What Is the Minimal Force a Mother Must Exert to Lift Her 6.0 Kg Baby Out of Its Crib?

Anatomical Changes

Women undergo many physical changes during pregnancy due to hormonal fluctuations and the need to arrange a growing fetus.

Learning Objectives

Draw the anatomic changes to a pregnant woman that occur over the course of the pregnancy

Key Takeaways

Key Points

• As the fetus grows and develops, several anatomical changes must occur to the female body to adjust the growing fetus, including placental development, weight proceeds, abdominal extension, breast enlargement, glandular development, and posture changes.
• During the second trimester, morn sickness subsides, the uterus expands upwards to 20 times its normal size, breasts enlarge, and movements of the fetus may be felt.
• During the third trimester the fetus grows most apace and final weight proceeds occurs. The belly drops and fetal movement can go quite stiff. The adult female feels ready to give birth.

Central Terms

• implantation: The attachment of the fertilized ovum to the uterine wall.
• decidua: A mucous membrane that lines the uterus that is shed during menses and modified during pregnancy.
• pelvic crenel: A body cavity that is bounded by the bones of the pelvis. Its oblique roof is the pelvic inlet (the superior opening of the pelvis). Its lower boundary is the pelvic floor.

Physical Changes During Pregnancy

Pregnancy begins when the developing embryo implants in the endometrial lining of a woman'south uterus. Most pregnant women do non take any specific signs or symptoms after implantation, although it is not uncommon to experience minimal bleeding.

After implantation, the uterine endometrium is called the decidua. The placenta, which is partly formed from the decidua and partly from outer layers of the embryo, connects the developing embryo to the uterine wall to allow nutrient uptake, waste emptying, and gas exchange via the mother'southward blood supply.

The umbilical cord connects the embryo or fetus to the placenta. The developing embryo undergoes tremendous growth and changes during the procedure of fetal development.

Most pregnant women feel a number of symptoms that tin can signify pregnancy. The symptoms include nausea and vomiting, excessive tiredness and fatigue, cravings for sure foods that are non commonly sought out, and frequent urination, especially during the night.

A number of early medical signs are associated with pregnancy. These signs typically appear, if at all, within the outset few weeks after formulation. Not all of these signs are universally present, nor are all of them diagnostic by themselves; taken together, however, they may make a presumptive diagnosis of pregnancy.

These signs include:

• The presence of human chorionic gonadotropin (hCG) in the blood and urine.
• Missed menstrual catamenia.
• Implantation haemorrhage (occurs at implantation of the embryo in the uterus during the third or fourth calendar week after last menstrual menstruum).
• Increased basal trunk temperature sustained for over two weeks after ovulation.
• Chadwick's sign (darkening of the cervix, vagina, and vulva).
• Goodell'due south sign (softening of the vaginal portion of the neck).
• Hegar'south sign (softening of the uterus isthmus).
• Pigmentation of the linea alba (called linea nigra), which is concealment of the skin in a midline of the abdomen. This darkening is caused by hyperpigmentation resulting from hormonal changes, usually appearing effectually the middle of pregnancy.

Chest tenderness is common during the first trimester. Presently later conception, the nipples and areolas begin to darken due to a temporary increment in hormones. This process continues throughout the pregnancy.

Despite all the signs, some women may non realize they are pregnant until they are far along in pregnancy. In some cases, a few have not been aware of their pregnancy until they begin labor. This can be caused by many factors, including irregular periods (quite common in teenagers), certain medications (not related to conceiving children), and obese women who disregard the pregnancy-related weight gain. Others may be in denial of their situation.

The First Trimester

The showtime 12 weeks of pregnancy are known as the first trimester. During this trimester, fetal development tin be divided into different stages.

At the outset of the fetal phase, the hazard of miscarriage decreases sharply. All major structures, including the head, brain, easily, anxiety, and other organs accept been formed by the fetal stage. Once pregnancy moves into the second trimester, the risks of miscarriage and birth defects drops drastically.

The Second Trimester

Weeks 13 to 28 of the pregnancy are called the second trimester. Most women feel more energized in this period. They put on weight as the symptoms of morning sickness subside and somewhen fade away.

By the finish of the second trimester, the expanding uterus has created a visible baby bump. Although the breasts have been developing internally since the beginning of the pregnancy, most of the visible changes appear after this indicate.

The uterus can expand up to 20 times its normal size during pregnancy. Although the fetus begins to move and takes a recognizable human shape during the offset trimester, it is not until the 2nd trimester that movement of the fetus, ofttimes referred to equally quickening, tin can be felt by the woman.

The Third Trimester

Last weight proceeds takes place during the third trimester, and it is the well-nigh weight gain throughout the pregnancy. The fetus will be growing most apace during this stage, gaining up to 28g per day.

A pregnant woman: A meaning woman'south abdomen drops due to the fetus turning in a downward position ready for birth.

The woman'south abdomen volition transform in shape as the belly drops due to the fetus turning in a down position set for birth, and the woman will be able to lift her abdomen up and down. The woman'southward bellybutton will sometimes become convex—popping out—due to her expanding abdomen. This period of her pregnancy can be uncomfortable and cause symptoms similar weak bladder control and backache.

The body's posture changes as the pregnancy progresses. The pelvis tilts and the back arches to help keep balance. Poor posture occurs naturally from the stretching of the adult female's intestinal muscles as the fetus grows. These muscles are less able to contract and continue the lower back in proper alignment.

The significant woman has a different gait. The stride lengthens equally the pregnancy progresses due to weight gain and changes in posture. In addition, the increased body weight of pregnancy, fluid retention, and weight gain lowers the arches of the foot, farther adding to the foot's length and width.

The influences of increased hormones such as estrogen and relaxin initiate the remodeling of soft tissues, cartilage, and ligaments. Certain skeletal joints (due east.g., the pubic symphysis and sacroiliac) widen or take increased laxity.

Metabolic Changes

Protein and carbohydrate metabolisms are afflicted during pregnancy and maternal insulin resistance can lead to gestational diabetes.

Learning Objectives

Analyze the metabolic factors involved in gestational diabetes

Key Takeaways

Cardinal Points

• During pregnancy, the metabolism shifts to provide the growing fetus with more than nutrients as well as to ensure the development of the uterine lining and breast glandular tissue.
• Hormonal changes during pregnancy increase nutrient requirements and fat deposition.
• Insulin resistance tin can develop and lead to gestational diabetes.

Key Terms

• cortisol: A steroid hormone (as well called hydrocortisone) produced by the adrenal cortex, that regulates the metabolism of carbohydrates and maintains blood pressure.
• gestational diabetes: Also chosen gestational diabetes mellitus (GDM), it is a status in which women without previously diagnosed diabetes exhibit high blood glucose levels during pregnancy (specially during the third trimester).
• lactogen: Man placental lactogen (HPL), likewise called human chorionic somatomammotropin (HCS), is a polypeptide placental hormone. Its structure and part is similar to that of human being growth hormone. It modifies the metabolic state of the mother during pregnancy to facilitate the free energy supply of the fetus.

Nutrient Metabolism

During pregnancy, both protein metabolism and carbohydrate metabolism are affected. One kilogram of actress protein is deposited, with one-half going to the fetus and placenta, and another half going to uterine contractile proteins, chest glandular tissue, plasma poly peptide, and hemoglobin.

An increase in nutrients is required for fetal growth and fatty deposition. Changes are acquired by steroid hormones, lactogen, and cortisol. Increased liver metabolism is as well seen, with increased gluconeogenesis that leads to increased maternal glucose levels. Maternal insulin resistance tin lead to gestational diabetes.

Gestational Diabetes

Gestational diabetes (or gestational diabetes mellitus, GDM) is a condition in which women without previously diagnosed diabetes exhibit loftier blood glucose levels during pregnancy (specially during the tertiary trimester). There is some question whether the condition is natural during pregnancy.

Maternal insulin resistance can lead to gestational diabetes. This type of diabetes is caused when the insulin receptors exercise non function properly. This is likely due to pregnancy-related factors, such as the presence of human placental lactogen that interferes with susceptible insulin receptors. This in turn causes inappropriately elevated blood sugar levels.

Gestational diabetes mostly has few symptoms and it is most commonly diagnosed by screening during pregnancy. Diagnostic tests detect inappropriately high levels of glucose in blood samples. Gestational diabetes affects iii–10% of pregnancies, depending on the population studied, and then it may exist a natural phenomenon.

Effect of insulin on glucose uptake and metabolism: Insulin binds to its receptor (i) on the cell membrane which in turn starts many protein activation cascades (two). These include: the translocation of the glut-iv transporter to the plasma membrane and an influx of glucose (3), glycogen synthesis (iv), glycolysis (5) and fatty acid synthesis (6).

Babies born to mothers with untreated gestational diabetes are typically at an increased take a chance of problems, such as being big for gestational historic period (which may atomic number 82 to delivery complications), depression blood saccharide, and jaundice. If untreated, information technology tin also crusade seizures or still birth.

Gestational diabetes is a treatable condition and women who take acceptable control of glucose levels tin can finer subtract these risks.

Physiological Changes

Maternal physiological changes in pregnancy are entirely normal and serve as adaptations to meliorate arrange embryonic/fetal evolution.

Learning Objectives

Depict the physiological changes a woman undergoes during pregnancy

Key Takeaways

Key Points

• Women undergo several changes during pregnancy, including cardiovascular, hematologic, metabolic, renal, and respiratory changes that provide adequate nutrition and gas exchange for the developing fetus.
• Progesterone and estrogen levels ascent continually through pregnancy, together with claret sugar, breathing rate, and cardiac output.
• The trunk's posture changes during pregnancy to adjust the growing fetus and the female parent volition experience weight gain.
• Breasts grow and change in grooming for lactation in one case the infant is born. One time lactation begins, the woman'due south breasts swell significantly and tin experience achy, lumpy, and heavy (engorgement). This is relieved past nursing the infant.
• Plasma and claret volume increase over the course of the pregnancy and lead to changes in heart rate and blood force per unit area. Women may also have a higher risk of claret clots, peculiarly in the weeks post-obit labor.

Key Terms

• human placental lactogen: Also chosen human chorionic somatomammotropin, this is a polypeptide placental hormone. Its construction and function is similar to that of homo growth hormone. It modifies the metabolic state of the mother during pregnancy to facilitate the energy supply of the fetus.
• human chorionic gonadotropin: A peptide hormone produced during pregnancy that prevents the breakdown of the corpus luteum and maintains progesterone production.
• progesterone: A steroid hormone, secreted by the ovaries, whose function is to set the uterus for the implantation of a fertilized ovum and to maintain pregnancy.

Maternal physiological changes in pregnancy are the normal adaptations that a woman undergoes during pregnancy to ameliorate accommodate the embryo or fetus, and include cardiovascular, hematologic, metabolic, renal, and respiratory changes. The female body must alter its physiological and homeostatic mechanisms in pregnancy to ensure proper fetal development. Increases in blood sugar, breathing, and cardiac output are all required.

Hormonal Changes

Pregnant women experience adjustments in their endocrine system. Levels of progesterone and estrogens rise continuously throughout pregnancy to suppress the hypothalamic axis and, afterwards, the menstrual cycle.

Estrogen produced by the placenta is associated with fetal well being. Women besides experience an increase in homo chorionic gonadotropin (β-hCG), which is produced by the placenta and maintains progesterone production by the corpus luteum.

The increase in progesterone production primarily functions to relax smooth muscles. Prolactin levels increase due to maternal pituitary gland enlargement that mediate a change in the structure of the mammary gland from ductal to lobular-alveolar.

Parathyroid hormone increases and leads to increased calcium uptake in the gut and reabsorption by the kidney. Adrenal hormones such as cortisol and aldosterone also increase.

Human placental lactogen (HPL) is produced by the placenta, stimulating lipolysis and fatty acid metabolism past the woman and conserving claret glucose for use by the fetus. It tin also decrease maternal tissue sensitivity to insulin and consequence in gestational diabetes.

Weight Changes

One of the most noticeable alterations in pregnancy is the gain in weight. The enlarging uterus, the growing fetus, the placenta and liquor amnii, and the acquisition of fat and h2o retention, all contribute to weight gain.

The weight gain varies and tin can be anywhere from five pounds (2.3 kg) to over 100 pounds (45 kg). In the U.S., the doctor-recommended weight gain range is 25 pounds (xi kg) to 35 pounds (16 kg), less if the woman is overweight, more (up to 40 pounds eighteen kg) if the woman is underweight.

Pregnancy: During pregnancy, a woman gains weight and her breasts overstate.

A adult female'due south breasts grow during pregnancy, ordinarily one to two cup sizes, but maybe larger. A woman who wore a C cup bra prior to her pregnancy may need to buy an F loving cup or larger bra while nursing. A women's torso also grows and her bra band size may increment 1 or two sizes.

Once the babe is born (virtually 50 to 73 hours after nascence), the mother will experience her breasts filling with milk, at which bespeak changes in the breast happen very quickly. Once lactation begins, the adult female's breasts bully significantly and can feel achy, lumpy, and heavy (engorgement). Her breasts may increment over again in size. Individual breast size can vary daily or for longer periods depending on how much the baby nurses from each chest.

Circulatory Changes

Plasma and blood book slowly increase past xl–50% over the course of the pregnancy (due to increased aldosterone) to accommodate the changes, resulting in an increment in heart rate (15 beats/min more than usual), stroke volume, and cardiac output. Cardiac output increases past about 50%, primarily during the get-go trimester.

The systemic vascular resistance likewise drops due to the smooth muscle relaxation and overall vasodilation acquired by elevated progesterone, leading to a autumn in blood pressure. Diastolic claret pressure consequently decreases between 12–26 weeks, and increases over again to pre-pregnancy levels past 36 weeks.

Edema (swelling) of the feet is common during pregnancy, partly because the enlarging uterus compresses veins and lymphatic drainage from the legs.

A pregnant adult female will also become hypercoagulable, leading to increased gamble for developing claret clots and embolisms due to increased liver product of coagulation factors. Women are at highest risk for developing clots (thrombi) during the weeks following labor.

Clots usually develop in the left leg or the left iliac venous system because the left iliac vein is crossed past the right iliac artery. The increased flow in the right iliac artery after birth compresses the left iliac vein leading to an increased risk for thrombosis (clotting) that is exacerbated by a lack of airing (walking) following commitment. Both underlying thrombophilia and caesarean department tin further increase these risks.

Exercise and Pregnancy

In the absenteeism of complications, pregnant women should continue aerobic and forcefulness grooming exercise for the duration of gestation.

Learning Objectives

Evaluate the types of exercise appropriate for pregnant women

Key Takeaways

Key Points

• Moderate aerobic exercise and strength training improve the wellness of significant women while having no agin consequences on the developing fetus.
• A variety of practise activities are advisable, with the exception of those with a loftier risk for abdominal trauma, such every bit horseback riding, skiing, soccer, or hockey.
• Contraindications of exercise include: vaginal haemorrhage, dyspnea earlier exertion, dizziness, headache, chest pain, muscle weakness, preterm labor, decreased fetal motion, amniotic fluid leakage, and calf hurting or swelling (to dominion out thrombophlebitis).

Key Terms

• contraindication: A factor or symptom that makes the prescribed treatment inadvisable.
• aerobic exercise: Physical exercise of depression to high intensity that depends primarily on the aerobic energy-generating process.
• strength-conditioning: The apply of resistance to muscular contraction to build the strength, anaerobic endurance, and size of skeletal muscles. In that location are many unlike methods of strength training, the most common being the apply of gravity or rubberband/hydraulic forces to oppose muscle wrinkle.
• thrombophlebitis: Phlebitis (vein inflammation) related to a thrombus (blood clot).

Exercising while meaning: A strong, good for you woman volition more often than not take a good pregnancy upshot. Physicians recommend moderate exercise during pregnancy, including strength-training.

Regular aerobic practise during pregnancy appears to improve (or maintain) physical fitness. Although an upper level of safe exercise intensity has not been established, women who were regular exercisers before pregnancy and who have uncomplicated, healthy pregnancies should exist able to engage in loftier-intensity exercise programs (e.g., jogging and aerobics) for less than 45 minutes with no agin effects. They just demand to be mindful of the possibility that they may need to increase their free energy intake, and are careful to not become overheated.

In the absenteeism of either medical or obstetric complications, doctors advise an aggregating of xxx minutes a 24-hour interval of exercise on most if not all days of the week. The Clinical Exercise Obstetrics Committee of Canada recommends that "all women without contraindications should be encouraged to participate in aerobic and strength-conditioning exercises equally function of a healthy lifestyle during their pregnancy."

In general, participation in a wide range of recreational activities appears to be condom. Pregnant women merely need to avoid those with a high risk of falling such as horseback riding or skiing, or those that behave a take a chance of intestinal trauma, such as soccer or hockey.

In the past, the primary concerns of practice in pregnancy were focused on the fetus and any potential maternal benefit was thought to be kickoff by potential risks to the fetus. Even so, more recent information suggests that in the unproblematic pregnancy, fetal injuries are highly unlikely.

Contraindications for exercise include, vaginal bleeding, dyspnea before exertion, dizziness, headache, chest pain, muscle weakness, preterm labor, decreased fetal movement, amniotic fluid leakage, and calf pain or swelling (to rule out thrombophlebitis).

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Source: https://courses.lumenlearning.com/boundless-ap/chapter/changes-to-the-mothers-body-during-pregnancy/

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