

12 week

The most important stage in the development of the fetus. Critical moments are more dependent on the lifestyle of the expectant mother and her health, eating behavior. The little body is no more than 6-9 cm in length.

But at the same time, the future baby already has all the fingers and toes, and the organs of the gastrointestinal tract are actively formed. The immune system improves and begins to function.

13 week

The critical cycle ends and the expectant mother will become easier. Her baby has future milk teeth. All systems evolve and continue to improve. Muscle and bone tissue slowly builds up.

The sex organs are already differentiated. The length of the fetus at week 13 reaches 8 cm, and the weight is still very small - 15-25 g.

14 week

At this wonderful stage, you can already determine the sex of the child. The baby is actively developing and has already grown from about 8 to 10 cm, and weighs about 30-40 g. Every day the fetus looks more and more like a little man.

The bones of the fetus are getting stronger, the skeleton is gradually growing, ribs are already beginning to form. The movements of the diaphragm of the crumbs are more and more reminiscent of respiratory ones. The baby already has a Rh factor and a blood type, as its composition is gradually stabilizing.

15 week

In the fetus at this stage, the cerebral cortex begins to form. This is a lengthy process that will take up most of the entire 2nd trimester. The endocrine system of a small organism starts to work. The sebaceous and sweat glands begin their activity.

At week 15, the fetus has already formed taste buds, but the respiratory system is still improving.

The baby weighs about 70 g, height is around 10 cm. At this stage, even if you have a multiple pregnancy, their size does not interfere with free movements either for you or for the babies.

16 week

During this period, the baby is no more than 11 cm tall, and it weighs about 120 g. The baby's neck has already taken a steady, even position, the head turns freely.

Ears and eyes are still in an unusual place, but gradually begin to rise up. The liver of the crumbs begins to take over its functions.

Under the condition of multiple pregnancy, the expectant mother can feel the movements of the children, who are becoming more active.

17 week

The immune system of the baby is included in active work, interferon and immunoglobulin begin to be produced. The kid is already becoming able to provide protection from various infections coming from outside. But still, microbes can be critical for such a fragile organism.

At the 17th week, the crumbs appear, albeit not a large, but fatty layer. The girl has a uterus. The length of the fetus is no more than 13 cm, and weighs about 140 grams.

The baby is already able to capture sounds, feel emotions. Therefore, try to make sure to establish contact with the baby. Talk to him, stroke his tummy, sing songs. This is extremely important for establishing a bond between the expectant mother and the baby.

18 week

The immune system and the brain are actively developing at this stage, adipose tissue continues to accumulate. In the fetus, the formation of the rudiments of molars can be seen. Height is about 14 cm, weight - 200 grams, like a pack of butter.

In the crumbs, a clear reaction to light appears, hearing is noticeably enhanced.

19 week

At this stage, there is a sharp and significant jump in the formation of the fetus and its development. His movements can be called more meaningful and orderly. The respiratory organs are improved and developed. The body of a tiny baby is covered with the so-called primordial lubrication.

The head of the crumbs begins to rotate freely, he can hold it in a fixed position. The fetus weighs about 250 g at week 19, and growth does not exceed 15 centimeters.

20 week

The fetal heartbeat can already be heard with an ordinary stethoscope. The limbs of the baby are fully formed and visible on ultrasound. For the baby, the sounds become more audible. The fruit is about 25 cm long and weighs about 300 grams. Movement is already felt in the tummy.

21-30 weeks

21 weeks

The growth of the fetus at this stage does not exceed 26 cm, and the weight is 360 grams. The digestive system of the tiny man is much more active than before. He often swallows amniotic fluid. Gradually grows and strengthens muscle and bone tissue. The spleen is connected to the organs that work independently.

22 week

This week the baby weighs about 400 grams. Growth can reach up to 28 cm. The fetus is already quite viable, even in case of premature birth.

His brain and spinal skeleton are already fully formed. Reflexes continue to develop. The heart of the crumbs increases significantly in size.

23 week

By this period, the fetus is already quite well formed, its digestive organs work independently. While slowly, but adipose tissue accumulates. The sex organs can be easily distinguished.

The growth of the baby can reach 28 cm, and weight - 500 g. The spleen becomes more active.

24 week

Outwardly, your fetus is already quite similar to a newborn baby. Due to the lack of a large amount of fat, the baby weighs only about 400 - 600 g with a height of 23-30 cm. But from the 24th week, your fetus will begin to produce growth hormone on its own, which will allow you to gain weight faster.

The respiratory organs are moving to their final stage of development. Reflexes develop very quickly, all sense organs are improved. The baby is already developing a sleep and wakefulness regimen. He begins to feel and respond to the mother's emotions. Fetal movements become more sensitive for the expectant mother.

25 week

Your fetus this week weighs about 700 g, and the growth of a tiny man is about 34 cm. Every day he becomes more and more like a newborn.

Your baby's lungs are getting ready to take their first breath.

The sense of smell at this stage is very well developed, and the baby feels even slight mood swings of the mother and can react to them. The bone skeleton develops and begins to grow more and more actively with muscles. Boys develop testicles and girls develop vaginas.

26 week

An extraordinarily wonderful week of pregnancy. Your baby, being in your tummy, is already acquiring its own individual characteristics and is even able to recognize the voices of its parents. Therefore, try to talk with the baby more often, read to him.

The eyes gradually open. The skeleton of the baby is noticeably strengthened. His lungs are not yet fully formed, but are already taking their final shape.

The baby's brain begins to produce various hormones. The weight is approximately 750 g, but the height reaches approximately 36 cm. During this period, the baby sleeps a lot, for 16-20 hours. His movements can be seen.

27 week

The baby weighs about 900 g. Every week there is an active growth and build-up of muscle mass and subcutaneous fat. The endocrine system of a tiny human begins a new phase of its activity.

At this stage, the stability of his pancreas is important. After all, it is she who affects the development of all metabolic processes, as well as his mental abilities. The production of surfactant in the lungs gradually stabilizes.

Mom every day feels the development of the baby more and more.

28 week

The bones of the crumbs are still getting stronger. Alveoli gradually appear in the baby's lungs. The weight of the crumbs can reach 1 kg. And the growth is already at around 38 cm. Having become so large, he begins to realize his cramped position in the mother's uterus, but at the same time, bright activity does not appear.

29 week

At this stage, the baby can already do a lot. If you shine a flashlight through the belly, he will notice the light and follow it, this indicates that the eyes are gradually gaining the ability to focus. He has already arranged heat exchange and regulation, the work of the immune system is being debugged.

The skin of the baby becomes lighter, the folds are gradually smoothed out due to the fact that there is more subcutaneous fat. Muscles are actively growing.

30 week

At this stage, a tiny baby weighs no more than 1.3 - 1.5 kg. His nervous system starts to activate. The liver is preparing to carry out its functions. A girl's heart will beat faster than a boy's.

The eyes of the crumbs at this time are open, and the movements become more calm and meaningful. Most often, at week 30, the fetus takes the position from which it will subsequently be born. Therefore, it is worth monitoring his movements so that he takes the correct position.

31-40 weeks

31 weeks

At this time, the baby reaches a weight of no more than 1.5 kg. His internal organs are actively learning to work independently. The liver can already cleanse the blood on its own.

Surfactant, that is, a mixture of surfactants that lines the inside of the lung alveoli, is still being produced. Gradually, the connection of the brain with peripheral nerve cells is established. If the baby decides to touch his eye, then he will definitely close his eyes.

32 week

This is the phase when the baby is actively growing and continuing its development. The organs and systems of his body are establishing their full-fledged work. The baby is becoming more and more like a familiar newborn.

The baby in this period finally takes the head presentation. His Skull is still soft.

33 week

During this period, the baby weighs up to 2 kg. He is already continuing to build up his muscles, getting stronger and forming a fatty layer. His body becomes more proportional, the limbs are slightly lengthened.

The baby is already even able to express his emotions, and many systems of his body are fully functioning. The child is able to express emotions. The kidneys are just preparing for the main function in the future - the ability to filter.

34 week

These days, the development of the baby is almost completely completed. The facial features of the crumbs acquire individual characteristics and become clearer. The baby is actively developing and improving gastrointestinal functions.

35 week

This week is characterized by activity in the growth of both muscle and adipose tissue by the infant. Weekly, the baby continues to gain about 220 g. His skin is completely freed from lanugo, and his shoulders are rounded.

36 week

The body of the crumbs, growing stronger every day, continues the path of improvement. In his already formed liver, the process of iron accumulation is underway. All systems of the body continue to be debugged for flawless operation. The baby is actively moving in the womb, sucking a finger, preparing for the first time to attach to the mother's breast. By 36 weeks, most pre-birth babies lie head down.

37 week

The baby in the womb has formed, as all the vital organs are ready for independent work. The stomach is ready to take food, the heat exchange process is well established. The lungs are ready to take the first breath outside the mother's body. The baby continues to grow stronger and gain weight.

38 week

The baby is formed and ready to be born. In boys, the testicles at this time gradually descend into the scrotum. The skin of babies at 38 weeks acquires a pleasant pink tone.

39 week

Your baby is already fully developed and is often born exactly at 39 weeks, without waiting for the due date. All organs of the baby are fully suitable for independent functioning. The baby reacts to light stimuli and is very sensitive to sounds. The skin is completely cleansed of the original lubrication.

40 week

At the fortieth, final week, the baby is fully formed and ready to be born. His height is already about 49-55 cm, and his weight is from 2.5 to 4 kg. Everything will depend not only on how you ate during pregnancy, but also on genetics.

41-42 weeks

Sometimes the pregnancy lasts more than 40 weeks, the baby is already overdue. At this time, they resort to artificial stimulation of childbirth.

All stages of pregnancy and fetal development from conception to birth video

Knowing how your baby is developing in your tummy is a must. So you can protect yourself from possible complications. Do not forget to regularly visit the gynecologist as well. An experienced doctor will help determine possible deviations during pregnancy and prevent complications.

periods of childhood.

Child education

Age periods are life spans of time within which the process of growth and development, as well as the morphological and functional characteristics of the organism, are identical. When characterizing each age period of childhood, the laws of growth and development are evaluated; morphofunctional state of organs and systems; features of the central nervous system (CNS), neuropsychic development; leading lines of development; features of the endocrine system; immunological features; the main nature of the pathology characteristic of this age period; infectious agents of diseases; the most unfavorable factors affecting the child's body; creating conditions for harmonious development, taking into account the age and principles of raising children. Thus, the allocation of individual age periods contributes to a differentiated approach to the child.

In the process of development of the fetus and child, there are still critical periods in relation to growth and development, maturation and formation of the functions of organs and systems.

According to the 1999 International Convention for the Protection of the Rights of the Child, children are human individuals from birth to 18 years of age. The following age periods are distinguished:

I. Prenatal period - from the moment of conception to the birth of a child. It lasts 280 days (10 lunar months), starting from the first day of the woman's last menstrual cycle.

II. The neonatal period is from the moment of ligation of the umbilical cord to the 28th day of life. Within its limits, there are: early neonatal period - until the end of the 7th day (168 hours in total); late neonatal period - from the 8th to the 28th day of a newborn's life; perinatal period - from the 24th week of pregnancy until the end of the first week after birth.

On the recommendation of WHO experts (1960), it was calculated from 28 weeks of intrauterine development until the end of the first week after birth. Currently, the perinatal period is calculated from the 24th week of pregnancy, since studies have shown that from 23-24 weeks of gestational age, the child is viable out of utero with the improvement of modern methods of nursing premature newborns.

III. The period of infancy - from the 29th day of a child's life to 1 year.

IV. The period of early childhood - from 1 year to 3 years.

V. The period of preschool age - from 3 to 7 years.

VI. The period of primary school age is from 7 to 11 years.

VII. The period of senior school age - from 12 to 17-18 years.

prenatal period

The intrauterine period is the most important period that determines the biological fate of the human body for subsequent years, the state of health, adaptive reactions, and the risk of developing diseases. Currently, we can talk about the increasing importance of deviations in the health of the fetus in the formation of human diseases. Hence the great importance of perinatal diagnosis, and the fetus acts as a patient. For a direct assessment of the study of the functional state of the fetus, a biophysical profile, monitor control of the fetal cardiac activity, a study of uteroplacental and fetal-placental blood flow are used; synchronous study of computerized intervalogram of mother and fetus.

The definition of the biophysical profile includes fetal sucking movements, swallowing, sleep and purposeful movements, reflexes.

Characterized by rapid growth and tissue differentiation of the fetus. At a period of 8 weeks, the rudiments of all major organs and systems were formed. From the 4th week, the heartbeat in the embryo is determined, at the 8th week a muscular reaction is observed in response to stimulation, by the 9th week the palms and soles become reflexogenic, spontaneous intestinal motility is noted. The fetal circulatory system reaches its final development between 8 and 12 weeks of gestation. By 12 weeks, the cerebral cortex is determined. By 13–14 weeks, smooth movements appear in response to stimulation of various zones. At the 14th week, swallowing movements begin. By the 17th week, a grasping reflex appears. At the 18th week, respiratory movements are noted. From the 20th to the 28th week, bone marrow hematopoiesis is established (instead of the hepatic one). From 28–29 weeks, the fetus can actively suckle.

By the end of the second trimester of pregnancy, the fetal weight is 1000 g, and the body length is 35 cm, and by the end of pregnancy, the body weight is 3200–3500 g, the body length is 48–50 cm or more.

Critical periods for growth and development:

    the first 7-9 days - the period of egg implantation;

    3–12 weeks - early fetal period - intensive growth and tissue differentiation of the fetus;

    after 28 weeks and before the onset of labor - the late fetal period, when exceptionally rapid growth and accumulation of cell mass are noted; the processes of deposition of many nutritional components are provided: depot of calcium, iron, fluorine, copper, vitamins D and B12. During the same period, the maturation of the surfactant in the respiratory organs occurs. At this time, there is a high level of passive immunity, maturation of enzyme systems, non-specific factors of body defense.

The development of the fetus is determined by the functional system mother-placenta-fetus; these are nervous, humoral, immune connections (direct and reverse).

The main factors that determine and regulate fetal growth are uterine blood flow and placental perfusion. A special role is played by insulin, pituitary hormones. One of the main factors that ensure the normal development and growth of the body before birth are hemodynamic processes in the functional system mother-placenta-fetus. With the help of a Doppler study, the fetal heartbeat can be determined from 10-12 weeks of pregnancy.

Features of the CNS of the fetus. The growth rate of the brain up to the 33rd week exceeds the growth rate of other systems and organs, especially the rapid increase in brain mass in the last weeks before birth. The maturation of the cerebral cortex occurs at the 12-16th week. On the 12th week, the time of appearance of electrical impulses in the respiratory centers in response to external stimuli is noted. From the 13–14th week, smooth graceful movements of the fetus are recorded in response to stimulation of all zones, with the exception of the areas of the back, occiput, crown. From the 17th week, grasping reflexes of the hands are formed and well developed. By 27 weeks, the influence of motor activity and emotions of the mother on the fetus was recorded. By the 28th week, the motor-cardiac reflex matures in the fetus, and by the 32nd week, the fetal reaction to the sound transmitted through the abdominal wall by changing the pulse rate is recorded.

The critical period of brain maturation is the time when electrical shifts appear in the cerebral cortex and its responses to external stimuli - 12–16 weeks.

The electroencephalogram of the fetus from 5 months is of the same type and intermittent. From 7 months, interzonal differentiation is observed. From the age of 8 months, the EEG acquires a continuous character, then qualitative differences between sleep and wakefulness appear.

Regulation of fetal motility and posture. The main significance of the spinal level of reflex activity is to ensure the posture of the fetus. Starting from the 9th week, impulses from skeletal muscle receptors were noted. From the 20th to the 40th week, a rapid increase in the cerebellum (12 times), the regulation of motility and posture. The cerebellar cortex is directly involved in the regulation of the general level of fetal activity, spatial orientation, modulation of the autonomic nervous system, providing adaptive behavior in the external environment of the newborn.

Features of the endocrine system of the fetus. There is a predominance of adrenal function. The cortical zone of the adrenal glands is very wide, the fascicular zone is indistinctly expressed; the adrenal medulla is not detected - this is the so-called embryonic type. From the 25th week, the fetus forms corticosteroids from its own substrates.

Insulin is determined in the b-cells of the pancreas by the 12th week, its synthesis increases by the middle of the intrauterine period, and the concentration of insulin in the blood of the fetus does not differ from that in the blood of the mother.

Insulin and somatomedins under the influence of the growth hormone of the pituitary gland determine the growth of the fetus. The pituitary gland is laid in the embryo at the 4th week, and from the 9th–10th week, traces of adrenocorticotropic hormone (ACTH) are determined. Pituitary growth hormone through insulin-like growth factors affects metabolism and growth.

The thyroid gland by the 4th month is structurally formed, functionally active and does not differ from adults in terms of intrathyroid iodine metabolism. The regulation of the fetal thyroid gland is carried out by the pituitary gland's own thyroid-stimulating hormone, since the mother's analogous hormone does not penetrate the placental barrier.

The functional pituitary-adrenal-hypothalamus system has been formed in the fetus since 27 weeks. Thanks to this system, the fetus is able to respond to stressful influences.

Features of fetal immunity. Passive immunity - transfer of maternal IgG through the placenta from the 26th week. Synthesis of fetal immunoglobulins is limited, enhanced in the presence of antigenic stimulation. The ability to independently synthesize IgM and IgG appears from 3 months of gestation, IgM from 7 months; IgE from 11 weeks in the lungs and liver; from the 21st week - in the spleen. The first B-lymphocytes appear at 7-8 weeks, and by the 14th week their number in the blood of the fetus reaches the level of an adult. The first T-lymphocytes are formed at 10-11 weeks. By the time of birth, their number is higher than that of an adult. From the 6th week, HLA antigens begin to be typed - an individual constitutional "portrait" is created.

Nonspecific factors of fetal resistance. The synthesis of lysozyme by the fetus was recorded from the 9th week, by the time of birth the level of lysozyme exceeds the level of an adult. The content of properdin in the fetus is low, it increases rapidly during the first week of a newborn's life. The formation of the complement system in the fetus was noted at 8–15 weeks; by the time of birth, the total complement level is 50% of its level in the mother's blood; By the end of the first week of a child's life, the amount of complement is rapidly increasing. Leukocytes throughout the fetal period and obtained from the umbilical cord blood of newborns have a low ability to phagocytosis and low mobility. The first peripheral lymphatic glands are formed starting from the 3rd month of gestation, their "settlement" with lymphoid elements occurs during the 4th month.

Lymph glands and formations of the gastrointestinal tract are formed after the 21st week.

Neuropsychic activity of the fetus. In the works of the end of the 20th century, arguments are given in favor of the presence of a kind of neuropsychic activity of the fetus already in the third trimester of pregnancy. The auditory and vestibular system of the fetus structurally matures by the 6th month of pregnancy. It has been proven that the fetus is able to perceive especially intonations of sounds, while more frequent repetitions of phonetic stimuli are necessary. The fetus reacts to the mother's voice, musical melodic sounds, which is fixed by an increase in heart rate, characteristic of the motor-cardiac reflex; at the same time, positive and negative reactions to tones were noted. The aforementioned hypothalamus-pituitary-adrenal system of the fetus, which is able to respond to stressful influences, plays a role.

The most informative indicators of developmental disorders of the fetal central nervous system were revealed. The main ones are the duration of the intermediate and calm state of the "activity-rest" cycle, the magnitude of the motor-cardiac reflex and oscillations of the fetal heart rate in the active state of the "activity-rest" cycle, as well as the features of the respiratory movements of the fetus.

With regard to the development of the neuropsychic activity of the fetus, the mother-child system is of great importance. The impact on the fetus and its development is carried out indirectly through the body, psyche, perception, lifestyle and activities of the mother, as well as through the genetic code. It is believed that acoustic stimulation to which the fetus is exposed at the end of pregnancy leaves a trace of a reaction in the nerve cells, which is the basis for the development of short-term memory.

Lack of maternal feeling, distortion or insufficiency of it are the most common source of stress for a child at the antenatal stage of development. Already at the stage of intrauterine development, the most important role of the mother and family in the rational development of the child is undeniable. The system of prenatal education involves the correction of the psycho-emotional state of a pregnant woman and the upbringing of a child, starting from intrauterine development.

Preventive measures. The task of active protection of the fetus is one of the most important goals during fetal development. This goal is achieved by influencing the fetus through the mother's body. It has been established that already from 5–5.5 months of intrauterine life, the taste, auditory, vestibular, tactile and other analyzers can function in the fetus, which makes it possible to begin prenatal education of the unborn child. This is a restructuring of the family's way of life with a constant focus on the interests of the expected child, love for him and kindness.

The mode of a pregnant woman is important: sufficient sleep, walks, hygienic gymnastics. A special role is played by motor activity, walking. The life support processes of the fetus depend on the motor activity of the pregnant woman (energy rule of skeletal muscles). A decrease in muscle activity is combined with a decrease in impulses in the central nervous system, the respiratory muscles of the fetus. Creative contact of mother and father with the fetus, conversations with him, affectionate singing are necessary. It is noted that the head of the child in the womb moves behind the hand of the father, stroking the belly of the pregnant woman. Melodic music plays a huge role. Examples of a differentiated relationship of the fetus to music in the third trimester of pregnancy are described: the music of Mozart, Vivaldi, Tchaikovsky calms the fetus; rock music works badly. The melodic singing of the mother calms the fetus, as well as the singing of the parents in a duet. A pregnant woman needs to give up television horror films and programs containing violence and cruelty. A pregnant woman should follow the recommendations for a balanced diet.

Of great importance is the preparation of the mammary glands for lactation.

The possible nature of the pathology in the prenatal period. Exposure to adverse factors in the embryonic stage (before the 8th day), especially viruses, radiation leads to chromosomal and gene abnormalities or death of the egg; in the embryonic (from the 8th day to 9-10 weeks) to a violation of organogenesis: deformities, congenital malformations.

Maternal diseases and toxic effects (smoking, alcohol, drugs) in the embryonic stage (11–12 weeks) can lead to intrauterine growth retardation, CNS damage. Under the influence of unfavorable factors in the early fetal stage (up to 28 weeks), there may be a delay in the growth and differentiation of organs and tissues: their hypo- and dysplasia; prematurity; and in late fetal (after 28 weeks) - insufficient formation of a depot in the body of the fetus: fat, protein, vitamin (D, B12) and mineral - calcium, iron, copper, selenium. During this period, there may be premature birth and functional immaturity of the fetus.

One of the most common syndromes of the perinatal period, which directly affects the physical, neuropsychic development and morbidity of the infant, is intrauterine growth retardation (IUGR). According to WHO, in European countries, IUGR occurs in 6.5%, and in Central Asia - up to 31%.

Hypoxic damage to the brain plays an important role in the pathology of the prenatal period, as well as a decrease in the number of brain glial cells in case of malnutrition of the pregnant woman. Nutritional deficiencies in folic acid, zinc, copper and other essential nutrients are especially dangerous.

An unfavorable effect on the development of the fetus is exerted by exogenous toxicants, especially salts of heavy metals, leading to metabolic disorders and damage to the organs and systems of the fetus. Magnetic resonance imaging provides almost 100% accuracy in visualizing the state of the fetal central nervous system and its anomalies.

Fetopathy can be caused by hormonal disorders of the mother: diabetes mellitus, hypothyroidism, adrenal insufficiency.

One of the leading places in the formation of fetal malformations belongs to the group of infectious pathogens: rubella, cytomegaly, toxoplasmosis and herpes viruses. A test for antibodies to rubella, cytomegalovirus and toxoplasma is mandatory.

When the fetus is infected before 5-6 months of pregnancy, a generalized process usually develops with a predominance of damage to the central nervous system, liver and kidneys. With later infection, and especially when infected immediately before birth or during childbirth, infectious diseases develop, such as pneumonia, pyelonephritis, otitis media, conjunctivitis, etc.

Children with manifestations of intrauterine infection (IUI) have prolonged jaundice, decreased muscle tone, motor activity and sucking reflex, significant initial weight loss and its slow recovery, repeated weight drops, a “flat” weight curve, and subfebrile body temperature. Tests for determining serum concentrations of C-reactive protein (CRP), interleukin-8 and prealbumin have the maximum diagnostic information in IUI of bacterial etiology [Volodin N. N. et al., 2001]. Elevated concentrations of CRP and IL-8 in the blood serum are regarded as the presence of systemic inflammation and are the basis for starting antibiotic therapy in newborns.

Currently, prenatal diagnosis in the I and II trimesters of pregnancy is of great importance. probes) in 85–95%, monogenic diseases of more than 50 nosological forms (Ailamazyan E.K.), gene diseases - cystic fibrosis, hemophilia A and B, von Willebrand disease, myotonic dystrophy, Duchenne myodystrophy.

The fetus acts as a patient in cases of fetosurgery, with hemolytic disease. The first successful attempts were made to treat human fetal brain tissues, using neurotransplantation of brain stem cells. Preclinical detection and treatment of phenylketonuria, galactosemia, and hypothyroidism is of great importance. Medical correction of defects in adrenogenital syndrome, hemophilia, and diabetes is successfully carried out. Prospects - in gene therapy.

Neonatal period

The neonatal period is the first 28 days of a baby's life, or four weeks. This is the most crucial period for the adaptation of the child to the conditions of the external environment. It is very important, according to WHO experts, to implement procedures immediately after birth that strengthen the bond between mother and newborn:

    put the baby on the mother's stomach;

    give the newborn a mother's breast in the ward of the maternity ward;

    ensure the coexistence of mother and child.

Distinguish between the early neonatal period - from the moment of tying the umbilical cord until the end of the 7th day of life (168 hours in total) and the late neonatal period - from the 8th to the 28th day of a newborn's life.

In the early neonatal period, the following periods of the greatest tension of adaptation reactions are noted: the first 30 minutes of life - acute respiratory-hemodynamic adaptation; period from 1 to 6 hours - synchronization of the main functional systems; on the 3rd–4th day of extrauterine life - intense metabolic adaptation due to the transition to a lactotrophic type of nutrition and anabolic type of metabolism.

In the late neonatal period, further adaptation to environmental conditions occurs. The most important criteria for the child's well-being during this period are the dynamics of body weight and growth, neuropsychic development, and the state of sleep. To assess physical development, the mass-height index (Quetle 1) or the Tour index is used - the quotient of dividing body weight in grams by body length in centimeters. The value of the mass-height index for healthy newborns ranges from 50 to 60.

The body weight of newborns on average in girls is 3200–3350 g, in boys 3400–3500 g, body length is 50–51 cm.

Features of growth and development. After birth, there is a physiological loss of body weight (by the 3rd–5th day of life) of the newborn by 6–8% of body weight at birth, and by the 6th–7th day of life - recovery. By the end of the first month of life, weight gain averages 600 g or 20% of body weight at birth. An increase in body length during the first month of life occurs by 3 cm. The head circumference of a newborn is 34–36 cm, chest circumference is 32–34 cm; leg length - 36–40% of body length. Spontaneous movements of the newborn have a positive effect on adaptation to environmental conditions, on the respiratory, circulatory and heat production organs; in this regard, it is important not to limit them.

Features of the CNS. The mass of the brain of a newborn is 10% of the total body mass. Large furrows and convolutions of the brain are well expressed, but have a shallow depth. There is insufficient differentiation of the cerebral cortex, the presence of unconditioned reflex reactions. Reactions to pain stimulation are of a general generalized nature. A newborn has 10 times more cold receptors than heat receptors, and therefore the child's sensitivity to cooling is higher than to overheating. The predominance of the food dominant is characteristic.

The cerebellar cortex is involved in the processing of sensory information, spatial orientation.

Within 2-3 days, the newborn has an increased level of non-opiate peptides - mediator neuroamines (neurotensin, substance P, bombensin), involved in the regulation of a number of hormones of the gastrointestinal tract, pancreas, and sympathetic-adrenal system.

The newborn has developed gustatory and olfactory analyzers. The taste threshold is higher than that of an adult.

During the neonatal period, there is an intensive development of auditory, visual analyzers; tactile and emotional contact with the mother. An important role is played by the presence of a congenital orienting reflex of the newborn - the development of positive emotional orienting reactions from auditory and visual analyzers.

The newborn has inborn reflexes: search - a reflex of searching for the mother's breast; sucking and swallowing; prehensile. The newborn has a reflex of support on the legs and automatic walking (stepping). With a normally expressed walking reflex, the legs do not give way and do not cross. By 1–1.5 months of a child's life, this reflex fades. Reflex turn of the head to the left or right when the child is on the stomach, arms along the head. The newborn has a crawling reflex - when the palm touches the feet, the child makes an attempt to crawl.

Features of the endocrine system of the newborn. There are three successive phases of hormonal adaptation of newborns:

Phase I - the first 3 hours of a newborn's life. It is characterized by the highest level of maternal and fetal hormones (thyroxine, triiodothyronine, thyroid-stimulating and somatotropic hormones).

Phase II - the next 3 days - there is a decrease in maternal hormones, an increase in the newborn's own hormones.

Phase III - from the 4th to the 6th day of a newborn's life. It is characterized by a minimum level of fetoplacental hormones, maintaining the level of pituitary hormones and a decrease in thyroid hormones.

In newborns, there is a low biological activity of the adrenal glands (80% of the adrenal cortex consists of the germinal zone). By 12-14 days of life, there is an increase in the level of corticosteroids.

The function of the goiter and thyroid glands predominates in the newborn. Transient hypofunction of the parathyroid glands is observed: early (on the 2nd or 3rd day) and / or late - on the 10th day and the first weeks of life. Transient hypofunction of the parathyroid glands can be manifested by increased neuromuscular excitability, readiness for convulsions (tetany of the newborn). A hormonal crisis of the newborn is possible, associated with a violation of the relationship between the endocrine apparatus of the mother and the child.

Features of immunity. At birth, the content of T and B cells in the blood of a child as in an adult, a low level of natural killers, IgG - maternal; IgM - traces, its amount increases from the first week; IgA in blood serum is low, synthesis increases from the third week. By the time of birth, the absence of secretory IgA was noted, from the end of the first week - traces; IgE can be increased under the condition of intrauterine sensitization.

A feature of the reaction of the newborn to the first contact with the antigen is the absence of memory cells and their appearance after repeated contacts.

Nonspecific protective factors. The newborn has a higher level of lysozyme than the mother; by the 7-8th day it decreases to the level of an adult. At the time of birth, the level of properdin in the blood is low, during the week it increases rapidly and by the end of the 1st month of life does not differ from the level in adults. The level of complement components C3a and C5a is lowered, and therefore chemotaxis, opsonization and bactericidal activity are reduced (resistance to viral and bacterial infections is reduced). The production of interleukins and gamma-interferons is limited. In a newborn, the absorptive capacity of phagocytes is sufficiently developed, but the completed phase of phagocytosis is not perfect.

The first critical period of immunity in a child is noted - this is a weak resistance to opportunistic gram-negative flora.

The newborn is characterized by a tendency to generalize the infectious process, resulting in the frequency of septic conditions.

Newborns who have had intrauterine infection or are suffering from it have elevated levels of IgA and IgM.

Neuropsychic development. Within 1-2 hours after a normal delivery, the newborn is in a state of alertness. Able to scan simple geometric shapes, among them a preference for more similar to a human face. During the first month of life, the child pays attention mainly to the eyes of people. Inhibition processes predominate. Most of the time he sleeps, but on the 2nd-3rd day there is an anticipation of the upcoming feeding, and on the 5th-7th days - hungry excitement. When hunger is felt, a "digging" reflex is observed - turning the head to the nipple of the mother's breast and "digging" movements around it, due to hunger or other irritants of the mouth area. At the end of the 2nd week, a reflex to the position of the newborn under the mother's breast and a reflex of visual concentration appear. It is expressed by the active cognition of an adult, 2-3 minutes after suckling the breast. By the end of the 2nd week, the newborn has auditory concentration, and visual concentration by the end of the 1st month of life. An indicator of the perception of an object by a newborn is the movements of the eyeballs, expressed in tracking and fixing the gaze.