By Devashish Bisht
Introduction
Entire length of human pregnancy is about 40 weeks
or 280 days.
Length of human pregnancy is broadly classified into
two main headings:- embryonic period and fetal
period.
Embryonic period occurs from the point in ampulla
up to 8th week of development.
Fetal period occurs from 8th week of development till
termination of pregnancy
Embryonic Period
Embryonic period is further classified as germinal
period and embryonic period proper.
Germinal Period is the period from the point of
fertilization to 3rd week of development.
Germinal period involve formation of three germ
layers. The Ectoderm, Endoderm, and Mesoderm.
Embryonic Period Proper is from point of 4th week of
development till 8th week of development
Events occurring in 1st week of development
Major events occurring in 1st week of development are
as follows:-
Cleavage Division
Formation of morula
Formation of blastocyst
Implantation
1st week of Development
After fertilization of gamete, Formation of zygote will
take place, the zygote or fertilized ovum is very large
so in order to bring it in normal shape it undergo
repeated mitotic division and this repeated mitotic
division is called as the cleavage division.
As a result of repeated cleavage division cell undergo
repeated mitotic division and will form 2 celled
stage, 4-celled stage, 12-celled stage, 16-celled stage,
and it will continue dividing by repeated mitotic
division.
1st week of development
Formation of Morula-When cell reach to 12 celled
and 16 celled they adhere each other and it will result
in formation of a sphere. The sphere is covered by an
outer covering called Zona pellucida. It prevents the
implantation of the zygote during its travel from
ampulla to the uterine cavity
If Zona pellucida is not found around the zygote then
it will get implanted between ampulla and uterine
tube
1st week of development
Now if we look inside the zygote the cell divide under
the process of cleavage division now when it reaches
12-16 celled stage .
By process of compaction the cell of outer periphery
forms the outer cell mass and the extra cell mass is
joined by tight junction.
Cells within the inner aspect of zygote are loosely
connected with inner spaces in between and this
group of cells is known as inner cell mass
The cells of inner cell mass will be around 12-16
celled stage.
1st week of Development
The formation of outer cell mass and inner cell mass
inside zygote is called as morula
Now, the morula will move from uterine tube and it
will reach uterine cavity.
Once it will reach uterine cavity the uterine cavity
will start secreting a fluid called as uterine milk.
This uterine milk will start entering the developed
morula
1st week of Development
The uterine milk will start occupying the space
between the inner cell mass cells
Now these cell(inner cell mass) will be pushed to one
side and the small cavities will coalesce to form a
larger cavity
The large cavity thus formed is termed as blastocoel.
Morula with blastocoel is called as blastocyst
Number of cells in blastocyst would be 32-64 cells
We can also say that Blastocyst is the morula with a
cavity known as blastocoel
1st week of Development
Point of attachment of inner cell mass(embryoblast)
is called as Polar trophoblast
Remaining Trophoblast is called as Mural
Trophoblast
What is the reason behind calling the inner layer
as embryoblast and outer layer as trophoblast?
Reason behind calling the inner cell mass as
embryoblast as it is giving rise to embryo proper
outer cell mass as trophoblast as in future this
layer will give rise to chorion and placenta .
‘Tropho’ means nutrition so the outer layer will
provide nutrition to future chorionic and placenta.
Now the uterine cavity is now getting ready to
receive the fertilized ovum
As we know uterine wall is made up of three layers
endometrium, myometrium and , perimetrium
Endometrium is further divided into 3 layers from
within lumen outward stratum compactum(inner
most layer), stratum songeosum(middle most layer),
statum basale(outer most layer)
Once blastocyst is formed about 5th day of
intrauterine life it will start invading the uterine wall
First change when implantation would be
disappearance of Zona pellucida that happen by
trypsin like enzyme .
The blastocyst starts invading stratum compactum
the point at the base of the blastocyst starts invading
stratum compactum is called as embryonic pole and
the rest of the part is called the Abembryonic pole.
Implantation is not a one time event it take time for
entire blastocyst to get implanted within the
endometrium.
So it would take 2-3 days to complete process of
implantation
Where is the site of implantation?
Usually site of implantation is set to be in upper
uterine section we can divide uterine cavity into
upper segments and lower segments
If implantation occurs in the upper section then it is
considered as normal implantation
But if implantation occurs in lower section then
implantation is considered to be abnormal
Intra-Uterine Ectopic Pregnancy
Abnormal plantation can be classified into intra-
uterine ectopic pregnancy and Extra-Uterine Ectopic
Pregnancy
Intra-Uterine Ectopic pregnancy means
implantation is done inside the uterine cavity but it
is not in the upper segment i.e. it is in lower segment
Extra-Uterine Ectopic Pregnancy
Extra-Uterine Ectopic Pregnancy means
implantation is done outside the uterus i.e. it can be
in fallopian tube it can be within the ovary it can be
in the abdominal cavity
Placenta Previa and its types
Placenta Previa is the term given for intra-uterine
ectopic pregnancy.
It has got four grades:-
Grade 1 Placenta Previa- If implantation occurs in
lower section of uterine cavity near the os of the
cervix then this type of implantation is termed as
grade 1 Placenta Previa
Grade 2 Placenta Previa
When implantation occurs near the vaginal os then
this type of implantation is called as Grade 2
Placenta Previa
Grade 3 Placenta Previa
When implantation site is at vaginal os i.e. when it
covers vaginal os and the cervix is dilated then this
type of implantation is termed as grade 3 Placenta
Pervia
Grade 4 Placenta Previa
When the implantation site completely occlude the
vaginal os then this type of implantation is termed as
Grade 4 Placenta Previa
