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[object Object],[object Object],[object Object],[object Object]
review
review
[object Object]
Diagnosis of the first trimester pregnancy
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
Maternal physiologic adjustment  in pregnancy ,[object Object],[object Object]
The fetus
[object Object],[object Object],[object Object],Fetal growth and development
8 weeks : the organ are beginning to form. 12 weeks :  the finger and toes have nails,  and the external genitalia may be recognizable.
16 weeks :  the sex is discernible as male or female. 20 weeks :  movement have been perceived by the mother.
[object Object],[object Object]
[object Object]
37 ,[object Object],[object Object]
The limits of the fetal role in maintaining fetal homeostasis are clear. ,[object Object],[object Object]
The placenta,umbilical cord and amniotic fluid
The placenta ,[object Object],[object Object]
[object Object],[object Object],[object Object]
decidua Maternal blood chorion trophoblast
trophoblast Inner cell mass Destine to become the   embryo blastocyst
[object Object]
Functions of the placenta ,[object Object]
[object Object],[object Object]
The umbilical cord ,[object Object],[object Object],[object Object]
The amniotic fluid ,[object Object],[object Object],[object Object]
Function of the amniotic fluid ,[object Object],[object Object],[object Object],[object Object],[object Object]
Maternal physiology during pregnancy
CONTENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Genital tract
Uterus Almost –solid structure  thin-walled muscular organ Weighing about 70g  1100g Cavity of 10 ml or less  5L
Ovary ,[object Object]
Human chorionic gonadotrophin ,[object Object],[object Object],[object Object]
Cardiovascular system
Cardiovascular changes in pregnancy Peaks in early 2nd trimester, then stable until term ↑ 33%-45% Cardiac output Early 2nd trimester, then stable ↑ 10%-30% Stroke volume Early 2nd trimester, then stable ↑ 12-18 beats/min Heart rate All bottom at 20-24 wk, then rise gradually to prepregnancy values at term ↓ 4-6mm Hg ↓ 8-15mm Hg ↓ 6-10mm Hg Arterial blood pressures Systolic Diastolic Mean Timing Account of change Parameter
Cardiovascular system ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],Cardiac output
[object Object]
[object Object],[object Object]
[object Object]
Cardiac output ,[object Object],[object Object]
Cardiac output ,[object Object],[object Object],[object Object]
Cardiac output ,[object Object],[object Object]
 
Intravascular pressures ,[object Object]
[object Object],[object Object],Intravascular pressures
Mechanical circulatory effects of gravid uterus ,[object Object],[object Object]
[object Object],[object Object],Mechanical circulatory effects of gravid uterus
Mechanical circulatory effects of gravid uterus ,[object Object],[object Object],[object Object]
Regional blood flow ,[object Object],[object Object]
Regional blood flow ,[object Object],[object Object]
Regional blood flow ,[object Object],[object Object]
Regional blood flow ,[object Object],[object Object]
Regional blood flow ,[object Object],[object Object]
Regional blood flow ,[object Object],[object Object],[object Object]
Control of cardiovascular changes ,[object Object],[object Object]
Control of cardiovascular changes ,[object Object]
Oxygen-carrying capacity of blood ,[object Object],[object Object]
[object Object]
Respiratory system
The major respiratory changes in pregnancy ,[object Object],[object Object],[object Object]
No significant change Progressive  rise  throughout pregnancy of 0.1-0.2L Lowered  by about 15%(0.55L in late pregnancy compared with 0.65L postpartum) Falls  considerably (0.77L in late pregnancy compared with 0.96L postpartum) Unchanged ,expect for possibly a small terminal diminution Increased  by about 5% Lowered  by about 18% Increased  by about 40% as a result of the increased tidal volume and unchanged respiratory rate Respiratory rate Tidal volume Expiratory reserve volume Residual volume Vital capacity Inspiratory capacity Functional residual capacity Minute ventilation Change in Pregnancy Test Lung volumes and capacities in pregnancy
[object Object],[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object]
Oxygen consumption and ventilation ,[object Object],[object Object],[object Object],[object Object]
Oxygen consumption and ventilation ,[object Object],[object Object],[object Object]
[object Object]
Oxygen consumption and ventilation ,[object Object]
Oxygen consumption and ventilation ,[object Object],[object Object]
Alveolar-arterial gradient and arterial blood gas measurements ,[object Object],[object Object]
Alveolar-arterial gradient and arterial blood gas measurements ,[object Object]
Alveolar-arterial gradient and arterial blood gas measurements ,[object Object],[object Object]
Renal physiology
Anatomic changes in the urinaty tract
[object Object],[object Object]
[object Object],[object Object],[object Object]
Renal blood flow and glomerular filtration rate
[object Object],[object Object]
Renal tubular function ,[object Object],[object Object]
Renal tubular function ,[object Object],[object Object],[object Object]
Renal tubular function ,[object Object],[object Object]
Fluid volumes ,[object Object],[object Object],[object Object]
Renin-angiotensin system in pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Homeostasis of maternal energy substrates
[object Object],Insulin effects and glucose metabolism
Insulin effects and glucose metabolism ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Lipid metabolism ,[object Object],[object Object]
Placental transfer of nutrients ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Other endocrine changes
Thyroid ,[object Object],[object Object],[object Object]
Adrenal ,[object Object],[object Object]
Weight gain in pregnancy
[object Object],[object Object]
THANKS FOR YOUR ATTENDANCE

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3.Maternal Physiology2009

  • 1.
  • 4.
  • 5. Diagnosis of the first trimester pregnancy
  • 6.
  • 7.
  • 8.
  • 10.
  • 11. 8 weeks : the organ are beginning to form. 12 weeks : the finger and toes have nails, and the external genitalia may be recognizable.
  • 12. 16 weeks : the sex is discernible as male or female. 20 weeks : movement have been perceived by the mother.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17. The placenta,umbilical cord and amniotic fluid
  • 18.
  • 19.
  • 20. decidua Maternal blood chorion trophoblast
  • 21. trophoblast Inner cell mass Destine to become the embryo blastocyst
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 29.
  • 31. Uterus Almost –solid structure thin-walled muscular organ Weighing about 70g 1100g Cavity of 10 ml or less 5L
  • 32.
  • 33.
  • 35. Cardiovascular changes in pregnancy Peaks in early 2nd trimester, then stable until term ↑ 33%-45% Cardiac output Early 2nd trimester, then stable ↑ 10%-30% Stroke volume Early 2nd trimester, then stable ↑ 12-18 beats/min Heart rate All bottom at 20-24 wk, then rise gradually to prepregnancy values at term ↓ 4-6mm Hg ↓ 8-15mm Hg ↓ 6-10mm Hg Arterial blood pressures Systolic Diastolic Mean Timing Account of change Parameter
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.  
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.
  • 52.
  • 53.
  • 54.
  • 55.
  • 56.
  • 57.
  • 58.
  • 59.
  • 61.
  • 62. No significant change Progressive rise throughout pregnancy of 0.1-0.2L Lowered by about 15%(0.55L in late pregnancy compared with 0.65L postpartum) Falls considerably (0.77L in late pregnancy compared with 0.96L postpartum) Unchanged ,expect for possibly a small terminal diminution Increased by about 5% Lowered by about 18% Increased by about 40% as a result of the increased tidal volume and unchanged respiratory rate Respiratory rate Tidal volume Expiratory reserve volume Residual volume Vital capacity Inspiratory capacity Functional residual capacity Minute ventilation Change in Pregnancy Test Lung volumes and capacities in pregnancy
  • 63.
  • 64.
  • 65.
  • 66.
  • 67.
  • 68.
  • 69.
  • 70.
  • 71.
  • 72.
  • 73.
  • 75. Anatomic changes in the urinaty tract
  • 76.
  • 77.
  • 78. Renal blood flow and glomerular filtration rate
  • 79.
  • 80.
  • 81.
  • 82.
  • 83.
  • 84.
  • 85. Homeostasis of maternal energy substrates
  • 86.
  • 87.
  • 88.
  • 89.
  • 90.
  • 91.
  • 93.
  • 94.
  • 95. Weight gain in pregnancy
  • 96.
  • 97. THANKS FOR YOUR ATTENDANCE