Journal of Pregnancy and Neonatal Medicine

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Mini Review - Journal of Pregnancy and Neonatal Medicine (2024) Volume 8, Issue 1

Gestational Age and Fetal Development: Milestones and Markers

Vicki Prentis *

School of Public Health and Social Work, Queensland University of Technology, Australia

*Corresponding Author:
Vicki Prentis
School of Public Health and Social Work, Queensland University of Technology, Australia
E-mail: Vicki33@australia.com

Received:25-Jan-2024, Manuscript No. AAPNM-24-126901; Editor assigned: 27-Jan-2024, PreQC No. AAPNM-24-126901 (PQ); Reviewed:10-Feb-2024, QC No. AAPNM-24-126901; Revised:15-Feb-2024, Manuscript No. AAPNM-24-126901(R); Published:22-Feb-2024, DOI:10.35841/aapnm -8.1.184

Citation: Prentis V. Gestational Age and Fetal Development: Milestones and Markers. J Preg Neonatal Med. 2023;8(1):184

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Introduction

Gestational age, the age of a pregnancy measured from the first day of the woman's last menstrual period (LMP) or by ultrasound dating, serves as a critical parameter in monitoring fetal development. Understanding the milestones and markers of fetal development throughout gestation is essential for assessing fetal viability, detecting anomalies, and guiding obstetric management. From the earliest stages of embryogenesis to the final weeks of gestation, fetal development follows a complex and highly orchestrated sequence of events, marked by distinct milestones and markers that reflect the progression of organogenesis, growth, and maturation [1].

The embryonic period spans the first eight weeks of gestation, beginning with fertilization of the egg by sperm to the formation of the embryo's basic body plan. During the first week, the fertilized egg undergoes cleavage and forms a blastocyst, which implants into the uterine wall around day 6-7 post-fertilization. By the end of the third week, the embryonic disc, consisting of three germ layers (ectoderm, mesoderm, and endoderm), develops, giving rise to major organ systems [2].

By the fourth week, the neural tube closes, initiating the development of the central nervous system. Limb buds emerge, and the heart begins to beat, marking the onset of cardiac activity. Facial features, including eyes, ears, and nostrils, start to form. By the end of the embryonic period, at around eight weeks, the embryo is referred to as a fetus, and major organs, including the brain, heart, liver, and kidneys, are present, albeit immature [3].

The fetal period, spanning from the ninth week until birth, is characterized by rapid growth and differentiation of organ systems, refinement of structures, and the development of fetal movements and reflexes. During the first trimester, fetal development focuses on the growth and maturation of existing structures rather than the formation of new organs [4].

By the end of the first trimester, at 12 weeks, the fetus has distinct human features, with fully formed limbs, fingers, and toes. External genitalia begin to differentiate, although gender determination by ultrasound is typically feasible after 16 weeks. The second trimester, weeks 13-26, is marked by continued growth, with the fetus increasing in size and weight. Organs and systems undergo further maturation, and fetal movements become more coordinated and perceptible to the mother [5].

The third trimester, weeks 27 to birth, is characterized by rapid brain development, lung maturation, and the accumulation of adipose tissue. Fetal viability, the ability of the fetus to survive outside the womb with medical assistance, is a crucial consideration during this period, with the age of viability typically around 24-26 weeks gestation. Towards the end of gestation, the fetus assumes a head-down position in preparation for birth, and fetal growth slows as space within the uterus becomes limited [6].

Throughout gestation, various markers of fetal development are used to assess growth, well-being, and gestational age. These markers encompass physical measurements, such as fetal biometry obtained through ultrasound, as well as physiological parameters and behavioral indicators. Common markers of fetal development include: Crown-Rump Length (CRL): A measurement taken during early ultrasound examinations (up to 12 weeks gestation) to estimate gestational age and assess embryonic growth [7].

Biparietal Diameter (BPD): The diameter of the fetal skull measured between the two parietal bones, used to assess fetal head size and monitor brain development. Femur Length (FL): Measurement of the length of the fetal femur bone, used to estimate gestational age and assess skeletal growth. Abdominal Circumference (AC): The circumference of the fetal abdomen, used in conjunction with other biometric measurements to assess fetal growth and detect abnormalities such as intrauterine growth restriction (IUGR) [8].

Amniotic Fluid Volume (AFV): The volume of amniotic fluid surrounding the fetus, which provides protection, facilitates fetal movement, and plays a role in fetal lung development. Fetal Heart Rate (FHR): The rate at which the fetal heart beats, typically measured using Doppler ultrasound, with normal ranges varying throughout gestation. Fetal Movement Counting: Maternal perception of fetal movements, commonly used as a non-invasive method to assess fetal well-being and monitor fetal activity [9].

Markers of fetal development are invaluable tools in obstetric practice, providing clinicians with essential information to monitor fetal growth, assess well-being, and detect anomalies or complications. Serial ultrasound examinations, combined with other prenatal assessments such as maternal serum screening and fetal monitoring, enable clinicians to track fetal development and intervene when necessary to optimize maternal and fetal outcomes [10].

Conclusion

Accurate determination of gestational age and assessment of fetal development are essential components of prenatal care, guiding clinical decision-making regarding timing of interventions, management of high-risk pregnancies, and counseling expectant parents. By monitoring fetal milestones and markers throughout gestation, healthcare providers can identify deviations from normal development early, initiate appropriate interventions, and support the best possible outcomes for both mother and baby.

References

  1. Damhuis SE, Ganzevoort W, Gordijn SJ. Abnormal fetal growth: small for gestational age, fetal growth restriction, large for gestational age: definitions and epidemiology. Obstet Gynecol Clin North Am. 2021;48(2):267-79.

    2. Indexed at, Google Scholar, Cross Ref

  2. Sacchi C, Marino C, Nosarti C, et al. Association of intrauterine growth restriction and small for gestational age status with childhood cognitive outcomes: a systematic review and meta-analysis. JAMA Pediatr. 2020;174(8):772-81.

    3. Indexed at, Google Scholar, Cross Ref

  3. Van Mieghem T, Abbasi N, Shinar S, et al. Monochorionic monoamniotic twin pregnancies. Am J Obstet Gynecol MFM. 2022;4(2):100520.

    4. Indexed at, Google Scholar, Cross Ref

  4. Marcinkowski KA, Mehta V, Mercier R, et al. Pelvic inflammatory disease in pregnancy: a systematic review focusing on perinatal outcomes. Am J Obstet Gynecol MFM. 2022;4(4):100643.

    5. Indexed at, Google Scholar, Cross Ref

  5. Adibi JJ, Zhao Y, Koistinen H, et al. Molecular pathways in placental-fetal development and disruption. Mol Cell Endocrinol. 2023:112075.

    6. Indexed at, Google Scholar, Cross Ref

  6. Bruin C, Damhuis S, Gordijn S, et al. Evaluation and management of suspected fetal growth restriction. Obstet Gynecol Clin North Am. 2021;48(2):371-85.

    7. Indexed at, Google Scholar, Cross Ref

  7. Novak CM, Graham EM. Obstetric management, tests, and technologies that impact childhood development. Dev Med Child Neurol. 2019;61(9):1002-7.

    8. Indexed at, Google Scholar, Cross Ref

  8. Raffé-Devine J, Somerset DA, Metcalfe A, et al. Maternal, fetal, and neonatal outcomes of elective fetal reduction among multiple gestation pregnancies: a systematic review. J Obstet Gynaecol Can. 2022;44(1):60-70.

    9. Indexed at, Google Scholar, Cross Ref

  9. Howe CG, Nozadi SS, Garcia E, et al. Prenatal metal (loid) mixtures and birth weight for gestational age: a pooled analysis of three cohorts participating in the ECHO program. Environ Int. 2022;161:107102.

    10. Indexed at, Google Scholar, Cross Ref

  10. O’Callaghan JL, Clifton VL, Prentis P, et al. Modulation of placental gene expression in small-for-gestational-age infants. Genes (Basel). 2020;11(1):80.

    11. Indexed at, Google Scholar, Cross Ref

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