Changes in development of pregnancy and how to take care of its safe current of
Supervision, inspection, prevention and treatment at emergence of complications has to occur according to the pregnancy development period. The entire period of a course of pregnancy can be divided into three parts - trimesters. The I trimester represents the early fetalny period which lasts till 12 weeks. The II trimester is a srednefetalny period which proceeds from 13 to 27 weeks. The III trimester or as it is called still, “the fruit period“, begins with 28 weeks and proceeds to the term of childbirth.
the I trimester of pregnancy
In the I trimester of pregnancy, in 1 week after fertilization occurs implantation of fetal egg, formation of future placenta and development of an embryo begins. The Predymplantatsionny period and the period of implantation carry to “critical“ as the germ is most sensitive to action of the damaging factors from 4 do8 weeks of pregnancy, there is bookmark and the beginning of formation of various bodies and fabrics. At the same time education matochno - placentary blood circulation begins. In a placenta synthesis of hormones begins and endocrine function is suppressed. In this sense the importance gains ability of a placenta from the earliest terms of pregnancy properly will provide necessary conditions for normal growth and development of a fruit and to protect it from the damaging factors. However, in the I trimester the placenta in insufficient degree is capable to protect a fruit from penetration of a number of drugs (including hormonal), alcohol, nicotine, narcotic substances that is the prerequisite for manifestation of their damaging influence.
in general, all the I trimester it is possible to consider critical as highlights of a bookmark, growth and development of separate fabrics, bodies and systems in time do not coincide. To the termination I of a trimester mechanisms which allow a fruit to adapt to the changing living conditions are not developed yet.
the Most frequent complications in the I trimester are:
- not developing pregnancy.
- Spontaneous abortion.
- Early toxicosis.
of the Reason for not developing pregnancy and its interruptions during various periods of the I trimester are not identical. So, till 3 weeks it is most often genetic and chromosomal damages, and also insufficient preliminary preparation an endometriya to the forthcoming implantation of fetal egg. In 4 - 8 weeks, as a rule, the main reasons are the hormonal violations, an infection, an anti-phospholipidic syndrome resulting in primary fetoplatsentarny insufficiency and violation of an embryogenesis. In 9 - 12 weeks the main negative influence can be shown both from already listed factors, and at insufficient stretching of a uterus, for example, at genital infantility or malformations of a uterus.
Emergence of blood allocations, or so-called “ablution of a fruit“, it is necessary to regard, first of all, as probability of an otsloyka of fetal egg from a uterus wall that it is qualified as the begun spontaneous abortion.
Therefore if pains in the bottom of a stomach and in a waist develop or bloody allocations from a genital tract appear, it is necessary to see immediately a doctor for specification of current situation.
One of the most important conditions of normal development of pregnancy is forecasting and prevention of possible complications. In this regard already in the I trimester of pregnancy it is necessary to reveal risk factors of these complications to which, first of all, carry: the age of pervorodyashchy is younger than 17 years and 35 years are more senior; adverse socially - living conditions; toxic and radiative effects of external environment; harmful addictions (alcohol, smoking, drugs); an exacerbation of chronic diseases or for the first time the arisen acute infectious diseases during the real pregnancy; existence of various diseases, including gynecologic; complications during the previous pregnancies.For prevention of possible complications during pregnancy at a stage of its planning preliminary survey at the obstetrician`s expert - the gynecologist, the therapist, the oculist, the stomatologist is expedient to take place
. To make research of tests of blood, urine, separated from an urogenital path.Lechebno`s
- preventive actions in the I trimester consist in profound inspection and an assessment of health of the pregnant woman, decrease in physical activity, observance of the sparing guarding mode, the organization of a balanced diet.
After the first address to the doctor concerning the come pregnancy needs to pass inspection which includes:
- Definition of a blood type and a Rhesus factor - a factor (even in spite of the fact that earlier such research was already conducted, and these indicators are already known).
- the Blood test on syphilis (RW), HIV - an infection, hepatitises.
- Clinical blood test for an assessment of its cellular structure, level of hemoglobin and size SOE.
- the Assessment of activity of the curtailing system of blood.
- General analysis of urine.
- Studying of the material separated from a vagina the channel of a neck of a uterus and an urethra on existence of causative agents of various infections. Besides, it is necessary to use serologichesky research for identification of specific antibodies of immunoglobulins of a class M and G by means of an immunofermental method.
One of the most objective methods of diagnostics is ultrasonic research which is expedient for carrying out after 10 weeks. The main objectives of this research are: confirmation of the progressing pregnancy; specification of estimated term of pregnancy; identification of polycarpous pregnancy; definition of the place of implantation of fetal egg and localization of a placenta; measurement of thickness of vorotnikovy space (in 10 - 14 weeks); identification of signs of the complicated course of pregnancy (threat of a spontaneous abortion, an otsloyka of a horion, istmiko - tservikalny insufficiency, puzyrny drift, etc.) .Besides, in the I trimester of pregnancy in terms from 8 to 11 weeks carrying out the combined screening test for an exception of risk of possible violations in development of a fruit which includes definition of free b - subjedinitsa of HGCh, PAPP - A is possible
If at the pregnant woman notes tendency to a varicosity, then during pregnancy this situation can worsen. For prevention of similar complications several times a day, within 15 - 20 minutes during rest it is necessary to give to legs sublime situation for ensuring more optimum outflow of blood. If veins standing acted, use of special compression stockings is expedient. Also special consultation of the vascular surgeon is necessary.
during pregnancy from its earliest terms locks can already begin to disturb the woman that can lead to development of hemorrhoids, and also nausea or heartburn. For prevention of similar troubles expediently from the very beginning of pregnancy to adhere to a rational diet, using fractional meal with the corresponding set of products.Should be limited to
strictly use of medicines in early terms of pregnancy that is caused by danger of their damaging impact on an embryo. It is not necessary to self-medicate. Expediency of use of these or those medicines has to be coordinated with the doctor.Hospitalization and drug treatment are necessary for
only in the presence of Clinical signs of the menacing abortion. Before an initiation of treatment, directed to pregnancy preservation, it is necessary to be convinced of the correct development of a fruit. Pregnancy preservation “by all means“, intensive use of medicines including hormonal, can do more harm, than advantage and to increase number of failures.
the II trimester of pregnancy
In the II trimester of pregnancy proceeds growth of a placenta and fruit. At the same time there is a formation and development of the highest structures of a brain of a fruit, neuroendocrine, vegetative nervous system. At a fruit appear protectively - adaptive reactions. After 19 - 20 weeks intensity matochno - placentary and plodovo - a placentary blood-groove increases. Function of a placenta provides the increasing requirements of a fruit.
the Most characteristic complications of the II trimester of pregnancy are: threat of a late spontaneous abortion, bleeding from - for an otsloyka of a placenta, anemia, early forms of a gestoz, a pre-natal infection. The specified complications promote formation of fetoplatsentarny insufficiency and an arrest of development of a fruit.
From - for the uterus increasing in sizes which begins to displace abdominal organs towards a thorax after 15 - 16 weeks short wind and heartburn can begin to disturb. Kidneys begin to experience considerable strain.
women with ekstragenitalny diseases (diseases of kidneys, a hypertensive illness, neurocirculator dystonia) from 20 weeks have a danger of development of a gestoz. In this regard it is necessary to pay attention to emergence of hypostases, an excess and uneven increase of body weight, increase of arterial pressure, emergence of protein in urine.
Therefore, important is control of normal development of a fruit and the course of pregnancy, and also the prevention of possible complications.
the Pregnant woman has to visit the doctor at least, than once a month, and in a number of situations and is more often. At each visit the doctor examines the patient, controls a body weight increase, measures length of a circle of a stomach and height of standing of a bottom of a uterus over a bosom, determines arterial pressure, listens to heartbeat of a fruit. Appoints necessary additional researches.
B 20 - 24 of week of pregnancy conduct the second obligatory ultrasonic research which is necessary for determination of compliance of the sizes of a fruit to the estimated term of pregnancy for the purpose of an exception of an arrest of development of a fruit; detection of malformations of a fruit; estimates of amount of amniotic waters; studying of a condition of a placenta. Also Doppler research which conduct at ultrasonic research for an intensity assessment matochno - placentary and plodovo - a placentary blood-groove is important. > it is expedient to p to determine by
In the II trimester of pregnancy in an interval from 16 to 20 weeks for prenatal screening of possible anomalies of development of a fruit in blood the a level - a fetoprotein (AFP), a free estriol of E3, an ingibin - And yes a horionichesky gonadotrophin of the person (the general HGCh).If do not have
contraindications, then after 17 weeks it is possible to begin to carry out a special complex of physical exercises for pregnant women who allow to operate muscles of a crotch and an abdominal tension. It is important to master breathing exercises also. > Medicamentous prevention at pregnant women of risk group it is expedient to p to begin
with 14 - 16 weeks of pregnancy under control of the doctor. It is not necessary to self-medicate.
the III trimester of pregnancy
III the trimester of pregnancy is characterized by the most intensive growth of a fruit and increase of functional activity of its bodies and systems.by
in process of pregnancy development, especially in the III trimester, notes increase in volume of the circulating blood, loading on warmly - vascular system increases, breath volume increases. The sizes of a uterus reach already considerable size. In a prone position on a back unpleasant feelings in the form of short wind, weaknesses, dizzinesses, serdtsebiyeniye can be observed that is caused by the uterus pressure upon large vessels and decrease in inflow of blood to heart.After 28 weeks from a breast release of colostrum can begin
that demonstrates preparation of mammary glands for process of a lactation.
C 30 - oh weeks working as women grant dorodovy leave which is necessary for rest and full preparation for childbirth. Since this period it is also expedient to carry a bandage which size has to be picked up so that it, first of all, supported a forward belly wall and helped to keep a bearing.
Till 32 - 33 weeks of pregnancy the fruit can change repeatedly within a day the situation in a uterus and, as a rule, after 35 - 36 weeks holds the final position before the childbirth.
C 30 - y on 35 - yu week the maximum stretching of a uterus occurs that increases risk of premature birth, especially at polycarpous pregnancy, and also the probability of a rupture of a defective hem on a uterus after Cesarean section increases.
One of the most frequent complications of the III trimester of pregnancy is fetoplatsentarny insufficiency which is followed by decrease in arterial blood supply of a placenta and fruit; reduction of receipt to a fruit of necessary amount of nutrients and removal of products of a metabolism. All these changes reduce protectively - adaptive opportunities of system mother - a placenta - a fruit; slow down growth and development of a fruit; cause the complicated course of pregnancy and childbirth.
the Most typical clinical manifestations of fetoplatsentarny insufficiency are: violation of physical activity of a fruit, increase of a tone of a uterus, discrepancy (reduction) of the sizes of a stomach of the pregnant woman to pregnancy term, perenashivany pregnancies, abundance of water or lack of water.
From - for violations of protective function of a placenta pre-natal infection of a fruit which is shown in the form of a delay of its development, thinning or increase in thickness of a placenta, kaltsinozy placentae and kistozno - similar inclusions in its structure, by abundance of water or lack of water can arise.
the Most dangerous complication of the III trimester of pregnancy is gestoz which arises owing to fetoplatsentarny insufficiency and is externally shown in the form of hypostases and an uneven increase of body weight (a liquid delay in an organism), increases of arterial pressure (violation of regulation of a vascular tone), emergence of protein in urine (dysfunction of kidneys). Gestoz is followed by the most expressed complications from a fruit and bears threat for health of the pregnant woman.to
During this period of pregnancy needs the most attentive and profound supervision over character of a course of pregnancy with carrying out complex inspection and an assessment of degree of risk of possible complications. After 28 weeks the pregnant woman has to visit the doctor at least 1 time in 2 weeks, and according to indications and a thicket.
At the third obligatory ultrasonic research which is conducted in 32 - 34 weeks, are defined by the fruit sizes, study a condition of a placenta, estimate amount of amniotic waters. Besides, conditions of a fruit and its behavioural reactions carry out an ekhografichesky functional assessment, repeat a dopplerometriya. After 32 weeks for an assessment of a state it is warm - vascular system of a fruit use a kardiotokografiya. This method is absolutely safe for a fruit and has no contraindications.
At suspicion on a pre-natal infection investigate material from an urogenital path and determine the level of specific antibodies to causative agents of an infection in blood serum.is closer than
to the end of pregnancy very important to have a clear idea of physiology of patrimonial process, the nobility with what childbirth and as they proceed and also how to behave in labor and many other things begins. Besides, during this period it is already necessary to choose maternity hospital where it is planned to carry out the forthcoming childbirth. All these questions should be discussed with the attending physician in advance.