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Defecation in utero, and hence meconium in the amniotic fluid, is associated with post-term pregnancies and fetal hypoxia. Aspiration of meconium-stained liquor by the fetus at birth can result in meconium aspiration syndrome and respiratory distress. While body water content gradually diminishes, glycogen and fat stores increase about five-fold in the last trimester. Preterm infants have virtually no fat and a severely reduced ability to withstand starvation. This is aggravated by an incompletely developed alimentary system, and may manifest in a poor sucking, uncoordinated swallowing mechanism, delayed gastric emptying, and poor absorption of carbohydrates, fat and other nutrients.
Fetal blood The first fetal blood cells are formed on the surface of the yolk sac 14–19 days after conception. Haemopoiesis continues from this site until the third postconceptual month. During the fifth week of embryonic life, extramedullary haemopoiesis begins in the liver and to a lesser extent in the spleen. The bone marrow starts to produce red cells at 7–8 weeks and is the predominant source of red cells from 26 weeks’ gestation. Most haemoglobin in the fetus is fetal haemoglobin (HbF), which, having a higher affinity for oxygen, enhances the transfer of oxygen across the placenta.
At this time, the zona pellucida is shed and the blastocyst consists of a shell of flattened trophoblastic cells (which later form placental tissue) and a central group of about 16 cells, known as the inner cell mass or embryoblast, from which the entire embryo will form. Implantation of the blastocyst into the uterine endometrium commences on about the sixth day after fertilization, at approximately day 20 of the menstrual cycle. Implantation and the pre-embryonic period By day 6, the trophoblastic layer of the blastocyst, comes into contact with the endometrium of the uterus, usually at the upper posterior wall, and begins to implant.