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Pregnancy - physiology

Hormones

hCG - human chorionic gonadotropin - present in blood and urine, produced by blastocyst and placenta

Low levels of hCG could mean miscarriage, ectopic pregnancy, miscalculation of dates

High levels = molar pregnancy (cells that normally form a baby dysfunction and form cysts instead), multiple pregnancy (twins etc), miscalculation of dates

Progesterone increases fat deposition in early weeks and stimulates appetite

Increased oestrogen from corpus luteum promotes mammary gland development (breasts enlarge)

And inhibits ovulation via negative feedback [OES decreases GnRH release by hypothalamus –> linhibition of FHS and LH –> no ovulation]

Relaxin (secreted by corpus luteum) softens connective tissue in preparation for labour - not specific, all joints can be affected

Peaks in early and late pregnancy

Physical changes

Blood pressure

As early as 4 weeks into pregnancy 

plasma volume increase

caused by the affects of oestrogen and progesterone on the kidneys

OES and Prg cause vasodilation 

less resistance = less pressure

Heart rate increases by 25% to compensate

stroke volume increases 

increased overall cardiac output by 50% in third trimester

Direct action of enlarged uterus:

compresses the descending aorta and inferior vena cava 

decreased venous return - less blood in means less blood out, less blood in ventricle –> reduced pressure on walls –> reduced force to exit –> reduced placental perfusion

increased aortic pressure

increased heart rate

[shouldn’t sleep on back for this reason]

Outcomes:

Fall in blood pressure (can cause collapse if serious)

Can cause foetal hypoxia even without mother symptoms

Haematological changes

red cell mass increase by 20% (renal - increased erythropoietin production in response to detection of blood oxygenation and sodium/water balance)

Plasma volume increases more than RBC count does, causing the impression of decreased haemoglobin (anaemia)

Increased tendency to clot (hypercoagulable)

due to increase in clotting factors and plasma fibrinogen

platelet production increase (however count drops due to increase in activity and consumption) - function remains normal]

WBC count may increase due to an increase in granulocytes

Respiratory changes

Increased chest diameter, diaphragmatic expression and elevation

dyspnoea common (difficulty breathing)

breathing becomes more costal (mouth) than abdominal 

mainly mediated by progesterone levels (cause bronchial and smooth muscle relaxation and hypersensitivity to CO2)

Changes to the urinary system

cardiac output increase –> increase in renal plasma flow and glomerular filtration

increase in urea, creatinine, urate and biocarbonate clearance 

with progesterone, renin and aldosterone up water retention increases

can lead to urinary stasis and increased risk of UTI

Any drugs given that are excreted renally must be given in much higher quantities consequently

Gastrointestinal changes

Appetite increase + cravings 

Gastric reflux sphincter relaxation (increased indigestion, also due to increased intra-gastric pressure (expanding uterus)) 

gallbladder dilated 

GI motility decreased and transit time slower 

albumin and protein decrease 

cholesterol twice normal value

Muskuloskeletal 

Calcium reuptake into bloodstream results in mild decalcification of bones 

relaxin softens joints (pubic symphysis + alters gait (waddling))

abdominal muscles stretch to elastic limit 

stretch marks (stria gravidarum) caused by rupture of elastic fibres and small blood vessels 

Reproductive changes

Massive increase in mass

Placenta growth (nutrition, excretion, immunity, endocrine) 

Parental blood supply 

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“Pregnancy is a beautiful thing, and I believe it should be celebrated; whether it lasts 3 weeks or 9 months.”

— @myrainbowboyandme

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A dream is a wish your heart makes.

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[babygirlsbaby22-blog]

If I have a child and it's female I have two names I like and because of the ace family . I love the name Elle and aláia.

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So it's been a few months and I am not pregnant I got my depo shot today and took a pregnancy test before and it was negative I was secretly hoping it was positive and got my hopes up. So kinda upset about that still. When it's time it's time I guess.

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The bump

I just want that cute baby bump. I want people to look at it and smile. I want to feel that little life moving inside me. I need this.

I’m so scared it won’t happen. Ever.

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Not pregnant 😣

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Updateeeee

lately I've been having symptoms of pregnancy and have this gut feeling that I am. So I took an at home pregnancy test and if it does turn out how it's suppose to I'll get a real pregnancy test. So in 4 hours I'll update with the results.

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I hope

I keep seeing pregnancy things on Facebook, pregnant women in person and just everywhere I honestly think it’s a sign mabey the universe is hinting at me that it’ll happen for me soon .

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Ouch

My jaw hurts today had a bad ear infection last week hopefully nothing spread to my jaw.

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Omg

My 18month old niece got 6 shots today and blood taken and they wernt no baby needles. I feel so bad . No way in hell will I let my baby get that many shots I'll reschedule for two then rest a different time . She's in so much pain You can tell. I love you li

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I'm ready

I'm so ready to be a mommy even tho the timings not right. I just want a baby so bad lol. When the time comes I pray your a happy and healthy baby.

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My child is gonna have so many things, I'm gonna get her/him puzzles, drawing stuff,playdough, all that kinda stuff. tomagochis, and pixel chixs. I can't wait!