Changes during Pregnancy

Pregnancy

State of fertilization and development for one or more offspring within a woman’s uterus. The prenatal offspring (also called the conceptus) is referred to as an embryo or fetus.

Embryo

Used primarily for developing humans up to eight weeks after fertilization (to the 10th week of gestation), after which they are called a fetus.

First Trimester

• First 12 weeks of pregnancy.

• Carries the highest risk of miscarriage (natural death of embryo or fetus)

Second Trimester

• Weeks 13 to 28 of the pregnancy

• The development of the fetus is more easily monitored

Third Trimester

Often the approximates the point of viability, or the ability of the fetus to survive, with or without medical help, outside the uterus

Gravidity

One scientific term for the state of pregnancy

Gravida

A pregnant female

Parity

Used for the number of times a female has given birth

Nulligravida

A woman who has never been pregnant

Multigravida

A woman in subsequent pregnancies

Nulliparous

A woman who has never given birth

Multiparous

A woman who has had more than one live birth

Uterine endometrium

decidua

embryo or fetus

the umbilical cord connects the

human chorionic gonadotropin (hCG)

The presence of ______ in the blood and urine.

Hegar’s Sign

Softening of the uterus isthmus

Chadwick’s Sign

Darkening of the cervix, vagina, and vulva

Goodell’s Sign

Softening of the vaginal portion of cervix

Pigmentation of the line alba (linea nigra)

darkening of the skin in a midline of the abdomen.

Gestational Diabetes

• Condition in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy.

• This type of diabetes is caused when the insulin receptors do not function properly.

  • This is likely due to pregnancy-related factors such as the presence of human placental lactogen that interferes with susceptible insulin receptors.

Hormonal Changes

• Adjustments in their endocrine system

• Women also experience an increase in human chorionic gonadotropin

• Progesterone production primarily functions to relax smooth muscles

• Parathyroid hormone and adrenal hormones increases

• Human placental lactogen (HPL) is produced by the placenta

Weight Changes

• The enlarging uterus, the growing fetus, the placenta and amniotic fluid, and the acquisition of fat and water retention all contribute to weight gain

• The weight gain varies and can be anywhere from five pounds (2.3kg) to over 100 pounds (45kg)

• A woman’s breast grow

Circulatory Changes

• Plasma and blood volume slowly increase by 40%-50%

• Systematic vascular resistance also drops

• Edema of feet is common

• A pregnant woman will also become hypercoagulable, leading to increased risk for developing blood clots and embolism

Description of the Diet

Dietary intake should be increased for optimal pregnancy outcome

Characteristics of the Diet

Diet for pregnant women varies according to nutritional status of the mother pre- and during conception, as well as which trimester both mother and child are in

Weight gain in Pregnancy

There are three components to maternal weight gain

• the maternal body

• the maternal support tissues

• the products of conception

The Maternal Body

Whose changes include increased blood and extra cellular fluid volume

The Maternal Support Tissues

Increased size of the uterus and breasts

The Product of Conception

The fetus and the placenta. Inappropriate weight gain by the mother suggests that she may not have received adequate nutrition during pregnancy

Underweight

BMI: <18.5

Total Weight Gain Ranges: 28-40

Normal

BMI: 18.5-24.9

Total Weight Gain Ranges: 25-35

Overweight

BMI:25.0-29.9

Total Weight Gain Ranges: 11-25

Obese (all classes)

BMI: >30

Total Weight Gain Ranges: 11-20

Mitochondrial Diseases

• Diabetes and inherited cardiomyopathies

• Alzheimer’s Diseases

Most Common Micronutrient Deficiencies

• Iodine Deficiency Disorders

• Iron Deficiency Anemia

• Vitamin A Deficiency

Iodine Deficiency

• Causes brain damage to the fetus that results in a gross intellectual retardation (cretinism)., neurological disorders, and growth retardation, which are apparent in childhood.

• Fully preventable and can be corrected before conception or in the early stages.

Iron Deficiency

• Consequences are increased maternal mortality and adverse pregnancy outcomes.

• Low intake of heme iron (animal origin) or poor bioavailability of non-heme iron (plant origin)

Main causes of Iron Deficiency

Dietary factors, parasitic infestations by hookworms, chronic recurrent infections, and in some cases genetic anemia, such as thalassemia

At risk of Iron Deficiency

Vegetarians

Vitamin A Deficiency

• Can lead to eye damage

Folate or Folic Acid

• Plays a crucial role in the development of the central nervous system during the early weeks of gestation, which is generally before the pregnancy is confirmed.

• In a significant number of embryos, an inadequate supply of folate at this time leads to a failure of the primitive neural tube to close and to differentiate normally, and this results in neural tube birth defects (NTD)

Folic Acid Deficiency

• Another cause of anemia in pregnant women (megaloblastic anemia)