Pregnancy Advisor Self Help

Principle event in the happening of pregnancy:

1. impregnation / fertilization: meet it egg cell / ovum woman with seed cell / spermatozoa man.

2. cell cleavage (zygote). impregnation result.

3. nidasi / implantasi zygote in reproduction channel wall (in the situation normal: implantasi in layer endometrium wall kavum uteri).

4. growth and zygote development - embryo - fetus is future new individual.

pregnancy is influenced various hormone: estrogen, progesteron, human chorionic gonadotropin, human somatomammotropin, prolaktin etc.

human chorionic gonadotropin (hcg) special mobile hormone that impersonates during beginning pregnancy time, fluctuate the degree during pregnancy.

happen also in anatomy and reproduction system organs physiology and another body system organs, influenced especially by balance change hormonal.

change in reproduction system organs

uterus

grow to expand primary, also secondary contents growth consequence conception intrauterin. estrogen causes hiperplasi network, progesteron impersonate for elasticity / flexibility uterus.

magnification coarse estimation uterus in tall groping fundus:

- not pregnant / normal: as big as chicken’s egg (+ 30 g)

- pregnancy 8 weeks: duck egg

- pregnancy 12 weeks: goose egg

- pregnancy 16 weeks: mid centre-simfisis

- pregnancy 20 weeks: edge under centre

- pregnancy 24 weeks: edge on centre

- pregnancy 28 weeks: one-third centre-xyphoid

- pregnancy 32 weeks: mid centre-xyphoid

- 36-42 week: 3 until 1 finger under xyphoid

ismus uteri, part from serviks, limit anatomik be difficult determined, in pregnancy trimester i am lengthways and stronger. in pregnancy 16 weeks is one parts with corpus, and in pregnancy ends above 32 weeks is segment under uterus. vaskularization a little, layer muskular thin, easy ruptur, contaction minimal -> dangerous if weak, can ruptur, threaten fetus soul and mother soul.

serviks uteri experience hipervaskularisasi stimulation consequence estrogen and perluna consequence progesteron (-> sign hegar), colour is livide / kebiruan.

mucus secretion serviks increase in pregnancy gives phenomenon keputihan.

vagina / vulva

happen hipervaskularisasi influence consequence estrogen and progesteron, ruddle (sign chadwick).

ovary

since pregnancy 16 weeks, function is taken to displace by placenta, especially production function progesteron and estrogen. during ovary pregnancy calm/takes a rest. doesn’t happen formation and new follicle maturation, doesn’t happen ovulation, doesn’t happen cycle hormonal menstruation.

breast

influence consequence estrogen happen hiperplasia system duktus and network interstisial breast. hormone laktogenik placenta (mengantaranya somatomammotropin) causes hipertrofi and cells increase asinus breast, with increase product substances kasein, laktoalbumin, laktoglobulin, fat cells, kolostrum. mammae expand and tense, happen hiperpigmentasi skin with hipertrofi gland montgomery, especially region areola and papilla influence consequence melanofor. milk bipple expands and jut. (several literatures doesn’t put into breast in woman reproduction system that studied in gynaecology)

body heavy enhanced during pregnant

body heavy normal increases around 6-16 kg, especially from contents growth konsepsi and volume various organ / liquid intrauterin.

heavy fetus + 2.5-3.5 kg, heavy placenta + 0.5 kg, liquid amnion + 1.0 kg, heavy uterus + 1.0 kg, circulation volume increasing maternal + 1.5 kg, growth mammae + 1 kg, liquid heaping interstisial at pelvis and ekstremitas + 1.0-1.5 kg.

change in another body system organs

(read also lecture note anestesiologi - reasonable complete tuh)

system respirasi

oxygen need increases until 20%, besides also impel to kranial -> happen hiperventilasi shallow (20-24x/minute) consequence kompliansi breast (chest compliance) decreased. volume tidal increase. residue volume paru (functional residual capacity) decreased. vital capacity decreaseds.

system gastrointestinal

estrogen and hcg increase with sick side effects and vomits, besides happen also change peristaltik with phenomenon often puffed up, konstipasi, hungry a more regular / feeling wants to eat then (crave for), also sour enhanced consequence lambung. in the situation patologik certain can happen to vomits many until more than 10 times per day (hiperemesis gravidarum).

circulation system / cardiovaskular

(read also heart difference lecture + lecture anestesiologi)

physiology change in normal pregnancy, most off all change hemodinamik maternal, cover:

- liquid retention, increase it volume load and curah heart

- relative anaemia

- hormone influence consequence, arrest perifer vaskular decreased

- blood pressure arterial decreased

- curah heart increases 30-50%, maximal ends trimester 1, held to the last pregnancy

- blood volume maternal overall increase until 50%

- volume plasma increase quicker in the early pregnancy,

then increase slowly to the last

pregnancy

in trimester first, happen:

- increasing curah heart, volume plasma and liquid volume ekstraselular, espoused current enhanced plasma kidney and rapid filtrasi glomerulus

- increasing / water retention and natrium that can be exchanged in body, enhanced tbw / total body water

- finally happen aktifasi system renin-angiotensin and threshold depreciation osmotik for deliverance mediat

- finally also happen concentration depreciation natrium in plasma and depreciation osmolalitas plasma, so that happen oedema in 80% pregnant woman.

happen volume enhanced plasma until 25-45%, with total eritrosit increase only a little (haemoglobin degree decreaseds relative anaemia consequence). cardiac output increase until 20-40%. resistence perifer also decreased, often appear as varisces leg. leucocyte increases until 15.000/mm3, reaction consequence antigen-antiibodi fisiologik that in pregnancy. infection is suspected when leucocyte exceeds 15.000/mm3. trombosite increases until 300.000-600.000/mm3, tromboplastin important to hemostasis good in pregnancy and persalinan. fibrinogen also increase 350-750 mg/dl (normal 250-350 mg/dl). rapid endap blood increases. protein total increases, but ratio albumin-globulin increase because happen depreciation albumin alfa-1, alfa-2 and i am followed enhanced globulin alfa-1, alfa-2 and i. coagulation factors increases.

metabolism

basalt metabolic rate increase until 15%, happen also hipertrofi tiroid. carbohydrate need increases until 2300 kal/days (pregnant) and 2800 kal/days (gives. need protein 1 g/kgbb/day to subsidize fetus growth. cholesterol degree plasma increase until 300 g/100ml. calcium need, phosphorus, magnesium, cuprum increase. ferrum wanted until degree 800 mg, for addition haemoglobin formation.

(read also lecture mengabetes mellitus)

special for carbohydrate metabolism, in normal pregnancy, happen glucose degree plasma lower mother according to haves because:

- placenta circulation glucose take increases,

- glucose production from heart decreaseds

- production alanin (one of [the] prekursor glukoneogenesis) decreased

- activities ekskresi kidney increases

- hormones effect gestasional (human placental lactogen, hormon2 another placenta, hormon2 ovary, hipofisis, pancreas, adrenal, growth factors, etc).

besides happen also fat metabolism change and sour amino. happen also metabolism enzymes activities enhanced in general.

traktus urinarius

ureter expand, tonus urine channel muscles increase influence consequence estrogen and progesteron. urinate a more regular (poliuria), rapid filtrasi increase until 60%-150%. urine channel wall can depress by magnification uterus, causes hidroureter and may be hidronefrosis temporary.

degree creatinin, urea and sour tendon in blood may be decreased but this matter is assumed normal.

skin

activities enhanced melanophore stimulating hormone causess change shaped hiperpigmentasi in face (kloasma gravidarum), breast, linea alba (-> linea grisea), striae lividae in stomach, etc.

change psikis

attitude / mother acceptance towards the pregnant conditon, very influence also well-being / mother generality with fetus conditon in the pregnancy.

usually desirable pregnancy be greeted with happy attitude, escorted with pattern eats, body treatment and efforts investigate self regularly well. sometimes emerge phenomenon common called “ngidam”, that is willing towards certain matters doesn’t as usual (certain food kind for example, but may be also matters other)

but undesirable pregnancy, possibility will be greeted with attitude will not support, passion eats to decreased, doesn’t want to investigate self regularly, even sometimes also mother until do efforts to abort the pregnancy.

diagnostic pregnancy

based on changes anatomik and fisiologik, collectable matters may be have a meaning in investigation fisis also supporting, to aim in mengagnosis pregnancy.

phenomenon and sign that can aim mengagnosis existence a pregnancy:

1. amenorea (actually have a meaning if 3 months or more)

2. expansion uterus (appear espoused stomach expansion, or in young pregnancy is inspected with palpasi)

3. existence kontraksi uterus in palpasi (braxton-hicks)

4. aba/asa fetus movement in palpasi or appear in imaging. ballotement (). if (-) suspicious mola hidatidosa.

5. heard fetus heart (by means of laennec/ doppler) or heart appear visual throbs in imaging (packing ultrasound echoscopy).

6. aba fetus body part in palpasi (leopold) or appear in imaging (ultrasonografi)

7. change serviks uterus (chadwick / hegar sign)

8. body temperature curve increases

9. test urine b-hcg (pack’s test / gallimainini) positive. be careful because faked positive can also happen example because urine dirty, expired tool or wrong investigation manner.

10. titer b-hcg increase in pregnancy around 90 days, then decreased to like beginning pregnancy, even can until not deteksi.

11. sick feeling and vomit to repeat, morning sickness.

12. breast change

13. poliuria