Normal Pregnancy and Associated Conditions

Duration of Pregnancy

  • Duration calculated as 10 lunar months, 9 calendar months, or 280 days (40 weeks) from the first day of the last menstrual period (gestational age).

First Trimester (12 weeks) Symptoms

Subjective Symptoms:

  • Amenorrhea (missed menstruation)
  • Morning sickness (nausea & vomiting)
  • Frequent urination
  • Breast discomfort (fullness & pricking sensation)
  • Fatigue

Objective Signs:

  • Changes in breasts, size, shape, and pigmentation
  • Uterine changes in size and shape
  • Softening of vaginal walls
  • Cervical changes (blueish discoloration)

Diagnosis of Pregnancy

  • Pregnancy test detects hCG in urine or serum.
  • Blood investigations (grouping, viral markers, blood pressure, thyroid profile, sugar test).

Second Trimester (13-28 weeks)

Symptoms:

  • Nausea and vomiting subside
  • Added medications: calcium and iron (100 mg), and T.T vaccines
  • Investigations repeated
  • Targeted Imaging for Fetal Anomalies (TIFA) scan (18-22 weeks).
  • Quickening marks fetal movements (18 weeks).

Third Trimester (29-40 weeks)

Symptoms:

  • Increased abdomen size
  • Reappearance of urinary frequency
  • Repeated investigations
  • Growth scan checks for fetal growth
  • Monitoring fetal heart sounds from 18-20 weeks.
  • Complications - oligohydramnios and polyhydramnios.

Placenta Function

  • Connects embryo to mother, providing nourishment and waste removal. Secretes hormones like hCG, estrogen, progestin.
  • Types include Choriovitelline and Chorioallantoic placenta.

Placenta Previa Types and Complications

  • Types: Normal, Complete, Partial, Marginal.
  • Complications: maternal bleeding, malpresentation, premature labor.

Fundal Height Measurements

  • Uterus measured at various intervals (up to 40 weeks).

Hyperemesis Gravidarum (HG)

  • Severe vomiting causes dehydration, weight loss, metabolic imbalances. Managed mostly in the first trimester.

Antenatal Care

  • Systematic supervision to monitor health through history taking, examination, and advice to prevent complications.

Individual Health Monitoring

  • Monitoring general health (anemia, past medical/surgical history).

Nutritional Advice

  • Adequate nutrition for maternal health and fetal growth, iron supplementation.

Edema and Hypertension in Pregnancy

  • Edema might indicate pregnancy complications; hypertension linked to maternal and fetal risks.

Complications in Third Stage of Labour

  • PPH, retained placenta, shock, uterine inversion.

Classifications of Anemia in Pregnancy

1) Deficiency anemia (iron, folic acid, B12, protein)
2) Hemorrhagic anemia
3) Hereditary and Bone marrow insufficiency anemia.

Preeclampsia and Eclampsia

  • Preeclampsia defined by hypertension and proteinuria after 20 weeks.
  • Eclampsia involves seizures.

Neonatal Resuscitation Steps

  • Ventilation is vital; administer warmth, clear airways, and monitor heart rate and breathing.

Episiotomy Types

  • Types: Medio-lateral, Median, Lateral, J-shaped.
  • Purpose: enlarging birth canal and preventing tissue injury.

Ovarian and Cervical Cancer Management

  • Early detection through routine screening (Pap smear).
  • Treatment includes surgery, chemotherapy, radiotherapy.

Abnormalities in Pregnancy

  • Polyhydramnios, oligohydramnios care needs, and complications management.
  • Platelet disorders and thrombocytopenia management in pregnancy.
  • IUCDs for contraception.

Key Physiological Changes in Pregnancy

  • Increases in blood volume, cardiac output; changes in respiratory system, blood pressure, and renal function apply.
  • Nutritional requirements and physical activity emphasis throughout gestation.