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Pregnancy
Dr. Sara Sadiq
MBBS, M.Phil
Pregnancy
Hormones  Human chorionic gonadotrophic
(β-HCG)
• Secreted from trophoblast of the developing embryo
• Maintains corpus luteum until placenta takes over
• Prevent menstruation and cause the endometrium to continue to grow and
store large amounts of nutrients
• Used in tests to confirm pregnancy
Pregnancy
Hormones  Estrogen
• Produced in corpus luteum
• Produced by placenta after 12 weeks
• Responsible for
1. Enlargement of the mother’s uterus
2. Enlargement of the mother’s breasts and breast ductal structure
3. Enlargement of the mother’s female external genitalia
4. Relax the pelvic ligaments of the mother
Hormones  Progesterone
• Produced in corpus luteum and then the placenta
• Responsible for:
1. Provide nutrition to embryo by developing decidual cells
2. Inhibits uterine contractions until uterus is prepared for labour
3. Helps estrogen prepare the mother’s breasts for lactation
• Relaxes smooth muscle
• Colon activity reduced, nausea, constipation
• Diastolic pressure reduced
• Venous dilatation raises temperature
Hormones  Human Chorionic
Somatomammotropin
• Also named as human placental lactogen
• Alters maternal metabolism
• Decreased insulin sensitivity and decreased utilization of glucose in the
mother  Diverts glucose to fetus
• Mobilises free fatty acids from maternal stores
Changes During Pregnancy
Endocrinal Changes
• Pituitary secretion increases  Corticotropin, thyrotropin, prolactin
 FSH, LH suppressed
• Corticosteroid secretion increases (Pregnancy induced HTN)
• Thyroid secretion increases
• Parathyroid secretion increases
• Secretion of relaxin by ovaries and placenta
Metabolic Changes
• Basal metabolic rate increases  Thyroxine
 Adrenocortical hormone
 Sex hormones
Weight Gain
• There is an increase weight of approximately
12.5 Kg at term
• The main increase occurs in the 2nd half of the
pregnancy  0.5 Kg/week
• Causes:
• growth of the conceptus
• enlargement of the maternal organs
• maternal storage of fat
• increase in maternal blood and interstitial
fluid
Changes in maternal circulatory system
• To meet increased metabolic demand.
• Increased blood volume / RBC mass
• Decreased Hct and viscosity
• Increased cardiac output
Effect on maternal respiration
• Because of increase metabolic rate  20% increases in oxygen demand
• Minute ventilation increases  high Progesterone  increase respiratory
center sensitivity to CO2
• Respiratory rate also increases due to abdominal pressure over diaphragm
Amniotic Fluid & Its Formation
• Amniotic fluid  fluid inside uterus in
which fetus floats
• 500ml to 1lit
• Large portion derived from renal
excretion by fetus
Pregnancy
Pregnancy
Pregnancy
Pregnancy
Thank You

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Pregnancy

  • 3. Hormones  Human chorionic gonadotrophic (β-HCG) • Secreted from trophoblast of the developing embryo • Maintains corpus luteum until placenta takes over • Prevent menstruation and cause the endometrium to continue to grow and store large amounts of nutrients • Used in tests to confirm pregnancy
  • 5. Hormones  Estrogen • Produced in corpus luteum • Produced by placenta after 12 weeks • Responsible for 1. Enlargement of the mother’s uterus 2. Enlargement of the mother’s breasts and breast ductal structure 3. Enlargement of the mother’s female external genitalia 4. Relax the pelvic ligaments of the mother
  • 6. Hormones  Progesterone • Produced in corpus luteum and then the placenta • Responsible for: 1. Provide nutrition to embryo by developing decidual cells 2. Inhibits uterine contractions until uterus is prepared for labour 3. Helps estrogen prepare the mother’s breasts for lactation • Relaxes smooth muscle • Colon activity reduced, nausea, constipation • Diastolic pressure reduced • Venous dilatation raises temperature
  • 7. Hormones  Human Chorionic Somatomammotropin • Also named as human placental lactogen • Alters maternal metabolism • Decreased insulin sensitivity and decreased utilization of glucose in the mother  Diverts glucose to fetus • Mobilises free fatty acids from maternal stores
  • 9. Endocrinal Changes • Pituitary secretion increases  Corticotropin, thyrotropin, prolactin  FSH, LH suppressed • Corticosteroid secretion increases (Pregnancy induced HTN) • Thyroid secretion increases • Parathyroid secretion increases • Secretion of relaxin by ovaries and placenta
  • 10. Metabolic Changes • Basal metabolic rate increases  Thyroxine  Adrenocortical hormone  Sex hormones
  • 11. Weight Gain • There is an increase weight of approximately 12.5 Kg at term • The main increase occurs in the 2nd half of the pregnancy  0.5 Kg/week • Causes: • growth of the conceptus • enlargement of the maternal organs • maternal storage of fat • increase in maternal blood and interstitial fluid
  • 12. Changes in maternal circulatory system • To meet increased metabolic demand. • Increased blood volume / RBC mass • Decreased Hct and viscosity • Increased cardiac output
  • 13. Effect on maternal respiration • Because of increase metabolic rate  20% increases in oxygen demand • Minute ventilation increases  high Progesterone  increase respiratory center sensitivity to CO2 • Respiratory rate also increases due to abdominal pressure over diaphragm
  • 14. Amniotic Fluid & Its Formation • Amniotic fluid  fluid inside uterus in which fetus floats • 500ml to 1lit • Large portion derived from renal excretion by fetus