K - 13 Perkembangan Morfologi Dan Fungsional Janin (Obgyn)
description
Transcript of K - 13 Perkembangan Morfologi Dan Fungsional Janin (Obgyn)
-
Perkembangan Morfologi dan Fungsional janinProf R Haryono Roeshadi SpOG KLetta Sari Lintang SpOG
- Normal PregnancyPregnancy The course that the embryo and the fetus grow in the maternal bodyStages of pregnancyEarly pregnancy: 12 weeksMid pregnancy: 13 weeks,27 weeks Late pregnancy:28 weeksTerm pregnancy:37 weeks,
-
Fertilization
SPERM + EGG(OOCYTE) = ZYGOTEThe fertilization process takes about 24 hours.Sperm life = 48 hoursIt 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 FertilizationPlace: oviduct (ampulla)Process capacitation acrosome reaction penetrate the zona pellucida second meiosis zygote
-
FERTILISASI
-
PERKEMBANGAN SEL TELUR SAMPAI BLASTOKISTA
-
300 million sperm enter the the vagina... only 1%, 3 million, enter the uterusThe next step is the penetration of the zona pellucida, a tough membrane surrounding the oocyte. Penetration of the zona pellucida takes about twenty minutes
-
Within 11 hours following fertilization, the oocyte has extruded a polar body with its excess chromosomes. The fusion of the oocyte and sperm nuclei marks the creation of the zygote and the end of fertilization.
-
Formation of EmbryoImplantationrequirementDisappear of zona pellucidaFormation of syncytiotrophoblastSynchronized development of blastocyst and endometriumAdequate progesterone
-
Placental Circulation System Begins to form0.1 - 0.2 mm7 - 12 days post-ovulationTrophoblast cells engulf and destroy cells of the uterine lining creating blood pools, both stimulating new capillaries to grow and foretelling the growth of the placenta.
-
Formation of EmbryoProcessmorula (day 3) enter uterine cavity (day 4) early blastocyst late blastocyst (day 6-7) implantationlocation adherence penetration
-
Development of embryo and fetusDefinitionembryo: 8 weeksFetus: 9 weeks, human shape
-
Development of embryo and fetusPhysiology of fetusCirculationfetus placenta mater1 umbilical vein (full of oxygen), 2 umbilical artery (lack of oxygen)Mixed blood (vein and artery)
-
Fetal CirculationFetal circulation is complex and different from adult blood flows with three major shunts:Ductus venosus Forman ovale Ductus arterosus
-
Development of embryo and fetus
-
Development of embryo and fetusHematologyErythropoiesisFrom yolk sac: 3 weeksFrom liver: 10 weeksFrom bone marrow and spleen: term (90%)EPO production: 32nd week
-
Development of embryo and fetusFetal hemoglobinFetal hemoglobin: early pregnancyAdult hemoglobin: 32nd weekTerm: fetal type Hb 25%White cellsLeukocytes: 8 weekLymphocytes (antibody production): 12 week, thymus and spleen
-
Development of embryo and fetusGastrointestinal tractdrink amniotic fluid: 4th monthno proteolytic activityenzymatic deficiencies in liver: bilirubin is not easy to be clear.
-
Development of embryo and fetusKidney Its function begins at 11-14th weekEndocrinologyFetal thyroid: the first endocrine gland (6th week), synthesize thyroxine at 12th weekFetal adrenal cortex: widen (20th week), a fetal zone. synthesize steroid hormones (E3, liver placenta mater)
-
PlacentaStructurePrimary villus syncytiotrophoblast cytotrophoblastSecondary villusthird class vilusfetal capillary enter the stroma
-
PlacentaFunctionmetabolismExchange of O2 and CO2Exchange of nutritive factors and wasteDefensiveLimited. IgG, virus, drug
-
PlacentaEndocrineHCGHPLEPOxytocinaseCytokines and Growth FactorsImmunity tolerance
-
Fetal membranesStructure chorion and amnionAmnion A double-layered translucent membrane Become distended with fluid
-
Umbilical CordStructure amnion, yolk sac, one vein, two artery and Wharton jellyLength 30-70cm
-
Amniotic fliudSourceexudation of fetal membranes (early pregnancy)Fetal urineFetal lungExudation of amnion and fetal skin
-
Amniotic fliudAbsordFetal membraneUmbilical cordFetal skinFetal drinkingFeature1000-1500ml at 36th-38th week (peak), transparent slightly turbid
-
Amniotic FliudFunctionProtect fetal move freely, warmProtect mater prevent infection
-
Physiologic changes in pregnant womanGenital organsUteruscapacity: 5ml-5000ml.weight: 50g-1000gHypertrophy of muscle cellsEndometriumdecidua: basal decidua, capsular decidua, true deciduaContraction: Braxton HicksIsthmus uteri: 1cm 7-10cm
-
Physiologic changes in pregnant womanCervix: coloredOvary: placenta replaces ovary (10th week)Vagina: dilated and soft, pH(anti-bacteri bacteria)Ligaments: relaxed
-
Physiologic changes in pregnant womanCardiovascular systemHeart: move upward, hypertrophy of cardiac muscleCardiac Output increase by 30%, reach to peak at 32nd 34th weekBlood pressure early or mid pregnancy Bp.late pregnancy Bp .Supine hypotensive syndrome
-
Physiologic changes in pregnant womanHematologyBlood volumeIncrease by 30%-45% at 32nd 34th (peak)Relatively dilutedCompositionRed cells Hb:130110g/L, HCT:38% 31%.White cells: slightly increaseCoagulating power of blood: Albumin: ,35 g/L
-
Physiologic changes in pregnant womanThe Respiratory systemR rate: slightly vital capacity: no changeTidal volume: 40%Functional residual capacity: O2 consumption: 20%
-
Physiologic changes in pregnant womanThe urinary systemKidneyRenal plasma flow (RFP):35%Glomerular filtration rate (GFR): 50%Ureter Dilated (P)Bladder Frequent micturation
-
Physiologic changes in pregnant womanGastrointestinal systemGastric emptying time is prolonged nausea. The motility of large bowel is diminished constipationLiver function: unchanged
-
Physiologic changes in pregnant womanEndocrinePituitary (hypertrophy)LH/FSH: PRL:TSH and ACTH:Thyroidenlarged (TSH and HCG)thyroxine and TBG free T3 T4 unchanged