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Physiology of pregnancy
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Physiology of pregnancy

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  • 1. Physiology of pregnancy
  • 2. Definition of pregnancy
    • Pregnancy is defined as the course of embryo and fetal growth and development in uterine
    • It begain at the fertilization and end the delivery of the fetal and it’s attachment
  • 3. Definition of fertilazation
    • Fertilization is defined as the course of combination of the oocyte and sperm
    • It onset 12h after ovulation usually in ampulla of the oviduct(fallopian tube)
  • 4. The Development of the fertilizated egg
    • 3 days after ovulation, the morula (early blast)is fomulated
    • 4 days after ovulation, the late blast is fomulated
    • 6-7 days after ovulation, the egg imbeds in the uterus
  • 5. The stage of egg imbed
    • Apposition
    • Adhesion
    • Penetration
  • 6. The necessary conditions of imbed
    • Disapearing of the pellucid zone
    • Syntrophoblast formed from the blast
    • Synchronizing development of blast and the endometriun
    • P Secretory enough
  • 7. Changes of endometrium after the egg imbed
    • The endometrium changes into dicedua
    • Basal decidua
    • Capsular decidua
    • True decidua
  • 8. Attachment of the fetal
    • Placenta
    • Fetal membranes
    • Umbilical cord
    • Amniotic fluid
  • 9. placenta
    • It’s an exchange organ between maternal and fetal
    • Amniotic membrane
    • chorion frondosum
    • Basal decidua
  • 10. chorion frondosum
    • 13-21 days after ovulation, villi fomulating gradually
    • Grade I viili
    • Grade II Iviili
    • Grade III viili
  • 11. Structure of placenta
    • Round
    • Weight:450-650g
    • Diameter:16-20cm
    • Thickness:1-3cm
    • thick in center and thin in margin
  • 12. Function of placenta
    • One important function of placenta is substance exchange between maternal and fetal
  • 13.
    • The position of exchange is VSM(vasculo-syncytial membrane)
    • VSM is comprised of
    • Syntrophoblastocyte
    • Basal membrane of Syntrophoblastocyte
    • Stroma of villi
    • Basal membrane of capillary
    • Endothelium of capillary
  • 14.
    • The way of substance exchange
    • Simple diffusion
    • Facilitated diffusion
    • Active transportion
    • phagocytosis
  • 15.
    • The functions of placenta
    • Gas exchange
    • Suply of nutrition
    • Depletion of fetal product of metabolisn
    • Defense function
    • Hormone synthesis
    • Human chorionic gonadotropin(HCG)
    • Human placental lactogen(HPL)
    • Pregnancy specific  -glycoprotein(PS  1G)
    • Human chorionic thyrotropin(HCT)
    • Estrogen, P, Oxytocinase, heat stable alkaline
    • phosphatase(HSAP)
  • 16.
    • Fetal membrane
    • Chorion
    • Amnion
    • Umbilical cord
    • Length:30-70cm average:50cm
    • Consist of 2 artery and 1 vein
  • 17.
    • Amniotic fluid
    • Source: early from serum dialysis
    • late fron fetal urine
    • Absorse: by fetal membrane, fetal
    • swallowing(500ml/day)
    • Amniotic exchange: between maternal
    • and fetal 400ml/h
  • 18.
    • Volume of amniotic fluid
    • 8 weeks:5-10ml
    • 10 weeks:30ml
    • 20 weeks:400ml
    • 38 weeks:1000ml
  • 19.
    • Status of amniotic fluid
    • pH : 7.20
    • Density : 1.007-1.025
    • Contained : water(98-99%)
    • inorganic substance
    • organic substance(1-2%)
  • 20. The function of amniotic fluid Protect maternal and fetal
  • 21. Maternal changes during pregnancy The maternal system may produce a series of changes in order to adapt to the needing of fetal growth and development influenceed by placenta hormone and neuro-endocrine
  • 22. Changes of reproductive system Uterus Body: become enlargement and soft from 7×5 ×3cm pre-pregnancy to 35×25 ×22cm at term Volume of uterus cavity: become enlargement from 5ml pre-pregnancy to 5000ml .at term
  • 23. Weight: be increased from from 50g pre- pregnancy to 1000g at term Wall: become thickness and the thickist at mid- period from 1 cm pre-pregnancy to 2-2.5 cm at term Blood suply: blood flow increased significantly upto 500- 700ml/min ,increased 4-6 times and most of blood flow is transported to the placenta (80-85%)
  • 24. Isthmus: be dialated and become soft from 1cm pre-pregnancy a portion of the uterus after 12 gestational weeks Cervix: be soft and coloration or stain secrete amount of mucus avoiding the uterus cavity suffer from infection
  • 25.
    • Changes of ovary
    • Stop ovulation
    • Corpus luteum formation and maintains for
    • 10 weeks
    • And the function of corpus luteum is
    • substituted by the placenta
    • Corpus luteum atretic gradually after 3-4
    • months gestation.
  • 26. Changes of the circulation Heart border: become enlargement Heart rate: increased 10-15 beat per min at the late pregnancy Heart volume: increased 10% at the late pregnancy
  • 27. Cardiac output Very important for fetal growth and development Incrased begain 10 weeks and upto the peak at 32 weeks 80ml/bp and keeps the level to the term pregancy
  • 28.
    • Blood pressure changes due to pregnancy
    • No obvious change in Systolic pressure
    • Mild decreased in diastolic pressure
    • Vein pressure
    • No significantly changes in Upper limb vein
    • pressure
    • Lower limb vein pressure increased because of
    • the disturbance of vein reflux
  • 29. Changes of blood system Volume: increased (30-45% ) begain 6- 8 weeks and up to the peak at 32-34 weeks increased about 1500ml including plasma 1000ml and red cell 500ml
  • 30. Changes of blood component Red cell: reticulocyte increased red cell decreased 3.6×1012(4.2×1012) Hb decreased 110g/L(130g/L) WBC: neutrophilic granulocyte increased lymphocyte mild increased no change in orther blood cells
  • 31. Coagulation Hypercoagulability Factor ⅱⅴⅶ ⅷ Ⅸ ⅹ increased ESR increased significantly upto 100mm/h Plasma protein albumin decreased