The endochondral skeleton begins forming in the embryo, but it is not until the third trimester that substantial bone is formed and mineralized. The average human fetus has 30 g of calciumby term,with 80% of that accreted during the third trimester. Although the kidneys and
intestines control the delivery and excretion of minerals in the adult,they are relatively unimportant for the normal fetus. Instead, it is the placenta that actively transportsminerals fromthematernal circulation,and returns excess minerals and waste products back to the mother.
Physiological studies in animals, and limited human data, have shownthat the placenta is usually capable of extracting adequate mineral for the fetus even when maternal mineral concentrations are low. More marked maternal hypocalcemia from severe hypoparathyroidism, for
example, is required to cause fetal hypocalcemia and reduced skeletal mineral content.
The endochondral skeleton begins forming in the embryo, but it is not until the third trimester that substantial bone is formed and mineralized. The average human fetus has 30 g of calciumby term,with 80% of that accreted during the third trimester. Although the kidneys andintestines control the delivery and excretion of minerals in the adult,they are relatively unimportant for the normal fetus. Instead, it is the placenta that actively transportsminerals fromthematernal circulation,and returns excess minerals and waste products back to the mother.Physiological studies in animals, and limited human data, have shownthat the placenta is usually capable of extracting adequate mineral for the fetus even when maternal mineral concentrations are low. More marked maternal hypocalcemia from severe hypoparathyroidism, forexample, is required to cause fetal hypocalcemia and reduced skeletal mineral content.
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