482
Table 21–2 GROWTH OF THE EMBRYO–FETUS
Month of Approximate Overall
Gestation (end) Aspects of Development Size in Inches
1 2 3 4 5 6 7 8 9
- Heart begins to beat; limb buds form; backbone forms; facial fea-
tures not distinct - Calcification of bones begins; fingers and toes are apparent on
limbs; facial features more distinct; body systems are established - Facial features distinct but eyes are still closed; nails develop on fin-
gers and toes; ossification of skeleton continues; fetus is distinguish-
able as male or female - Head still quite large in proportion to body, but the arms and
legs lengthen; hair appears on head; body systems continue to
develop - Skeletal muscles become active (“quickening” may be felt by the
mother); body grows more rapidly than head; body is covered with
fine hair (lanugo) - Eyelashes and eyebrows form; eyelids open; skin is quite wrinkled;
pulmonary surfactant is first produced - Head and body approach normal infant proportions; deposition of
subcutaneous fat makes skin less wrinkled - Testes of male fetus descend into scrotum; more subcutaneous fat is
deposited; production of pulmonary surfactant is sufficient to permit
breathing if birth is premature - Lanugo is shed; nails are fully developed; cranial bones are ossified
with fontanels present; lungs are more mature
0.25
1.25–1.5
3
5–7
10–12
11–14
13–17
16–18
19–21
Table 21–3 MATERNAL CHANGES DURING PREGNANCY
Aspect Change
Weight
Uterus
Thyroid gland
Skin
Circulatory system
Digestive system
Urinary system
Respiratory system
Skeletal system
- Gain of 2–3 pounds for each month of gestation
- Enlarges considerably and displaces abdominal organs upward
- Increases secretion of thyroxine, which increases metabolic rate
- Appearance of striae (stretch marks) on abdomen
- Heart rate increases, as do stroke volume and cardiac output; blood volume increases; vari-
cose veins may develop in the legs and anal canal - Nausea and vomiting may occur in early pregnancy (morning sickness); constipation may
occur in later pregnancy - Kidney activity increases; frequency of urination often increases in later pregnancy (bladder is
compressed by uterus) - Respiratory rate increases; lung capacity decreases as diaphragm is forced upward by com-
pressed abdominal organs in later pregnancy - Lordosis may occur with increased weight at front of abdomen; sacroiliac joints and pubic
symphysis become more flexible prior to birth