Fetuses Need Their Exercise Too!

People experience pregnancy differently, emotionally speaking. Some burst with tears of joy but some just burst into tears of disappointment; commonly when the pregnancy was actually uncalled for. They were freaking out especially when this is their first, unplanned pregnancy. I have seen countless times, in the OBGYN clinic, people put blames on others (be it husband or anyone related to them, sometimes even the doctor who told them such news) which could have been a sign of grief even though I'm not sure what are there to grieve for; whatever, I wouldn't have understood what they were going through, so who am I to judge. Nevertheless, the experience of pregnancy would never be understood by people who haven't been pregnant yet and I can tell that most of the mothers agree with this statement. Among all of the medical fields, obstetric and gynaecology is my least interested field, just because I felt useless in that particular department.

Why is it so? In Malaysia, most of the Malay people, even in some other races (including me), were deeply religious. We have some form of boundaries when it comes to interaction between man and woman and when the problems at hand were related to the sexual organs, we prefer someone who is of the same gender as us. Guess what, I'm a man and there is a lot of women doctor who was available in the department so it would be reasonable for them (instead of me) to be asked to handle a certain case (unless the case is emergency and require an immediate attention). Quite frustrating, huh? Most of the times, I was able to practice my clinical skills on foreigners; they didn't mind at all, thank god. You know what, I would never specialised in this field (my interest is currently paediatric anyway).

The Story of Steve and Elaine

Steve is a sperm. Among millions, Steve is currently the best. He is currently, the fastest, strongest and honestly speaking, quite tactical sperm compared to others. Everyone knows that to win a war (or race, whatever), you need a good strategy, so for days, he has been studying the pathway best taken for him to win a once in a lifetime, the ultimate race that could have made him one of the most unique (or not) organisms in the world. He studies about his potential competitors and crosses off a few which he deems unworthy, I mean, the double-headed guy would never win the race, they were stupid and look stupid too. There were a few other guys which Steve has crossed off his list; the sedentary tailless guy, the guy who has a weird head shape and sure, the one with crooked, double tails; like that going to be useful, pfft.

One day, some sperms who were forever on the watchtower sounded a signal. They arranged themselves in a group of a few hundred, preparing to swim through an unknown maze, searching for the one and only, princess, which according to some folklore which they have heard yesterday, has been unclosed in a weird and sticky covering; talk about disgusting things. After he made sure everything was in place, including his "bullet" to destroy the "capsule", he stands in the middle of the crowd while convincing himself, this is the time to be real. Well, let's do it! The go-to signal has been sounded and everyone was ejaculated from their sweet and comfortable potential space into the unknown territory. They swim hard until they reach a junction, which one to take? They only have enough fuel to invest in one.

Even if finding the princess by going into of the thing seems like a gamble, it is not for Steve. He knew exactly which way he has to take in order to meet with his potential lover. He, purposely, blurted some clues to the other sperms in which they trust him immediately. Well, Steve is a trusted guy after all. I knew him. No, you don't. Everything is fair in love and war. While the majority of the sperms went right, Steve swims left. Now his potential competitors drastically dropped to a few hundred. Now, his probability of winning is extremely high. I mean, "Hello double headed guy", Steve grin while passing through the double-headed sperm who seem struggling to swim while maintaining their single body. After he (Steve) found the ovum, he deploys his deadly chemical, which he has created using his own formula, went through the jelly-like substance with ease as opposed to the other, disable and retard-looking sperms. After he passed through the barrier, a dreadful safety system is activated to prevent the other from passing through; it even cut off his tail. That was easy, says Steve.

He looks around, searching for his prize. He saw a rounded, magnificent female pronucleus in which he turns himself into a male pronucleus. "I'm Steve. You are?". The female pronucleus blinks her eyes while whispering "I'm Elaine, I'm yours". Steve quickly when to hug Elaine and they started to fuse into a single entity; "We are going to be beautiful, you and I.".

The Fetal Kick

That was beautiful, isn't it? Steve and Elaine are currently a fetus. It has been 17 weeks since the first time they met and moved to a new home; or is it 18th? Everything is going well, as planned and while the host (Janine) is working, she felt a strong kick upon her belly. She smiles immediately and now, everyone in the office wants to palpate her belly. "It's great to be appreciated, isn't it, Elaine?". "It's not like we want to kick or anything, we just control this new body just yet". In a paper published in the European Cells and Materials (2015) which have been written by Nowlan has deduced that the early movement felt by the mother, most likely described as a "kick" was actually an involuntary movement produced by reflex which could have originated from the spinal cord. Most of the movements are uncoordinated but slowly, as the brain developed, they assume the role and decide when and how many movements is necessary to indicate the foetus as healthy.

Even though Janine only felt the movement during the 17th week, Steve and Elaine have been moving since the 7th (Source). They have been stretching their own neck and as the week progresses, they learn new moves like yawning, thumb sucking and sure, some kicks which are usually thought as a form of communication between the developing foetus and the outside world to tell them that they were perfectly healthy. It's reasonable to think that the growth of the foetus during the 17th week is significant enough for their movement to be detected. It is actually unclear whether movements felt by the mother were purposeful or is it just a pure coincidence but foetal movements is an important aspect of a healthy foetus that would allow them to develop a strong bone and joints. This hypothesis has been explained greatly by Nowlan which associate incidence of congenital malformations with reduced in foetal movement.

It is difficult to study foetal movement and its significance on a normal and healthy foetal development due to the fact that they were quite brief. In May 2018, Nowlan and a few other collaborators published a paper in the PLOS ONE outlining a few key protocols in foetal movement studies that can be adopted by researchers in the future. They were using a device to detect acoustic signals which are thought as an equivalent to foetal movements, combining it with an accelerometer to differentiate between the maternal and foetal movement, hence, producing an accurate fetal movement pattern. This is an effort to establish a much accurate result to confirm the validity of data produced by numerous studies in the past regarding foetal movements. In 2001 for example, C. Robert Almli et al has demonstrated the difference between a male and female foetus in terms of movements were quite significant. Boys are assumed to move more than girls but the result of such studies was questionable as the number of subjects was small.

Even if there were quite a few types of movements performed by the foetus, the most profound one would be the kick. Generally, the strength of the foetal kick would increase from week to another maxing out at approximately 4kg of force when the foetus is in the 30th week of pregnancy. After that, their strength would reduce; the possible explanation for this can be due to the fact that the foetus is growing up more, leaving a small room for them to stretch out. Even with a limited space, they were still moving, just now the most prominent part is the chest which resembles the movement when we were breathing. Reduce chest wall movement during the foetal stage is usually associated with poor breathing effort after they have been born due to the underdeveloped chest muscle. It is vital for a foetus to move not only for telling people they were actually alive in there, but to prepare themselves for a much extensive functioning after they were born. Foetuses need to exercise or else their chances of living outside of the human womb, would have been poor.

Sources

• Pregnancy - Britannica
• Why Do Babies Kick in the Womb?
• Normal fetal motility: an overview
• Biomechanic of Foetal Movement
• Human Fetal and Neonatal Movement Patterns: Gender Differences and Fetal-to-Neonatal Continuity
• Performance of a wearable acoustic system for fetal movement discrimination

Picture were all taken from Pixabay: 1,2,3

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