Changes in a woman’s body during pregnancy are subordinated to a single important goal - to fully ensure conditions for the proper development and growth of the embryo (fetus).

• Physiological changes
• Heart and blood vessels
  • Phlebeurysm
  • Haemorrhoids
• Digestive organs
  • Heartburn
  • Nausea, vomiting, constipation
• Hormonal changes
• Breast changes during pregnancy
• The immune system
• Muscles and back pain
• Respiratory system
• Genitourinary system
• Uterus and cervix

From the moment of implantation until the onset of labor, the demands of the fetus will steadily increase, which will entail changes in all systems of the female body and tissues:

• endocrine system;
• central and peripheral nervous system;
• cardiovascular;
• digestive;
• excretory;
• in the musculoskeletal system;
• immune;
• skin and its appendages (hair, nails).

The basal metabolism changes. The developing fetus will force the pregnant woman's body to constantly adapt to the increasing load, and therefore physiological changes will be observed.

All important microelements, proteins, carbohydrates, fats will be received from the mother’s blood, and through it the metabolites of metabolism and breakdown will be eliminated. This is one of the reasons for changes in taste, appearance, change in color of stool and urine.

In 85% of cases, pregnant women do not need intervention from doctors. All that is required is observation and psycho-emotional support. 15% fall into a certain risk group due to the presence of chronic diseases. These women require close medical supervision.

Changes in the cardiovascular system during pregnancy

During pregnancy, changes in cardiovascular system the most significant. Because the volume of circulating blood increases. Normal human blood volume is on average 5 liters. The amount of blood begins to increase from the first weeks of pregnancy and reaches a peak at 32 weeks, which is 35-45% more than outside pregnancy. As a result, the number of formed elements in the blood changes.

As a result of a sharp increase in plasma volume, physiological hemodelution is observed - the increase in blood cells (erythrocytes) “lags behind” and occurs.

Physiologically, a change in blood composition occurs. Decreases slightly:

• red blood cell count;
• hemoglobin concentration();
• hematocrit value;
• plasma folic acid level.

This increases:

• leukocyte count;
• erythrocyte sedimentation rate;
• fibrinogen concentration.

An increase in blood volume meets the increased demands of the uterus and fetus, protects against hypotension syndrome in the supine position, and prevents critical loss of fluid during childbirth.

During pregnancy, functional early (sometimes medium) systolic murmurs and extrasystoles (premature myocardial contractions) may appear.

From the third month by 10-15 mm. rt. Sat blood pressure decreases. Starting from the third trimester, on the contrary, a rise in blood pressure is characteristic. due to peripheral dilatation - decreased vascular resistance of the hands and feet, increased metabolism and the formed arteriovenous placental shunt.

Peripheral vasodilation leads to increased secretion of nasal mucus, which leads to discomfort. This condition is called pregnant rhinitis, which disappears with the outcome of pregnancy. Complaints appear:

• for nasal congestion;
• difficulty in nasal breathing;
• nosebleeds.

An increase in venous pressure in the lower extremities and compression of the central venous lines by an enlarged uterus contributes to hemorrhoids.

Swelling often occurs during pregnancy. noted by 50-80% of pregnant women. They are localized on the lower extremities, but may have another localization - on the face, fingers. Because of this, a change in the appearance of the pregnant woman occurs. Such edema is characterized by a gradual development, smoothly combined with an increase in body weight. External changes on the face also appear due to the action of the hormone somatotropin. This substance awakens the remaining areas of bone tissue growth. There may be a slight increase in the brow ridges, the tip of the nose grows, and the finger joints thicken.

1. Avoid prolonged standing and sitting. It is necessary to move more and encourage active physical exercise.
2. Don't wear tight clothes.
3. During sleep, your legs should be in an elevated position.
4. Sleep on your side.
5. You cannot cross your legs while sitting.
6. Wear elastic stockings or tights.

Discomfort from hemorrhoids

Complaints of hemorrhoids often arise for the first time during pregnancy. To avoid its development, it is necessary to improve the functioning of the gastrointestinal tract. To do this, it is enough to slightly change your diet due to fiber. In severe cases, resort to medicines in the form of suppositories and antihemorrhoidal creams.

Changes and discomfort during pregnancy from the gastrointestinal tract (GIT)

Women often have complaints from the digestive system during pregnancy. This is also caused by physiological changes:

• decrease in the level of hydrochloric acid in gastric juice, enzymes;
• decreased intestinal motility and the digestive system as a whole under the influence of;
• an increase in the reabsorption of water from the large intestine under the influence of the hormone aldosterone.

Changes in taste during pregnancy are the result of a decrease in the sensitivity of the taste buds on the tongue.

Discomfort during pregnancy from the gastrointestinal tract is manifested in the following:

• There are complaints of nausea, increased salivation, vomiting as a result of a decrease in the level of hydrochloric acids and a decrease in the level of the enzyme pepsin.
• Preferences in smells change, familiar ones begin to irritate, unusual ones begin to be liked.
• Constipation occurs (due to intestinal hypotension caused by progesterone).

Breast changes during pregnancy begin to appear early:

• The volume of the breast changes (by 2-3 sizes) under the influence of estrogen and progesterone - the volume of connective tissue increases and milk ducts develop;
• metabolic processes and blood supply increase, which makes the breasts more sensitive and painful when touched, a vascular network may appear on the skin;
• nipples grow, the circumference of the areolas increases (from 3 cm to 5 cm), they take on a more saturated color due to increased melatonin synthesis (from dark red to brown).

In the later stages, there is a high probability of scarring - stretch marks (this is a consequence of the rupture of collagen fibers in the skin of the breast) and the release of colostrum.

Towards the end of pregnancy, the synthesis of oxytocin increases, which takes part in the birth itself.

Changes in the immune system during pregnancy

Consultation with an orthopedic surgeon is indicated for severe pain, if it extends to the legs or if neurological symptoms are present.

Changes in the body during pregnancy. Respiratory system

The respiratory system undergoes minimal changes. The growing uterus moves the diaphragm upward, but the volume of exhalation and inhalation remains unchanged. The respiratory rate remains within the physiological range - 14-15 per minute.

Physiological changes during pregnancy. Genitourinary system

During pregnancy, changes in a woman’s body are clearly expressed in the genitourinary system. Renal blood flow and glomerular filtration increase by 50% (a larger volume of blood passes through the vessels of the kidneys at an increased speed), which leads to an increase in urine volume. Therefore, pregnant women begin to complain of frequent urination. There is a urge to urinate at night. 1-2 trips to the toilet per night for a pregnant woman is the norm.

Under the influence of progesterone and the pressure of the enlarging uterus on the upper edge of the pelvis.

Changes in the uterus during pregnancy

It is obvious that changes in the uterus occur during pregnancy. It increases in size. By the end of pregnancy, its volume increases 1000 times, its weight is 1000 g (for comparison, in a non-pregnant state the weight is within 70 grams).

From the first trimester, the uterus begins to contract irregularly and painlessly - in later stages they can cause significant and noticeable discomfort.

In the early stages of pregnancy, the cervix retains its density. The isthmus softens, the cervix becomes more mobile.

Changes in the cervix in early pregnancy include:

• change in color (due to an increase in the number of vessels and blood flow, the cervix becomes bluish);
• provisions;
• consistency (loose);
• shape and size.

A mucus plug forms in the lumen of the cervix - a mechanical and immune barrier to the penetration of infection into the uterine cavity.

Normally, there is a change in the volume of vaginal discharge (under the influence of estrogen). Pathological discharge should be excluded, for example, with candidiasis infection, which quite often bothers women in an interesting position. The appearance of bloody discharge after sexual intercourse allows one to suspect erosion of the cervix, which already becomes very vulnerable.

The walls of the vagina become loose and elastic, the labia enlarge and change color to a more saturated one.

Changes in the central nervous system

The first 3-4 months of pregnancy are accompanied by inhibition of the central nervous system (CNS). Excitability increases after 4 months. A decrease in reflex excitability helps to relax the uterus, which ensures the normal development of pregnancy in a woman’s body.

Due to changes in the nervous system, complaints appear about:

• drowsiness;
• mood swings;
• imbalance;
• change in taste preferences;
• salivation;
• vomiting;
• tendency to dizziness;
• general fatigue.

An increase in the excitability of the peripheral nerves causes pain to be felt in response to irritation, which before pregnancy simply caused discomfort. Neurological pain appears in the lower back, sacrum, and cramps of the calf muscles.

Changes in a woman’s body during pregnancy are physiological and are not symptoms of the disease. They may manifest as discomfort and unpleasant sensations, but do not require treatment, with the exception of pathological conditions.

Articles on the topic

During the period of bearing a child, a woman changes radically physiologically and psychologically. All organs and systems undergo changes, appearance, well-being. What do you need to know about the upcoming changes during pregnancy?

When do changes begin in a woman’s body during pregnancy?

The expectant mother does not yet know about her interesting situation, but her body is already restructuring its work. Changes in the body begin from the first days after successful conception. This is fine. The expectant mother does not yet feel toxicosis, and human chorionic gonadotropin (hCG), the pregnancy hormone, is already beginning to increase in her blood. This is what doctors call the main identifying sign of successful conception. HCG starts the process of bearing a baby and preparing the body for childbirth.

It is worth noting that internal changes are felt in different ways. For some, already from the first weeks of bearing a child, they begin to feel sick and constantly feel sleepy. Others may not experience any signs of early or late toxicosis at all, despite the fact that everything inside the body is changing. There are women who, almost without feeling physiological changes, change greatly psychologically. They become touchy, whiny, angry, and nervous. And these are also symptoms of hormonal changes.

How the body changes during pregnancy by month

If we talk about the first two months of gestation, the external parameters of the female body have not yet changed. Weight gain is not noticeable in the early stages. More often it's the other way around. Toxicosis leads to future mommy loses a kilo or two.

At the end of the second or third month, some pregnant women are concerned about increased urination, which is caused by the pressure of the uterus on the bladder and a general increase in the volume of fluid in the body.

Also in the first two months, a woman may feel swelling of the mammary glands. This is due to an increase in the level of estrogen and progesterone in the blood. Also, the area around the nipples darkens and enlarges. Breast sensitivity increases. In some women, the vascular network may even protrude. This is how the mammary glands prepare to supply the baby with milk.

In the first two months, women sometimes experience bleeding. Only a doctor can determine the degree of their danger.

By the end of the third month, the external parameters of the body remain almost unchanged. If a woman had early toxicosis, then her health improves. She continues to go to the toilet more often, but due to the formation of the baby’s excretory system.

The first constipation and heartburn may begin. As for weight, the increase can be a kilogram or one and a half. Before 12 weeks, many women notice from their clothing that their pelvis has expanded.

Inconvenience in the third month of bearing a baby can be caused by a lack or, conversely, an increase in appetite, headaches, and pigmentation on the face.

From the fourth month life together It’s time for the fetus and mother to think about looser clothing. The belly begins to grow, but others do not notice it yet. By the end of the fourth month, the fundus of the uterus is 17-18 centimeters above the pubic bone. It is during this period that a woman’s gait begins to change. The upper part of the body leans back a little, and the stomach moves forward.

The inconveniences of this period are indigestion, bleeding gums, fainting and dizziness, nosebleeds, mild swelling of the feet and ankles.

In the fifth month of pregnancy, many women feel a lack of calcium in the body. This manifests itself as dental problems. If a woman consumes few calcium-containing foods, fillings may fall out and teeth may crumble.

Another symptom of calcium deficiency may be leg cramps.

The growth of the uterus is accompanied by pain in the lower abdomen, constipation, and increased frequency of urination at night. Gums may bleed, varicose veins of the legs or hemorrhoids appear.

Another thing that happens in a woman’s body is pigmentation of the skin on the abdomen.

By the end of the fifth month of bearing a baby, a woman feels the first movements of her child. Her growing belly is noticeable to others. And she herself sees how her hips are rounded and fat deposits appear on them.

In the sixth month of pregnancy, there is a risk of compression of large veins. This is manifested by progressive varicose veins, pain in the legs, and swelling.

By the 24th week of intrauterine development, the baby filled the entire uterine cavity. It increases and stretches, which is felt by all the pelvic organs. The woman is noticeably rounder.

During this period, many pregnant women may feel training contractions (or, as gynecologists also call them, Braxton Gix contractions). They are not painful or dangerous.

Seventh month of pregnancy. The uterus rises high and is already supporting the diaphragm. The whole body feels the strain and regular swelling appears. Many women complain of pain in the lower abdomen, increased vaginal discharge, stuffy ears, itchy abdominal skin, and back pain. During this period, as a rule, sleep problems begin, and colostrum may also appear. Most women notice stretch marks on their body by this time.

In the eighth month, the uterus is very sensitive to the baby's movements. The woman feels this with muscle tension. Many people experience late toxicosis. The amount of blood in a woman’s body increases by approximately one liter.

By week 36, the uterus moves away from the diaphragm, it moves forward because the baby's head is pressed against the entrance to the pelvis.

The inconveniences of the eighth month are shortness of breath, increasing constipation, swelling of the face and hands, difficulty sleeping, heaviness when walking, fatigue. Visually, the woman becomes clumsy.

The ninth month is the period of maximum increase in the load on the body of a pregnant woman. The stomach goes down. The placenta has exhausted its resources, so the baby “insists” on life outside the womb.

The expectant mother experiences severe pain in the back, legs, and lower abdomen. To maintain balance, a pregnant woman is forced to walk, leaning back. She walks more slowly, more carefully.

The mammary glands become greatly enlarged, and the appearance of colostrum already foreshadows childbirth.

Load on a woman's body during pregnancy

The cardiovascular system adapts to additional stress. This occurs due to an increase in the mass of the heart muscle. By the seventh month of pregnancy, the volume of blood in the body increases by one liter. In the last trimester, many women are concerned about increased blood pressure. Lung activity also increases. Increasing the volume of air that is inhaled makes it easier for the fetus to eliminate carbon dioxide through the placenta. The respiratory rate increases slightly towards the end of the period.

A huge burden during pregnancy falls on the kidneys. A pregnant woman excretes up to 1600 ml of urine per day, 1200 of which are excreted during the day, and the rest at night. The tone decreases Bladder, and this can lead to stagnation of urine and promote infection.

Under the influence of hormones, intestinal tone also decreases, which leads to frequent constipation. The stomach is compressed, and some of its contents are sometimes thrown into the esophagus, which causes heartburn in the second half of pregnancy.

The main barrier organ, the liver, also works with double load. It neutralizes metabolic products expectant mother and fruit.

Increased pressure on joints. The joints of the pelvis become especially mobile under the influence of growing body weight.

In the mammary glands, the number of lobules and the amount of adipose tissue increases. Breasts can double in size. The uterus experiences the greatest changes, making it difficult for all pelvic organs to function. The volume of her cavity increases approximately 500 times before birth. This occurs due to an increase in the size of muscle fibers.

The position of the uterus changes in parallel with its size. By the end of the first trimester, the organ “extends” beyond the pelvis. The uterus reaches the hypochondrium closer to childbirth. She resides in correct position thanks to ligaments that stretch and thicken. But the pain that pregnant women experience in the third trimester is precisely caused by the tension of these ligaments.

Since the blood supply to the genital organs increases, varicose veins may appear on the labia. The growth of the fetus in the womb contributes to an increase in her body weight.

By the end of pregnancy, a healthy woman's weight increases by an average of 12 kilograms. But an increase of 8 to 18 is allowed. In the first half of the term, weight can increase by 4-5 kilograms. In the second half of pregnancy, this figure is twice as high. Usually visual weight gain in overweight women is not visible, but the skinny ones are noticeably rounded. They are more difficult to bear the increasing load on the body.

Especially for - Diana Rudenko

Pregnancy is a state of prolonged physical adaptation necessary to meet the needs of the growing fetus, as well as to ensure the constancy of the environment in which it grows. The degree of this adaptation generally exceeds the needs of the fetus, so there are significant reserves to endure periods of stress or deprivation without significant changes in the fetal environment. Each of the mother's body systems experiences changes.

Endocrine system.

The endocrine system plays an extremely important role in the occurrence and development of pregnancy.

With the onset of pregnancy, changes appear in all endocrine glands.

In one of the ovaries, a new endocrine gland begins to function - the corpus luteum of pregnancy. It exists and functions in the body during the first 3-4 months. The hormone of the corpus luteum - progesterone - promotes the nidation of the fertilized egg into the mucous membrane of the uterus, reduces its excitability and thereby favors the development of pregnancy. Progesterone has a protective effect on the fertilized egg and uterus. Under its influence, the transmission of nervous excitation from one muscle fiber to another slows down, as a result of which the activity of the neuromuscular apparatus of the uterus decreases. It promotes the growth of the uterus during pregnancy and the development of glandular tissue of the mammary glands. The level of progesterone in the first weeks of pregnancy is 10 - 30 ng/ml, increasing from the 7th week of pregnancy above this figure.

The corpus luteum gradually regresses from 10 to 12 weeks of pregnancy, ceasing its function completely by 16 weeks.

At this time, a new endocrine gland appears - the placenta, which communicates the fetus with the mother’s body. The placenta produces a number of hormones (gonadotropins, progesterone, estrogens, etc.). Human chorionic gonadotropin promotes the progression of pregnancy, affects the development of the adrenal glands and gonads of the fetus, and the processes of steroid metabolism in the placenta. Chorionic gonadotropin begins to be detected at the 3rd week of pregnancy, at 5 weeks its level in the urine is 2500 - 5000 IU/L, at 7 weeks it increases to 80,000 - 100,000 IU/L, and by 12 - 13 weeks the level of human chorionic gonadotropin decreases to 10,000 - 20,000 IU/l and remains at this level until the end of pregnancy. The placenta produces placental lactogen - chorionic somatotropic hormone, which, due to its anti-insulin effect, enhances the processes of glyconeogenesis in the liver, reducing the body's tolerance to glucose, and enhancing lipolysis.

The placenta also produces other hormones: melanocyte-stimulating hormone (MSH), adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), oxytocin, vasopressin; as well as biologically active substances – relaxin, acetylcholine and others.

The placenta produces estrogen steroid hormones, one of which is estriol. Its level in the blood during pregnancy increases 5–10 times, and excretion in urine increases hundreds of times. Estriol, neutralizing the effect of other placental estrogens (estrone and estradiol), reduces the contractile activity of the uterus during pregnancy.

Great changes also occur in the pituitary gland, thyroid gland and adrenal glands.

Thus, one of the first indications of pregnancy may be the detection of a steady increase in luteinizing hormone (LH) from the pituitary gland. Usually, the production of melanocyte-stimulating hormone (MSH) also increases, which determines the tendency to hyperpigmentation in pregnant women. The anterior lobe of the pituitary gland produces hormones that stimulate the function of the corpus luteum at the beginning of pregnancy. The posterior lobe of the pituitary gland produces vasopressin and oxytocin. Oxytocin stimulates contractions of the uterine muscles, probably by facilitating the effects of prostaglandin. It is a weak antidiuretic and, in isolation, also has a vasodilatory effect, although during pregnancy the latter is suppressed by estrogens. The accumulation and action of oxytocin are directly dependent on the content of estrogen and serotonin in the placenta, which block oxytocinase. This enzyme inactivates oxytocin in a woman's blood during pregnancy; it is produced in the trophoblast and is a pregnancy enzyme.

During childbirth, the production of pituitrin by the posterior pituitary gland increases significantly. In the postpartum period, hormones of the anterior pituitary gland contribute to the formation of a new function - the function of lactation.

In the first months of pregnancy, there may be a slight increase in thyroid function; in the second half, hypofunction sometimes occurs. The level of circulating thyroxine during pregnancy generally does not increase, although the basal metabolic rate increases by 10% of the original level. Clinically, pregnant women may experience slight swelling of the thyroid gland, caused by an increase in its activity due to the need to compensate for the increased excretion of iodine by the kidneys.

During pregnancy, the zona fasciculata of the adrenal cortex hypertrophies. The formation of glucocorticoids, which regulate carbohydrate and protein metabolism, increases. In the adrenal cortex, the synthesis of cortisol, estrogens, progesterone and androgens increases. Under the influence of the activity of the adrenal glands, metabolic processes in the pregnant woman’s body intensify, the content of cholesterol and other lipids in the blood increases, and skin pigmentation increases.

During normal pregnancy, aldosterone levels increase, which stimulates sodium excretion by the kidneys.

Insulin levels increase, probably due to stimulation of the islets of Langerhans by the lactogenic hormone of the placenta.

the cardiovascular system.

During pregnancy, the cardiovascular system of healthy women undergoes significant changes.

Hemodynamic changes.

Hemodynamic changes during pregnancy are a manifestation of compensatory and adaptive adaptation to the coexistence of the mother and fetus. They are expressed in increased cardiac output, increased blood volume, increased heart rate and venous pressure. Changes in hemodynamics are closely related to an increase in body weight, uterus, fetus, placenta, an increase in metabolic rate by 15–20%, and the inclusion of additional placental blood circulation. One of the main mechanisms ensuring the maintenance of optimal microcirculation conditions in the placenta and vital organs of the mother (heart, brain, kidneys) during pregnancy and childbirth is the physiological hypervolemia of pregnant women. Blood plasma volume in pregnant women begins to increase from the 10th week of pregnancy. An intensive increase in the volume of circulating blood plasma continues until the 34th week of pregnancy, after which the increase continues, but much more slowly. At the 34th week of pregnancy, the increase in the amount of blood plasma reaches 30-40%, by the end of pregnancy - 50%. Thus, the GCP by the end of pregnancy is 3900 - 4000 ml. The volume of red blood cells also increases, but to a lesser extent, increasing by the end of pregnancy by approximately 18 - 20% of the initial level. The disproportion between the volume of plasma and the volume of blood cells leads to the fact that at 26-32 weeks of pregnancy the hemoglobin content and the number of red blood cells, despite their absolute increase, may decrease by 10-20%, i.e. Oligecythemic anemia develops and blood viscosity decreases. Thus, almost every woman during pregnancy experiences a relative decrease in hemoglobin levels, sometimes called “pregnant hydremia,” which can be prevented by prescribing iron supplements. This is the so-called state physiological hypervolemia(autohemodilution).

Physiological hypervolemia is an important compensatory-adaptive mechanism, which: 1). maintains optimal microcirculation conditions in vital organs during pregnancy; 2). allows some pregnant women to lose 30–35% of blood volume without developing severe hypotension (protective effect of autohemodilution).

During pregnancy mean arterial pressure rises from 95 mmHg. normally up to 105 mmHg, which facilitates the transfer of oxygen from mother to fetus. Average blood pressure is determined by the formula: blood pressure avg. = (SBP + 2DBP)/3,

where SBP is systolic blood pressure, DBP is diastolic blood pressure.

Cardiac output, which is 4.2 l/min in a healthy non-pregnant woman, increases at 8–10 weeks to approximately 6.5 l/min, and this level is maintained almost until childbirth, immediately before which there is a tendency for the release to decrease. The increase in output consists of an increase in stroke volume and an increase in heart rate from 72 to 78.

Minute volume of the heart (MCV) with a physiologically proceeding pregnancy, it increases by an average of 30-32% by 26-32 weeks of pregnancy. By the end of pregnancy, MOS decreases slightly, and at the beginning of labor it increases and slightly exceeds the initial value.

Peripheral vascular resistance decreases, especially towards the middle of pregnancy, so between the 16th and 28th week there is a tendency for blood pressure to decrease. The decrease in general and peripheral vascular resistance is explained by the formation of the uteroplacental circulation and the vasodilating effect of progesterone and estrogens. There is dilation of the blood vessels in the skin, as a result of which the woman feels the cold less and can sometimes feel worse in warm weather. An increase in the surface area of ​​blood flow is noticeable on the ulnar side of the palms in the form of palmar erythema. Some women have petechial hemorrhages in the area of ​​palmar erythema. They are not considered a manifestation of damage to the liver or hemostatic system, but are only a clinical manifestation of an increase in estrogen concentrations and disappear 5 to 6 weeks after birth.

Arterial pressure, if we do not talk about the tendency for a slight drop in the middle of pregnancy, it practically does not change in a healthy pregnant woman. The individual blood pressure level is determined by the ratio of 4 factors:

1).decrease in total peripheral resistance;

2).decrease in blood viscosity;

3).increase in circulating blood volume (CBV);

4).increase in cardiac output.

The first two factors contribute to a decrease in blood pressure, the last two - an increase. The interaction of all four factors maintains blood pressure at an optimal level.

Cardiac activity.

During pregnancy, physiological tachycardia is observed. In the third trimester of pregnancy, the heart rate (HR) is 15-20 beats/min higher than the heart rate before pregnancy. Central venous pressure rises to an average of 8 cm of water column. (outside of pregnancy it is 2-5 cm of water column). The pressure in the veins of the upper extremities does not change. The pressure in the veins of the lower extremities increases. This is partly caused by gravity and partly by obstruction caused by the return of blood from the uterus and placenta. The pregnant uterus compresses the inferior vena cava. Deterioration of venous outflow occurring through the lumbar and paravertebral veins, as well as a decrease in cardiac output in some women causes collapse. Therefore, pregnant women are advised to avoid lying on their back.

The high position of the uterine fundus leads to limited mobility of the diaphragm and a change in the position of the heart in the chest. In this regard, in half of healthy women during pregnancy, a systolic murmur is heard at the apex of the heart. There is an increase in the first tone at the apex of the heart, sometimes there is an emphasis on the pulmonary artery. No significant ECG changes are observed during pregnancy.

Hematological parameters during pregnancy.

Table 3.

Normal hematological parameters of pregnancy

The total number of leukocytes increases from 7,500 to 10,000 per 1 mm 3, and the erythrocyte sedimentation rate reaches a maximum of 50 mm in the first hour.

The number of platelets approximately doubles, reaching 316,000 per 1 mm 3 by the time of birth. The content of serum fibrinogen increases from 3 g/l before pregnancy to 6 at the time of birth. In the second and third trimesters of pregnancy, the content of blood clotting factors increases and the prothrombin index increases. The rate of blood clotting gradually increases, and the structural properties of the blood clot are enhanced.

The level of proteins in the blood plasma decreases from 70 to 60 g/l, which causes a drop in plasma osmotic pressure, resulting in a tendency to edema. The albumin/globulin ratio drops from 1.5 to 1. These changes occur due to a decrease in albumin levels and an increase in alpha and beta globulins. The level of gamma globulins also decreases.

respiratory system.

Pregnancy requires an increase in respiratory metabolism to meet the increasing metabolic demands due to the presence of a fetus - a continuously growing organism with intense metabolic processes, as well as an increase in maternal metabolism. In this regard, starting from 8-9 weeks of pregnancy, the mother’s respiratory system undergoes a number of morphofunctional adaptive changes, which, together with changes in the blood system and circulatory system, ensure the supply of oxygen and the release of carbon dioxide in accordance with the needs of the body.

Morphofunctional changes in the chest.

By the end of pregnancy, the diaphragm rises by 4 cm, and despite this, its excursions during breathing have a large scope, both in vertical and horizontal positions. High mobility of the diaphragm is ensured by a decrease in the tone of the abdominal muscles and expansion of the chest, the circumference of which increases by 6 cm due to an increase in the transverse diameter. Changes in the chest and diaphragm lead to a change in the type of breathing in pregnant women, which becomes predominantly diaphragmatic.

Ventilation of the lungs.

During pregnancy, lung activity increases due to increased oxygen demands. The total oxygen consumption by the end of pregnancy increases by 30 - 40%, and during pushing - by 150 - 250% of the original, reaching 800 - 900 ml O 2 /min in primiparous women.

P CO2 drops from 38 to 32 mmHg. due to hyperventilation, which facilitates the removal of CO 2 into the maternal bloodstream.

These compensatory reactions are provided by the processes of hyperventilation of the lungs, hyperfunction of the heart, and activation of erythropoiesis, leading to an increase in the number of circulating red blood cells.

However, excursion of the diaphragm during pregnancy remains limited, and pulmonary ventilation is difficult. This is mainly expressed in increased breathing (by 10% of the original), and a gradual increase (by the end of pregnancy - 30-40% of the original) tidal volume. Minute respiration volume (MRV) increases from 8.4 l/min at 12 weeks of pregnancy to 11.1 l/min by the time of delivery.

The increase in tidal volume occurs due to a decrease in the reserve output volume.

Vital capacity of the lungs(the maximum volume of air removed by maximum exhalation after maximum inhalation) does not actually change during pregnancy. Although vital capacity does not undergo significant changes during pregnancy, its components, current volume and reserve inspiratory volume, undergo major quantitative changes. Current volume - the amount of air inhaled and exhaled during normal breathing - increases progressively from the third month until the date of delivery, reaching values ​​of approximately 100 - 200 ml (40%) more than in non-pregnant women. The reserve inspiratory volume increases in late pregnancy due to an increase in the size of the chest. The reserve inspiratory volume combined with the current volume is inspiratory capacity, which in the sixth – seventh months of pregnancy is approximately 120 ml (5%) more than the rate for non-pregnant women. In contrast, expiratory reserve volume decreases by approximately 100 ml (15%) in the second half of pregnancy, reaching its lowest values ​​at 24–28 weeks of pregnancy. The reduction in the reserve exhaled volume is explained by an increase in the current volume, and since the vital capacity does not change, by the end of a normal inhalation the compression atelectasis of the lungs of a pregnant woman intensifies and they contain relatively less air than in the lungs of a non-pregnant woman.

Residual volume – the amount of air remaining in the lungs after maximum exhalation is approximately 20% less during full-term pregnancy than outside it. In the same time functional residual capacity(FOE) and total lung volume(OOL) due to the high position of the diaphragm decreases. Maximum lung capacity– the volume of air contained in the lungs at the end of the maximum inspiration is reduced.

The work of the respiratory muscles increases, their oxygen consumption increases, although the resistance of the respiratory tract by the end of pregnancy decreases by almost 1.5 times.

Arterial partial pressure of oxygen during a normal pregnancy decreases to 30 - 32 mmHg, however, due to the simultaneous increase in the excretion of sodium bicarbonate by the kidneys pH blood remains normal.

Mechanical properties of the lungs. During pregnancy, the overall resistance of the lungs is 50% less than outside of pregnancy due to a weakening of the smooth muscle tone of the bronchioles due to excess progesterone.

Lung perfusion during pregnancy increases, the diffusion of oxygen through the alveolar-capillary membrane does not change, or decreases slightly, while maintaining the ability to increase during exercise.

Thus, morphofunctional changes in the respiratory system during pregnancy create the necessary conditions for pulmonary hyperventilation, which, in combination with an increase in pulmonary perfusion and an increase in the exchangeable alveolar-capillary area, makes it possible to increase respiratory gas exchange in accordance with the needs of the pregnant woman’s body and her growing fetus.

Urinary system.

In the first and second trimester of pregnancy, renal blood flow increases, gradually returning to its original level at the time of delivery. IN late dates During pregnancy, the enlarged uterus obstructs venous drainage from the kidney, although this is only detected when the pregnant woman lies on the appropriate side.

The intensity of glomerular filtration increases by 50%, returning to normal only after childbirth. Inulin clearance increases from 90 to 150 ml/min. Additionally, almost 100 liters of liquid are filtered daily. Despite this, urine output is slightly reduced. During the second trimester of pregnancy, an increase in cardiac output, plasma volume, and glomerular filtration rate of up to 40% is observed. In the third trimester of pregnancy, these indicators return to their original levels. In the last 3 months of pregnancy, renal blood flow is 10% higher than normal, while glomerular filtration returns to normal by the end of the 8th month of pregnancy.

Due to increased glomerular filtration and increased plasma volume, serum creatinine levels are lower than in non-pregnant women. This is also facilitated by a decrease in protein catabolism during pregnancy.

The excretion of urea and uric acid also increases. At approximately 16–20 weeks of pregnancy, the renal threshold for glucose drops sharply, which is why glucosuria is quite common. The excretion of 140 mg/day of glucose in the urine is considered the upper limit of physiological glucosuria.

During pregnancy, approximately 20% of women experience the appearance of orthostatic proteinuria. The probable cause of this proteinuria may be compression of the inferior vena cava and uterine veins of the kidneys by the liver. Basic indicators of renal function are presented in Table 4.

Under the influence of progesterone, the muscle fibers of the bladder hypertrophy, causing it to become elongated and flaccid, which can lead to its bending and stagnation of urine. Due to the relaxing effect of progesterone on smooth muscle muscles, some atony of the ureters is observed, which can contribute to reverse reflux and reflux of urine into the overlying parts of the urinary system. The situation is aggravated with the growth of the uterus, which presses on the bladder, which together contributes to the introduction of infection and the development of hydronephrosis. Thus, conditions are created for the development of pyelonephritis during pregnancy, the risk of which is especially high if the vaginal ecology is disrupted.

Table 4.

Kidney function during pregnancy.

genitals.

In the reproductive system, the main changes concern the uterus. By the time of birth, the uterus increases to a size of 28x24x20 cm. Thus, the length of the non-pregnant uterus is 7-8 cm, by the end of pregnancy it increases to 37-38 cm. The transverse size of the uterus increases from 4-5 cm outside pregnancy to 25-26 cm. the weight of the uterus increases from 50-100 g outside pregnancy to 1000 - 1500 g at the time of birth.

During this period, it moves the diaphragm upward, and in the supine position it compresses the inferior vena cava so much that it interferes with the venous flow to the heart from the lower half of the body and causes hypotensive syndrome. An increase in the size of the uterus is determined more by hypertrophy of muscle fibers than by an increase in their number. Each muscle fiber lengthens 10-12 times and thickens 4-5 times. Hypertrophy occurs under the influence of estrogens and progesterone.

The lower segment of the uterus begins to form from about the 12th week of pregnancy, partly from the lower part of the uterine body and partly from the upper part of the cervix, which is lined with glandular epithelium, similar to the epithelium of the uterine body, while the cervical canal is slightly shortened. The cervix becomes softer and vascularized, taking on a bluish tint. The cervical canal remains tightly closed with a plug of viscous, opaque mucus, which serves as a barrier to bacteria from the vagina. The epithelium of the cervical canal grows, the glandular tissue becomes more active.

The muscle tissue of the uterine body softens and becomes more plastic and elastic. The uterus acquires the ability to respond with increased tone in response to various irritations. The mucous membrane of the uterus undergoes a certain restructuring, and the decidual (falling off) membrane develops from the functional layer of the endometrium.

The vascular network of the uterus grows: arterial, venous, and lymphatic vessels expand, lengthen, and increase in number. Blood vessels especially grow in the area where the placenta is attached. The number of nerve elements of the uterus increases, new sensitive receptors are formed that ensure the transmission of nerve impulses.

The excitability of the uterus decreases in the first months of pregnancy. However, gradually the normal rhythmic contractions of the uterus, characteristic of the luteal stage of the menstrual cycle, intensify, although they remain completely painless (Braxton Gix contractions). As pregnancy progresses, these contractions gradually increase in strength and frequency and, although they are not strong enough to cause the cervix to dilate, they may have some role in the “ripening” of the cervix.

In the uterine muscle, the amount of the contractile protein actomyosin progressively increases, the level of total phosphorus increases, and creatine phosphate and glycogen also accumulate. Biologically active substances gradually accumulate: serotonin, catecholamines, histamine. The uterine ligaments lengthen and thicken, which helps keep the uterus in the correct position both during pregnancy and childbirth. The round uterine ligaments and sacrouterine ligaments undergo the greatest hypertrophy.

The fallopian tubes thicken due to serous impregnation of the tissues. As pregnancy progresses, the fallopian tubes move down along the sides of the uterus and the tubes become inactive during pregnancy.

As the corpus luteum degenerates, the ovaries become inactive, cyclic changes in them cease, and as pregnancy progresses, they move from the pelvic cavity to the abdominal cavity.

The vagina and pelvic floor become softer, the number of vessels in them increases. The thickness of the vaginal epithelium also increases, and the reaction of the vaginal environment becomes more acidic.

The blood supply to the external genitalia increases, and varicose veins may appear on the labia majora. The elasticity and pliability of the vaginal walls, external genitalia and pelvic floor increases, as a result of which they become more distensible, preparing for the passage of the fetus during childbirth.

Gastrointestinal tract.

As pregnancy progresses, some displacements of the digestive organs occur in the anatomical sense. Thus, the stomach is positioned more horizontally, and increased pressure on the diaphragm can lead to disruption of the activity of the gastric sphincters, which causes the acidic contents to regurgitate and cause heartburn. The small intestine moves upward and toward the peritoneal wall. The cecum with its appendage moves upward and sideways - a trap for the careless surgeon.

The contractility of intestinal smooth muscle decreases, probably under the influence of progesterone, which often leads to constipation. The tendency to constipation may be aggravated by increased absorption of water in the colon. Stagnation of bile often occurs, which leads to cholestatic jaundice. The acidity of gastric juice decreases.

Pregnancy during its normal course usually does not cause any significant changes in the liver. Histologically, an increase in glycogen content and fat deposition in liver cells was revealed. Characteristic of pregnancy is an increase in alkaline phosphatase (from 26 to 75 IU versus 25 IU in non-pregnant women), direct bilirubin (up to 0.5 - 3.0 mmol/l).

musculoskeletal system.

The relaxing effect of progesterone during pregnancy is also reflected on the ligaments and joints, it is especially pronounced on the joints of the pelvis, which facilitates the passage of the fetus through the birth canal. This phenomenon is partly due to the flattening and elongation of the feet of pregnant women. Skeletal muscle tone decreases somewhat, which can lead to drooping of the shoulder girdle and compression of the brachial plexus, causing typical ulnar paresthesia. However, this rarely happens. A more common manifestation during pregnancy is the development of lumbar lordosis due to the need to balance the weight of an enlarged uterus. This lordosis can increase back pain. Lordosis is aggravated if a woman wears high-heeled shoes.

Leather.

In pregnant women, skin pigmentation increases, especially pronounced on the face, around the nipples and the white line of the abdomen, especially pronounced in brunettes (chloasma uterinum). . This phenomenon is due to an increase in the amount of circulating melanostimulating hormone. Longitudinal stripes 5-6 cm long and about 0.5 cm wide appear on the stomach and thighs. At first they are pink, but then they become pale and more dense. It is believed that they are caused by the separation of the elastic layer of the skin from other layers due to an increase in the level of circulating adrenal hormones. They are called pregnancy stripes (striae gravidarum). Sometimes birthmarks appear.

The intensity of work of the sebaceous and sweat glands increases.

Nervous system

From the moment pregnancy occurs, a stream of impulses begins to flow into the mother’s central nervous system, which causes the development of a local focus of increased excitability in the central nervous system - a gestational dominant. The excitability of the cerebral cortex is reduced until 3–4 months of pregnancy, and then gradually increases. The excitability of the underlying parts of the central nervous system and the reflex apparatus of the uterus is reduced, which ensures relaxation of the uterus and the normal course of pregnancy. Before childbirth, the excitability of the spinal cord and nerve elements of the uterus increases, creating favorable conditions for the onset of labor. The tone of the autonomic nervous system changes, and therefore pregnant women often experience drowsiness, tearfulness, increased irritability, sometimes dizziness and other disorders. Usually these phenomena gradually disappear as pregnancy progresses.

Metabolism.

During pregnancy, basal metabolism and oxygen consumption increase. The basal metabolic rate of a healthy non-pregnant woman is approximately 2,300 calories per day. During pregnancy, the basal metabolic rate increases by approximately 10%, due to increased oxygen consumption and fetal activity, so that the total energy expenditure is approximately 2500 cal per day. In total, additional energy expenditure for the entire pregnancy is approximately 68,000 calories, half of which is covered by fats and one third by carbohydrates. Proteins provide only 6.5% of energy, as they are used almost exclusively for tissue formation.

A woman’s body accumulates protein substances necessary to meet the amino acid needs of a growing fetus.

Changes in carbohydrate metabolism lead to the accumulation of glycogen in liver cells, muscles, uterus, and placenta. Carbohydrates pass to the fetus in the form of glucose, which provides the energy needs of the fetus and the processes of anaerobic glycolysis.

In the blood of pregnant women, the concentration of neutral fat, cholesterol and lipids increases. Fats pass to the fetus in the form of glycerol and fatty acids, which are used as energy material and also for tissue construction.

During pregnancy, the pregnant woman's body's needs for calcium, phosphorus, and iron salts increase, which are necessary for the ossification of the fetal skeleton, the formation of its hematopoiesis, and the development of the nervous system.

The normal total body weight gain during pregnancy is 12 kg. One third of the gain, 4 kg, is gained in the first half of pregnancy, and the remaining two thirds, 8 kg, in the second. 60% of total body weight gain is due to water retention caused by sodium accumulation. The retained water is distributed as follows: in plasma 1.3 l, in the fetus, placenta and amniotic fluid 2 l, in the uterus, mammary glands 0.7 l, and in extragenital interstitial fluid 2.5 l. At the time of delivery, the fetus and amniotic fluid together weigh about 5.5 kg, and this weight is lost after birth. The remaining 6.5 kg comes from the uterus, mammary glands, and fat reserves (especially on the hips and buttocks).

After a sharp decrease in body weight in the first four days after birth due to increased diuresis resulting from the cessation of placental hormones, it continues to gradually decrease over the next 3 months or so.

Self-control tests .

The volume of circulating blood during pregnancy increases by:

Doesn't change at all.

2. Physiological hypervolemia of pregnant women occurs at term:

20-22 weeks of pregnancy

- *34-35 weeks of pregnancy

38-39 weeks of pregnancy

16-15 weeks of pregnancy.

3. The level of proteins in the blood plasma during pregnancy decreases to:

4. Total oxygen consumption at the end of pregnancy:

- *increases

Decreases

5. Normally during pregnancy the following is noted:

- *increased breathing

Decreased breathing

The breathing rate does not change.

6. Physiological glucosuria during pregnancy is indicated by the level of glucose in the urine:

120 mg/day

130 mg/day

- *140 mg/day

150 mg/day

7. The corpus luteum of pregnancy functions in the body until:

2 months pregnant

3 months pregnant

- *up to 3-4 months of pregnancy

Until the due date.

8. The placenta secretes all of the following except:

Human chorionic gonadotropin

Placental lactogen

Melanocyte stimulating hormone

- *placental insulin.

9. Formation of glucocorticoids during pregnancy:

- *intensifies

Decreases

Doesn't change significantly.

10. The normal total body weight gain during pregnancy is:

11. The main function of human chorionic gonadotropin is:

- *maintaining the function of the corpus luteum

Initiation of implantation

Initiation of breast development

Determination of fetal viability.

During pregnancy, significant physiological changes occur in a woman’s body, which provide proper development fetus, prepare the body for the upcoming birth and feeding. During this difficult period, the load on all organs and systems of a woman’s body increases significantly, which can lead to exacerbation of chronic diseases and the development of complications. That is why you should register as soon as possible antenatal clinic, go through all the necessary specialists and take tests. This will allow you to take adequate preventive measures and prepare for childbirth.

Heart

During pregnancy, the cardiovascular system performs more intense work, as an additional placental circulation appears in the body. Here the blood flow is so great that 500 ml of blood passes through the placenta every minute. The heart of a healthy woman during pregnancy easily adapts to additional loads: the mass of the heart muscle and cardiac blood output increase. To meet the growing needs of the fetus for nutrients, oxygen and building materials In the mother’s body, blood volume begins to increase, reaching a maximum by the 7th month of pregnancy. Instead of 4000 ml of blood, 5300-5500 ml now circulates in the body. In pregnant women with heart disease, this load can cause complications; that is why, at 27-28 weeks, they are recommended to be hospitalized in specialized maternity hospitals.

Arterial pressure

Blood pressure remains virtually unchanged during a normal pregnancy. On the contrary, in women who have an increase in it before or in the early stages of pregnancy, in the middle of pregnancy it usually stabilizes and is in the range of 100/60-130/85 mmHg. This is due to a decrease in the tone of peripheral blood vessels under the influence of the hormone progesterone.

However, in the last trimester of pregnancy, blood pressure can increase, reaching very high values. High blood pressure (140/90 mmHg and above) is one of the signs of late toxicosis in pregnant women. This condition is very dangerous and may require emergency delivery.

Lungs

Due to the increase in the woman's body's need for oxygen during pregnancy, lung activity increases. Despite the fact that as pregnancy progresses, the diaphragm rises upward and limits the respiratory movements of the lungs, their capacity increases. This occurs due to the expansion of the chest, as well as due to the expansion of the bronchi. Increasing the volume of inhaled air during pregnancy makes it easier for the fetus to remove used oxygen through the placenta. The respiratory rate does not change, remaining 16-18 times per minute, increasing slightly towards the end of pregnancy. Therefore, if shortness of breath or other breathing problems occurs, a pregnant woman should definitely consult a doctor.

Kidneys

The kidneys function under great strain during pregnancy, as they remove metabolic products from the body of the pregnant woman and her growing fetus. The amount of urine produced fluctuates depending on the amount of fluid you drink. A healthy pregnant woman excretes an average of 1200-1600 ml of urine per day, with 950-1200 ml of urine excreted during the day, and the rest at night.

Under the influence of the hormone progesterone, the tone of the bladder decreases, which can lead to stagnation of urine. Under these conditions, the introduction of infection into the urinary tract is facilitated, so pregnant women often experience exacerbation of pyelonephritis. About the infection urinary tract indicates the appearance of leukocytes in urine tests - more than 10-12 per field of view.

In addition, the pregnant uterus, turning slightly to the right, can cause difficulty in the outflow of urine from the right kidney. In this case, the risk of hydronephrosis increases, that is, expansion of the pelvis and calyces due to excessive accumulation of urine in them.

Digestive organs

Many women in the first 3 months of pregnancy experience changes in the digestive organs: nausea and often vomiting in the morning (signs early toxicosis), taste sensations change, and a craving for unusual substances (clay, chalk) appears. As a rule, these phenomena disappear by 3-4 months of pregnancy, sometimes at a later date. Under the influence of placental hormones, intestinal tone decreases, which often leads to constipation. The intestines are pushed upward by the pregnant uterus, the stomach is also shifted upward and compressed, and some of its contents can be thrown into the esophagus and cause heartburn (especially in the second half of pregnancy). In such cases, it is recommended to take antacid medications (for example, Maalox, Rennie), eat food 2 hours before bedtime, and lie in bed with the head end elevated.

During pregnancy, the liver works with greater load, as it neutralizes metabolic products of the woman and the fetus.

Joints

During pregnancy, women experience some joint laxity. The joints of the pelvis become especially mobile, which facilitates the passage of the fetus through it during childbirth. Sometimes the softening of the pelvic joints is so pronounced that a slight divergence of the pubic bones is observed. Then the pregnant woman experiences pain in the pubic area and a “duck” gait. You should inform your doctor about this and receive appropriate recommendations.

Mammary gland

During pregnancy, the mammary glands prepare for the upcoming feeding. The number of lobules and adipose tissue increases in them, and blood supply improves. The mammary glands increase in size, the nipples become hard.

Genitals

The greatest changes during pregnancy occur in the genitals and mainly affect the uterus. The pregnant uterus constantly increases in size, by the end of pregnancy its height reaches 35 cm instead of 7-8 cm outside pregnancy, the weight increases to 1000-1200 g (without a fetus) instead of 50-100 g. The volume of the uterine cavity by the end of pregnancy increases by approximately 500 once. A change in the size of the uterus occurs due to an increase in the size of muscle fibers under the influence of placental hormones. The blood vessels expand, their number increases, they seem to entwine the uterus. Irregular contractions of the uterus are observed, which become more active towards the end of pregnancy and are felt as “squeezing”. These so-called Braxton-Hicks contractions, which normally occur from the 30th week of pregnancy, are considered as training for real labor contractions.

The position of the uterus changes according to its size. By the end of the 3rd month of pregnancy, it extends beyond the pelvis, and closer to childbirth it reaches the hypochondrium. The uterus is held in position by ligaments, which thicken and stretch during pregnancy. Pain that occurs on the sides of the abdomen, especially when changing body position, is often caused by tension in the ligaments. The blood supply to the external genitalia increases, and varicose veins may appear in the vagina and labia (the same varicose veins can also appear on the lower extremities and in the rectum).

Weight gain

Fetal growth and physiological changes in the pregnant woman's body affect her body weight. In a healthy woman, by the end of pregnancy, body weight increases by an average of 12 kg with fluctuations from 8 to 18 kg. Usually in the first half of pregnancy it increases by 4 kg, in the second half - 2 times more. Weekly weight gain up to 20 weeks is approximately 300+30 g, from 21 to 30 weeks - 330+40 g and after 30 weeks before birth - 340+30 g. In women with underweight before pregnancy, weekly weight gain may be even greater more.

Psychology of women

In addition to physiological changes in the body, a pregnant woman’s mental state changes.

A woman’s attitude towards pregnancy and childbirth is influenced by various factors, including social, moral, ethical, economic, etc., as well as the personality characteristics of the pregnant woman herself.

In the first half of pregnancy, most women are more concerned about their own health, and in the second half, especially after the appearance of fetal movements, all the thoughts and concerns of the expectant mother are aimed at the well-being of the fetus. A woman can address her child with kind words, she fantasizes, endowing him with individual characteristics. Along with this, many women deliberately give up some attachments and habits for the sake of upcoming motherhood.

Pregnant women may also experience various concerns and fears. During this period, a woman may be concerned about changes in appearance, loss of attractiveness, and relationships with her husband. Close relatives (especially the husband) should become a reliable support for the pregnant woman and try to provide the woman with psychological comfort. If a pregnant woman experiences severe anxiety or depression, it is recommended to seek advice from a specialist.

Are you going to become parents soon? Congratulations! Pregnancy is one of the most wonderful periods in a woman’s life. And it’s always so interesting what happens inside the uterus, how your child grows, what changes are characteristic of the female body. Gynecologist, Candidate of Medical Sciences Elena Nesyaeva talks about all this.

Let's start in order. First of all, I would like to remind you that there is a distinction between the true period of pregnancy - from the day of conception - and the obstetric one, which is counted from the first day of the last menstruation. That is, the obstetric period is 2 weeks longer than the true one. We will talk about the obstetric period. This is justified, because the egg begins to mature in a woman’s body precisely with the arrival of the next menstruation.

Examination during pregnancy

The word "pregnancy" comes from the word "burden". Pregnancy is a significant burden on a woman’s entire body. Therefore, if the pregnancy is planned, try to cure your chronic diseases first. If you did not expect pregnancy, but, nevertheless, it turned out to be desired, consult a doctor as soon as possible. You will be examined, treatment will be selected and all necessary recommendations will be given for further pregnancy.

If you are healthy, you will just need to get tested.

1. Analysis for syphilis, HIV infection, hepatitis B and C. The first time this test is taken is at the first visit to the antenatal clinic. You will have to retake it once every 3 months (3 times during the entire pregnancy).
2. A general blood test will have to be taken monthly. The doctor will be interested in the level of hemoglobin, the number of leukocytes, platelets, and ESR.