Physiological changes in pregnancy include increased blood volume, cardiac output, and respiration. The uterus grows significantly to accommodate the fetus, while other systems like renal and endocrine adapt to support the demands of pregnancy. Diagnosis involves tests to detect hCG in urine or blood from very early pregnancy, and ultrasound to visualize the developing fetus.
what is labor and what is the normal?
what are the signs of labor?
what are the stages of labor?
what are the mechanism of labor?
what are the factors that affect the labor?
Physiological changes in pregnancy. It includes changes in the genital organs, uterus, cardiovascular changes, respiratory, metabolic, alimentary, skin, skeleton, psychological changes, urinary changes and weight gain in pregnancy.
what is labor and what is the normal?
what are the signs of labor?
what are the stages of labor?
what are the mechanism of labor?
what are the factors that affect the labor?
Physiological changes in pregnancy. It includes changes in the genital organs, uterus, cardiovascular changes, respiratory, metabolic, alimentary, skin, skeleton, psychological changes, urinary changes and weight gain in pregnancy.
Detailed account of the various changes that occur in maternal anatomy, physiology, and metabolism of pregnant women. These physiological changes are often very precise, and deviations of physiological responses can be a prelude to possible disease/infectious states. In this second part of Labor, we will examine the various systems of the human body,its altered states during pregnancy, and how those changes affect the woman preparing for delivery. Special care is imperative in properly determining the needs of an expecting mother, so developing an intimate, trusting relationship between the mother and fully understanding her physiological output will lead to the best chances of a successful delivery.
obstetric and gyneacology; Changes in pregnancy, cardiovascular changes, respiratory changes, endocrine changes, gastrointestinal changes, related organ changes in pregnancy. hormonal changes during pregnancy.
Maternal physiological changes in pregnancy are the adaptations during pregnancy that a woman's body undergoes to accommodate the growing embryo or fetus. ... The pregnant woman and the placenta also produce many other hormones that have a broad range of effects during the pregnancy.
physiological changes during pregnancy
effect of pregnancy on physiological functions during pregnancy
cardiovascular, respiratory and hormonal changes
Shifa Riaz
gynecology
obstetrics
females
Organizational planning for hospital nursing servicesJayashree Ajith
Nursing is a vital aspect of health care and need to be properly organized . nursing services administration s is complex of elements in interaction .It results in output of clients whose health is avoidable . deteriorating maintained or improved through input of personnel and material resources.
Importance of antioxidant micronutrients in pregancy, importance selenium, copper, zinc. vit c&E pathogenesis etc Deficiencynof micronutrients will cause pre eclampsia and low birth weight babies
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
3. Introduction
The normal for adult female particularly when pregnant
often differ significantly from young adult males.
Aim to maximize nutrition and oxygen to the
developing fetus and help the maternal system
adjust to the extra stress.
Lack of appreciation of this difference may lead to
inappropriate management of clinical problems in
obstetric.
4. The major maternal physiological
adaptation to pregnancy
1-Systemic changes:
-volume homeostasis.
-blood
-cardio vascular system.
2-Respiratory changes.
3-urinary tract and renal function.
4-Alimentary tract.
5-Reproductive organs.
6-endocrinological changes.
5. systemic changes
A.volume homeostasis:
• fluid retention is the most fundamental
systemic changes of normal pregnancy.
• the total blood volume is increased during
pregnancy 30%.(Red cell mass)the most
marked expansion occurs in extra cellular
volume (ECV) with some increase in intra
cellular water.
6. The factors contributing including:
Increase sodium retention.
Decrease in plasma osmotic pressure.
Decrease in thirst threshold.
Resetting of osmostate.
Decrease in plasma oncotic pressure.
7. B. Blood:
The marked increase in plasma volume associated with
normal pregnancy causes dilution of many circulating
factors.
Hematological changes
Decrease in:
o red cell count.
o hemoglobin concentration.
o haematocrit.
o plasma folate concentration.
Increase in :
o white cell count.
o erythrocyte segmentation rate .
o fibrogen concentration.
8. CARDIOVASCULAR SYSTEM
• POSITION AND SIZE OF HEART
• Displaced to upward and to the left with
rotation on its long axis
• Heart size increase 12%
• Cardiac capacity increase by 70-80%
• Hyper trophy of cardiac muscles
• Cardiac output increase 30-40%
9. C.Cardio vascular changes:
Earliest changes is periphral vasodilatation
Results in decreased systemic vascular resistence→
↑CO 6 L/ min. Max. (22-28)wks.
• heart rate increase (10-20%).
• stroke volume increase (10%).
• cardiac out put increase (30-50%).
• Mean arterial blood pressure decrease
(10%).-
• Peripheral resistance decrease (35%).-
10. BLOOD PRESSURE
• Systolic blood pressure decrease
• Diastolic pressure decline up to 5-10mm hg
• 12-26 weeks
• Decreased blood return to the heart due to
pressure on presenting part on the illiac vein
and gravid uterus on inferior vena cava.
• Decrese cardiac out put leads in low blood
pressure, cause edema in lower limb
11. normal changes in heart sounds during
pregnancy:
increase loudness of both S1 & S2.
>95% develop systolic murmur which
disappears after delivery.
20% have a transient diastolic murmur.
10% develop continues murmur due to
increase mammary blood flow.
ectopics
Relative tachy cardia
collapsing pulse
12. Respiratory changes
increase O2 demand by 20 %.
↑tidal volume with normal respiratory rate.
↑po2 and ↓pco2 with compensatory ↓HCO3(mild
compensated respiratory alkalosis).
Breathlessness due to hyperventilation and
elevation of diaphragm.
tissue and oxygen availability to placenta improves.
PH alters little.
13. CHANGES IN RIB CAGE
• Upward displace ment of rib cage due to
elevated diaphragm.
• Hyperventilation leads dysponea and
dizziness.
• Hyperaemia and expansion of the upper
respiratory mucosa cause stuffy nose.
•
15. URINARY SYSTEM
• Each kidney increase in length 1-1.5 cm
• Dilated ureters up to pelvic brim
• Ureters elongated ,wide and more curved.
• Bladder vascularity increase ,muscle tone
decrease,bladder mucosa become edmatous
16. The urinary tract and renal function
• blood flow increase (60-70%).
• glomerular filtration increased (50%).
• clearance of most substances is enhanced.
• plasma creatinine ,urea,urate are reduced.
• glycoseuria is normal.
• Renal plasma rate increase by 25-50%.
17. Alimentary system changes
• the gums becomes spongy.
• the lower oesophageal sphincter is relaxed
(hurt burn).
• gastric secretion is reduced.
• the intestinal musculature is relaxed
(constipation).due to decrease
gastrointestinal motility
• Pica
18. METABOLIC CHANGES
• Enhances the protein storage
• Decrease in blood urea level
• Cholesterol level increase, increase fat
absorbtion
• Fat metabolism increase
• Iron demand increase
19. SKELETAL CHANGES
• Lordosis
• Numbness,aching,weakness in the arms
• Oestrogen relax pelvic joints,Progestron relax
and weakens pelvic ligaments,relaxin softens
pelvic joints and ligaments
• Pelvic pain due to relaxation of symphysis
pubis
• Low back pain due to increase motility in
sacroilliac and sacrococcygeal joint
20. Reproductive organs
A. the uterus:
the adult uterus comprising three
layers:
inner layer thin circular MF.
outer layer thin long MF.
central layer thick inter locking fiber.
the ratio of muscle to connective tissue
increase from the lower part of the
uterus to the fundus.
21. in early pregnancy uterine growth result from both
hyperplasia and hypertrophy while later
hypertrophy accounts for most of increase.
it weight one kilo gram at term( in pre pregnancy
50-60 grams
as the pregnancy advanced the uterus divided into
upper and lower uterine segment the lower uterine
segment composed of lower part of uterus and the
upper cervix composed mainly from connective
tissue because of this the lower uterine segment
becomes stretched in late pregnancy.
22. B. the cervix:
• the cervix becomes softer and swollen in
pregnancy with the result columnar epithelium
lining cervical canal becomes exposed to vaginal
secretion.
• oestradiol stimulate growth of columnar epithelial
of the cervical canal so it becomes violte and is
called ectropine.
• the mucus gland becomes distended and secrete
mucus which forms a mucus plug that is expelled in
labour as the show.
• prostaglandins and collagenase especially in last
weeks of pregnancy act on collagen fiber make
cervix more softer.
23. C. the vagina :
• the vaginal mucosa becomes thicker during
pregnancy.
• the vaginal discharge during pregnancy
increased due to increase desquamation of
the superficial vaginal mucosal cells
24. D-breasts and lactation :
• the earliest changes is a swelling of the breast
tissue.
• oestrogen leads to increase in number of glandular
ducts.
• progesterone leads to proliferation of glandular
epithelium of the alveoli.
• prolactine leads to active secretion of milk after
birth.
25. Endocrinological changes:
• prolactine concentration increases markedly
but act after delivery.
• human growth hormone is suppressed .
• insulin resistance develop.
• thyroid function changes little.
• trans placental calcium transport is enhanced.
• corticosteroid concentration increased.
• aldesterone concentration increased.
• angiotensin and renine increased
26. Hormones produced within uterus
human chorionic gonadotrophin (HCG):
• it is secreted by trophoblast and can be detected
in serum 10 days after conception (RIA).
• there is high level of circulating HCG in early
pregnancy (to provide a suitable environment for
implantation and development).
• to support corpus luteum secretion of oestrogen
and progesterone in the first trimester until the
placenta becomes able to produce these
hormone.
• the peak level normally occur in the 12th week .
27. • constant level of HCG in late pregnancy is
useful in:
controlling placental secretion of Estrogen
progesterone.
suppressing maternal immune system
against fetus.
• the human chorionic gonadotrophine
normally disappear from urine 7-10 days
after delivery of placenta.
28. human placental lactogen
• it is secreted by syncytotrophoblast.
• It is level increase when the level of HCG start to
drop .
• HPL has no effect on fetus.
• HPL effect on :
1-the breast:
o mammary growth during pregnancy.
o produce of colostrums.
o milk production lactation.
29. 2-protiens:
o HPL stimulate protein synthesis at cellular level.
3-carbohydrate:
o stimulate insuline secretion .
o inhibit insulin action.
4-fat:
HPL mobilize fat from body store (lypolysis) lead to
increase maternal blood glucose and maternal
tissue can not utilze the glucose so the glucose will
be available for fetus.
30. Estrogen
• it is produce by corpus luteum in early pregnancy.
• it is produce by placenta in late pregnancy.
• fetus (liver and adrenal ) provide certain enzyme
which are lack in placenta.
role of estrogen:
On connective tissue: estrogen leads to
polymerization of mucopoly saccarides of the
ground substance leads to loose connective tissue
mainly in the cervix.
On the protein: estrogen stimulate directly RNA
synthesis lead to protein synthesis.
31. progesterone
• it is production same as estrogen.
• it has effect on smooth muscle leads to
decrease muscle excitability leads to muscle
relaxation mainly in uterus.
32. Thyroid function
• increase thyroid binding globulin.
• increase bound form of T3,T4.
• no change in free form of T3,T4.
So no evidence to support what previously
thought to be physiological such as increase in
size of thyroid gland , increase BMR, body
temperature, heart rate.
33.
34. CHANGES IN ENDOCRINE SYSTEM
• Syncytotrophoblast secrete Human
chorionic gonadotrophins
• Placenta secretes Human placental
lactogen
35. Diagnosis of pregnancy
• History: symptoms.
• Examination: signs.
• Investigation : pregnancy test and
ultrasound.
36. symptoms of pregnancy
1-Amenorrhoea:
abrupt cessation of menses in a woman with
regular cycle is highly suggestive.
2-breast symptoms:
tenderness and fullness may be noticed .
3-frequency of micturation :
pressure on the urinary bladder by enlarging
uterus.
37. 4-nausea with or without (morning sickness).
5-abdominal enlargement.
6-fetal movement:
quickening is the first feels fetal movement
PG at (18-20wks).
Multi para at (16-18wks).
38. signs of pregnancy
1-breasts signs:
• enlargement and increase pigmentation of the nipple.
• increased pigmentation in the areola (areola).
• formation of secondary areola.
• montgomery areola or tubercle:
• small tubercles 12-20 at the periphery of primary areola
appear at 8th week due to active sebaceous gland.
• prominent vein on the surface.
• colostrum at 16th week is reliable in primigravida.
40. 3-genital tract signs:
• bluish discolouration of the vulva.
• genital tract becomes more soft and warm.
• Uterine changes:
uterus becomes abdominal organs at 12th week.
uterus becomes rounded (globular) instead of
flatten in antero posterioly.
uterus becomes soft due to increase vascularity.
41. 4-signs due to presence of the fetus:
• fetal heart sounds:
• after 12 weeks fetal heart heard with fetal sonicaid.
• after 24th week fetal heart heard with fetal
stethoscope.
• FHR 120-160 beats/minuts.
• funic soufflé:heard when fetal steatoscope lie
directly over umbilical cord it is soft blowing
murmur synchronous with fetal heart sounds.
• palpitation of fetal parts from 24th weeks.
• fetal movement:may felt during palpation.
• Braxton hicks sign:irregular painless contraction
palpable at 20th week.
42. investigation
1-pregnancy tests:
• a pregnancy tests detects human chorionic
gonadotrophine(HCG) in mother urine or serum.
urine tests: agglutation inhibition (day 35 after
LNMP).
• standard HCG is adsorbed on particles or cells in
suspension..
• anti serum (Ab) and some of patient urine is added.
• if urine contains HCG it will combine with the
antibody and thus prevents it from binding and
agglutinating the particles.
43. • if urine containing no HCG anti body binds adjacent
particles thus causing agglutination.
• the test can be carried out on slides or in tubes.
blood tests (day 10 after implantation):
radio immune assay (RIA).
Enzyme-linked immuno assay (Elisa):
o Can detect levels as low as 0.1-0.3 iu/l
o Can detect pregnancy before the patient missed
period.