Interesting Facts 

Pregnancy what happens to the body. Changes during pregnancy. Changes in the subcutaneous tissue of a woman during pregnancy

The first changes that occur in the body of a pregnant woman at the same time help about the very fact of pregnancy. And if some signs can only be seen by a doctor during examination (cyanosis of the mucous membrane of the vagina and cervix, a slight increase and softening of the uterus), then most of the changes are noticeable to the expectant mother herself.

First of all, this is the cessation of menstruation. Delay is one of the main signs of pregnancy. In rare cases, menstruation does not stop in the first few months, but if bleeding occurs after pregnancy is confirmed, this is an occasion for immediate medical attention, especially if it is accompanied by pain in the lower abdomen.

In the first weeks, the breast increases in size and becomes heavier, it becomes more sensitive, pain or tingling in the mammary glands may be noted.


Changes in hormonal levels cause changes in the work of the intestines and bladder - urination becomes more frequent, but many women complain of constipation.

An elevated basal body temperature may indicate the onset of pregnancy. If the temperature usually rises during ovulation and decreases before the onset, it rises slightly with the onset of pregnancy and remains so even in later ones.

Everything you can't see with your eyes

Women's mood swings are proverbial. Due to changes in hormonal levels, a woman can feel overwhelmed, tired, and even the joy of her new condition cannot always smooth it out. The emotional state of a woman during this period easily changes from sadness to inexplicable fun. Often, expectant mothers note that they become more nervous and even whiny.

Sensitivity to odors changes, habitual perfumes may dislike, the sense of smell becomes unusually sharp. It is not uncommon to have an aversion to certain types of food and a desire for certain foods or unusual combinations of them. The craving for salty and sour foods has been known for a long time - sometimes the desire for pickled or pickled cucumbers betrays pregnancy before other signs appear.

Toxicosis with nausea and weakness usually begins at 6-7 weeks of gestation and disappears by the end of the first trimester. Some women do not suffer from it at all or experience mild nausea in the morning, but others suffer from repeated vomiting throughout the day. Frequent vomiting is dangerous because it can lead to dehydration, so it is better to consult a doctor - he will explain with toxicosis, and with frequent vomiting, he will advise you to go to the hospital.


Often there is low blood pressure, leading to drowsiness, weakness, dizziness and even fainting. Possible tachycardia associated with an increase in blood volume.

In the early stages, existing chronic diseases and sluggish infections may worsen. If you did not pay attention to treatment during pregnancy planning, the first is not the right time for taking medications and certain medical procedures. If you cannot do without them, the doctor will select the most sparing treatment regimen for you.
Pregnant women are often annoyed by pain in the lower back, lower abdomen, joints or headaches. Pain in the abdomen can be explained by an increase in the sensitivity of the uterus and stretching of the ligaments that support it. In some cases, there is hypertonicity of the uterus - the lower abdomen seems to be "". In this case, you need to move less, perhaps the doctor will recommend taking safe antispasmodics.

External changes

Barely seeing two stripes, a woman expecting her first child is already peering intently into the mirror in anticipation of a change in appearance.

In the first weeks of pregnancy, external changes are insignificant. First of all, this is a change in the color of the areolas - the areas around the nipples noticeably darken. Later, pigmentation of the white line of the abdomen leading from the navel to the pubis may appear. Spots on the face, which women often fear, appear much later, if they appear at all.

Fluctuations in hormonal levels and a decrease in immunity, characteristic of early pregnancy, can spoil the appearance for a while - the skin and hair sometimes become more oily and dull, the face swells. This is a temporary condition, usually by the end of the first trimester it passes, the hair becomes thick and lush.


In rare cases, pregnant women notice an increase in body hair growth. This may be due to increased levels of male hormones and requires consultation with an endocrinologist.

The abdomen until the second trimester of pregnancy, and sometimes longer, is almost invisible. However, other women notice that the stomach has nevertheless increased in volume, but this is not due to an increase in the uterus, but to fluid retention in the body and intestinal hypotension.

Incredible Facts

1. You have a brand new organ

The placenta is the only transitional organ in the human body. It begins to form when a fertilized egg, which at the time is a multicellular blatocyst, attaches itself to the wall of the uterus about a week after conception. The outer layer of the blatocyst, called the trophoblast, forms into what is later called the placenta.

Once the placenta is formed, its job is to build a barrier between the mother's and baby's blood flow. Maternal vessels carry nutrients and oxygen to the intervillous region of the placenta, from where the fetus takes them. So he only takes what he needs.

The placenta plays another less well-known role as a temporary organ. This 2.2-kilogram dark red "disk" is also an endocrine organ, that is, it secretes hormones. These hormones, from human chorionic gonadotropin (hCG, based on the presence of this hormone, pregnancy tests work) to estrogen and progesterone, are essential for maintaining pregnancy and for preparing the mammary glands for feeding.

2. Bones "relax"

The baby's head has to come out somehow. Fortunately, the "pregnant body" produces the hormone relaxin, which relaxes the cartilage that holds the bones together. Relaxin relaxes the pubic symphysis, a spot on the pubic bone just in front of the bladder. Such relaxation greatly facilitates the process of childbirth, however, unfortunately, it does not affect only the bones in the pelvic area. During pregnancy, the level of the hormone relaxin in a woman's body is 10 times higher than normal, and it affects all bones. The hormone is one of the reasons why many women experience back and joint pain as their pregnancy progresses. Relaxin is also to blame for the fact that some women experience an increase in shoe size during pregnancy.

3. Memory deteriorates

Wait, what did I do? The "pregnant brain" is not a myth, according to a 2010 study that found women in the second and third trimesters of pregnancy performed worse than non-pregnant women on spatial memory tests. It's entirely possible, according to study author Diane Farrar, that hormonal changes, which are known to be responsible for dramatic mood swings during pregnancy, are to blame.


4. You may feel sick

First, the bad news: "morning weakness" is a misconception. A pregnant woman can experience nausea and vomiting at any time of the day. Fortunately, the "side effect" of pregnancy usually goes away by about the 12th week. No one knows exactly why morning sickness affects nearly half of all pregnant women, but a 2008 study suggested that nausea may be an adaptation process to keep the developing embryo safe.

The analysis showed that morning sickness is most often triggered by strong smells and tastes, suggesting that the body is trying to prevent the consumption of potentially harmful substances. The peak frequency of the onset of weakness coincides with the time of the initial development of the organs in the embryo, which once again confirms that the body is on high alert during this period.

5. Frequent heartburn

Heartburn occurs due to the pressure exerted by the expanding uterus on the digestive system. Normally, stomach acid is retained by the esophageal sphincter (a muscle in the diaphragm that activates and closes off the esophagus when abdominal pressure rises). But during pregnancy, the hormone progesterone relaxes the sphincter. Meanwhile, as the child grows, the pressure on the intestines and stomach increases.


6. The bladder "flattens"

Surely, you have seen a pregnant woman standing in line for the toilet more than once, and you probably know that expectant mothers have a frequent need to go to the toilet. What is the reason? The growing baby is to blame because it puts pressure on the bladder, urethra, and pelvic muscles. This kind of pressure not only means frequent urination, but is also the cause of "leakage" when coughing, sneezing or laughing.


7. You now have 50 percent more blood.

Pregnancy is hard work for the body, which requires more blood vessels and more blood. By the 20th week of pregnancy, the body contains 50 percent more blood than at the time of conception. However, all the extra blood is often accompanied by side effects such as varicose veins, hemorrhoids, and "shiny" skin. Additional blood can also cause nosebleeds and nasal congestion due to swelling of the mucous membranes.


8. Tingling hands

You don't have to be a typist or a pianist to know what it is, as pregnancy is often the cause of carpal tunnel syndrome. Marked with numbness or tingling, this side effect is caused by the swelling experienced by a pregnant woman. Excess fluid (which is responsible for 25 percent of pregnancy weight) can accumulate in the ankles or wrists due to gravity. On the wrists, it "touches" the nerves, which causes tingling.

Pregnancy is a state of continuous physical adaptation necessary to meet the needs of the growing fetus, as well as to ensure the constancy of the environment in which it occurs. 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 environment of the fetus. Each of the systems of the mother's body is undergoing changes.

Endocrine system.

The endocrine system plays an extremely important role in the onset 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 corpus luteum hormone - progesterone - promotes the nidation of a fertilized ovum into the uterine mucosa, 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 breast tissue. The level of progesterone in the first weeks of pregnancy is 10 - 30 ng / ml, increasing from the 7th week of pregnancy above the above indicator.

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

At this time, a new endocrine gland appears - the placenta, which connects the fetus with the mother's body. The placenta produces a number of hormones (gonadotropins, progesterone, estrogens, etc.). Chorionic gonadotropin contributes to the progression of pregnancy, affects the development of the adrenal glands and fetal gonads, and the processes of steroid metabolism in the placenta. Chorionic gonadotropin begins to be determined at the 3rd week of pregnancy, at 5 weeks its level in the urine is 2500 - 5000 IU / L, at 7 weeks it rises to 80,000 - 100,000 IU / L, and by 12 - 13 weeks the content of 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, a chorionic somatotropic hormone, which, due to its anti-insulin action, enhances the processes of gluconeogenesis in the liver, reducing the body's tolerance to glucose, and enhances lipolysis.

The placenta also produces other hormones: melanocyte-stimulating hormone (MSH), adrenocorticotropic (ACTH) hormone, 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 the urine increases hundreds of times. Estriol, neutralizing the action of other placental estrogens (estrone and estradiol), reduces the contractile activity of the uterus during pregnancy.

The pituitary, thyroid, and adrenal glands also undergo great changes.

So, one of the first indications of pregnancy may be the detection of a steady increase in luteinizing hormone (LH) from the pituitary gland. The production of melanocyte-stimulating hormone (MSH) usually also increases, which determines the tendency to hyperpigmentation in pregnant women. The anterior pituitary gland produces hormones that stimulate the function of the corpus luteum at the beginning of pregnancy. The posterior pituitary gland produces vasopressin and oxytocin. Oxytocin stimulates uterine muscle contractions, probably by facilitating the effects of prostaglandins. It is a weak antidiuretic and also has a vasodilating effect in isolation, although during pregnancy the latter is suppressed by estrogens. The accumulation and action of oxytocin are directly dependent on the content of estrogens 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 the enzyme of pregnancy.

In childbirth, the production of pituitrin by the posterior pituitary gland increases significantly. In the postpartum period, the 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 some increase in thyroid function, in the second half - sometimes its hypofunction occurs. The level of circulating thyroxine during pregnancy generally does not increase, although the intensity of the main metabolism increases by 10% of the initial one. Clinically, pregnant women may show a slight swelling of the thyroid gland, due to an increase in its activity due to the need to compensate for the increased excretion of iodine by the kidneys.

During pregnancy, the fascicular zone of the adrenal cortex hypertrophies. The formation of glucocorticoids, which regulate carbohydrate and protein metabolism, is enhanced. 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 body of a pregnant woman increase, the content of cholesterol and other lipids in the blood increases, and skin pigmentation increases.

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

Insulin levels rise, probably due to stimulation of the islets of Langerhans by placental lactogenic hormone.

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-adaptive adaptation to the coexistence of mother and fetus organisms. They are expressed in an increase in cardiac output, an increase in blood volume, an increase in 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 circulation. One of the main mechanisms that ensure 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. The volume of blood plasma 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, an increase in the amount of blood plasma reaches 30-40%, by the end of pregnancy - 50%. Thus, the VCP by the end of pregnancy is 3900 - 4000 ml. The volume of erythrocytes also increases, but to a lesser extent, increasing by the end of pregnancy by about 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, can decrease by 10-20%, i.e. oligecythemic anemia develops and blood viscosity decreases. Thus, in almost every woman during pregnancy, there is a relative decrease in hemoglobin levels, sometimes called "pregnancy hydremia", which can be prevented by the appointment of iron supplements. This state of the so-called 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 the development of severe hypotension (the protective effect of autohemodilution).

During pregnancy mean arterial pressure rises from 95 mm Hg. normally up to 105 mm Hg, which facilitates the transfer of oxygen from the mother to the fetus. The average blood pressure is determined by the formula: blood pressure cf. \u003d (SBP + 2DAD) / 3,

where SBP is systolic blood pressure and 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 the very birth, immediately before which there is a tendency to reduce the emission. The increase in output is made up of an increase in stroke volume and an increase in heart rate from 72 to 78.

Cardiac minute volume (MOV) 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, therefore, between the 16th and 28th week, there is a tendency for a decrease in blood pressure. The decrease in total and peripheral vascular resistance is explained by the formation of the uteroplacental circulation and the vasodilating effect of progesterone and estrogens. There is vasodilation of the skin, as a result of which the woman feels less cold and can sometimes feel worse in warm weather. An increase in the blood flow surface 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 the hemostasis system, but are only a clinical manifestation of an increase in the concentration of estrogen and disappear 5 to 6 weeks after birth.

Arterial pressure, apart from the tendency to a slight drop in the middle of pregnancy, it practically does not change in a healthy pregnant woman. The individual level of blood pressure is determined by the ratio of 4 factors:

1) a decrease in total peripheral resistance;

2) a decrease in blood viscosity;

3). an increase in the volume of circulating blood (BCC);

4).an increase in cardiac output.

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

Heart activity.

During pregnancy, physiological tachycardia is observed. In the III 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. (outside of pregnancy is 2-5 cm of water). 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 due to gravity and partly due to obstruction caused by the return of blood from the uterus and placenta. The pregnant uterus compresses the inferior vena cava. Deterioration of venous outflow 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 the supine position.

The high standing of the fundus of the uterus leads to a limitation of the 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 I tone at the apex of the heart, sometimes there is an emphasis on the pulmonary artery. There are no significant ECG changes 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 in 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 in 1 mm 3 by the time of delivery. The content of serum fibrinogen increases from 3 g/l before pregnancy to 6 by the time of delivery. In the II and III trimesters of pregnancy, the content of blood coagulation factors increases, the prothrombin index increases. The rate of blood coagulation gradually increases, the structural properties of the blood clot increase.

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

respiratory system.

Pregnancy requires an increase in respiratory exchange to meet the increasing metabolic demands due to the presence of the fetus - a continuously growing organism with intensive 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 morphological and functional adaptive changes, which, together with changes in the blood and circulatory systems, provide oxygen supply and carbon dioxide release 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 a vertical and horizontal position. High mobility of the diaphragm is provided 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 demand. The total oxygen consumption by the end of pregnancy increases by 30 - 40%, and during attempts - by 150 - 250% of the original, reaching 800 - 900 ml O 2 / min in primiparas.

P CO2 drops from 38 to 32 mm Hg. 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, activation of erythropoiesis, leading to an increase in the number of circulating red blood cells.

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

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

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

Residual volume - the amount of air remaining in the lungs after maximum exhalation is about 20% less during a full-term pregnancy than outside it. In the same time functional residual lung capacity(FOE) and total lung volume(OOL) due to the high standing of the diaphragm are reduced. Maximum lung capacity- the volume of air contained in the lungs by the end of the maximum breath - is reduced.

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

Arterial partial pressure of oxygen during a normal pregnancy decreases to 30 - 32 mm Hg, 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 less by 50% than outside pregnancy due to the weakening of the tone of the smooth muscles of the bronchioles due to excess progesterone.

Lung perfusion increases during pregnancy, oxygen diffusion 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 the implementation of pulmonary hyperventilation, which, combined with an increase in pulmonary perfusion and an increase in the exchange alveolar-capillary area, makes it possible to increase respiratory gas exchange in accordance with the needs of the body of the pregnant woman and her growing fetus.

urinary system.

In the first and second trimester of pregnancy, renal blood flow increases, gradually returning to its original level by the time of delivery. In late pregnancy, an enlarged uterus prevents venous drainage from the kidney, although this is only detected when the pregnant woman lies on her 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. In addition, almost 100 liters of liquid are filtered daily. Despite this, urine output is somewhat reduced. During the second trimester of pregnancy, there is an increase in cardiac output, plasma volume, and glomerular filtration rate up to 40%. In the III trimester of pregnancy, these indicators return to their original level. 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 eighth 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. Around 16-20 weeks of gestation, the renal threshold for glucose falls sharply, which is why glucosuria is quite common. Excretion of 140 mg/day of glucose in the urine is considered the upper limit of physiological glucosuria.

During pregnancy, about 20% of women experience orthostatic proteinuria. The probable cause of this proteinuria may be compression of the inferior vena cava by the liver and the uterus of the veins of the kidneys. The main indicators of kidney function are presented in table 4.

Under the influence of progesterone, the muscle fibers of the bladder hypertrophy, due to which it becomes elongated and sluggish, 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 urine reflux into the overlying parts of the urinary system. The situation is aggravated with the growth of the uterus, which presses down on the bladder, which together contributes to the introduction of infection, the development of hydronephrosis. Thus, conditions are created for the development of pyelonephritis during pregnancy, the risk of which is especially high in violation of the ecology of the vagina.

Table 4

Kidney function during pregnancy.

sexual organs.

In the reproductive system, the main changes concern the uterus. By the time of delivery, 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 of pregnancy to 25-26 cm. the mass of the uterus increases from 50-100 g outside of pregnancy to 1000-1500 g by the time of delivery.

During this period, it shifts the diaphragm upward, and in the supine position it compresses the inferior vena cava so much that it interferes with venous flow to the heart from the lower half of the body and causes hypotensive syndrome. The increase in the size of the uterus is determined rather 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 at about 12 weeks of gestation, partly from the lower part of the uterine body and partly from the upper part of the cervix, which is lined with a glandular epithelium similar to that of the body of the uterus, 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 that acts as a barrier to bacteria from entering the vagina. The epithelium of the cervical canal grows, the glandular tissue becomes more active.

Softens and becomes more plastic and elastic and the muscular tissue of the body of the uterus. The uterus acquires the ability to respond with an increase in tone in response to various irritations. The mucous membrane of the uterus undergoes a certain restructuring, a decidual (falling away) membrane develops from the functional layer of the endometrium.

The vascular network of the uterus grows: expand, lengthen, increase in the number of arterial, venous, lymphatic vessels. Blood vessels in the area of ​​​​attachment of the placenta grow especially. 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 in the first months of pregnancy decreases. Gradually, however, the normal rhythmic contractions of the uterus, characteristic of the luteal stage of the menstrual cycle, increase, although they remain completely painless (Brexton Hicks contractions). As the 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 something to do with the "ripening" of the cervix.

In the muscle of the uterus, 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 ligaments of the uterus lengthen and thicken, which helps to keep the uterus in the correct position both during pregnancy and childbirth. Round uterine ligaments, sacro-uterine ligaments are exposed to the greatest hypertrophy.

The fallopian tubes thicken due to serous impregnation of the tissues. As pregnancy progresses, the fallopian tubes descend along the lateral surfaces of the uterus, the tubes become inactive during pregnancy.

The ovaries, as the corpus luteum degenerates, become inactive, cyclic changes in them stop, with the growth of pregnancy, 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, the reaction of the vaginal environment becomes more acidic.

The blood supply to the external genital organs increases, varicose veins may appear on the labia majora. The elasticity and suppleness of the walls of the vagina, external genital organs and the pelvic floor increase, as a result of which they become more extensible, preparing for the passage of the fetus during childbirth.

Gastrointestinal tract.

As pregnancy progresses, some displacements of the digestive organs in the anatomical sense occur. Thus, the stomach is located more horizontally, and increased pressure on the diaphragm can lead to disruption of the activity of the sphincters of the stomach, due to which its acidic contents burp and cause heartburn. The small intestine moves upward and toward the wall of the peritoneum. The caecum with the process moves up and to the side - a trap for the careless surgeon.

The contractility of the smooth muscles of the intestine decreases, probably under the influence of progesterone, which often leads to constipation. The tendency to constipation may be exacerbated by increased absorption of water in the colon. Often bile stasis is formed, which leads to cholestatic jaundice. The acidity of the gastric juice decreases.

Pregnancy during its normal course usually does not cause any significant changes in the liver. Histologically, an increase in the content of glycogen and fatty deposits in the liver cells were 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 also affects 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 stretching of the feet in pregnant women. Skeletal muscle tone is slightly reduced, 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 the enlarged uterus. This lordosis can increase back pain. Lordosis is aggravated if a woman walks in 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 abdomen and thighs. At first they are pink, but then they become pale and more compacted. They are thought to be caused by separation of the elastic layer of the skin from other layers due to increased levels of circulating adrenal hormones. They are called pregnancy stripes (striae gravidarum). Sometimes there are birthmarks.

Increases the intensity of the sebaceous and sweat glands.

Nervous system

From the moment of the onset of pregnancy, the flow 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 up to 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 the relaxation of the uterus and the normal course of pregnancy. Before childbirth, the excitability of the spinal cord and the nervous elements of the uterus increases, creating favorable conditions for the onset of labor. The tone of the autonomic nervous system changes, in connection with which pregnant women often experience drowsiness, tearfulness, irritability, sometimes dizziness and other disorders. Usually these phenomena gradually disappear with the growth of pregnancy.

Metabolism.

During pregnancy, basal metabolic rate and oxygen consumption increase. The basal metabolic rate for a healthy non-pregnant woman is approximately 2300 calories per day. During pregnancy, the basal metabolic rate increases by about 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 fat and one third by carbohydrates. Proteins provide only 6.5% of energy, as they are used almost exclusively for tissue formation.

In the body of a woman, protein substances are accumulated that are necessary to meet the needs of a growing fetus in amino acids.

Changes in carbohydrate metabolism lead to the accumulation of glycogen in the cells of the liver, muscles, uterus, placenta. Carbohydrates pass to the fetus in the form of glucose, which provides the energy needs of the fetus, 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 an energy material, as well as for building tissues.

During pregnancy, the needs of the pregnant woman's body 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 total weight gain during pregnancy is normally 12 kg. One third of the increase, 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. 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. By the time of delivery, the fetus and amniotic fluid together weigh about 5.5 kg, and this mass is lost after childbirth. The remaining 6.5 kg fall on the share of the uterus, mammary glands, 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 urine output resulting from the cessation of placental hormones, it continues to gradually decrease over the next 3 months or so.

Tests for self-control .

    The volume of circulating blood during pregnancy increases by:

Doesn't change at all.

2. Physiological hypervolemia of pregnant women occurs at the time:

20-22 weeks pregnant

- *34-35 weeks of pregnancy

38-39 weeks pregnant

16-15 weeks of pregnancy.

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

4. Total oxygen consumption by the end of pregnancy:

- *increases

Decreases

5. Normally during pregnancy it is noted:

- *acceleration of breathing

Decreased breath

The respiratory rate does not change.

6. Physiological glucosuria during pregnancy is spoken of at 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:

Chorionic gonadotropin

Placental lactogen

melanocyte-stimulating hormone

* placental insulin.

9. Formation of glucocorticoids during pregnancy:

- *intensifies

Decreases

Does not change significantly.

10. The total weight gain during pregnancy is normally:

11. The main function of chorionic gonadotropin is:

- * maintaining the function of the corpus luteum

Initiation of implantation

Initiation of breast development

Determination of fetal viability.

During pregnancy, a woman's body undergoes significant physiological changes that ensure the proper development of the 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 an exacerbation of chronic diseases and the development of complications. That is why you should register at the antenatal clinic as early as possible, go through all the necessary specialists and pass tests. This will allow you to take adequate preventive measures and prepare for childbirth.

Heart

The cardiovascular system during pregnancy performs more intense work, as an additional placental circle of blood circulation appears in the body. Here the blood flow is so great that every minute 500 ml of blood passes through the placenta. The heart of a healthy woman during pregnancy easily adapts to additional loads: the mass of the heart muscle and cardiac output of blood increase. To meet the growing needs of the fetus in nutrients, oxygen and building materials, the volume of blood in the mother's body begins to increase, reaching a maximum by the 7th month of pregnancy. Instead of 4000 ml of blood, 5300-5500 ml circulates in the body now. 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 a specialized maternity hospital.

Arterial pressure

Blood pressure during a normal pregnancy practically does not change. On the contrary, in women who have its increase 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 mm Hg. This is due to a decrease in the tone of peripheral blood vessels under the action of the hormone progesterone.

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

Lungs

Due to the increase in the woman's body's need for oxygen during pregnancy, the activity of the lungs increases. Despite the fact that as pregnancy progresses, the diaphragm rises and restricts the respiratory movements of the lungs, their capacity increases. This is 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 facilitates the removal of used oxygen by the fetus through the placenta. The respiratory rate does not change, remains 16-18 times per minute, slightly increasing towards the end of pregnancy. Therefore, if shortness of breath or other respiratory disorders occur, a pregnant woman should definitely consult a doctor.

kidneys

The kidneys during pregnancy function with great stress, as they remove the metabolic products of the pregnant woman herself and her growing fetus from the body. The amount of urine excreted varies depending on the amount of liquid drunk. A healthy pregnant woman excretes an average of 1200-1600 ml of urine per day, while 950-1200 ml of urine is excreted during the daytime, 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, therefore, in pregnant women, an exacerbation of pyelonephritis often occurs. An infection of the urinary tract is indicated by 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, the expansion of the pelvis and cups due to excessive accumulation of urine in them.

Digestive organs

In the first 3 months of pregnancy, many women experience changes in the digestive organs: nausea and often vomiting in the morning (signs of early toxicosis), taste sensations change, and an attraction to 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 intestine is pushed up by the pregnant uterus, the stomach is also shifted upward and squeezed, while part 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 antacids (for example, Maalox, Rennie), eat 2 hours before bedtime, and position in bed with a raised head end.

The liver during pregnancy works with a greater load, as it neutralizes the metabolic products of the woman herself and the fetus.

joints

During pregnancy, women experience some looseness in the joints. 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 there is a slight divergence of the pubic bones. Then the pregnant woman has pain in the womb, a "duck" gait. This should be reported to the doctor and receive appropriate recommendations.

Mammary gland

During pregnancy, the mammary glands are prepared for the upcoming feeding. They increase the number of lobules, adipose tissue, improves blood circulation. The mammary glands increase in size, the nipples become rough.

Sex organs

The greatest changes during pregnancy occur in the genitals and concern mainly the uterus. The pregnant uterus is constantly increasing in size, by the end of pregnancy its height reaches 35 cm instead of 7-8 cm outside of 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 about 500 once. The change in the size of the uterus occurs due to an increase in the size of muscle fibers under the influence of placental hormones. Blood vessels expand, their number increases, they seem to braid the uterus. Irregular contractions of the uterus are observed, which become more active towards the end of pregnancy and are felt as a "squeeze". These so-called Braxton Hicks contractions, which are normal from the 30th week of pregnancy, are considered as training before the real contractions in childbirth.

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

Weight gain

The growth of the fetus and physiological changes in the body of a pregnant woman 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 delivery - 340 + 30 g. In women with underweight before pregnancy, weekly weight gain may be even more.

Psychology of a woman

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

A woman's attitude to pregnancy and childbirth is influenced by various factors, including social, moral and ethical, economic, etc., as well as the characteristics of the personality 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 directed to the well-being of the fetus. A woman can address a child with affectionate words, she fantasizes, endowing him with individual characteristics. Along with this, many women deliberately give up certain attachments and habits for the sake of the upcoming motherhood.

Also, pregnant women may have various fears and fears. During this period, a woman may be concerned about changes in appearance, loss of attractiveness, 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. With severe anxiety, a depressed state of a pregnant woman, it is recommended to seek advice from a specialist.

Pregnancy this is a normal (physiological) process that occurs in a woman's body during fetal development. During pregnancy, a woman's body undergoes profound transformations. With the normal development of pregnancy, all the changes that take place in a woman's body are aimed at creating a harmonious relationship between the mother's body and the body of the developing fetus. Also, from the very first days of pregnancy, the body of a pregnant woman begins to prepare for future childbirth and breastfeeding.

Below we will consider in more detail the most important changes in a woman's body during pregnancy, as well as their significance for normal evolution of pregnancy itself, childbirth and the period of breastfeeding.

Body systems that undergo changes during pregnancy
From the very first days of pregnancy, the body of a pregnant woman undergoes profound transformations. These transformations are the result of the coordinated work of almost all body systems, as well as the result of the interaction of the mother's body with the child's body.

Changes in the nervous and endocrine systems
The nervous and endocrine systems play the main roles in the implementation of the transformations of the female body during pregnancy.

At the level central nervous system(brain and spinal cord), complex nervous mechanisms are launched aimed at maintaining the constancy of substances in the body of a pregnant woman necessary for the normal development of the fetus. For example, it has been noted that up to the 39th week of pregnancy, impulses coming from the sensitive receptors of the uterus are blocked at the level of the spinal cord, which allows the preservation of pregnancy and prevents premature birth. Changes in the central nervous system lead to some changes in the mood and behavior of a pregnant woman. Especially in the first weeks of pregnancy, a woman may notice increased irritability, fatigue, drowsiness - all these are defense mechanisms developed by the central nervous system to prevent excessive fatigue of a pregnant woman. Changes in smell (intolerance to certain odors), taste and gastronomic preferences, as well as incoming nausea, vomiting and dizziness are associated with a change in the tone of the vagus nerve (the nerve that regulates the functioning of most of the internal organs).

It is well known that the nervous and endocrine systems are in close interaction. This interaction is especially clear during pregnancy, the normal course of which is the result of the interaction of these two systems. The inclusion of the endocrine system in the development of pregnancy takes place even before the moment of fertilization. The normal functioning of the hypothalamus (the center of the brain responsible for transmitting nerve signals from the nervous system to the endocrine system), the pituitary gland (the central human endocrine gland) and the ovaries (the sex glands of the woman's body), make it possible for the development of the egg and prepare the female reproductive system for fertilization. From the first days of pregnancy until the 10th week, the development of pregnancy is supported by hormones secreted by the ovaries. During this period, there is an intensive growth of the placenta of the fetus. The placenta, as you know, in addition to the role of nutrition of the fetus, also carries out the synthesis of hormones necessary for the normal development of pregnancy. The main hormone of the placenta is estriol (it is also called the protector of pregnancy). This hormone stimulates the development of blood vessels and improves the supply of oxygen and nutrients to the fetus.

In smaller quantities, the placenta synthesizes estrone and estradiol. Under the influence of these hormones, the genital organs of a pregnant woman grow: the uterus, vagina, mammary glands, an increase in the volume of circulating blood in the mother's body (to improve the nutrition of the fetus). In case of violation of the functioning of the placenta (during various diseases of the mother or fetus), abortion or impaired fetal development (underdevelopment).

Also, the placenta synthesizes progesterone, which stimulates the development of the mammary glands and prepares them for lactation. Under the action of progesterone, the muscles of the uterus and intestines relax. Progesterone has an inhibitory effect on the nervous system, determining the drowsiness and fatigue described above. The effect of progesterone on the development of adipose tissue of a pregnant woman is important. The storage of nutrients in adipose tissue during pregnancy is necessary to ensure fetal nutrition and milk production in the postpartum period.

In addition to hormones synthesized in the placenta, various hormones produced by the endocrine system of the mother's body play an important role. It should be noted that at the initial stages of development, the fetal body is not able to synthesize many hormones, but they come to it from the mother's body. For example, thyroid hormones are an extremely important factor in fetal development. These hormones stimulate bone formation, brain growth and development, and energy production. To meet the needs of the fetus, the mother's body synthesizes large amounts of hormones.

Various incoming changes, such as skin pigmentation and an increase in the width of bones and facial contours, occur due to the action of the pituitary gland of a pregnant woman, which synthesizes melanotropin (a hormone that stimulates the production of skin pigment) and somatotropin (a hormone that stimulates body growth).

Changes in the metabolic process
Metabolic changes during pregnancy are aimed at meeting the needs of the developing fetus. It is clear that for the normal course of metabolism, and, consequently, the development of the fetus, the normal functioning of metabolic processes in the mother's body is necessary.

To increase the amount of assimilated food, the mother's body produces more digestive enzymes. At the level of the lungs, oxygen saturation increases. This is mainly due to an increase in the number of red blood cells, and an increase in the content of hemoglobin in them.

In the blood of a pregnant woman, there is an increase in the concentration of glucose and insulin, as well as fatty acids, proteins and amino acids. All these nutrients pass through the placenta into the blood of the fetus, thereby providing the developing organism with material for growth and development.

It is important to change the metabolism of minerals in the body of a pregnant woman. There is an increase in the concentration in the blood of many minerals: iron, calcium, phosphorus, copper, cobalt, magnesium. Like nutrients, these elements enter the blood of the fetus through the placenta and are used by the growing body for development.

During pregnancy, the woman's body's need for vitamins increases. This is due to the intensification of metabolic processes, both in the body of a pregnant woman, and with the fact that part of the vitamins from the mother's body passes into the body of the hearth and is used by them for their own development.

Changes in internal organs during pregnancy
During pregnancy, many internal organs undergo significant restructuring. These changes are adaptive in nature, and, in most cases, are short-lived and completely disappear after childbirth.

The cardiovascular system mothers during pregnancy are forced to pump more blood to ensure an adequate supply of nutrients and oxygen to the fetus. In this regard, during pregnancy, the thickness and strength of the heart muscles increase, the pulse and the amount of blood pumped by the heart in one minute increase. In addition, the volume of circulating blood increases. In some cases, blood pressure increases. The tone of blood vessels during pregnancy decreases, which creates favorable conditions for increased supply of tissues with nutrients and oxygen.

All of the above changes in the cardiovascular system completely disappear after childbirth.

Respiratory system works hard during pregnancy. The respiratory rate increases. This is due to an increase in the need of the mother and fetus for oxygen, as well as in the limitation of the respiratory movements of the diaphragm due to an increase in the size of the uterus, which occupies a significant space of the abdominal cavity.

The most significant changes, however, occur in the genitals of a pregnant woman. These changes prepare the woman's reproductive system for childbirth and breastfeeding.

Uterus pregnant woman increases significantly in size. Its mass increases from 50 g - at the beginning of pregnancy to 1200 g - at the end of pregnancy. The volume of the uterine cavity by the end of pregnancy increases by more than 500 times! The blood supply to the uterus is greatly increased. In the walls of the uterus, the number of muscle fibers increases. Cervix filled with thick mucus that clogs the cavity of the cervical canal. Fallopian tubes and ovaries also increase in size. In one of the ovaries, there is a "corpus luteum of pregnancy" - a place for the synthesis of hormones that support pregnancy.

The walls of the vagina loosen, become more elastic.

external genitalia(small and large labia), also increase in size and become more elastic. The tissues of the perineum are loosened. In addition, there is an increase in mobility in the joints of the pelvis and a divergence of the pubic bones. The changes in the genital tract described above are of extremely important physiological significance for childbirth. Loosening the walls, increasing the mobility and elasticity of the genital tract increases their throughput and facilitates the movement of the fetus through them during childbirth.

Leather in the genital area and along the midline of the abdomen, it usually becomes darker in color. Sometimes "stretch marks" (striae gravidarum) form on the skin of the lateral parts of the abdomen, which after childbirth turn into whitish stripes.

Mammary gland increase in size, become more elastic, tense. When pressing on the nipple, colostrum (first milk) is released.

The body weight of a pregnant woman increases in size. Normal weight gain at the end of pregnancy is 10-12 kg. Or 12-14% of the body weight of a pregnant woman.

All the changes described above that occur during pregnancy should be distinguished from the signs of the so-called "imaginary" or "false pregnancy". A false pregnancy occurs when a non-pregnant woman is convinced that she is pregnant. This situation is observed in some cases in patients with mental or endocrine disorders. At the same time, the power of a woman's self-hypnosis is so great that some physiological changes characteristic of a real pregnancy occur: an increase in the mammary glands, the appearance of colostrum, the disappearance of menstruation. Examination of the patient helps to establish the diagnosis and recognize a false pregnancy. It is also important to recognize a false pregnancy from a simulated pregnancy, in which a woman knows that she is not pregnant, but based on some considerations, she tries to convince others of the opposite.

Bibliography:

  • Kokhanevich E.V. Topical issues of obstetrics, gynecology and reproduction, M Triada-X, 2006
  • Savelyeva G.M. Obstetrics, Medicine, M., 2000
  • Carr F. Obstetrics, gynecology and women's health, MEDpress-inform 2005