Pregnancy (latin graviditas) is the carrying of one or more offspring, known as a fetus or embryo, inside the uterus of a female human. Latin ( lingua Latīna, laˈtiːna is an Italic language, historically spoken in Latium and Ancient Rome. A fetus (or foetus or fœtus) is a developing Mammal or other Viviparous Vertebrate, after the Embryonic stage and An embryo (from Greek:, plural, lit "that which grows" from en- "in" + bryein "to swell be full" is a multicellular The uterus (from the Latin word for womb) is the major Female reproductive organ of most Mammals including Humans One end the Female (♀ is the Sex of an Organism, or a part of an organism which produces ova (egg cells Human beings, humans or man (Origin 1590–1600 L homō man OL hemō the earthly one (see Humus In a pregnancy, there can be multiple gestations, as in the case of twins or triplets. Gestation is the carrying of an Embryo or Fetus inside a Female Viviparous Animal. Twins are Offspring resulting from the same Pregnancy, either of the same or opposite Sex. A multiple birth occurs when more than one Fetus is carried to term in a single Pregnancy. Human pregnancy is the most studied of all mammalian pregnancies. In mammals pregnancy is the period of Reproduction during which a Female carries one or more live offspring from Implantation in the uterus through Obstetrics is the medical field that studies and treats pregnant patients. Obstetrics (from the Latin obstare, "to stand by" is the surgical speciality dealing with the care of a woman and her offspring during Pregnancy

Childbirth usually occurs about 38 weeks from fertilization, i. Childbirth (also called labour, birth, partus or parturition) is the culmination of a Human Pregnancy or Human fertilization is the union of a human egg and sperm, usually occurring in the Ampulla of the fallopian tube. e. , approximately 40 weeks from the start of the last menstruation. See also "Mensuration" a term sometimes used to describe Measurement, particularly in the context of Forestry. Thus, pregnancy lasts about nine months, although the exact definition of the English word “pregnancy” is a subject of controversy. Controversy over the beginning of pregnancy usually occurs in the context of the Abortion debate

Contents 1 Terminology 2 Characteristics 3 Diagnosis 4 Physiology 4.1 First trimester 4.2 Second trimester 4.3 Third trimester 4.4 Prenatal development and sonograph images 5 Physiological changes in pregnancy 5.1 Hormonal changes 5.2 Physical changes 5.3 Cardiovascular changes 5.4 Respiratory changes 5.5 Metabolic changes 5.6 Renal changes 6 Management 6.1 Nutrition 6.2 Weight gain 6.3 Immunological tolerance 6.4 Sexuality during pregnancy 6.5 Abortion 7 Progression 7.1 Complaints 7.2 Childbirth 7.3 Postnatal period 8 Context 9 See also 10 References

Terminology

One scientific term for the state of pregnancy is gravid, and a pregnant female is sometimes referred to as a gravida. Female (♀ is the Sex of an Organism, or a part of an organism which produces ova (egg cells In Medicine, gravidity refers to the number of times a woman has been Pregnant. ^[1] Both words are rarely used in common speech. Similarly, the term "parity" (abbreviated as "para") is used for the number of previous successful live births. For other uses of the term in other fields see Parity. In Medicine, parity is a technical term that refers to the number of times Medically, women who have never been pregnant are referred to as "nulliparous" ("gravida 0, para 0"),^[2], during a first pregnancy as a "primigravida" ("gravida 1, para 0") and in subsequent pregnancies as "multigravida" or "multiparous". ^[3] Hence during a second pregnancy a woman would be described as "gravida 2, para 1" and upon delivery as "gravida 2, para 2". Incomplete pregnancies of abortions, miscarriages or stillbirths account for parity values being less than the gravida number, whereas a multiple birth will increase the parity value.

The term embryo is used to describe the developing offspring during the initial weeks, and the term fetus is used from about two months of development until birth. ^[4][5]

In many societies' medical and legal definitions, human pregnancy is somewhat arbitrarily divided into three trimester periods, as a means to simplify reference to the different stages of prenatal development. Pregnancy ( Latin graviditas) is the carrying of one or more offspring known as a Fetus or Embryo, inside the Uterus of a Female Prenatal development is the process in which an embryo or fetus (or foetus) gestates during Pregnancy, from fertilization The first trimester carries the highest risk of miscarriage (natural death of embryo or fetus). Miscarriage or spontaneous abortion is the natural or spontaneous end of a Pregnancy at a stage where the embryo or fetus is incapable of surviving generally defined During the second trimester, the development of the fetus can be more easily monitored and diagnosed. The beginning of the third trimester often approximates the point of viability, or the ability of the fetus to survive, with or without medical help, outside of the uterus. A fetus (or foetus or fœtus) is a developing Mammal or other Viviparous Vertebrate, after the Embryonic stage and The uterus (from the Latin word for womb) is the major Female reproductive organ of most Mammals including Humans One end the ^[6]

Characteristics

Pregnancy occurs as the result of the female gamete or oocyte (egg) being penetrated by the male gamete spermatozoon in a process referred to, in medicine, as "fertilization", or more commonly known as "conception". An oocyte, ovocyte, or rarely ocyte, is a female Gametocyte or Germ cell involved in reproduction. An ovum (plural ova) is a Haploid Female reproductive cell or Gamete. A spermatozoon or spermatozoan ( pl spermatozoa) from the Ancient Greek σπέρμα (seed and ζῷον (living being and more commonly known For soil improvement see Fertilization (soil. The fusion of male and female gametes usually occurs through the act of sexual intercourse or, very rarely, other non-penetrative sexual activity. Sexual intercourse, in its biological sense is the act in which the male reproductive organ (in humans and other higher animals enters the female reproductive tract However, the advent of artificial insemination has also made achieving pregnancy possible in such cases where sexual intercourse is not potentially fertile (through choice or male/female infertility). AIH redirects here For the indie rock band abbreviated AIH see Architecture in Helsinki Artificial insemination (AI is the process by which

Though pregnancy begins at implantation, it is more convenient to date from the first day of a woman's last menstrual period (acronym = LMP), or from the date of conception (if known). Starting from one of these dates, the expected date of delivery (acronym = EDD) can be calculated. Counting from the LMP, pregnancy usually lasts between 37 and 42 weeks, with the EDD at 40 weeks,^[7] 38 weeks after conception. 40 weeks is a little more than nine months and six days, which forms the basis of Naegele's rule for estimating date of delivery. Naegele's Rule is a standard way of calculating the Due date for a Pregnancy.

Pregnancy is considered 'at term' when gestation attains 37 complete weeks but is less than 42 (between 259 and 294 days since LMP). Events before completion of 37 weeks (259 days) are considered pre-term; from week 42 (294 days) events are considered post-term. Premature birth (also known as preterm birth) is the Birth of a Baby before the standard period of Pregnancy is completed In order for an infant to be considered postmature they must be born after 42 week gestation ^[8] When a pregnancy exceeds 42 weeks (294 days), the risk of complications for mother and fetus increases significantly. ^[7][9] As such, obstetricians usually prefer to induce labour, in an uncomplicated pregnancy, at some stage between 41 and 42 weeks. ^[10][11]

Recent medical literature prefers the terminology pre-term and post-term to premature and post-mature. Pre-term and post-term are unambiguously defined as above, whereas premature and postmature have historical meaning and relate more to the infant's size and state of development rather than to the stage of pregnancy. ^[12][13]

Though these are the averages, the actual length of pregnancy depends on various factors. For example, the first pregnancy tends to last longer than subsequent pregnancies. Fewer than 10% of births occur on the due date; 50% of births are within a week of the due date, and almost 90% within two weeks. ^[14]

Accurate dating of pregnancy is important, because it is used in calculating the results of various prenatal tests (for example, in the triple test). Prenatal testing is Testing for diseases or conditions in a Fetus or Embryo before it is born The triple test, also called triple screen, the Kettering test or the Bart's test is an investigation performed during Pregnancy (usually the second trimester A decision may be made to induce labour if a fetus is perceived to be overdue. Induction is a method of artificially or prematurely stimulating labour in a woman Due dates are only a rough estimate, and the process of accurately dating a pregnancy using the LMP method is complicated by the fact that not all women have 28 day menstrual cycles, nor ovulate on the 14th day following their last menstrual period.

A number of medical signs are associated with pregnancy. A Sign is an indication of some fact or quality and a medical sign is an objective indication of some medical fact or quality that is detected by a Physician ^[15][16] These signs typically appear, if at all, within the first few weeks after conception. Although not all of these signs are universally present, nor are all of them diagnostic by themselves, taken together they make a presumptive diagnosis of pregnancy. Diagnosis is the identification by Process of elimination, of the nature of anything These signs include the presence of human chorionic gonadotropin (hCG) in the blood and urine, missed menstrual period, implantation bleeding that occurs at implantation of the embryo in the uterus during the third or fourth week after last menstrual period, increased basal body temperature sustained for over two weeks after ovulation, Chadwick's sign (darkening of the cervix, vagina, and vulva), Goodell's sign (softening of the vaginal portion of the cervix), Hegar's sign (softening of the Vaginal fornix), and Linea nigra, (darkening of the skin in a vertical line on the abdomen, caused by hyperpigmentation resulting from hormonal changes; it usually appears around the middle of pregnancy). Human chorionic gonadotropin ( hCG) is a Glycoprotein Hormone produced in Pregnancy that is made by the Embryo soon after conception Blood is a specialized Bodily fluid that delivers necessary substances to the body's cells ��such as nutrients and oxygen—and transports Waste products Urine is a liquid waste product of the body secreted by the Kidneys by a process of filtration from Blood and Excreted through the Urethra. The menstrual cycle is a recurring cycle of physiologic changes that occurs in reproductive-age Females Overt menstruation (where there is blood flow from the Implantation is an event that occurs early in pregnancy in which the Embryo adheres to the wall of Uterus. Basal body temperature is the body temperature measured immediately after awakening and before any physical activity has been undertaken Chadwick's sign is a bluish discoloration of the Cervix, Vagina and Vulva caused by Venous congestion. The cervix (from Latin "neck" is the lower narrow portion of the Uterus where it joins with the top end of the Vagina. The vagina (from Latin, literally " Sheath " or " Scabbard " is a fibromuscular tubular tract leading from the Uterus The vulva (from Latin, vulva, plural vulvae or vulvas; see etymology) is the region of the external genital organs In Medicine, Goodell's sign is an indication of Pregnancy. It is a significant softening of the Vaginal portion of the Cervix. Hegar's sign is an indication of Pregnancy in a woman specifically the compressibility and softening of the Cervical isthmus (the portion of the cervix between the The fornices of the Vagina are the deepest portions of the vagina extending into the recesses created by the extension of the Cervix into the vaginal space Linea nigra ( Latin for "black line" is a dark vertical line that appears on the abdomen during Pregnancy. In Dermatology, hyperpigmentation is the darkening of an area of Skin or nails caused by increased Melanin. ^[15][16]

Diagnosis

Main article: Obstetrics

The beginning of pregnancy may be detected in a number of ways, including various pregnancy tests which detect hormones generated by the newly-formed placenta. Obstetrics (from the Latin obstare, "to stand by" is the surgical speciality dealing with the care of a woman and her offspring during Pregnancy The placenta is an Ephemeral organ present in placental Vertebrates, such as Eutherial Mammals and Sharks during Gestation Clinical blood and urine tests can detect pregnancy soon after implantation, which is as early as 6-8 days after fertilization. Home pregnancy tests are personal urine tests, which normally cannot detect a pregnancy until at least 12-15 days after fertilization. A pregnancy test attempts to determine whether or not a female is pregnant. Urine is a liquid waste product of the body secreted by the Kidneys by a process of filtration from Blood and Excreted through the Urethra. Both clinical and home tests can only detect the state of pregnancy, and cannot detect its age.

In the post-implantation phase, the blastocyst secretes a hormone named human chorionic gonadotropin which in turn, stimulates the corpus luteum in the woman's ovary to continue producing progesterone. The blastocyst is the structure formed in early Embryogenesis, after the formation of the Blastocoel, but before Implantation. Human chorionic gonadotropin ( hCG) is a Glycoprotein Hormone produced in Pregnancy that is made by the Embryo soon after conception The corpus luteum ( Latin for "yellow body" (plural corpora lutea) is a temporary Endocrine structure in mammals involved in production of Progesterone is a C-21 Steroid Hormone involved in the Female Menstrual cycle, Pregnancy (supports Gestation This acts to maintain the lining of the uterus so that the embryo will continue to be nourished. The glands in the lining of the uterus will swell in response to the blastocyst, and capillaries will be stimulated to grow in that region. This allows the blastocyst to receive vital nutrients from the woman.

An early sonograph can determine the age of the pregnancy fairly accurately. In practice, doctors typically express the age of a pregnancy (i. e. an "age" for an embryo) in terms of "menstrual date" based on the first day of a woman's last menstrual period, as the woman reports it. An embryo (from Greek:, plural, lit "that which grows" from en- "in" + bryein "to swell be full" is a multicellular Unless a woman's recent sexual activity has been limited, or she has been charting her cycles, or the conception is as the result of some types of fertility treatment (such as IUI or IVF) the exact date of fertilization is unknown. Human sexual behavior or different human sexual practices encompass a wide range of activities such as strategies to find or attract partners ( Mating and display AIH redirects here For the indie rock band abbreviated AIH see Architecture in Helsinki Artificial insemination (AI is the process by which In vitro fertilisation ( IVF) is a process by which Absent symptoms such as morning sickness, often the only visible sign of a pregnancy is an interruption of her normal monthly menstruation cycle, (i. Morning sickness, also called Nausea, Vomiting of Pregnancy ( emesis gravidarum or NVP) or pregnancy sickness e. a "late period"). Hence, the "menstrual date" is simply a common educated estimate for the age of a fetus, which is an average of two weeks later than the first day of the woman's last menstrual period. The term "conception date" may sometimes be used when that date is more certain, though even medical professionals can be imprecise with their use of the two distinct terms. The due date can be calculated by using Naegele's rule. Naegele's Rule is a standard way of calculating the Due date for a Pregnancy. The expected date of delivery may also be calculated from sonogram measurement of the fetus. This method is slightly more accurate than methods based on LMP. ^[17] The beginning of labour, which is variously called confinement or childbed, begins on the day predicted by LMP 3. 6% of the time and on the day predicted by sonography 4. 3% of the time. ^[18]

Diagnostic criteria are: Women who have menstrual cycles and are sexually active, a period delayed by a few days or weeks is suggestive of pregnancy; elevated B-hcG to around 100,000 mIU/mL by 10 weeks of gestation.

Physiology

The term trimester redirects here. For the term trimester used in academic settings, see Academic term

Pregnancy is typically broken into three periods, or trimesters, each of about three months. An academic term is a division of an academic year the time during which a School, College or University holds classes While there are no hard and fast rules, these distinctions are useful in describing the changes that take place over time.

First trimester

Traditionally, doctors have measured pregnancy from a number of convenient points, including the day of last menstruation, ovulation, fertilization, implantation and chemical detection. In medicine, pregnancy is often defined as beginning when the developing embryo becomes implanted into the endometrial lining of a woman's uterus. An embryo (from Greek:, plural, lit "that which grows" from en- "in" + bryein "to swell be full" is a multicellular Implantation is an event that occurs early in pregnancy in which the Embryo adheres to the wall of Uterus. The endometrium is the inner membrane of the Mammalian Uterus. The uterus (from the Latin word for womb) is the major Female reproductive organ of most Mammals including Humans One end the In some cases where complications may have arisen, the fertilized egg might implant itself in the fallopian tubes or the cervix, causing an ectopic pregnancy. The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges ( singular salpinx) are two very fine tubes lined with ciliated The cervix (from Latin "neck" is the lower narrow portion of the Uterus where it joins with the top end of the Vagina. An ectopic pregnancy is a Complication of pregnancy in which the fertilized Ovum is implanted in any tissue other than the uterine wall Most pregnant women do not have any specific signs or symptoms of implantation, although it is not uncommon to experience light bleeding at implantation. Some women will also experience cramping during their first trimester. This is usually of no concern unless there is spotting or bleeding as well. The outer layers of the embryo grow and form a placenta, for the purpose of receiving essential nutrients through the uterine wall, or endometrium. The placenta is an Ephemeral organ present in placental Vertebrates, such as Eutherial Mammals and Sharks during Gestation A nutrient is food or chemicals that an organism needs to live and grow or a substance used in an organism's metabolism which must be taken in from its environment The endometrium is the inner membrane of the Mammalian Uterus. The umbilical cord in a newborn child consists of the remnants of the connection to the placenta. In placental Mammals the umbilical cord (also called the birth cord or funiculus umbilicalis) is the connecting cord from the developing Embryo The developing embryo undergoes tremendous growth and changes during the process of foetal development. Prenatal development is the process in which an embryo or fetus (or foetus) gestates during Pregnancy, from fertilization

Morning sickness can occur in about seventy percent of all pregnant women and typically improves after the first trimester. Morning sickness, also called Nausea, Vomiting of Pregnancy ( emesis gravidarum or NVP) or pregnancy sickness ^[19] Most miscarriages occur during this period. Miscarriage or spontaneous abortion is the natural or spontaneous end of a Pregnancy at a stage where the embryo or fetus is incapable of surviving generally defined

Second trimester

Months 4 through 6 of the pregnancy are called the second trimester. Most women feel more energized in this period, and begin to put on weight as the symptoms of morning sickness subside and eventually fade away. Although the fetus begins moving and takes a recognizable human shape during the first trimester, it is not until the second trimester that movement of the fetus, often referred to as "quickening", can be felt. A fetus (or foetus or fœtus) is a developing Mammal or other Viviparous Vertebrate, after the Embryonic stage and In Pregnancy terms the moment of quickening refers to the initial motion of the Fetus in the Uterus as it is perceived or felt by the pregnant woman This typically happens by the fourth month. The placenta is now fully functioning and the fetus is making insulin and urinating. The teeth are now formed inside the fetus's gums and the reproductive organs can be recognized, and can distinguish the fetus as male or female.

Third trimester

Final weight gain takes place, and the fetus begins to move regularly. A fetus (or foetus or fœtus) is a developing Mammal or other Viviparous Vertebrate, after the Embryonic stage and The woman's navel will sometimes become convex, "popping" out, due to her expanding abdomen. The navel (also called an umbilicus or colloquially belly button) is a Scar on the Abdomen, caused when the Umbilical cord is removed In Vertebrates such as Mammals the abdomen (belly constitutes the part of the body between the Thorax (chest and Pelvis. This period of her pregnancy can be uncomfortable, causing symptoms like weak bladder control and back-ache. Movement of the fetus becomes stronger and more frequent and via improved brain, eye, and muscle function the fetus is prepared for ex utero viability. The woman can feel the fetus "rolling" and it may cause pain or discomfort when it is near the woman's ribs and spine.

It is during this time that a baby born prematurely may survive. Premature birth (also known as preterm birth) is the Birth of a Baby before the standard period of Pregnancy is completed The use of modern medical intensive care technology has greatly increased the probability of premature babies living, and has pushed back the boundary of viability to much earlier dates than would be possible without assistance. Intensive Care Medicine or critical care medicine is a branch of medicine concerned with the provision of Life support or organ support systems in patients ^[20] In spite of these developments, premature birth remains a major threat to the fetus, and may result in ill-health in later life, even if the baby survives.

Prenatal development and sonograph images

See also: Prenatal development

Prenatal development is divided into two primary biological stages. Prenatal development is the process in which an embryo or fetus (or foetus) gestates during Pregnancy, from fertilization The first is the embryonic stage, which lasts for about two months. An embryo (from Greek:, plural, lit "that which grows" from en- "in" + bryein "to swell be full" is a multicellular At this point, the fetal stage begins. A fetus (or foetus or fœtus) is a developing Mammal or other Viviparous Vertebrate, after the Embryonic stage and At the beginning of the foetal stage, the risk of miscarriage decreases sharply,^[21] all major structures including hands, feet, head, brain, and other organs are present, and they continue to grow and develop. When the fetal stage commences, a fetus is typically about 30 mm (1. 2 inches) in length, and the heart can be seen beating via sonograph; the fetus bends the head, and also makes general movements and startles that involve the whole body. ^[22] Brain stem activity has been detected as early as 54 days after conception,^[23] and the first measurable signs of EEG activity occur in the 12th week. The brain stem (or brainstem) is the lower part of the Brain, adjoining and structurally continuous with the Spinal cord. ^[24] Some fingerprint formation occurs from the beginning of the fetal stage. ^[25]

Embryo at 6 weeks after fertilization[26]	Fetus at 8 weeks after fertilization[27]	Fetus at 18 weeks after fertilization[28]	Fetus at 38 weeks after fertilization[29]
Relative size in 1st Month (simplified illustration)	Relative size in 3rd Month (simplified illustration)	Relative size in 5th Month (simplified illustration)	Relative size in 9th Month (simplified illustration)

One way to observe prenatal development is via ultrasound images. Modern 3D ultrasound images provide greater detail for prenatal diagnosis than the older 2D ultrasound technology. 3D ultrasound is a Medical ultrasound technique used during Pregnancy, providing three dimensional images of the Fetus. ^[30] Whilst 3D is popular with parents desiring a prenatal photograph as a keepsake,^[31] both 2D and 3D are discouraged by the FDA for non-medical use,^[32] but there are no definitive studies linking ultrasound to any adverse medical effects. ^[33] The following 3D ultrasound images were taken at different stages of pregnancy:

3-inch fetus (about 14 weeks gestational age)

Fetus at 17 weeks

Fetus at 20 weeks

Physiological changes in pregnancy

The body must change its physiological and homeostatic mechanisms in pregnancy to ensure the fetus is provided for. Gestational age is usually considered to be the age of an Embryo or Fetus (or newborn infant from the first day of the woman's last menstrual period (LMP Increases in blood sugar, breathing and cardiac output are all required.

Hormonal changes

Levels of progesterone and oestrogens rise continually throughout pregnancy, suppressing the hypothalamic axis and subsequently the menstrual cycle. The mother and the placenta also produces many hormones.

Prolactin levels increase due to maternal Pituitary gland enlargement by 50%. Prolactin ( PRL) or Luteotropic hormone ( LTH) is a Peptide hormone primarily associated with Lactation. The pituitary gland, or hypophysis, is an Endocrine gland about the size of a Pea. This mediates a change in the structure of the Mammary gland from ductal to lobular-alveolar. Mammary glands are the organs that in Mammals produce Milk for the sustenance of the young Parathyroid hormone is increased to increases calcium uptake in the gut and reabsorption by the kidney. Parathyroid hormone (PTH, or parathormone, is secreted by the Parathyroid glands as a Polypeptide containing 84 Amino acids. Adrenal hormones such as cortisol and aldosterone also increase. Cortisol is a Corticosteroid Hormone produced by the Adrenal gland (in the Zona fasciculata of the Adrenal cortex) Aldosterone is a hormone that causes the tubules of the kidneys to retain sodium and water

Placental lactogen is produced by the placenta and stimulates lipolysis and fatty acid metabolism by the mother, conserving blood glucose for use by the fetus. Placental lactogen is a Polypeptide Placental Hormone. Its structure and function is similar to that of Growth hormone. It also decreases maternal tissue sensitivity to insulin, resulting in gestational diabetes. Gestational diabetes (or gestational diabetes mellitus, GDM) is a condition in which women without previously diagnosed diabetes exhibit high blood

Physical changes

12-15kg are gained during pregnancy due to fat deposition, growth of the reproductive organs and fetal tissues.

Cardiovascular changes

Blood volume increases by 40% in the first two trimesters. This is just to an increase in plasma volume through increased aldosterone. Progesterone may also interact with the aldosterone receptor, thus leading to increased levels. Red blood cell numbers increase due to increased erythropoietin levels. Erythropoietin (ɨˌɹɪθɹoʊˈpɔɪɨtɨn /ɨˌɹɪθɹoʊˈpɔɪtən/ or /ɨˌɹiːθɹoʊ-/ or EPO is a Glycoprotein Hormone that controls

Cardiac function is also modified, with increase heart rate and increased stroke volume. A decrease in vagal tone and increase in sympathetic tone is the cause. Blood volume increases act to increase stroke volume of the heart via Starling's law. The Frank-Starling law of the heart (also known as Starling's law or the Frank-Starling mechanism) states that the greater the volume of blood entering After pregnancy the change in stroke volume is not reversed. Cardiac output rises from 4 to 7 litres in the 2nd trimester

Blood pressure also fluctuates. In the first trimester it falls. Initially this is due to decreased sensitivity to angiotensin and vasodilation provoked by increased blood volume. Angiotensin causes blood vessels to constrict and drives blood pressure up Later however, it is caused by decresed resistence to the growing uteroplacental bed.

Respiratory changes

Decreased functional residual capacity is seen, typically falling from 1. 7 to 1. 35 litres, due to the compression of the diaphragm by the uterus. Tidal volume increases, from 0. 45 to 0. 65 litres, giving an increase in pulmonary ventilation. This is necessaary to meet the increased oxygen requirement of the body, which reaches 50ml/min - 20ml of which goes to reproductive tissues.

Progesterone may act centrally on chemoreceptors to reset the set point to a lower partial pressure of carbon dioxide. This maintains an increased respiration rate even at a decreased level of carbon dioxide.

Metabolic changes

An increased requirement for nutrients is given by fetal growth and fat deposition. Changes are caused by steroid hormones, lactogen and cortisol.

Maternal insulin resistance can lead to gestational diabetes. Increase liver metabolism is also seen, with increased gluconeogenesis to increase maternal glucose levels.

Renal changes

Renal plasma flow increases, as does aldosterone and erthropoietin production as discussed. The tubular maximum for glucose is reduced, which may precipitate gestational diabetes. Gestational diabetes (or gestational diabetes mellitus, GDM) is a condition in which women without previously diagnosed diabetes exhibit high blood

Management

Prenatal medical care is of recognized value throughout the developed world. Pregnancy ( Latin graviditas) is the carrying of one or more offspring known as a Fetus or Embryo, inside the Uterus of a Female Periconceptional Folic acid supplementation is the only type of supplementation of proven efficacy. Folic acid (also known as Vitamin M and Folacin) and Folate (the Anionic form are forms of the water-soluble Vitamin B9

Nutrition

Main article: Nutrition and pregnancy

A balanced, nutritious diet is an important aspect of a healthy pregnancy. Nutrition and pregnancy refers to the nutrient intake and dietary planning that is undertaken before during and after pregnancy If the woman is healthy, balancing carbohydrates, fat, and proteins, and eating a variety of fruits and vegetables usually ensure good nutrition. Carbohydrates (from ' Hydrates of Carbon ' or saccharides ( Greek σάκχαρον meaning " Sugar " are the most Fats consist of a wide group of compounds that are generally soluble in organic solvents and largely insoluble in water Proteins are large Organic compounds made of Amino acids arranged in a linear chain and joined together by Peptide bonds between the Carboxyl The term fruit has different meanings dependent on context and the term is not synonymous in Food preparation and Biology. The term " vegetable " generally means the edible parts of Plants The definition of the word is traditional rather than Scientific, however Those whose diets are affected by health issues, religious requirements, or ethical beliefs may choose to consult a health professional for specific advice.

Adequate periconceptional folic acid (also called folate or Vitamin B9) intake has been proven to limit fetal neural tube defects, preventing spina bifida, a very serious birth defect. Folic acid (also known as Vitamin M and Folacin) and Folate (the Anionic form are forms of the water-soluble Vitamin B9 Spina bifida ( Latin: "split spine" is a developmental Birth defect involving the Neural tube: incomplete closure of the Embryonic neural A congenital disorder is a disease or disorder that is present at birth The neural tube develops during the first 28 days of pregnancy and this explains the necessity to guarantee adequate periconceptional folate intake. ^[34][35] Folates (from folia, leaf) are abundant in spinach (fresh, frozen or canned), and are also found in green vegetables, salads, melon, hummus, and eggs. Spinach ( Spinacia oleracea) is a Flowering plant in the family of Amaranthaceae. Leaf vegetables, also called potherbs, greens, or leafy greens, are plant leaves eaten as a Vegetable, sometimes accompanied For the biological matter in soil see Humus; for the band see Humus (band. An egg is a round or oval body laid by the female of many animals consisting of an Ovum surrounded by layers of Membranes and an outer casing which acts to nourish In the United States and Canada, most wheat products (flour, noodles) are fortified with folic acid. ^[36]

Several micronutrients are important for the health of the developing fetus, especially in areas of the world where insufficient nutrition is prevalent. Dietary minerals are the Chemical elements required by living Organisms other than the four elements Carbon, Hydrogen, Nitrogen, and ^[37] In developed areas, such as Western Europe and the United States, certain nutrients such as Vitamin D and calcium, required for bone development, may require supplementation. Western Europe at its most general meaning means 'all the countries in the West of Europe ' The United States of America —commonly referred to as the Vitamin D is a group of fat-soluble Prohormones, the two major forms of which are vitamin D2 (or Ergocalciferol) and vitamin D3 (or Calcium (ˈkælsiəm is the Chemical element with the symbol Ca and Atomic number 20 ^[38][39][40]

There is some evidence that long-chain omega-3 (n-3) fatty acids have an effect on the developing fetus, but further research is required. n −3 fatty acids (popularly referred to as ω−3 fatty acids or omega-3 fatty acids) are a family of unsaturated Fatty acids that ^[41] At this time, supplementing the diet with foods rich in these fatty acids is not recommended, but is not harmful. ^[42]

Dangerous bacteria or parasites may contaminate foods, particularly listeria and toxoplasma, toxoplasmosis agent. Listeria is a Bacterial Genus containing six species Named in honour of Joseph Lister, Listeria species are Gram-positive Toxoplasmosis is a Parasitic disease caused by the Protozoan Toxoplasma gondii. Careful washing of fruits and raw vegetables may remove these pathogens, as may thoroughly cooking leftovers, meat, or processed meat. Soft cheeses may contain listeria, if milk is raw the risk may increase. Cat feces pose a particular risk of toxoplasmosis. Pregnant women are also more prone to catching salmonella infection from eggs and poultry, which should be thoroughly cooked. Salmonella is a Genus of rod-shaped Gram-negative enterobacteria that causes Typhoid fever, Paratyphoid fever Practicing good hygiene in the kitchen can reduce these risks. ^[43]

Weight gain

Caloric intake must be increased, to ensure proper development of the fetus. The amount of weight gained during pregnancy varies between women. The National Health Service recommends that overall weight gain during the 9 month period for women who start pregnancy with normal weight be 10 to 12 kilograms (22–26 lb). The National Health Service is the name commonly used to refer to the four Publicly-funded healthcare systems of the United Kingdom collectively or individually (although The pound or pound-mass (abbreviation lb, lbm, or sometimes in the United States #) is a unit of Mass ^[44] During pregnancy, insufficient weight gain can compromise the health of the fetus. Women with fears of weight gain or with eating disorders may choose to work with a health professional, to ensure that pregnancy does not trigger disordered eating. An eating disorder is a compulsion to eat or avoid eating that negatively affects both one's physical and mental health Likewise, excessive weight gain can pose risks to the woman and the fetus. Women who are prone to being overweight may choose to plan a healthy diet and exercise plan to help moderate the amount of weight gained. Overweight is generally defined as having more body fat (adipose tissue than is optimally Healthy Being overweight is a common condition especially where

Immunological tolerance

Main article: Pre-eclampsia

Research on the immunological basis for pre-eclampsia has indicated that continued exposure to a partner's semen has a strong protective effect against pre-eclampsia, largely due to the absorption of several immune modulating factors present in seminal fluid. Pre-eclampsia (US preeclampsia) is a Medical condition where Hypertension arises in pregnancy ( Pregnancy-induced hypertension) in association ^[45] Studies also showed that long periods of sexual cohabitation with the same partner fathering a woman's child significantly decreased her chances of suffering pre-eclampsia. ^[46] Several other studies have since investigated the strongly decreased incidence of pre-eclampsia in women who had received blood transfusions from their partner, those with long, preceding histories of sex without barrier contraceptives, and in women who had been regularly performing oral sex,^[47] with one study concluding that "induction of allogeneic tolerance to the paternal HLA molecules of the fetus may be crucial. Data collected strongly suggests that exposure, and especially oral exposure to soluble HLA from semen can lead to transplantation tolerance. "^[47]

Other studies have investigated the roles of semen in the female reproductive tracts of mice, showing that "insemination elicits inflammatory changes in female reproductive tissues,"^[48] concluding that the changes "likely lead to immunological priming to paternal antigens or influence pregnancy outcomes. " A similar series of studies confirmed the importance of immune modulation in female mice through the absorption of specific immune factors in semen, including TGF-Beta, lack of which is also being investigated as a cause of miscarriage in women and infertility in men. Transforming growth factor (sometimes referred to as Tumor growth factor, or TGF) is used to describe two classes of Polypeptide Growth factors Miscarriage or spontaneous abortion is the natural or spontaneous end of a Pregnancy at a stage where the embryo or fetus is incapable of surviving generally defined Female infertility|Male infertility Infertility primarily refers to the biological inability of a Man or a Woman to contribute to conception.

According to the theory, pre-eclampsia is frequently caused by a failure of the mother's immune system to accept the fetus and placenta, which both contain "foreign" proteins from paternal genes. Regular exposure to the father's semen causes her immune system to develop tolerance to the paternal antigens, a process which is significantly supported by as many as 93 currently identified immune regulating factors in seminal fluid. An antigen (from antibody-generating) or immunogen is a substance that prompts the generation of Antibodies and can cause an immune response ^[49][50] Having already noted the importance of a woman's immunological tolerance to her baby's paternal genes, several Dutch reproductive biologists decided to take their research a step further. Immune or immunological tolerance is the process by which the Immune system does not attack an Antigen. Consistent with the fact that human immune systems tolerate things better when they enter the body via the mouth, the Dutch researchers conducted a series of studies that confirmed a surprisingly strong correlation between a diminished incidence of pre-eclampsia and a woman's practice of oral sex, and noted that the protective effects were strongest if she swallowed her partner's semen. ^[51] The researchers concluded that while any exposure to a partner's semen during sexual activity appears to decrease a woman's chances for the various immunological disorders that can occur during pregnancy, immunological tolerance could be most quickly established through oral introduction and gastrointestinal absorption of semen. Immune or immunological tolerance is the process by which the Immune system does not attack an Antigen. ^[51] Recognizing that some of the studies potentially included the presence of confounding factors, such as the likelihood that women who regularly perform oral sex and swallow semen engage in more frequent vaginal intercourse, the researchers also noted that, either way, the data still overwhelmingly supports the main theory behind all their studies--that repeated exposure to semen establishes the maternal immunological tolerance necessary for a safe and successful pregnancy. Immune or immunological tolerance is the process by which the Immune system does not attack an Antigen.

Sexuality during pregnancy

Most pregnant women can enjoy sexual intercourse throughout gravidity. Sexual intercourse, in its biological sense is the act in which the male reproductive organ (in humans and other higher animals enters the female reproductive tract Most research suggests that, during pregnancy, both sexual desire and frequency of sexual relations decrease. ^[52][53] In context of this overall decrease in desire, some studies indicate a second-trimester increase, preceding a decrease. ^[54] However, these decreases are not universal: a significant number of women report greater sexual satisfaction throughout their pregnancies. ^[55]

In some places, until the mid 20th century, it was considered a socio-moral "taboo" action for pregnant women to engage in sexual activities. This is far from universal however, for example the Talmud recommends it for the health of the mother and child. The Talmud ( Hebrew: he תַּלְמוּד is a record of Rabbinic discussions pertaining to Jewish law, ethics, customs and history Sex during pregnancy is a low-risk behaviour except when the physician advises that sexual intercourse be avoided, which may, in some pregnancies, lead to serious pregnancy complications or health issues such as a high-risk for premature labour or a ruptured uterus. An organism's sex is defined by the gametes it produces males produce male gametes (spermatozoa or Sperm) while females produce female gametes (ova or Egg cells; individual Such a decision may be based upon a history of difficulties in a previous childbirth.

Some psychological research studies in the 1980s and '90s contend that it is useful for pregnant women to continue to have sexual activity, specifically noting that overall sexual satisfaction was correlated with feeling happy about being pregnant, feeling more attractive in late pregnancy than before pregnancy and experiencing orgasm. ^[54] Sexual activity has also been suggested as a way to prepare for induced labour, as some believe the natural prostaglandin content of seminal liquid can favour the maturation process of the cervix making it more flexible, allowing for easier and faster dilation and effacement of the cervix. However, the efficacy of using sexual intercourse as an induction agent "remains uncertain". ^[56]

During pregnancy, the baby is protected from the thrusting of sex by the amniotic fluid in the womb and by the woman's abdomen. ^[57]

Abortion

Main article: Abortion

An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death. An An This can occur spontaneously or accidentally as with a miscarriage, or be artificially induced by medical, surgical or other means.

Progression

Complaints

See also: Complications of pregnancy

The following are complaints that may occur during pregnancy:

• Back pain. Complications of pregnancy are the symptoms and problems that are associated with Pregnancy. Back pain (also known " dorsalgia " is Pain felt in the back that usually originates from the Muscles Nerves Bones A particularly common complaint in the third trimester when the patient's center of gravity has shifted.
• Constipation. Constipation, costiveness, or irregularity, is a condition of the Digestive system in which a person (or animal experiences hard Feces that A complaint that is caused by decreased bowel motility secondary to elevated progesterone (normal in pregnancy), which can lead to greater absorption of water. Progesterone is a C-21 Steroid Hormone involved in the Female Menstrual cycle, Pregnancy (supports Gestation
• Braxton Hicks contractions. For the album Braxton Hicks by Jebediah see Braxton Hicks (album. Occasional, irregular, painless contractions that occur several times per day.
• Edema. Oedema (or Edema in American English formerly known as dropsy or hydropsy, is the increase of Interstitial fluid in any organ &mdash swelling Common complaint in advancing pregnancy. Caused by compression of the inferior vena cava (IVC) and pelvic veins by the uterus leads to increased hydrostatic pressure in lower extremities. The inferior vena cava (or IVC is the large Vein that carries de-oxygenated Blood from the lower half of the body into the Heart. The uterus (from the Latin word for womb) is the major Female reproductive organ of most Mammals including Humans One end the
• Regurgitation, heartburn and nausea. Heartburn or pyrosis is a painful or burning sensation in the Esophagus, just below the breastbone usually associated with regurgitation of gastric acid Nausea ( Latin: Nausea, Greek:, " Sea-sickness " also called wamble) is the sensation of unease and discomfort Common complaints that may be caused by Gastroesophageal Reflux Disease (GERD); this is determined by relaxation of the lower esophageal sphincter (LES) and increased transit time in the stomach (normal in pregnancy)
• Haemorrhoids. Gastroesophageal reflux disease ( American English and Canadian English) or Gastro-oesophageal reflux disease ( British English, Hiberno-English The cardia (also known as Z-line or esophagogastric junction or gastroesophageal junction) is the anatomical term for the junction orifice of Hemorrhoids ( AmE) haemorrhoids ( BrE) emerods, or piles are varicosities or swelling and Inflammation Complaint that is often noted in advancing pregnancy. Caused by increased venous stasis and IVC compression leading to congestion in venous system along with increased abdominal pressure secondary to the pregnant space-occupying uterus and constipation.
• Pelvic girdle pain. Pregnancy related Pelvic Girdle Pain (PGP causes pain, instability and/or dysfunction in any of the three pelvic joints A common complaint is pain, instability or dysfunction of the symphysis pubis and/or sacroiliac joints resulting from either excess strain or injury (such as Diastasis symphysis pubis) during the course of the pregnancy or birthing process. Diastasis symphysis pubis is the separation of normally joined Pubic bones as in the dislocation of the bones without a fracture
• Increased urinary frequency. In Medicine, polyuria is a condition characterized by the passage of large volumes of urine (at least 2 A common complaint referred by the gravida that is caused by increased intravascular volume, elevated GFR (glomerular filtration rate), and compression of the bladder by the expanding uterus. Renal function, in Nephrology, is an indication of the state of the Kidney and its role in Renal physiology. In Anatomy, the urinary bladder is a hollow muscular, and distensible (or elastic organ that sits on the Pelvic floor in Mammals It is the
• Varicose veins. Varicose veins are Veins that have become enlarged and twisted Common complaint caused by relaxation of the venous smooth muscle and increased intravascular pressure. Smooth muscle is a type of non- Striated muscle, found within the Tunica media layer of large and small Arteries and Veins, the bladder

Childbirth

Main article: Childbirth

Childbirth is the process whereby an infant is born. Childbirth (also called labour, birth, partus or parturition) is the culmination of a Human Pregnancy or Childbirth (also called labour, birth, partus or parturition) is the culmination of a Human Pregnancy or It is considered by many to be the beginning of a person's life, and age is defined relative to this event in most cultures.

A woman is considered to be in labour when she begins experiencing regular uterine contractions, accompanied by changes of her cervix — primarily effacement and dilation. While childbirth is widely experienced as painful, some women do report painless labours, while others find that concentrating on the birth helps to quicken labour and lessen the sensations. Most births are successful vaginal births, but sometimes complications arise and a woman may undergo a caesarean section. A Caesarean section (or Cesarean section in American English) also known as C-section, is a form of Childbirth in which a surgical

During the time immediately after birth, both the mother and the baby are hormonally cued to bond, the mother through the release of oxytocin, a hormone also released during breastfeeding. "Mom" "Mum" and "Mommy" redirect here Oxytocin ( IPA: /ˌɔksɪˈtoʊsɪn/ (Greek "quick birth" is a Mammalian Hormone that also acts as a Neurotransmitter in the Breastfeeding is the feeding of an Infant or young Child with Breast milk directly from human Breasts, not from a Baby bottle or other

Postnatal period

Main article: Postnatal

Context

There are fine distinctions between the concepts of fertilization and the actual state of pregnancy, which starts with implantation. Postnatal ( Latin for 'after birth' from post meaning "after" and natalis meaning "of birth" is the period beginning immediately after In a normal pregnancy, the fertilization of the egg usually will have occurred in the Fallopian tubes or in the uterus. The Fallopian tubes, also known as oviducts, uterine tubes, and salpinges ( singular salpinx) are two very fine tubes lined with ciliated The uterus (from the Latin word for womb) is the major Female reproductive organ of most Mammals including Humans One end the (Often, an egg may become fertilized yet fail to become implanted in the uterus. ) If the pregnancy is the result of in-vitro fertilization, the fertilization will have occurred in a Petri dish, after which pregnancy begins when one or more zygotes implant after being transferred by a physician into the woman's uterus. In vitro fertilisation ( IVF) is a process by which A Petri dish is a shallow Glass or Plastic Cylindrical lidded dish that biologists use to culture cells It was named after A physician, medical practitioner or medical doctor who practices Medicine, and is concerned with maintaining or restoring human Health

In the context of political debates regarding a proper definition of life, the terminology of pregnancy can be confusing. Life is a state that distinguishes Organisms from non-living objects such as non-life and dead organisms being manifested by growth through Metabolism The medically and politically neutral term which remains is simply "pregnancy," though this can be problematic as it only refers indirectly to the embryo or fetus. De Crespigny observes that doctors' language has a powerful influence over the way patients think, and thus proposes that the best interests of patients are served by using language that both supports patient autonomy and is neutral. ^[58]

See also

Abortion Anticoagulation in pregnancy Birth control Egg donation Fertility Fetal alcohol syndrome

Maternal health Nesting instinct Parent Postnatal depression Pregnancy discrimination Pregnancy fetishism

Pregnancy over age 50 Pregnant patients' rights Prenatal care Simulated pregnancy Teenage pregnancy

References

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