Pregnancy , also known as pregnancy , is the time at which one or more offspring develops in a woman. Multiple pregnancies involve more than one offspring, as in twins. Pregnancy can occur through sexual intercourse or assisted reproductive technology. Childbirth usually occurs about 40 weeks from the last menstrual period (LMP). It's over nine months, where every month averages 29½ days. When measured from the conception it was about 38 weeks. The embryo is a developing child during the first eight weeks after conception, after which the term the fetus is used until birth. Early pregnancy symptoms may include missed periods, soft breasts, nausea and vomiting, starvation, and frequent urination. Pregnancy can be confirmed with a pregnancy test.
Pregnancy is usually divided into three trimesters. The first trimester is from first week to 12 and includes conception. Conception is when the sperm fertilizes the egg. The fertilized egg then runs into the fallopian tube and attaches to the inside of the uterus, where it begins to form the embryo and placenta. During the first trimester, the possibility of miscarriage (natural death of the embryo or fetus) is at its highest point. The second trimester is from week 13 to 28. Around the middle of the second trimester, fetal movement can be felt. At 28 weeks, more than 90% of infants can survive outside the uterus if given high-quality medical care. The third trimester is from 29 weeks to 40 weeks.
Prenatal care improves pregnancy outcomes. Prenatal care may include taking extra folic acid, avoiding drugs and alcohol, regular exercise, blood tests, and regular physical examination. Pregnancy complications may include high blood pressure disorders, gestational diabetes, iron deficiency anemia, and severe nausea and vomiting among others. In an ideal labor delivery begins by itself when a woman is "at term". Pregnancy is considered in the full term when the pregnancy has lasted 39 to 41 weeks. After 41 weeks, it is known as a late term and after 42 weeks postpartum. Infants born before 39 weeks are considered short-term while those before 37 weeks are premature. Premature babies are at higher risk of developing health problems such as cerebral palsy. Delivery before 39 weeks with labor induction or caesarean section is not recommended unless required for other medical reasons.
Approximately 213 million pregnancies occur in 2012, of which, 190 million are in developing countries and 23 million are in developed countries. The number of pregnancies in women ages 15 to 44 is 133 per 1,000 women. About 10% to 15% of pregnancies admitted end in miscarriage. In 2013, pregnancy complications resulted in 293,000 deaths, down from 377,000 deaths in 1990. Common causes include maternal bleeding, abortion complications, high blood pressure pregnancy, maternal sepsis, and delayed childbirth. Globally, 40% of pregnancies are unplanned. Half of unplanned pregnancies are aborted. Among unwanted pregnancies in the United States, 60% of women use birth control to some extent during the month of pregnancy.
Video Pregnancy
Terminology
Related terms for pregnancy are gravid and parous . Gravidus and gravid are derived from Latin for "weight" and pregnant women are sometimes referred to as gravida . Gravidity is a term used to describe how many times a pregnant woman is. Similarly, the term parity is used for the number of times a woman carries pregnancy to a proper level. Twins and other twin births are counted as one pregnancy and birth. A woman who has never been pregnant is called nulligravida. A woman who (or has only) been pregnant for the first time referred to as primigravida , and a woman in subsequent pregnancies as multigravida or as multipara. Therefore, during the second pregnancy a woman will be described as gravida 2, the 1 and after the delivery of life as gravida 2, the 2. Pregnancy in progress , abortion, miscarriage and/or birthdate account for parity value less than the gravida number. In the case of twin births, gravida numbers and parity values ​​increase only one. Women who never bring pregnancy reach more than 20 weeks of pregnancy are called nulipara.
The term premature and postterm have replaced most of the previous terms premature and postmature. Preterm and postterm are defined above, while premature and postmature have historical meaning and are more closely related to the size and condition of the baby's development than at the stage of pregnancy.
Maps Pregnancy
Signs and symptoms
The symptoms and discomfort of pregnancy are the presentations and conditions resulting from pregnancy but do not significantly interfere with daily life activities or pose a threat to the health of the mother or baby. This is different from pregnancy complications. Sometimes symptoms that are considered uncomfortable can be considered a complication when it is more severe. For example, morning sickness can be an inconvenience, but if, in combination with significant vomiting, causing an imbalance of water electrolytes, it is a complication known as hyperemesis gravidarum.
Common symptoms and discomforts of pregnancy include:
- Exhaustion.
- Constipation
- Pelvic pelvic pain
- Back pain
- Braxton Hicks contractions. Contractions are occasional, irregular, and often painless that occur several times per day.
- Edema (swelling). Common complaints in promoting pregnancy. Caused by compression of the inferior vena cava and pelvic veins by the uterus causes an increase in hydrostatic pressure in the lower extremities.
- Increased urinary frequency. Common complaints, caused by increased intravascular volume, increased glomerular filtration rate, and compression of the bladder by enlarged uterus.
- Urinary tract infection
- Varicose veins. Common complaints caused by venous smooth muscle relaxation and increased intravascular pressure.
- Haemorrhoids (piles). Venous swelling in or within the anus area. Due to impaired venous return, stroke is associated with constipation, or increased intra-abdominal pressure in subsequent pregnancies.
- Regurgitation, heartburn, and nausea. â € <â € <
- Stretch marks
- Breast tenderness is common during the first trimester, and is more common in women who are pregnant at a young age.
In addition, pregnancy can lead to pregnancy complications such as deep vein thrombosis or worsening of recurrent disease in pregnancy.
Chronology
The chronology of pregnancy is, unless otherwise specified, generally given as gestational age, where the starting point is the woman's last normal menstrual period (LMP), or the appropriate gestational age as predicted by more accurate methods if available. Sometimes, time can also use the age of fertilization which is the age of the embryo.
Start pregnancy
According to the American Congress of Obstetricians and Gynecologists, the main methods for calculating gestational age are:
- Immediately count the days since the beginning of the last menstrual period.
- Initial obstetric ultrasound, comparing the size of the embryo or fetus with a known pregnancy reference cohort (as calculated from the last menstrual period), and using the mean gestational age of another embryo or fetus of the same size. If the gestational age calculated from the initial ultrasound conflicts with those calculated directly from the last menstrual period, it is still one of the earliest ultrasound used for the remainder of pregnancy.
- In the case of in-vitro fertilization, count the days since oocyte retrieval or co-incubation and add 14 days.
Approximate time limit
The due date assessment basically follows two steps:
- Determining which time point will be used as the origin for gestational age, as described in the section above.
- Increase the estimated pregnancy age at delivery to the point above. Birth averages occur at 280 days of gestation (40 weeks), which is therefore often used as a standard estimate for individual pregnancies. However, alternative durations and more individual methods have also been suggested.
Naegele Rules is the standard way of calculating due dates for pregnancy when it assumes 280 days of gestational age at delivery. This rule estimates the expected delivery date (EDD) by adding one year, reducing three months, and adding seven days to the origin of gestational age. Or there is a mobile app, which basically always provides consistent estimates compared to each other and is true for leap years, while the paper-made gears can be different from each other for 7 days and are generally not true for leap years.
Furthermore, actual labor only has a certain possibility within the limits of the estimated due date. A study of single live births came to the outcome that labor had a standard deviation of 14 days when gestational age was estimated by first trimester ultrasound, and 16 days when estimated directly by the last menstrual period.
Physiology
Initiation
Through hormonal interactions that include the follicle stimulating hormone that stimulates folliculogenesis and oogenesis creates a mature egg cell, a female gamete. Fertilization is an event in which an egg blends with a male gamete, spermatozoa. After the fertilization point, the product incorporates female and male gametes referred to as zygotes or fertilized eggs. The mixture of male and female gametes usually occurs after the act of sexual intercourse. The pregnancy rate for intercourse is highest during the menstrual cycle time of about 5 days before to 1 to 2 days after ovulation. Fertilization can also occur with assisted reproduction technologies such as artificial insemination and in-vitro fertilization.
Fertilization (conception) is sometimes used as a pregnancy initiation, with a derivative age called fertilization period. Fertilization usually occurs about two weeks before the next menstrual period is expected.
The third point in time is also considered by some to be the true start of pregnancy: This is the time of implantation, when the future of the fetus is attached to the lining of the uterus. It's about a week to ten days after conception. In this model, during the time between conception and implantation, the future fetus exists, but the woman is not considered pregnant.
Embryo and fetal development
The sperm and ovum, which have been released from either of the two female ovaries, are united in one of the two fallopian tubes. The fertilized egg, known as a zygote, then moves toward the uterus, a journey that can take up to a week to complete. Cell division begins about 24 to 36 hours after the male and female cells unite. Cell division continues at a rapid rate and cells then develop into what is known as a blastocyst. The blastocyst arrives at the uterus and attaches to the uterine wall, a process known as implantation.
The development of the mass of cells to be infants is called embryogenesis during the first ten weeks of pregnancy. During this time, cells begin to differentiate into various body systems. The basic lines of the organ, body, and nervous system are formed. At the end of the embryo stage, the beginning of features such as fingers, eyes, mouth, and ears become visible. Also during this time, there is an important structural development to support embryos, including placenta and umbilical cord. The placenta connects the developing embryo to the uterine wall to allow nutrient uptake, waste disposal, and gas exchange through the maternal blood supply. The umbilical cord is the connecting cable from the embryo or fetus to the placenta.
After about ten weeks of gestation, the embryo becomes known as a fetus. At the beginning of the fetal stage, the risk of miscarriage decreases sharply. At this stage, the fetus is about 30 mm (1.2 in) long, the heartbeat is seen through ultrasound, and the fetus makes an unconscious movement. During advanced fetal development, early body systems, and structures established at the embryonic stage continue to grow. The sex organs begin to appear during the third month of pregnancy. The fetus continues to grow both in weight and length, although most physical growth occurs in the last weeks of pregnancy.
Electrical brain activity was first detected between the fifth and sixth weeks of pregnancy. It is considered a primitive neural activity rather than the beginning of conscious thought. Synapses begin to form at 17 weeks, and begin to multiply rapidly at 28 to 3 to 4 months after birth.
Maternal changes
During pregnancy, women undergo many physiological changes, which are completely normal, including behavioral changes, cardiovascular, haematological, metabolic, renal, and respiratory. Increased blood sugar, breathing, and cardiac output are all needed. Progesterone and estrogen levels rise steadily during pregnancy, suppressing the hypothalamus shaft and therefore also the menstrual cycle.
The fetus is genetically distinct from the female and can be seen as an extraordinarily successful allograft. The main reason for this success is increased immune tolerance during pregnancy. Immune tolerance is the concept that the body is unable to attach an immune system response to a particular trigger.
Pregnancy is usually divided into three periods, or trimesters, each about three months. Each trimester is defined as 14 weeks, with a total duration of 42 weeks, although the median duration of pregnancy is 40 weeks. Although there are no hard and fast rules, these differences are useful in describing the changes that occur over time.
First trimester
Minute vents increase by up to 40% in the first trimester. The uterus will grow to a lemon size of up to eight weeks. Many of the symptoms and discomforts of pregnancy such as nausea and tender breasts appear in the first trimester.
Second trimester
Week 13 to 28 pregnancy is called second trimester. Most women feel more energized in this period, and begin to gain weight when morning sickness symptoms subside and eventually fade. The uterus, a muscular organ that holds the developing fetus, can widen to 20 times its normal size during pregnancy.
Although the fetus begins to move during the first trimester, it is not until the second trimester of the movement, often referred to as "acceleration", can be felt. This usually occurs in the fourth month, more specifically at the 20th to the 21st week, or at week 19 if the woman is pregnant before. It is common for some women to not feel the fetus move to much later on. During the second trimester, most women start wearing maternity clothes.
Third trimester
The ultimate weight gain occurs, which is the most weight gain throughout pregnancy. The woman's stomach will change shape because it falls because the fetus rotates to the bottom position ready for birth. During the second trimester, the woman's stomach will be erect, while in the third trimester will go down. The fetus moves regularly, and is perceived by the woman. Fetal movement can be strong and disturbing women. Female navel sometimes becomes convex, "popping" out, due to enlarged belly.
Head involvement, in which the fetal head goes down to a cephalic presentation, reduces the pressure on the upper abdomen with a new comfort in breathing. It also greatly reduces bladder capacity, and increases pressure on the base of the pelvis and rectum.
It is also during the third trimester that maternal activity and sleeping position can affect fetal development due to limited blood flow. For example, enlarged uterus may block blood flow by pressing the cava vein when lying flat, which is relieved by lying on the left side.
Childbirth
Childbirth, called childbirth and delivery in the medical field, is the process by which babies are born.
A woman is considered in labor when she begins to experience regular uterine contractions, accompanied by cervical changes - especially thinning and dilation. When labor is experienced widely as a pain, some women report painless work, while others find that concentrating on deliveries helps speed up labor and reduce sensation. Most births are the birth of a successful vagina, but sometimes complications arise and a woman can undergo a cesarean section.
During the time immediately after birth, both the mother and the baby are hormonally bonded, the mother through the release of oxytocin, the hormone is also released during breastfeeding. Studies show that skin-to-skin contact between mother and baby immediately after birth is beneficial for both mother and baby. A review conducted by the World Health Organization found that skin-to-skin contact between mother and baby after birth reduced crying, increased maternal-baby interaction, and helped mothers to breastfeed successfully. They recommend that neonates be allowed to bond with mothers during the first two hours after birth, a period that they tend to be more vigilant than in the subsequent hours of early life.
Stage of baby's birth maturity
In an ideal labor delivery begins by itself when a woman is "at term". Events before the 37 week settlement are considered premature. Premature birth is associated with a variety of complications and should be avoided if possible.
Sometimes if a woman's water breaks or she contracts before 39 weeks, birth can not be avoided. However, spontaneous birth after 37 weeks is considered a term and unrelated to the risk of preterm birth. A birth plan before 39 weeks through caesarean section or labor induction, although "at times", results in an increased risk of complications. It stems from factors including the undeveloped lungs of newborns, infections due to the immature immune system, eating problems due to the underdeveloped brain, and jaundice of the less developed liver.
Babies born between 39 and 41 weeks' gestation have better results than babies born before or after this range. This particular time period is called "full term". Whenever possible, waiting for self-initiated labor in this period is best for maternal and infant health. The decision to induce should be done after considering the risks and benefits, but safer after 39 weeks.
Events after 42 weeks are considered post-post. When the pregnancy exceeds 42 weeks, the risk of complications for women and fetus increases significantly. Therefore, in uncomplicated pregnancies, obstetricians usually prefer to induce labor at a certain stage between 41 and 42 weeks.
Postnatal period
The postnatal period, also referred to as puerperium, begins shortly after delivery and extends for about six weeks. During this period, the mother's body begins to return to pre-pregnancy conditions that include changes in hormone levels and uterine size.
Diagnosis
Early pregnancy can be detected either based on symptoms by the women themselves, or by using a pregnancy test. However, an important condition with serious health implications that is quite common is the rejection of pregnancy by pregnant women. About one in 475 rejections will last until about the 20th week of pregnancy. The proportion of cases of rejection, persisting up to about 1 in 2500. In contrast, some non-pregnant women have a very strong belief that they are pregnant along with some physical changes. This condition is known as a fake pregnancy.
Physical signs
Most pregnant women experience a number of symptoms, which may indicate pregnancy. A number of early medical signs are associated with pregnancy. These signs include:
- the presence of human chorionic gonadotropin (hCG) in blood and urine
- skip the menstrual period
- implantation bleeding that occurs during implantation of the embryo in the uterus during the third or fourth week after the last menstrual period
- Continuous basal body temperature increase for more than 2 weeks after ovulation
- Chadwick's sign (cervical, vaginal, and vulva evaporation)
- Goodell sign (softening of cervical vaginal section)
- Hegar signs (softening of uterine ismus)
- Linea alba pigmentation - linea nigra, (darkening of the skin in the midline of the stomach, caused by hyperpigmentation due to hormonal changes, usually appears around mid-pregnancy).
- Dark nipples and areola due to increased hormones.
Biomarkers
Detection of pregnancy can be achieved by using one or more various pregnancy tests, which detect hormones produced by the newly formed placenta, serve as a biological marker of pregnancy. Blood and urine tests can detect pregnancy 12 days after implantation. Pregnancy blood tests are more sensitive than urine tests (giving less false negatives). Home pregnancy test is a urine test, and usually detects pregnancy 12 to 15 days after conception. Quantitative blood tests can determine approximately the date the embryo is conceived because HCG doubles every 36 to 48 hours. A progesterone level test may also help determine how likely the fetus will survive in those who have a miscarriage is threatened (bleeding early in pregnancy).
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Obstetric ultrasonography can detect fetal abnormalities, detect multiple pregnancies, and improve pregnancy at 24 weeks. It is thought that the gestational age and the date of birth of the fetus is slightly more accurate than the method based on the last menstrual period. Ultrasound is used to measure the nuchal crease to filter Downs syndrome.
Management
Prenatal care
Pre-conception counseling is a treatment given to women and/or partners to discuss conception, pregnancy, current health problems and recommendations for the pre-pregnancy period.
Prenatal medical care is the recommended medical and nursing care for women during pregnancy, the time interval and the exact destination of each visit are different in each country. High-risk women have better results if they are seen regularly and frequently by a medical professional rather than a low-risk woman. A woman can be labeled high risk for different reasons including previous complications in pregnancy, complications in current pregnancy, current medical illness, or social problems.
The goals of good prenatal care are prevention, early identification, and treatment of medical complications. The basic prenatal visit consists of measuring blood pressure, fundal height, body weight and fetal heart rate, checking for labor symptoms, and guidance for what will happen next.
Nutrition
Nutrition during pregnancy is important to ensure healthy fetal growth. Nutrition during pregnancy differs from non-pregnant state. There is an increase in energy requirements and specific micronutrient requirements. Women benefit from education to encourage balanced energy and protein intake during pregnancy. Some women may need professional medical advice if their diet is affected by a medical condition, food allergy, or certain religious/ethical beliefs.
Adequate consonception (time before and right after conception) of folic acid (also called folate or Vitamin B 9 ) intake has been shown to reduce the risk of fetal neural tube defects, such as spina bifida. The neural tube develops during the first 28 days of pregnancy, the urine pregnancy test is usually not positive until 14 days post-conception, explaining the need to ensure adequate folate intake before conception. Folate is abundant in green leafy vegetables, peas, and oranges. In the United States and Canada, most wheat products (flour, noodles) are enriched with folic acid.
DHA omega-3 is a major structural fatty acid in the brain and retina, and is naturally found in breast milk. It is important for women to consume enough DHA during pregnancy and while breastfeeding to support her health and the health of her baby. Developing a baby can not produce DHA efficiently, and should receive this essential nutrient from women through the placenta during pregnancy and in breast milk after birth.
Some micronutrients are important for the health of developing fetuses, especially in areas of the world where inadequate nutrition is common. Women living in low- and middle-income countries are advised to take some micronutrient supplements containing iron and folic acid. This supplement has been shown to increase birth outcomes in developing countries, but has no effect on perinatal mortality. Adequate intake of folic acid, and iron is often recommended. In the developed regions, such as Western Europe and the United States, certain nutrients such as Vitamin D and calcium, which are necessary for bone development, may also require supplementation. Vitamin E supplementation has not been shown to improve birth outcomes. Zinc supplements have been associated with a decrease in preterm birth, but it is unclear whether that is the cause. Iron supplementation daily reduces the risk of maternal anemia. A routine daily iron supplementation study for pregnant women found elevated blood plasma levels, with no clear clinical benefit. Nutritional needs for women carry twins or triplets. higher than women carrying a baby.
Women are counseled to avoid certain foods, because of possible contamination with bacteria or parasites that can cause disease. Washing raw fruits and vegetables can carefully remove these pathogens, such as cooking leftovers, meat, or processed meat thoroughly. Unpasteurized milk and deli meat may contain listeria, which can cause neonatal meningitis, stillbirth and miscarriage. Pregnant women are also more susceptible to Salmonella infection, which can be on eggs and poultry, which must be cooked thoroughly. Cat manure and undercooked meat may contain Toxoplasma gondii parasites and may cause toxoplasmosis. Practicing good hygiene in the kitchen can reduce this risk.
Women are also given counseling to eat enough seafood and to eliminate seafood known mercury high because of the risk of birth defects. Pregnant women are given counseling to consume moderate amounts of caffeine, because large amounts of caffeine are associated with miscarriage. However, the relationship between caffeine, birth weight, and premature birth is unclear.
Weight
The amount of healthy weight during pregnancy varies. Weight gain is associated with infant weight, placenta, extra circulatory fluid, larger tissues, and storage of fats and proteins. The most needed weight occurs later in pregnancy.
The Institute of Medicine recommends overall gestational weight gain for people of normal weight (body mass index 18.5-24.9), from 11.3-15.9 kg (25-35 pounds) having a single pregnancy. Women who are underweight (BMI less than 18.5), should get between 12.7-18 kg (28-40 pounds), while those who are overweight (BMI 25-29.9) are advised to get between 6, 8-11.3 kg (15 -25 pounds) and those who are obese (BMI & gt; 30) should get between 5-9 kg (11-20 pounds). These values ​​references expectations for term pregnancy.
During pregnancy, inadequate or excessive weight gain may compromise the health of the mother and fetus. The most effective intervention for weight gain in women with underweight is not clear. Being or being overweight in pregnancy increases the risk of complications for the mother and fetus, including caesarean section, gestational hypertension, pre-eclampsia, macrosomia and shoulder dystocia. Excessive weight gain can lose weight after pregnancy is difficult.
About 50% of women of childbearing age in developed countries such as the UK are overweight or obese before pregnancy. Dietary modification is the most effective way to reduce weight gain and associated risks in pregnancy. Diets that have foods with a low glycemic index can help prevent gestational diabetes.
Medication
Drugs used during pregnancy can have a temporary or permanent effect on the fetus. Anything (including medicines) that can cause permanent defects in the fetus are labeled as teratogens. In the US, drugs are classified into categories A, B, C, D, and X under the Food and Drug Administration (FDA) scoring system to provide therapeutic guidance based on the potential benefits and risks of the fetus. Drugs, including some multivitamins, which do not show fetal risks after controlled human studies are classified as Category A. On the other hand, drugs such as thalidomide with a proven fetal risk greater than all benefits are classified as Category X.
recreational drugs
The use of recreational drugs in pregnancy can lead to various complications of pregnancy.
- Ethanol during pregnancy can cause fetal alcohol syndrome and fetal alcohol spectrum disorders. Studies have shown that mild to moderate drinking during pregnancy may not pose a risk to the fetus, although no amount of alcohol during pregnancy can be guaranteed to be completely safe.
- Smoking tobacco during pregnancy can lead to a variety of behavioral, neurological, and physical disorders. Smoking during pregnancy causes twice the risk of premature rupture of membranes, placenta and placenta previa. Smoking is associated with a 30% higher likelihood of preterm delivery.
- Prenatal cocaine exposure is associated with premature birth, birth defects, and attention deficit disorder.
- Exposure to prenatal methamphetamine may lead to premature birth and congenital anomalies. Short-term neonatal outcomes show a small deficit in infant neurobehavioral function and growth restriction. Long-term effects in terms of brain development disorders can also be caused by the use of methamphetamine.
- Cannabis in pregnancy have been shown to be teratogenic in large doses in animals, but have not shown teratogenic effects in humans.
Exposure to poison
Intrauterine exposure to environmental toxins in pregnancy has the potential to cause adverse effects on embryonic/fetal development and lead to pregnancy complications. Air pollution has been linked to low birth weight babies. Specific severity conditions in pregnancy include mercury poisoning and lead poisoning. To minimize exposure to environmental toxins, the American College of Nurse-Midwives recommends: check if the house has lead paint, wash all fresh fruits and vegetables thoroughly and buy organic produce, and avoid toxic or "toxic" cleaning products. any product with a warning on the label.
Pregnant women can also be exposed to toxins in the workplace, including particles in the air. The effect of wearing a respirator respirator N95 respirator is similar for pregnant women as nonpregnant women, and wearing a respirator for an hour does not affect the fetal heart rate.
Sexual activity
Most women can continue to engage in sexual activity during pregnancy. Most studies show that during pregnancy, sexual desire and the frequency of intercourse decreases. In the context of this decrease in overall desirability, some studies show a second trimester increase, preceding a decrease during the third trimester.
Sex during pregnancy is a low-risk behavior except when healthcare providers recommend that sexual intercourse be avoided for certain medical reasons. For healthy pregnant women, there is no safe safe or way to have sex during pregnancy. Pregnancy alters vaginal flora by reducing microscopic species/genus diversity. Exercise
Regular aerobic exercise during pregnancy appears to improve (or maintain) physical fitness. Physical exercise during pregnancy does appear to reduce the risk of caesarean section. Bed rest, outside research studies, is not recommended because there is no evidence of benefit and potential harm.
The Obstetric Committee of Canadian Clinical Practice recommends that "All women without contraindications should be encouraged to participate in aerobic exercise and strengthening exercises as part of a healthy lifestyle during their pregnancy." Although the level of intensity of safe exercise has not been established, women who exercise regularly before pregnancy and who have uncomplicated pregnancies should be able to engage in high intensity exercise programs. In general, participation in a variety of recreational activities seems safe, by avoiding those at high risk of falling like horseback or skiing or those who carry the risk of trauma to the stomach, such as soccer or hockey.
The American College of Obstetricians and Gynecologists report that in the past, the main concern of exercise in pregnancy is focused on the fetus and any potential maternal benefit is considered to be offset by potential risks to the fetus. However, they wrote that more recent information suggests that in uncomplicated pregnancies, fetal injury is highly unlikely. However, they note some circumstances when a woman should contact her health care provider before continuing with an exercise program: vaginal bleeding, pre-activity dyspnoea, dizziness, headache, chest pain, muscle weakness, preterm labor, decreased fetal movement, amniotic fluid leakage, and calf pain or swelling (to get rid of thrombophlebitis).
Sleep
It has been suggested that shift work and light exposure at night should be avoided at least during the last trimester of pregnancy to reduce the risk of psychological and behavioral problems in the newborn.
Dental care
Increased levels of progesterone and estrogen during pregnancy can develop gingivitis; gums become edematous, red, and tend to bleed. Also a pyogenic granuloma or "pregnancy tumor," is usually seen on the labial surface of the papillae. The lesion may be treated with local debridement or an inner incision depending on its size, and by following adequate oral hygiene measures. It has been suggested that severe periodontitis may increase the risk of preterm delivery and low birth weight, however, Cochrane's review found insufficient evidence to determine whether periodontitis can develop an adverse birth outcome.
Complications
Every year, poor health as a result of pregnancy is experienced (sometimes permanently) by over 20 million women worldwide. In 2013 pregnancy complications resulted in 293,000 deaths falling from 377,000 deaths in 1990. Common causes include maternal bleeding (44,000), complications of abortion (44,000), high blood pressure of pregnancy (29,000), maternal sepsis (24,000), and delayed labor. (19,000).
Here are some examples of pregnancy complications:
- Pregnancy-induced hypertension
- Anemia
- Postpartum depression
- Postpartum psychosis
- Thromboembolic disorders. This is the leading cause of death in pregnant women in the US.
- PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy), a skin disease that develops around the 32nd week. Signs are red plaques, papules, and itching around the navel that then spread throughout the body except the inside of the hands and face.
- Ectopic pregnancy, implantation of the embryo outside the uterus.
- Hyperemesis gravidarum, excessive nausea and vomiting that is more severe than normal morning sickness.
- Pulmonary embolism, a blood clot formed on the feet that can migrate to the lungs.
There is also an increased sensitivity and severity of certain infections in pregnancy.
Recurrence disease
A pregnant woman may have a recurrent disease, which is defined as a disease not directly caused by pregnancy, but it can get worse or become a potential risk for pregnancy.
- Diabetes mellitus and pregnancy are associated with the interaction of diabetes mellitus (not limited to gestational diabetes) and pregnancy. Risks for children include miscarriage, growth restriction, growth acceleration, fetal obesity (macrosomia), polyhydramnios (too much amniotic fluid), and birth defects.
- Thyroid disease in pregnancy can, if not corrected, cause adverse effects on the fetus and maternal well-being. The damaging effects of thyroid dysfunction can also extend beyond pregnancy and childbirth to influence neurointellectual development early in a child's life. Thyroid hormone demand increases during pregnancy which can lead to a previously unrecognized thyroid disorder worsening.
- Untreated celiac disease can lead to spontaneous miscarriage (miscarriage), intrauterine growth restriction, small to gestational age, low birth weight and premature birth. Often reproductive disorders are the only manifestations of undiagnosed celiac disease and most cases are not recognized. Complications or failure of pregnancy can not be explained only by malabsorption, but by the autoimmune response induced by gluten exposure, which causes damage to the placenta. Gluten-free diets avoid or reduce the risk of developing reproductive disorders in pregnant women with celiac disease. Also, pregnancy can be a trigger for the development of celiac disease in women who are genetically susceptible who take gluten.
- Systemic lupus erythematosus in pregnancy causes an increase in fetal mortality in the uterus, spontaneous abortion, and neonatal lupus.
- Hypercoagulability in pregnancy is a tendency for pregnant women to develop thrombosis (blood clots). Pregnancy itself is a factor of hypercoagulability (pregnancy induced hypercoagulability), as a mechanism of physiological adaptation to prevent postpartum hemorrhage. However, in combination with the underlying hypercoagulation state, the risk of thrombosis or embolism may be substantial.
Medical description
Medical imaging may be indicated in pregnancy because of complications of pregnancy, infectious disease or routine pregnancy care. Magnetic resonance imaging (MRI) without MRI contrast agents as well as midwifery ultrasound is not associated with any risk to the mother or fetus, and imaging techniques of choice for pregnant women. Radiographic projection, X-ray computed tomography and the results of nuclear medicine imaging at some level of ionizing radiation exposure, but in most cases the absorbed dose is not related to the danger to the infant. At higher doses, the effect may include miscarriage, birth defects and intellectual disabilities.
Epidemiology
Approximately 213 million pregnancies occur in 2012 where 190 million are in developing countries and 23 million are in developed countries. This is about 133 pregnancies per 1,000 women between the ages of 15 and 44 years. About 10% to 15% of pregnancies admitted end in miscarriage. Globally, 40% of pregnancies are unplanned. Half of unplanned pregnancies are aborted.
Pregnancy in 2012 120 million occurs in Asia, 54 million in Africa, 19 million in Europe, 18 million in Latin America and the Caribbean, 7 million in North America, and 1 million in Oceania. The pregnancy rate is 140 per 1000 women of childbearing age in developing countries and 94 per 1,000 in developed countries.
The pregnancy rate, as well as the age at which it occurs, differs by country and region. This is influenced by a number of factors, such as cultural, social and religious norms; access to contraception; and level of education. The total fertility rate (TFR) in 2013 is estimated to be the highest in Niger (7.03 children/women) and the lowest in Singapore (0.79 children/women).
In Europe, the average productive age has been increasing continuously for some time. In Western Europe, North and South, first mothers aged 26 to 29, up from 23 to 25 in the early 1970s. In some European countries (Spain), the average age of women in the first delivery has crossed the threshold of 30 years.
This process is not limited to Europe. Asia, Japan and the United States all see the average age at the first birth as it increases, and the process is spreading to developing countries like China, Turkey and Iran. In the US, the first average age of childbirth is 25.4 in 2010.
In the United States and the UK, 40% of pregnancies are unplanned, and between a quarter and a half of unplanned pregnancies are unwanted pregnancies.
Globally, an estimated 270,000 women die from pregnancy-related complications each year.
Society and culture
In most cultures, pregnant women have a special status in society and receive very gentle care. At the same time, they are subject to expectations that can provide great psychological distress, such as having to produce sons and heirs. In many traditional societies, pregnancy should be preceded by marriage, on the pain of mother and child alienation (illegitimate).
Overall, pregnancy is accompanied by many customs that are often subject to ethnological research, often rooted in traditional or religious medicine. Baby showers are an example of modern habits.
Pregnancy is an important topic in the sociology of the family. Prospective children may initially be placed into many social roles. Parental relationships and relationships between parents and their environment are also affected.
Abdominal stomach can be made during pregnancy as a keepsake.
Art
Images of pregnant women, especially small statues, are made in traditional culture in many places and periods, though rarely one of the most common types of images. These include ceramic figures from some Pre-Columbian cultures, and some figures from most ancient Mediterranean cultures. Many of these seem to be related to fertility. Identifying whether the numbers are actually meant to show pregnancy is often a problem, as well as understanding their role in the culture.
Among the oldest examples of pregnancy depictions are prehistoric statues found in most Eurasians and collectively known as Venus sculptures. Some of them appear to be pregnant.
Because of the important role of the Mother of God in Christianity, Western art has a long tradition of portrayal of pregnancy, especially in the biblical scene of the Visitation, and the reflection image called Madonna del Parto.
An unpleasant scene usually called Diana and Callisto , denotes the moment of discovery of Callisto forbidden pregnancy, sometimes painted from the Renaissance and beyond. Gradually, portraits of pregnant women began to emerge, with a special mode for "pregnancy portraits" in elite portraits of about 1600 years.
Pregnancy, and especially pregnancy of unmarried women, is also an important motif in literature. Notable examples include Hardy Tess of the d'Urbervilles and Goethe's Faust .
- Pregnancy in art
Infertility
Modern reproductive medicine offers many forms of assisted reproductive technology for couples who remain childless against their desires, such as fertility drugs, artificial insemination, fertilization and freezing in vitro.
Abortion
Abortion is the termination of an embryo or fetus, either naturally or through a medical method. When done electively, it is more often done in the first trimester than the second, and rarely in the third. Not using contraception, contraceptive failure, poor family planning or rape can lead to unwanted pregnancies. The legality of abortion that is shown socially varies both internationally and over time. In most Western European countries, abortion during the first trimester was a criminal offense several decades ago but has since been legalized, sometimes through mandatory consultation. In Germany, for example, in 2009 less than 3% of abortions had medical indications.
Legal protection
Many countries have various legal rules to protect pregnant women and their children. The Pregnancy Protection Convention ensures that pregnant women are freed from activities such as night shifts or carrying heavy stock. Maternity leave usually gives paid leave from work during the last trimester of pregnancy and for some time after birth. Famous extreme cases include Norway (8 months in full salary) and the United States (no paid leave except in some states). In addition, many countries have laws against discrimination of pregnancy.
In 2014, the US state of Tennessee passed a law allowing prosecutors to prosecute a woman with a criminal offense if she used illegal drugs during her pregnancy and the fetus or baby was deemed harmed.
In the United States, the law makes several acts that result in a miscarriage or a stillbirth. One such law is the federal Unknown Anti-Violence Act.
See also
- Pseudopregnancy
- Pelvic pelvic pain
References
Further reading
- "Nutrition For First Trimester Pregnancy". IDEA Health & amp; Fitness Association . Retrieved December 9 2013 .
- Bothwell, TH (July 2000). "Requirement of iron in pregnancy and strategy to meet them". The American Journal of Clinical Nutrition . 72 (1 Suppl): 257S-264S. doi: 10.1093/ajcn/72.1.257S. PMIDÃ, 10871591.
- Stevens, Jacqueline (June 2005). "Envy of pregnancy and politics of masculinity compensation". Politics & amp; Gender . 1 (2): 265-296. doi: 10.1017/S1743923X05050087. < span>
External links
- Pregnancy in Curlie (based on DMOZ)
- Merck Household Health Manual - more details on illness, disorders, etc., which can complicate pregnancy.
- Pregnancy planners - NHS guides for having babies include preconception, pregnancy, childbirth, and birth.
Source of the article : Wikipedia
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