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3 processes commence :
1. Gastrulation
2. Somitogenesis
3. Neuralation

GASTRULASI
Pembentukan tiga lapisan embrio
(trilaminar embryo)
Semua jaringan tubuh dibentuk dari
tiga lapisan germinal ini

Ectoderm (epithelium)
Mesoderm (connective tissue)
Endoderm (epithelium)
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Ectoderm
forms the central and peripheral nervous
system and epithelium of the skin
Endoderm
forms gastrointestinal tract organs and
the epithelium of the gastrointestinal and
respiratory tracts
Mesoderm
forms the body connective tissues:
blood, bone, muscle, connective tissue
skin, gastrointestinal and respiratory
tracts
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Somitogenesis
Segmentasi mesoderm membentuk
somit yang berpasangan (d20)
1 somite pair/90 minutes until on average 44 pairs
eventually form.
Proses ini terjadi berurutan; oleh karena itu
digunakan utk menentukan tahapan usia dari
berbagai spesies embrio berdasarkan jumlah somit
yang terlihat
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Neurogenesis
Pembentukan sistem saraf
Pada manusia, neurogenesis akan
berlangsung mulai dari masa embriogenik,
fetal dan akan terus berlanjut sampai
periode postnatal .

 Neurogenesis dimulai dari segregasi

neural plate dari ectoderm
trilaminar embryo yang akan melipat
membentuk initially the neural groove,
bergabung neural tube (the central
nervous system progenitor, brain and spinal
cord) and associated neural crest.
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 Pembentukan sistem
saraf mrpkn sistem yg
pertama kali terbentuk
dan terakhir kali
sempurna setelah lahir.
Pembentukan SSP dimulai dari suatu lempeng saraf
melipat membentuk neural groove neural
tube yg kedua ujungnya terbuka menutup lagi
Failure of these opening to close contributes a major
class of neural abnormalities (neural tube defects).

WEEK 4
Permulaan organogenesis (jaringan spesifik dan
sistem mulai berdifferensiasi) dari trilaminar embryo
Pada permukaan embrio muncul sensory placodes
dan limb buds.
Sensory placodes (otic, lens, nasal) membentuk
komponen spesifik telinga, mata dan hidung.
Limb buds terbentuk dari ektoderm dan
mesoderm (komponen somit) ; "paddle-like"
projections dari batang tubuh membentuk upper
and lower limb components.
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 Pada embrio, periode organogenesis akan

selesai sampai minggu ke-8.
Lipatan embrio akan terus berlangsung
organ yang berfungsi pertama kali adalah
jantung
Sistem lain mulai berkembang : the circulatory,
digestive, urogenital and nervous system
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Week 5
Pituitary - Week 5 elongation, contacts
infundibulum, diverticulum of diencephalon
Heart - Week 5 septation starts, atrial and
ventricular
Respire - Week 5 left and right lung buds
push into the pericardioperitoneal canals
(primordia of pleural cavity)
Respire - Week 5 to 17 lung histology pseudoglandular
Hearing - Week 5 cochlear part of otic vesicle
elongates (humans 2.5 turns)
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Week 5

Ectoderm: sensory
placodes, lens pit, otocyst,
nasal placode,
primary/secondary
vesicles, fourth ventricle of
brain,
Mesoderm: continued
segmentation of paraxial
mesoderm, heart
prominence
Head: 1st, 2nd and 3rd
pharyngeal arch, forebrain,
site of lens placode, site of
otic placode, stomodeum
Body: heart, liver, umbilical
cord, mesonephric ridge
Limb: upper and lower limb
buds

FEATURE :
midbrain, nasal placode, lens pit, 1,2,3 pharyngeal arches,
fourth ventricle of brain, 1st pharyngeal groove, heart
prominence, cervical sinus, upper limb bud, mesonephric ridge,
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lower limb bud, umbilical cord.

Week 6
Limbs upper limb bud nerves
median nerve, radial nerve
and ulnar nerve entered into
hand plate, myoblasts
spindle shaped and oriented
parallel to limb bud axis.
Heart - outflow tract
elliptical configuration with
four cushions, the two larger
fusing at this stage.
Semilunar valve leaflets form
at the downstream end of the
cushions
Head lip and palate
components of the upper lip,
medial nasal prominence and
maxillary process present,
median palatine process
appears.

Pituitary - Week 6 connecting stalk between pouch and oral cavity degenerates
Parathyroid - Week 6 diverticulum elongate, hollow then solid, dorsal cell
proliferation
Thymus - Week 6 diverticulum elongate, hollow then solid, ventral cell
proliferation
Adrenal - Week 6 fetal cortex forms from mesothelium adjacent to dorsal
mesentery, medulla neural crest cells from adjacent sympathetic ganglia

Week 6 - descent of heart and

lungs into thorax.
Pleuroperitoneal foramen closes
Respire -

Tongue Week 6 - gustatory papilla, caudal midline near the foramen caecum
(week 6 to 7 - nerve fibers approach the lingual epithelium)
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Week 6
Neural - telencephalon areas of the
future archicortex, paleocortex, and
neocortex, visible. Beginning of future
choroid plexus[2]
Sense - Smell olfactory nerve fibres
enter the brain[3] Neural - primordium of
the epidural space appears first on the
ventral part of the vertebral canal and
develops rostro-caudally[4]
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Heart - separation of common cardiac

outflow (aortic arch and pulmonary
trunc)
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Week 7-8
Pancreas Week 7 to 20 pancreatic hormones
secretion increases, small amount maternal insulin
Respire - Week 7 enlargement of liver stops descent of
heart and lungs
Limb bones form by endochondral ossification and
throughout embryo replacement of cartilage with bone
(week 5-12).
Sense - Smell vomeronasal fibres and nervus terminalis
[1] GIT - Liver obturation due to epithelial proliferation,
bile ducts became reorganized, continuity between
liver cells and gut [2]
Neural - duramater appears[3]
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Week 9 - 38
Trisemester II dan III (Fetal Period)
Pertumbuhan dan differensiasi organ akan terus
berlangsung
Growth in size, length (Second Trimester)
Growth in weight (Third Trimester)

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When things go wrong

in development
Abnormalities that can occur during
development
Three main causes: Genetic,
Environmental
Unknown
First trimester most critical
Different effect depending on time
of insult (teratogen)
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Environment

Genetic

Trisomy 21 |
Trisomy 18 |
Trisomy X |
Philadelphia chro
mosome

Low folic acid

Iodine Deficiency
Drugs
Fetal Alcohol Synd
rome
TORCH Infections
Viral Infection |
Bacterial Infection |
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Critical Periods
Trisomy 21 | Trisomy
18 | Trisomy X |
Philadelphia
chromosome

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Bagan di atas menunjukkan periode

kritis dan eksposur dari teratogen
yang akan menyebabkan
perkembangan yang abnormal
Pada umumnya efek kelainan akan
lebih cenderung terjadi pada masa
embrionik selama proses
organogenesis pada Tm I
Eksposur teratogen pada akhir
trisemester I (awal fetal period dan
trisemester 2 dan 3) anomali less
severe (minor anomalies)
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Secara morfologis kelainan

kongenital terbagi atas 2, yaitu :

1. Kelainan kongenital mayor :

memberikan dampak besar pada
bidang medis, operatif, dan
kosmetik serta yang mempunyai
risiko kesakitan dan kematian
tinggi, misalnya : anensefalus,
hidrosefalus, hidronefrosis.

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2. Kelainan kongenital minor :

kelainan yang kurang
memberikan dampak medis
operatif maupun kosmetik dan
biasanya kurang
mempengaruhi kelangsungan
hidup, misalnya : hirsutisme,
labioschisis, polidactili.

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Diagnosis

Prenatal diagnosis
menentukan perkembangan
normal janin

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Chorionic Villus Sampling

Pemeriksaan yg dilakukan pada

minggu 10-12
Pemeriksaan dilakukan dengan
mengambil sel dari membran
korion atau plasenta

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Amniocentesis

Amniocentesis Pemeriksaan
prenatal pada minggu 14-18 .
Cairan amnion diambil dari
uterus sel embrio diisolasi
dan diperiksa di laboratorium

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Ultrasound Examinition

Aplikasi dari medical ultrasonography

to obstetrics,
Digunakan untuk memvisualisasikan
embrio atau fetus di dalam rahim ibu.
Merupakan prosedur standar
memberikan informasi mengenai
kemajuan perkembangan embrio dan
janin selama kehamilan
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Neonatal diagnosis (APGAR test)

Maternal diagnosis - often pregnancy will
expose maternal health problems

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