pregnancy

pregnancy

1. it is the period in which a fetus develops in the womb of a mother

2. gametogenesis

   • oogenesis
     • happens in the ovaries
     • primary oocytes develop before birth.
       • secondary oocytes develop with every ovulation
   • spermatogenesis
     • happens in the testes during puberty
   • the process of creating the gametes, sex cells
     • they have half the number of chromosomes
       • haploid, 23 chromosomes

3. fertilization

   • it is the fusion of sperm and egg
     • joining 2 haploid cells creates a diploid cell
     • the sperm must undergo capacitation and an acrosomal reaction
       • digest the corona radiata and the zona pellucida surrounding the ova
     • hundreds of sperms clear the way for a single sperm to enter the ova

4. ovulation

   • the release of the egg from the ovaries
     • the egg may not get fertilized
       • released with the uterus's lining during menstruation
         • 14 days after ovulation
   • happens on day 14 of the 28 days menstrual cycle
     • knowing when ovulation happens helps with achieving/preventing pregnancy
   • triggered by LH
   • has signs and symptoms

5. implantation

   • the attachment of the blastocyst to the wall of the uterus
     • happens 6 days after fertilization
     • the blastocyst digests the cells of the endometrium to bury itself deeper in the wall of the uterus
       • a week later the uterus is covering the blastocyst

6. menstrual cycle

   • follicular phase
     • follicles grow
     • zona pellucida forms around the ova
     • estrogen secretion
       • proliferation of the uterine wall cells
     • graafian follicles form
   • ovulation
     • releasing the oocyte
       • by LH secretion
     • secondary oocyte undergoes meiosis 1
     • progesterone release
       • promotes secretory action of the uterine wall cells
   • luteal phase
     • formation of the corpus luteum
       • in case of fertilization
         • releases progesterone
       • in case of menstruation
         • degenerates
         • progesterone levels decrease then estrogen
         • vasospasm of endometrial blood vessels
         • 40 ml of blood, 35 ml serous fluid

7. hormonal changes

   • hCG
     • promote nausea and vomiting
     • made by the syncytiotrophoblastic cells
   • hPL
     • made by the placenta
     • stimulate milk glands in the breast for breastfeeding
   • estrogen
     • levels keep increasing
     • promotes nausea
   • progesterone
     • stimulates uterine thickening
       • prepares uterus for pregnancy

8. how to confirm pregnancy

   • home pregnancy tests
     • urine test
       • hCG pregnancy strip
   • medical tests
     • blood tests
       • quantitative and qualitative hCG blood test
     • ultrasound
     • clinical urine test
   • checking the physical signs and symptoms
     • fatigue
     • nausea
     • frequent urination
     • menstruation stops

9. stages of pregnancy

   • what happens to the mother
     • 1st trimester
       • common pregnancy symptoms
         • most go away as pregnancy prgoresses
           • changing daily routine will help
             • sleeping early
             • eating more frequent meals
     • 2nd trimester
       • most important trimester for the baby
         • regular clinic visits
         • mother should take good care of herself
       • body shape changes occur
         • stretch marks
         • weight gain
     • 3rd trimester
       • baby starts pressuring the organs
         • breathing problems
         • incontinence
       • cervix softens
         • birth preparation
   • what happens to the fetus
     • 1st trimester
       • CNS and heart form
       • major organs and external structures develop
       • sex organs develop
         • gender check can be done
       • eyelids form but remain closed
         • eyes not yet developed
     • 2nd trimester
       • GI tract develops
         • 1st bowel movement
       • lanugo covers fetus
         • smooth hair
           • eyebrows and lashes
       • vernix covers the skin
         • waxy layer
         • toenails and fingernails
       • bone marrow produces blood cells
       • baby sleeps and wakes up regularly
       • developed yet nonfunctional lungs
     • 3rd trimester
       • eyes open and close
       • lanugo is replaced
       • body stores minerals
       • vernix gets thicker

10. routine investigations

    • blood pressure
      • high BP check
    • urine test
      • kidney and bladder infection
      • protein concentration
    • blood test
      • STDs
        • HIV
      • hepatitis B
      • anemia
      • blood group compatibility
      • glucose level
    • GBS check
      • causes pneumonia to the fetus
        • antibiotics during labor
    • abdominal circumference
      • checks fetus's growth
    • ultrasound
    • non-stress test
      • fetus heart rate and O2 count
    • kick counts
      • ensures muscle and nerve development

11. FDA pregnancy categories

    • indicates drugs that cause birth defects during pregnancy
      • the thialdomide tragedy
    • category A
      • harmless in small doses in the 1st trimester
      • levothyroxine
      • follic acid
      • liothyronine
    • category B
      • metformin
      • cyclobenzaprine
      • amoxicillin
      • hydrochlorothiazide
    • category C
      • benefits compensate for risks
      • gabapentin
      • amlodipine
      • trazodone
    • category D
      • evidence of fetal risk
        • benefits might compensate
      • losartan
    • category X
      • fetal abnormalities and human fetal risk
      • atorvastatin
      • simvastatin
      • methotrexate
      • finasterid

12. pregnancy and vaccination

    • flu shot
      • for women who are pregnant during flu season.
    • tetanus toxoid
      • during each pregnancy
        • protect against whooping cough

13. calculating EDD

    • 1st day of the last menstrual period
      • count back 3 months
        • add 1 year and 7 days

14. nutritional supplements during pregnancy

    • follic acid
      • should be taken until the 12th week
      • prevent neural tube defect
        • spina bifida
    • Ca and vitamin D
      • Ca for mother
        • muscle and nervous system function
      • Ca for fetus
        • bones and teeth
      • vitamin D
        • regulates Ca and phosphate levels
    • iron
      • Hb formation
        • O2 transformation
    • prebiotics
      • stimulate growth and activity of probiotics
      • strengthen immunity
    • fats, proteins and carbohydrates
    • probiotics
      • reduce discomforts
        • constipation
          • help breakdown food
        • vaginal yeast
        • bloating
        • heartburn
        • frequent urination
    • vitamin C
      • protects cells
        • keeps them healthy
    • magnesium
      • teeth and bones
      • muscle contractions
      • important for the enzyme system
    • DHA
      • for the developing brain and nerves
    • vitamin A
      • eyes, bones, skin and lung
      • too much usage can lead to birth defects