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Fungsional janin
Normal Pregnancy
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Pregnancy
The course that the embryo and the
fetus grow in the maternal body
Stages of pregnancy
Early pregnancy: 12 weeks
Mid pregnancy: 13 weeks,27 weeks
Late pregnancy:28 weeks
Term pregnancy:37 weeks,<42 weeks
Fertilization
SPERM + EGG(OOCYTE) = ZYGOTE
The fertilization process takes about
24 hours.
Sperm life = 48 hours
It takes about ten hours to navigate the
female productive track, moving up the
vaginal canal, through the cervix, and
into the fallopian tube where fertilization
begins.
Formation of Embryo
Fertilization
1. Place: oviduct (ampulla)
2. Process
capacitation acrosome reaction
penetrate the zona pellucida
second meiosis zygote
FERTILISASI
Formation of Embryo
Implantation
1. requirement
1) Disappear of zona pellucida
2) Formation of syncytiotrophoblast
3) Synchronized development of
blastocyst and endometrium
4) Adequate progesterone
Formation of Embryo
2. Process
1) morula (day 3) enter uterine
cavity (day 4) early
blastocyst late blastocyst
(day 6-7) implantation
2) location adherence
penetration
Definition
1. embryo: 8 weeks
2. Fetus: 9 weeks, human
shape
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Physiology of fetus
Circulation
fetus placenta mater
1 umbilical vein (full of oxygen),
2 umbilical artery (lack of
oxygen)
Mixed blood (vein and artery)
Fetal Circulation
Fetal circulation is
complex and
different
from adult blood
flows
with three major
shunts:
Ductus venosus
Forman ovale
Ductus arterosus
Placenta
Structure
1. Primary villus
syncytiotrophoblast
cytotrophoblast
2. Secondary villus
3. third class vilus
fetal capillary enter the stroma
Placenta
Function
1. metabolism
1) Exchange of O2 and CO2
2) Exchange of nutritive factors and
waste
2. Defensive
Limited. IgG, virus, drug
Placenta
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Endocrine
HCG
HPL
E
P
Oxytocinase
Cytokines and Growth Factors
Immunity tolerance
Fetal membranes
Structure
chorion and amnion
Amnion
A double-layered translucent
membrane
Become distended with fluid
Umbilical Cord
Structure
amnion, yolk sac, one vein, two
artery and Wharton jelly
Length
30-70cm
Amniotic fliud
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Source
exudation of fetal membranes
(early pregnancy)
Fetal urine
Fetal lung
Exudation of amnion and fetal
skin
Amniotic fliud
Absord
1. Fetal membrane
2. Umbilical cord
3. Fetal skin
4. Fetal drinking
Feature
1000-1500ml at 36th-38th week (peak),
transparent slightly turbid
Amniotic Fliud
Function
1. Protect fetal
move freely, warm
2. Protect mater
prevent infection
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Genital organs
Uterus
capacity: 5ml-5000ml.weight: 50g1000g
Hypertrophy of muscle cells
Endometrium decidua: basal decidua,
capsular decidua, true decidua
Contraction: Braxton Hicks
Isthmus uteri: 1cm 7-10cm
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Hematology
Blood volume
Increase by 30%-45% at 32nd 34th (peak)
Relatively diluted
Composition
Red cells
Hb:130 110g/L, HCT:38% 31%.
2) White cells: slightly increase
3) Coagulating power of blood:
4) Albumin: , 35 g/L
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Gastrointestinal system
Gastric emptying time is
prolonged nausea.
The motility of large bowel is
diminished constipation
Liver function: unchanged
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Endocrine
Pituitary (hypertrophy)
LH/FSH:
PRL:
TSH and ACTH:
Thyroid
enlarged (TSH and HCG )
thyroxine and TBG free T3 T4
unchanged