MATERNITY AND ISSUES REGARDING IT

LETS START WITH A SIMPLE DEFINITION OF PREGNANCY

PREGNANCY : IT IS A PHASE OR PERIOD OF FETAL DEVELOPMENT INSIDE A WOMENS’S

UTERUS . THE ENTIRE FPROCESS FROM FERTILISATION to birth WHICH takes an average of
266–270 days, or about nine months IS KNOWN AS PREGNANCY PERIOD .

INITIATION OF PREGNANCY :

CONCEPTION :

Conception is closely related to a person’s menstrual cycle. A menstrual cycle describes the
sequence of events that occur within your body as it prepares for the possibility of pregnancy
each month. Women or people assigned female at birth (AFAB) ovulate during their menstrual
cycle. Ovulation is when your ovary releases an egg for fertilization. Tiny finger-like structures
called fimbriae help guide the egg through your fallopian tubes towards your uterus . Sperm
production begins in the testicles of men or people assigned male at birth (AMAB). During
ejaculation, millions of sperm cells are set free with the sole purpose of finding an egg to
fertilize. When you have unprotected sex, sperm cells swim up through your vagina and into
your fallopian tubes. Millions of sperm battle to reach and penetrate the egg, but only one breaks
through the egg's outer layer to fertilize it. If sperm doesn't fertilize an egg, the egg dissolves.

A new individual is created ONLY when the elements of a potent sperm merge
with those of a fertile ovum, or egg. Before this union both the spermatozoon
(sperm) and the ovum have migrated for considerable distances in order to achieve
their union. A number of actively motile spermatozoa are deposited in the vagina,
pass through the uterus, and invade the uterine (fallopian) tube, where they
surround the ovum. The ovum has arrived TO THE AMPULLARY REGION after
extrusion from its follicle . FERTILISATION CAN OCCUR ONLY WHEN THE SPERM
AND OVUM ARE TRANSPORTED TO AMPULLARY REGION SIMULTANUOUSLY .
THIS IS THE REASON WHY ALL COPULATION DOES NOT RESULT TO PREGNANCY.

The process of fusion of sperm and the ovum is called

fertilisation. This occurs in falliopian or uterine tube
During fertilization a sperm comes in contact with the
zona pellucida layer of the ovum and induces changes
in the membrane that blocks the enry of additional
sperm. Thus it ensures that only one sperm can fertilise
an ovum and the sectretion of the acrosome help the
sperm enter into the cytoplasm of ovum. Through the
zon a pellucida and the plasma membrane Once it
has entered the substance of the ovum, the
nuclear head of this spermatozoon separates from its tail. The tail gradually
disappears, but the head with its nucleus survives. As it travels toward the
nucleus of the ovum (at this stage called the female pronucleus), the head
enlarges and becomes the male pronucleus. Thus the fusion of haploid
female nuclei and haploid male nuclei happens resulting in diploid zygote .

Implantation

Now after fertilization which happened in the ampullary

region of fallopian tube the formed zygote remains in
the tube for long time which cannot be determined but
within 72 hours of fertilization it reaches the uterine
wall or takes place anywhere between 6 and 12 days
after ovulation . It most commonly occurs 8 to 9 days
after conception . It is nourished during its passage by
the secretions from the mucous membrane lining the
tube.

The mitotic division starts as the zygote moves through isthmus region of the fallopian tube
which is called CLEAVAGE TOWARDS UTERUS and form 2,4,8,16 daughter cells called
blastomeres .The embryo with 8 to 16 blastomeres are known as MORULA . A morula is
composed of 60 or more cells. The morula continuous to divide and transforms into blastocytes
as it moves further into the uterus . The blastomeres in the blastocytes are arranged into an outer
layer called TROPOBLAST and an inner group of cells are attached to the tropoblast called
INNER CELLS MASS . The blastocyst, nurtured by the uterine secretions, floats free in the
uterine cavity for a short time and then is implanted in the uterine lining. Normally,
the implantation of the blastocyst occurs in the upper portion of the uterine lining . There are
certain signs of implantation like BLEEDING( pink or brown discharge ) , CRAMPS (due to
shift in hormones), DISCHARGE , BLOATING ( raise in progesterone level ) , TENDER
BREASTS ( due to increase in levels of hcg , estrogen , progesterone ) , NAUSEA ( increase in
levels of hormones ) , HEADACHES ( inc in progesterone) , CHANGES IN MOOD ( estrogen ,
progesterone , hcg ) . These are also symptoms of PMS (Pre menstrual syndrome ) . Mostly
every womens do not feel this signs .

AFTER IMPLANTATION

After implantation , finger like projection appears on the tropoblast called chorionic villi which
are surrounded by uterine tisse and maternal blood . The chorionic villi and the uterine tissue
become interdigitated with and jointly forms a structural anf functional unit between developing
embryo ( Foetus ) and maternal body called PLACENTA . This placenta facilitates the
supply of oxygen and nutrients to the embryo and also removal of carbon
dioxide and execretory or waste material produced by the embryo . Placenta
is connected to the embryo through an umbilical cord which helps in the
transport of substances to and from the embryo .The organ is usually
attached to the top, side, front or back of the uterus. In rare cases, the
placenta might attach in the lower area of the uterus . Placenta also acts as
a endocrine tissue and produces several hormones like HUMAN CHORIONIC
GONADROTROIPIN (HCG) , HUMAN PLACENTAL LACTOGEN (HPL),
ESTROGEN and PROGESTERONE . In later phase of pregnancy , a hormone
called Relaxin is also secreted by the ovary . It is Important to note that HCG
, HPL and RELAXIN are hormones that are released in womens only during
the pregnancy . In addition , during pregnancy the levels of other hormones
like estrogen , progesterone , cortisol , prolactin , thyroxine are increased
several folds in the maternal blood . Increased production of these hormones
is essential for supporting fetal growth , metablolic changes in the mother
and maintenance of pregnancy . Immediately after implantation the inner cell
mass ( embryo) differentiates into outer layer called ECTODERM and an
inner layer ENDODERM . A MESODERM soon appears between the ectoderm
and endoderm . As we know these three layers gives rise to all organs in
adults . All the inner cell mass contains certain cells called STEM CELLS
which have potency to give rise to all tissues and organs .

STAGES OF PREGNANCY

Basically pregnancy is calculated as 40 weeks period starting from the first

day of last menstrual period . It is classified into 3 trimesters . But pregnancy
duration can vary among womens from 37 to 40 weeks .

First trimester : From conception to 12 weeks

Second trimester : 13 weeks to 27 weeks

Third trimester : 28 weeks to 40 weeks

FIRST TRIMESTER
 This period includes period of conception to 12th week of pregnancy .

During first trimester the womens body undergoes certain changes .

Hormonal changes affect almost every organ system in the body

Extreme tiredness

Tender , Swollen breasts

Upset stomach with or without morning sickness , Constipation

Carvings or distaste for certain foods

Mood swings

Headache , Heart burn

Weight gain or loss

These may or may not make the women feel discomfort . Mostly the
discomfort may go away as pregnancy progresses .

1st week of pregnancy

The first week of pregnancy is actually the menstrual period . The

expected birth or the due date is calculated from the first day of the last
period . This period counts as a part of 40 weeks .

2nd week of pregnancy

Fertilisation of egg and the sperm takes place at the end of this week .
3rd week of pregnancy

Thirty hours after conception , the cells split into two . After several
divisions almost after 5 days the zygote reaches the womb . Aproximately
after 7 days of conception , the zygote burrows itself into the plump uterine
lining .

4th week of pregnancy

The developing baby is tinier than a grain if rice . The rapidly dividing
cells are in the process of forming the various body systems , including the
digestive system

This finishes the 1st month of pregnancy

5th week of pregnancy

The neural tube ( Brain ,Spinal cord and other neural tissue of the
central nervous system ) forms . The tiny HEART will beat 110 times a minute
by the end of the 5th week .

6th week of pregnancy

Now the baby is known as embryo . It would be 3mm in length now .

Tiny buds that become arms and legs also develops . Blood cells would take
shapes and circulations will begin. Structures that will become ears , eyes
and mouth would take form. By this time secretion of hormones takes place
which prevents from menstrual cycle .

7th week of pregnancy

The embryo has developed its placenta and amniotic sac . The placenta
is burrowing into the uterine wall to access oxygen and nutrients from the
mother’s bloodstream . Bones begin replacing soft cartilage and genitals
begin to form . The embryo’s head is large in proportion to the rest of its body
. Some people think the embryo resembles a small tadpoles or seahorse due
to its prominent tail and large head .

8th week of pregnancy

 The embryo is now around 1.3 cm in length . The rapidly growing spinal
cord looks like a tail . The head is disproportionately large . All of the major
organs and body systems will start to develop . The fetus has web like hands
and feets . Eyes become visible and ears begin to form . The unbilical cord is
fully developed and helps to transport oxygen and blood to embryo .

This finishes 2nd month of pregnancy . Afetr 2nd month the embryo is known as
fetus till the birth. By the end of second month the fetus is about 0.5 to 1
inch long .

( NOTE : The third month of pregnancy is when an embryo becomes a fetus .

It’s period of rapid growth and development . The fetus develops distinct
facial features , limbs, organs , bones and muscles . By the end of the 12 th
week ( 1st trimester ) the fetus will have an assigned sex , but it won’t be
visible on untrasound for several weeks .

9th week pregnancy

Tiny eyes , mouth and tongue are formed . Tiny muscles are formed and
allow the embryo to start moving and giving shape that is similar to the
human appearance. Blood cells are formed by the liver of embryo . Teeth and
taste buds starts forming. Bu still its head is 50% in length .

10th week of pregnancy

The embryo is now 2.5 cm in length . All the body organs are formed.The
arms , hands , fingers , feet and toe are fully formed . Fingernails and toenails
starts to develop and external ears forms . The external genitals also begin
to form , but it’s too soon to see them on an untrasound . The brain is active
and has brainwaves .

11th week of pregnancy

The fetus is starting to explore a bit by doing things like opening and
closing its fists and mouth . Its knees , elbows and ankles are working . BUut
its too soon to feel any kicks . The bones are hardening , but its skin is still
see-through . Facial features are more pominant . Teeths are budding inside
the gums . The tiny heart is developing further

12th week of pregnancy

 All the ogans , limbs , bones and muscles are present and will continue
to develop in order to become fully fnctional . The circulatory system ,
Digestive system , Excretory system are also working and the liver produces
bile . The fetus starts to drink and excrete .the fingers and toes are
recogonisable but still stuck together with webs of skin .

With this the 3rd month and the 1st trimester is over . By this time SCREENING
TEST EDWARDS SYNDROME (Trisomy 18) and DOWN SYNDROME (Trisomy
21).

SECOND TRIMESTER

The 2nd trimester compraises week 13 to week 24 .During this period , most
of the womens find that morning sickness eases and they have more
energy .During this time pregnancy would be visible and women gains some
weight . GESTATIONAL DIABETES is usually detected around 24 to 28 week
of pregnancy , although it can develop earlier . Symptoms like nausea and
fatigue feel will fade. But still there would be many changes that a women
can experience like

Body ache , such as back , abdomen , groin or thigh pain

Strech marks on your abdomen , breasts , thighs or buttocks

Darkening of the skin around the nipples

A line on the skin running from belly button to public hairline

 Patches of darker skin , Usually over the cheeks , Forehead ,
Nose or upper lip. Patches often match on both sides of the face . This is
sometimes called the mask of pregnancy

Numb or tingling hands , called Carpal tunnel syndrome

Itching on the abdomen , palms and soles of the feet

Swelling of the ankles , fingers and face

13th week of pregnancy

The fetus can swim about quite vigorously . It is now more than 7cm in
length . Vocal cords form and the fetus’s large head begins to grow
proportionate to its body .

14th week of pregnancy

The eyelids are fused over the fully developed eyes . The baby can
now mutely cry , since it has vocal cords . It may even start sucking its
thumb . The fingers and toes are growing nails . The fetus’s skin starts to
thicken and fine hair begins to grow . It can start bringing its fingers to its
mouth and turn its head . External genitals are fully developed and
fingerprints begin to form .

15th week of pregnancy

Some organs , like intestines and ears , are moving to their permanent
locations . The fetus still uses amniotic fluid to practice breathing , but its
lungs are beginning to develop . The fetus begins to make more purposefull
movements , like sucking its thumb or smiling .

16th week of pregnancy

The fetus is around 14cm in length . Eyelashes and eyebrows have

appeared , and the tongue has taste buds . The second trimester MATERNAL
SERUM SCREENING will be offered at this time if the first trimester test was
not done . The fetus has lips and its ears are developed enough that it can
hear sound from outside . Even though its eyes are closed , The fetus can
react to light by turning away from it .

With this the 4th month of pregnancy gets over

17th week of pregnancy

 The fetus still has thin skin , But will start to put on fat . Its skin is
covered with a whitish coating called VERNIX . This CHEESY substance is
thought to protect fetal skin from long-term exposure to amniotic fluid .

18th week of pregnancy

The fetus is covered in LANUGO , a peach fuzz-like hair . It helps keep

the fetus warm and provides another layer to protection . The fetus may have
a sleep-wake cycle and loud noises may wake the fetus if it’s asleep

19th week of pregnancy

The fetus is getting stronger and most people begin to feel kicks and
punches . The fetus also has its own unique set of fingerprints and can
hiccup. An ultrasound will be offered . This fetal morphography scan is to
check for structural abnormalities , position of placenta and multiple
pregnancies . Interestingly , Hiccoughs in the fetus can often be observed .

20th week of pregnancy

The fetus is around 21 cm in length. Its ears are fully functioning and
it can hear muffled sounds from the outside world . The fingerprints have
prints .The fetus’s nail grows towards the end of its fingers . The area of the
brain responsible for its five senses begins to develop .

This ends the 5th month of pregnancy . By the end of 5th month , the fetus is
about 9 to 10 inches long and weighs about 1 pound

(NOTE : During 6th month of pregnancy one can notice the fetus’s skin is
reddish in colour , wrinkled and veins are visible through translucent skin . In
this month the eyelids begin to part and notice jerky movements . The fetus
responds to the sound by moving or increasing its pulse)

21th week of pregnancy

Limbs movements are coordinated and frequent . The fetus has bone
marrow that helps it produce blood cells

22nd week of pregnancy

 The fetus’s grasp is getting stronger and it can touch its ears and the
unbilical cord . It can hear your heartbeat , your stomach rumble and your
breathing

23rd week of pregnancy

If born prematurely , the fetus may survive after the 23 rd week and
withintensive care . It will begin rapidly adding fat to its body .

24th week of pregnancy

The fetus is around 33cm in length . The fused eyelids now separate
into upper and lower lids , enabling the baby to open and shut its eye . The
skin is covered in fine hair and protected by a layer of waxy secretion .The
fetus’s lungs are fully developed , but not well enough to work outside your
uterus

This ends the 6th month of pregnancy. By the end of sixth month , most of
them begin to feel the fetus moving around . The first movement are called
QUICKENING and can feel like a flutter .

(NOTE : In the 7th month the fetus continues to mature and develop reserves
of body fat . The fetus changes position frequently and respond to stimuli ,
Including sound , pain and light . The amniotic fluid begins to diminish )

25th week of pregnancy

More body fat makes the fetus’s skin less wrinkled and plumper . Its
nervous system is quickly maturing

26th week of pregnancy

The fetus makes melanin , the substance that gives skin and eyes
their colour . The fetus’s lungs start to make surfactant , a substance that
helps it breathe after birth

27th week of pregnancy

The fetus can open its eyes and blink . It also has eyelashes .

28th week of pregnancy

 The fetusmay begin turning head-down in your uterus as it gets ready
for birth . At the end of seventh month . The fetus is about 14 to 15 inches
long and weights between 2 and 3 pounds

THIRD TRIMESTER

This is the final part of the pregnancy . During the third trimester the baby
would grow rapidly and most of the womens feel tired . Eventually the baby
moves down to engage into the pelvis for preparation of birth. Throughout
the third trimester , the fetus gains weight quickly , adding body fat that will
help after birth . PREECLAMPSIA may develop at any time during the second
half of the pregnancy .

(NOTE : The fetus continues to mature and develop reserves of body fat . The
brain develops most rapidly during this time . The fetus can see and hear
most stimuli . Most internal systems are well-developed , but the lungs may
still be immature )

29th week of pregnancy

One may notice the kicks and jabs feel more like pokes now that the
fetus is getting cramped in the amniotic sac.

30th week of pregnancy

 The fetus can control its own body heat . Its brain is maturing and
gowing rapidly

31st week of pregnancy

The fetus can process more information and stimuli . You can
probably notice more distinct patterns in which it’s awake and when it’s
asleep

32nd week of pregnancy

The fetus’s skin isn’t translucent anymore . Other than the lungs and
brain , most other organs are well-formed and ready for birth . The baby
spends most of the time asleep . Its movement are strong and coordinated .
It is probably at head down position for birth

This ends 8th month of pregnancy . Now the fetus is about 17 to 18 inches in
length and weighs as much as 5 pounds

(NOTE : During this stage , the fetus continues to grow and mature . The
lungs are close to being fully developed at this point in pregnancy . The
nineth month is mostly about putting the finishing touch on growth and brain
development )

33rd week of pregnancy

The fetus’s bone