Physiological Changes During Pregnancy & Fetal Development

Stages of Pregnancy: 1st Trimester

1-14 weeks

Stags of Pregnancy: 2nd Trimester

14-26 weeks

Stages of Pregnancy: 3rd Trimester

27-40 weeks

Gravidity “G”

Number of times a person is pregnant

“Nulligravida = Never pregnant”

“Primigravida = First pregnancy”

“Multigravida = Two or more pregnancies”

Parity “P”

Number of delivers that reach over 20 weeks gestation

Clinical indication of early pregnancy, hand goes in the cervix, while other hand is on abdomen palpating and finding the fundus of the uterus.

Hager’s sign

Softening of the cervix is called

Goodell’s sign

Blueish discoloration which represents increased vasculerzation in the cervix

Chadwick’s sign

Ovulation is ceased or keeps going during pregnancy

Ovulation is ceased

Why are woman more likely to have yeast infections during pregnancy

-V thickens

-Acidity increases

-Leukorrhea present (white discharge)

Cardiovascular system changes during pregnancy

↑ Blood volume due to loss of blood during labor

↑ Heart Rate

↓ Slightly BP

During pregnancy return of blood flow becomes more difficult due to enlarghed uterus leading too

-Dependent edema

-Varicose veins

Can cause postural hypotension

Supine Hypotensive Syndrome

-Lying on back leads to pressure on vena cava

-Leads to decreased CO and BP

-Leads to dizziness

-We fix this by moving them to the side.

Does WBC increase or decrease during preganancy

WBC increases

Does Clotting factor increase or decrease during pregnancy

Clotting factor increases → Increases DVT

Respiratory changes while pregnant

-Increased O2 consumption

-Diaphragm elevates due to uterus pushing up

-Increased nasal congestion

-Increased bloody noses (epistaxis)

What endocrine system effects fetal neurologic development

Thyroid hormone → Increases preterm births

Insulin production and its effect on the fetus

Insulin does not cross the placenta, fetus makes its own.

Why is FSH & LH inhibited during pregnancy

Because there is no ovulation occurring

Prolactin

-Promotes breast development and lactation

-Inhibited until baby is delivered

Oxytocin

Responsible for uterine contractions and milk ejection during breastfeeding

Weight gain in 1st trimester vs Post 1st trimester

1st Trimester = 3.5 to 5 pounds

Post 1st Trimester = 1 pound each week

What is produced in the second half of pregnancy

-hPL → Insulin antagonist → More insulin should be adminsiter in the second half

BMI of 18.5-25 (normal) weight gain range

25-35 pounds

BMI of 25-30 (overweight) weight gain range

15-20 pounds

BMI of 30 + (Obese) weight gain range

11-20 pounds

BMI of 18.5 or less (underweight) weight gain range

28-40 pounds

Excessive saliva production in mouth is called

Ptyalism

Upper GI effects from pregnancy

-N&V

-Pyrosis (heartburn)

-Pruritis (itching)

Lower GI pregnancy

-Delayed gastric emptying + decreased intestinal motility = bloating, constipation, & hemorrhoids

Renal during pregnancy

-Kidney size increases

-Kidney GFR increases

-Increase in urinary frequency

What is it called when the baby drops into the pelvis

Lightening

What hormone leads to the pregnant lady to waddle

relaxin due to the pelvic joints relaxing

What shape of pelvis is the best for giving birth

Gynecoid

Innate vs Adaptive immunity during pregnancy

Innate → Better inflammatory response

Adaptive → Prevents rejection of fetus in body, stabilizes chronic conditions (RA), more susceptible to UTIs

Partner experiences weight change or breast tenderness is called

Couvade’s Syndrome

Endometrial (menstrual) cycle has how many phases and deals with what organ

Four: 1) Menstrual Phase; 2) Proliferative Phase; 3) Secretory Phase: 4) Ischemic

Uterus

Menstrual Phase

-1-6 Days

-Endometrium is shed

-Estrogen & Progesterone levels are low

Proliferative Phase

-7-14 Days

-Endometrium increases

-Estrogen peaks & body temperature drops just before Ovulation (day 14)

-Ovulation → Cervical mucus at ovulation becomes thin, watery, and alkaline whch is more favorable for sperm.

Secretory Phase

-Days 15-26

-Estrogen drops sharply

-Progesterone dominates

-Endometrium is being maintained for implementation

Ischemic Phase

-Days 27-28

-Both Estrogen and Progesterone fall

-Vasoconstriction of spiral arteries

-Blood vessels rupture and blood escapes into uterine stormal cells

Ovarian Cycle phases and what organ does it involve

Two Phases: 1) Follicular Phase (Mid-Cycle Ovulation) & 2) Luteal Phase

Ovaries

Follicular Phase

-Days 1-14 HOWEVER THIS CAN VARY

-The Oocyte grows inside the maturing follicle

-Mid Cycle Ovulation → Mature follicle ruptures due to LH surge

-Mid Cycle Ovulation characteristics→ Mucus changes, lower abdomen cramping, Body temperature increases.

Leuterual Phase

-Days 15-28 FIXED LENGTH

-Begins when ovum leaves follicle

Hypothalamic-Pituutary Cycle

-FSH produced by Anterior Gland

-LH produced by Posterior Gland

-Both peak at ovulation, however LH is more prevelant

LH & FSH responsibilities in males

LH → Teste production & Testosterone

FSH → Development and maturation of sperm

Sperm cells are produced where and stored where

Produced → Seminiferous Tubules

Stored → Epipidymis

Preembryonic Stage

Fertilization occurs in fallopian tube

-Blastocyst is formed = Baby

-Trophoblast is formed = Placenta

-Implementation occurs 7-8 days after fertilization

-Cellular differentiation occurs and germ layers are formed

What is the most fertal time for a woman to get pregnant

2 days before or day of ovulation

Embryonic stage (3-8 weeks)

-Basic structure of all major body organs are formed

-Stage where the body is most vulnerable to tetrogenic substances

-Amniotic fluid is formed

-Umbilical cord and yolk sac formed

-Placenta formed

Amniotic Fluid functions

-Cushion

-Temp. Regulation

-Symmetrical growth and movement

-Infection barrier

-Made up of 98% water and fetal urine

-Oligohydraminos → Low levels of amniotic fluid

-Hydraminos → High levels of amniotic fluid

Umbilical Cord Characteristic

-1 vein that carries O2

-2 arteries that carries deoxygenated blood.

Yolk Sac main function

Production of RBC

Placenta functions

-Placenta is the interface for fetus and mom

-Does many of the bodily functions

-Make sure that mom and fetus blood never mix