Physiological and psychological changes during pregnancy. Useful tips for future moms. Changes in the nervous system in the body of a woman during pregnancy

From the moment of pregnancy, in the understanding of the specialist - since the implantation of fertilized yicexket (zygotes) in the tissue of the parent organism, in the body of a woman arises a set of changeswhich covers the functions of all organs and systems, is regulated by the central nervous system, it is observed throughout the pregnancy and is within the physiological borders, characteristic only of pregnancy.

The set of changes includes:

• termination of menstruation (changes in the mucous membrane of the uterine cavity caused by a change in the functional state of the ovary)
• long-term increase in rectal temperature (influence of progesterone - ovarian hormone on the center of thermoregulation in the brain)
• formation of the placenta - a new endocrine gland
• changing the appearance of a woman
• the emergence in the cerebral cortex of pregnancy, which ensures clear coordination of the functions of all organs and systems in the interests of the developing fetus
• changes in the function of the pituitary gland, adrenal glands, thyroid, parathyroid and pancreas
• changing the uterus (the greatest changes compared to other organs)
• changing the kidney function, liver, gastrointestinal tract
• change of metabolism
• changes in hematologic (blood) and hemodynamic (blood flow) indicators
• changes in circulating blood
• change of hemostasis system (bleeding stop): change in coagulation system (coagulation) and fibrinolysis (dissolution, anticulate)
• changes in the exchanging of iron, folate metabolism (folic acid)
• changes in the work of the cardiovascular system
• changes in colloid-osmotic state, etc, etc.

That is, with the onset of pregnancy, your body begins to completely rebuild its work.
He is preparing to endure the fruit, give birth and focus the child.
Therefore, such a restructuring is a normal condition for a pregnant woman.

The condition of any person doctor controls the laboratory and instrumental research.

• Healthy person - It has some indicators (the numbers you see on the analysis form are norms), for example, blood indicators, urine, etc.
• For a sick person - There are their indicators, they vary depending on the state of the patient and its disease
• Pregnant woman - is a song. She, like a person's patient, depending on the state, its normal indicators characteristic of physiological pregnancy. Moreover, in different trimesters of pregnancy, each indicator has its own norm, and these norms for a pregnant woman do not coincide with the norms for a healthy person.

  Moreover, sometimes what is the norm for a pregnant woman, a non-remote woman is estimated at the pathology. And for a man - generally deadly, they do not live with that.

Dear male loving husbands!

Remember that your pregnant wife is all the time while she puts out your child, is a "hard sick" man. That is why a loving husband should not allow the overwork of his wife "by farm". Well, what a patient man makes working. The patient is creating the most favorable conditions so that he recovered faster. A pregnant woman needs to create favorable conditions so that it can safely endure and give birth to a child, i.e. In order for her body to be able to qualitatively adapt to changing conditions with the development of pregnancy (the baby grows, develops, eats, "breathe", etc. - conditions are constantly changing).

If the body does not be able to adapt normally, then it has various unfavorable, first of all, for a child of the state. For a woman, this is also unfavorable states. In especially difficult cases, pregnancy donate for the salvation of a woman, because Abortion of pregnancy with this state immediately leads to recovery (conditional to recovery), but your child will not be on the light.

Take care of women always! And during pregnancy, especially!

Fetoplazater system - as a new endocrine iron.

After the implantation of the zygotes in the uterine cavity (we consider with you the normal development of pregnancy, but, in principle, the newly endocrine iron begins to form a new endocrine iron - placenta (child seat) in principle.

The placenta has two parts: the fruit and maternal, the blood circulation of which is never mixed. These parts of the placenta are as close as possible, which allows the exchange of substances between the organism of the mother and the fetus, i.e., in fact, allows the child to "eat, write and breathe", and, it means to grow and develop.

The exchange of substances between the organism of the mother and the fetus is the main factor for its development. Exchange due to the permeability of the placenta, which is violated with most of the sharp and chronic complications during pregnancy. Violation of the integrity of the parts of the placenta and the deterioration of its permeability leads to the death of the fetus and the cessation of pregnancy.

The death of the fetus and the cessation of pregnancy is possible and for another reason when the mother's organism suddenly decides that the fruit is a foreign protein for him. But this is actually so. However, nature has provided a protective mechanism that does not allow the Mother's immune system to recognize the antigens of paternal origin, laid down in the child (and we remember from school that half chromosomes the child receives from the mother, and the second half of the father).

This protective mechanism is some factors blocking the immune system of the mother and providing local immunological comfort. With spontaneous abortions, blocking factors in the blood of the mother are reduced or absent.

The placenta produces a wide range of hormones and specific proteins that enter the blood of the mother and in amniotic fluid. They regulate the normal course of pregnancy and the development of the fetus by changing the function of other endocrine glands, the exchange and allocation organs, the function of the nervous system and the body as a whole.

In terms of hormones and specific proteins, the placenta defined in the blood of the mother, in the blood of the fetus or in amniotic fluid, it is possible to evaluate the state of the fetus and the function of the placenta than and the obstetric endocrinology is engaged. Thus, the study of the endocrine function of the fetoplacentar complex allows to significantly improve the diagnosis of the state of the fetus at various times of pregnancy, to carry out the antenatal therapy or early delivery in the interests of the newborn.

The appearance of a new endocrine gland leads to other changes in the female organism.

The appearance of a woman's appearance changes.
Appears:

• pigmentation of skin (forehead, cheeks, chin, upper lips, white lines of abdomen, nipples and near-block zones), which is associated with a significant stimulation of pigment formation by skin cells. The formation of pigment depends on the adrenal melanoform hormone, the increased products of which takes place during pregnancy.
• there is a subfebrile body temperature, which can continue until 16-20 weeks of pregnancy and is associated with hormonal oscillations. Increasing the basal (rectal) temperature is the early diagnostic symptom of pregnancy (production of progesterone with a yellow body of pregnancy).

  Since the start of progesterone production, the flooding temperature decreases and comes to normal.

• it is noted heat and soreness of the breast due to an increase in its volume as a result of the growth of iron tissue, an increase in the nipples and the absorption of the amaralar glands. In the second half of pregnancy, a colostrum can be selected.
• violation of the proportions of the face (increasing the nose, lips, chin, thyroid gland, especially in the second half of pregnancy), some increase in limbs
• stretching the fabrics of the front abdominal wall, the breast, the hips and the occurrence of Strya ("Pregnant bands") on these sites (Stria Gravidarum). Their occurrence is associated with excessive stretching of the abdominal wall; This is more often observed in individuals with a large abdomen (large fruit, multi-way, multipleness) or with some lack of elastic fibers in the skin.

  The scars of pregnancy usually appear at first pregnancy. Fresh plots have cyanotic color due to translucent of small vascular formations

• it is aggravated or for the first time the varicose veins is manifested, especially lower extremities
• The "proud posture and gait" of a pregnant woman is due to the displacement of the center of gravity of the body, an increase in the mobility of the pelvic joints and the restriction of the mobility of hip joints.
• Progressive increase in body weight, which is due to both the growth of the fetus and the uterus and the peculiarities of metabolic processes, a fluid delay in tissues. Average body weight gain over a pregnancy period is 10-12 kg, of which 5-6 kg fall on a fruit egg (the fruit, the last, the breakfod fluid), 1.5-2 kg to an increase in the uterus and the mammary glands, 3-3.5 kg - on the increase directly mass of the body of a woman.

  Before childbirth (for 3-4 days), the mass of the body of a pregnant woman falls at 1.0-1.5 kg, due to the features of metabolic processes.

The structure of the external (and internal) genital organs changes

• exterior genitals become edema and hyperemic. Cyanosis of the mucous membranes of the vaginal part of the cervical cervix, the vagina and its run-up, indicates the expansion of blood vessels and blood, facilitating the serous impregnation of tissues required to deposit nutrients at the site of attachment of the fetal egg to the uterine wall
• the vagina during pregnancy is somewhat expanding and lengthens. Walls of vaginal edema and thickened. The separated becomes a more abundant, mucous membrane, milk-white or yellowish color with an acidic reaction. In a healthy pregnant woman, the vagina has i-hard cleaning of purity.

The uterus during pregnancy varies to the greatest extent compared to other bodies.
Its dimensions increase during pregnancy in all respects:

• mass - from 50-100 g to 1000-1200 g,
• length - from 7-9 cm to 38-40 cm,
• front factor size - from 2-3 cm to 23-25 \u200b\u200bcm,
• transverse size from 3-4 cm to 25-26 cm,
• volume - 500 times, reaching 2000 cm 3 or more.

Accordingly, changes occur in all tissues, blood supply and innervation of the uterus:

• The form and position of the uterus during pregnancy change. The uterus as it grows out of a small pelvis in the abdominal cavity, climbing on the 9th month of pregnancy to a sword-shaped process. The form of the uterus asymmetric by blowing the part where the placenta is attached.
• Thin arteries and veins of uterine are converted into powerful trunks that become corkscrewly winding, which allows you to maintain normal blood supply to pronounced changes in the uterus during pregnancy and when cutting it in childbirth
• The volume of blood circulation in the uterus during pregnancy increases in tens of times, providing uterine-placental blood flow, which is carried out on the principle of blood supply to vital organs and remains relatively optimal even with various stress (blood loss, anemia). This ensures the survival of the fetus in extreme situations
• The receptor system of the uterus changes: in the process of pregnancy, the sensitivity of the uterus to the exciting factors is reduced, before childbirth, the excitability of the uterus increases, part of the nerve structures is lost in order to reduce pain information from the uterus in childbirth.

With the advent of the placenta in the cerebral cortex, dominant pregnancy occurs, which provides clear coordination of the functions of all organs and systems in the interests of a developing fetus.

Women note a decrease in working capacity, an increase in drowsiness or vice versa, they are irritated, they have nausea, saliva, periodic vomiting, which refer to a light degree and the occurrence of which corresponds to the phase of functional shifts in the nervous system (neurosis phase).

During this period, expensive husbands, your wife is extremely necessary. Increased attention and care: Wear it breakfast in bed, feed your favorite meal and perform all her whims, all the same neurosis phase.

Pregnant women enhances the impression and self-abscess, which is taken into account when conducting psychoprophylactic preparation for childbirth.

Parastusia phenomena, neuralgic pain, muscle split groups, finger numbers and other disorders may occur. An increase in the excitability of peripheral nerves is also manifested by the amplification of knee reflexes.

With all this, sexually excitability decreasesAnd you, dear husbands, must be prepared for this. Do not, in no case !!! (Remember the increased suggestibility and self-sufficiency) Do not show your offense that the wife is cold to you and is inattentive, and therefore it swollen. She also loves you, she already hatches your child and she has a dominant in the cerebral cortex - to endure pregnancy in order for anything. And there is nothing to go anywhere.

But if you, in favor, try to overcome this dominant, then ensure pregnancy in some cases will be no one.

The pregnant woman changes the functions of some analyzers - hearing, vision, smell. The smell of a pregnant woman can increase so much that the woman will respond to the easiest (weakly catchy) smells, brought by a loved husband as a result, say, made of prehensions.

I foresee the righteous wrath of husbands. But I hurry you assure that your beloved wife will think that is very unlikely, which is different. Alien smell from you, but if this smell will be associated with female (let at least at work you went to the director and stood next to the secretary or she with you, nearby, in the cloud of spirits), an increased self-impression of pregnant woman will finish his black business.

You will consider dear men, when a woman is bad, sick and in general the world in gray tones, for some reason, for some reason, for some reason, who can lead to a deterioration in the state and, as a result, to interrupt pregnancy.

During pregnancy, the changes affect other organs

Adrenal glands During pregnancy, the glucocorticoid and mineralocorticoid function of the adrenal glands increases in size due to hyperplasia, accordingly the glucocorticoid and mineralocorticoid function of adrenal glands.

Strengthening the function of the adrenal cortex during pregnancy is aimed at increasing the defensive and adaptive mechanisms, including in childbirth.

Thyroid - increases in volume, the function rises. There is a goiter for pregnant women, especially in endemic zones (little iodine in soil and water) and hyperthyroidism without thyrotoxicosis. Strengthening the function of the thyroid gland is associated with the influence of the placenta hormones on it. Clinical thyrotoxicosis is not evolving due to an increase in the binding of summand hormones with plasma proteins. The protein-related hormone shape is further utilized by the fruit and the organism of the mother, since the need for it with the development of pregnancy, prior to the start of the fetal thyroid function, increases.

Porish-shaped glands (Calcium exchange) are exposed to hypertrophy, their functional activity increases due to the increase in calcium requirement, which is plastic material for the formation of the fetal musculoskeletal system. With a lack of its admission or impairment of absorption, the fruit receives calcium from the tissues of the maternal organism (bone, teeth), which can manifest itself with osteoporosis, fragility and caries of teeth. In the process of pregnancy, the concentration of calcium in the blood rises. The blood plasma decreases the content of phosphate compounds, iron and a number of trace elements (cobalt, iodine, manganese, copper). The deficit of these substances is due to the needs of the fetus and the strengthening of metabolic reactions, which include some of the micro and macroelements.

Pancreas - Strengthening the function of the insulin production machine. As a result, carbohydrates are absorbed very well and postponed in the liver of the mother and in the tissues of the fetus. In women with diabetes, large children are always born due to the utilization of the fruit of excessive carbohydrates. Part of the pregnant women there is glucosuria (sugar in the urine), which does not carry a pathological nature and manifests itself with a normal or even low content of carbohydrate blood.

Pituitary In pregnant women increase in volume and is difficult to fit in a Turkish saddle, there is a hyperproduction of growth hormone (STG), which, penetrating through the placenta, stimulates the growth of the embryo. This hormone also has an effect on the lactogenic function of the breast, causes in some cases an increase in the nose, lips, fingers. An increased secretion is noted by the pituitary gland of all trop hormones, although some of them can form a placenta (LH, ACTH).

Effect of pregnancy for kidney function

Renal blood flow increases and glomerular filtration increases (mascase in the middle of pregnancy) - connected with the elimination of the products of the sharing of the woman itself and the fetus.

The permeability of the kidneys for protein and carbohydrates increases (proteinuria (protein in the urine), glucosuria and lactosuria - lactose, unlike glucose, is not absorbed by the kidney channels).

The release of 140 mg / day glucose with urine is considered the upper boundary of physiological glucosuria. Glucose release peak is detected at the IX month of pregnancy.

The peristaltic function of the ureters is sharply suppressed, as a result of which they expand and the urine is delayed. Atonia ureterals leads to a violation of urine's leading from pelvis, which creates favorable conditions for the development of Pelitis of pregnant women. In the postpartum period, the specified phenomena will soon disappear.

Effect of pregnancy on liver function

The liver during pregnancy is in a state of high functional voltage. However, in healthy women in the physiological course of pregnancy, the functioning of the liver is not violated.

Notes

• minor liver increase in size in the absence of severe histological changes
• there is a decrease in antitoxic liver function.
• the level of serum protein is reduced, 60 g \\ l can reach childbirth
• albumin's relationship is changed to globulin. These changes occur due to a decrease in albumin levels and an increase in the content of alpha and beta globulins, the level of gamma globulin is reduced.
• The result of changes in serum proteins is an increase in SE
• Blood coagulation changes and fibrinolysis. These changes contribute to improving blood coagulation
• Part of women with normal pregnancy has palm erythema or phetechial hemorrhages. They are not considered a manifestation of liver damage, but are only a clinical symptom of increased concentration of estrogen and disappear in 5-6 weeks after delivery.

The function of the gastrointestinal tract.

There are changes in the function of the gastrointestinal tract. A number of women have a perversion of taste sensations by the type of disgust for certain types of food (meat, fats), the appearance of taste, the desire is even clay, chalk), an increase in appetite, and in some cases its decline. Due to the reduction of gastric secretion, the asseacitor ability of the stomach slows down. The intestinal function in pregnant women is characterized by a decrease in tone and a decrease in intestinal peristaltics, which determines the tendency to bloating abdomen, constipation, hachelor's disease. The intestinal atony may cause pathological conditions (intestinal obstruction).

Metabolism.

It is characterized by an increase in metabolic processes with some prevalence of assimilation over the dissimulation.

• The main exchange and consumption of oxygen rises, especially in the second half of pregnancy and in childbirth.
• Changes in water and electrolyte metabolism are characterized by a delay and an increased content of intravascular and intercellular fluid.
• The need for the assimilation of calcium, phosphorus, iron and other inorganic substances increases.
• In protein exchange, a positive nitrogen balance is noted (it is allocated from the nitrogen body less than being consumed with food). Excess nitrogen is spent on plastic processes in the uterus, breast and other tissues of generic pathways. During pregnancy, specific proteins (alpha-fetoproteins, etc.) appear.
• The carbohydrate exchange is characterized by an increase in blood glucose, and when the organism is overloaded with carbohydrates - the appearance of it in the urine (glucose). The depot for glycogen is not only the liver and muscles, but also placenta and uterus. During pregnancy, there are hidden forms of diabetes.
• In the blood, the content of lipids and cholesterol increases, but the pathological manifestation of this state is not observed. Enhanced fat deposition is noted with the characteristic distribution of it in subcutaneous tissue, lactic glands, the lower part of the abdomen, hips, buttocks. Lipids are consumed to build the tissues of the body of the mother and fetus, are also an energy material. In the bile, cholesterol decreases.

  Pregnant women have a tendency to dismiss the energy exchange between carbohydrates and fats, in connection with which the products of impaired metabolism (oil acid, acetoid, acetone) can accumulate.

• During pregnancy, there is an increased need for vitamins (A, B, D, C, E, K, PP).
• Some women in connection with pregnancy increases sweating and the release of liquid salts from the vagina, which is a mixture of mucus and transduce of the vascular network of genital organs.

The manifold of external and internal changes in the body of a woman is growing with an increase in the period of pregnancy, characteristic only of pregnancy and are aimed at creating optimal conditions for the development of the fetus and the flow of the generic act. That is why the norms peculiar to non-embled women can not be transferred to pregnant women.

Each trimester of pregnancy is characteristic of its norms. The knowledge of the norms allows to avoid unreasonable actions that can cause a violation of dynamic physiological equilibrium established between the fruit and the organism of the mother and the emergence of pathological ("conflict") states that may end the death of both the fetus (more often) and the mother (less often).

Thus, we have high, that with the development of a new endocrine gland in the body and the beginning of the production of hormones and specific proteins, the body of women under their action begins to stop and change themselves.

I pay again your attention to the fact that all these changes arise as a result of a complex restructuring due to the advent of the new endocrine gland - placenta.

According to change, how to say, in some cases not particularly good (it's how to get sick), woman's bodylike a patient human body includes adaptation mechanisms. Only in the patient, they are aimed at recovery, and in a pregnant woman to preserve pregnancy, which will not be able to keep the patient.

If the adaptation mechanisms are not included in the work in full force, then we will get a "full gentle set" of the kind of disadvantaged course of pregnancy and complications in childbirth.

Why can they not be engaged in work in full force?

The answer lies in the history of the life of a woman and the history of its diseases: often a girl was sick, there are chronic diseases - the probability of failure in the work of adaptation mechanisms is large.

That is why, at least eat, even if they are sitting in Holod, (only from where the body will take the "Stoying" material for his needs and the needs of the fetus? He will take it from his "stocks", he will "destroy" himself, will not be The income from the outside of nutrients on a hungry diet) is a little affects chronic or innate women's diseases, which are the cause of the failure of adaptation systems.

And which of this conclusion? Right: Prevention and treatment.

Do you think why pregnant visits the doctor every 2-3 weeks? The fruit is growing, pregnancy develops, the woman's body is stopped and then everything is stated above.

Do not self-medicate! But here's personal control over its condition must be carried out.

Table of contents of the topic "Fruit in certain periods of development. Lode as an object of childbirth. Changes in the body of a woman during pregnancy.":
1. Fruit in certain periods of development. Two (II) monthly fruit. The level of development of the two (II) monthly fetus.
2. The level of development of the three - six months of the fetus. Signs of three - six month old fetus.
3. The level of development of seven - eight months of fetus. The maturity of the newborn. Signs of maturity of a newborn.
4. Fruit as an object of childbirth. Fetal skull. Fetal skulls. Spring fetal skull.
5. The size of the fetus head. Small oblique size. Medium oblique size. Direct size. Big oblique size. Vertical size.
6. Changes in the body of a woman during pregnancy. System mother - fruit.
7. Endocrine woman system during pregnancy.
8. Nervous system of women during pregnancy. Gestational dominant.

10. Respiratory system of women during pregnancy. Respiratory volume of pregnant women.
11. Women's digestive system during pregnancy. The liver in pregnant women.

During pregnancy Significant changes in operation mother cardiovascular system. These changes make it possible to provide the intensity of the delivery of oxygen and diverse nutrients and removal of metabolic products necessary for the fetus.

The cardiovascular system Functions during pregnancy with high load. This increase in load is due to the enhancement of metabolism, an increase in the mass of circulating blood, development the uterine-placental circle of blood circulation, progressive increasing body weight of pregnant and a number of other factors. As the measurement of the uterus increases, the aperture mobility is limited, the inside-ribous pressure increases, the position of the heart in the chest (it is located more horizontally), on the top of the heart, some women occur a pronounced functional systolic noise.

Among numerous changes of cardio-vascular systeminherent in physiologically flowing pregnancy, first of all, it should be noted an increase in the volume of circulating blood (BCC). The increase in this indicator is already noted in the first trimester of pregnancy and in the future he increases all the time, reaching the maximum by the 36th week. The increase in the BCC is 30-50% of the initial level (before pregnancy).

Hypervolemia It occurs mainly due to an increase in blood plasma volume (by 35-47%), although the volume of circulating erythrocytes also increases (by 11-30%). Since the percentage increase in the volume of plasma exceeds the increase in the volume of red blood cells, the so-called pregnant physiological anemia. It is characterized by a decrease in the hematocrit (up to 30%) and the concentration of hemoglobin from 135-140 to 100-120 g / l. Since during pregnancy, a decrease in the hematocrit is observed, then a decrease in blood viscosity occurs. All these changes that have a pronounced adaptation nature provide maintenance during pregnancy and genera of optimal microcirculation conditions (oxygen transport) in the placenta and in such vital organs of the mother as CNS, heart and kidneys.

With normally prohibitive pregnancy systolic and diastolic blood pressure Reduced in the II trimester by 5-15 mm Hg. Peripheral vascular resistance is also usually reduced. This is mainly due to the formation of a blood circulation circle having low vascular resistance, as well as with an impact on the vascular wall of estrogen and progesterone placenta. Reducing peripheral vascular resistance together with a decrease in blood viscosity significantly facilitates the processes of hemocirculation.

Venous pressuremeasured on hand healthy pregnant women, it does not change significantly.

During pregnancy is observed physiological Tachycardia. The heart rate reaches a maximum of a trimester of pregnancy, when this figure is 15-20 per minute exceeds the source data (before pregnancy). Thus, the frequency of cardiac abbreviations in women in the late period of pregnancy is 80-95 per minute.

The most significant hemodynamic shift during pregnancy is an increase in cardiac output. The maximum increase in this indicator at rest is 30-40% of its magnitude to pregnancy. Heart emission starts to increase from the earliest time of pregnancy, while its maximum change is celebrated on the 20-24th week. In the first half of the pregnancy, the increase in cardiac emissions is mainly due to the increase in the impact volume of the heart, later - some increase in the frequency of heart abbreviations. The minute volume of the heart increases in part due to the impact on the myocardium of placental hormones (estrogen and progesterone), partly as a result of the formation of the uterine-placental circle of blood circulation.

Electrocardiographycarried out in the dynamics of pregnancy, allows you to detect the resistant deviation of the electrical axis of the heart to the left, reflecting the heart offset in this direction. According to echocardiography, there is an increase in the mass of the myocardium and the size of individual departments of the heart. When radiological examination, changes in the contours of the heart, resembling a mitral configuration.

Hemodynamic processes during pregnancy great influence, as already noted, has a new open-placental circle of blood circulation. Although the blood of the mother and the fetus is not mixed between themselves, the changes of hemodynamics in the uterus immediately reflect on blood circulation in the placenta and in the body of the fetus and vice versa. Unlike buds, CNS, myocardium and skeletal muscles, the uterus and the placenta are not able to maintain their blood flow at a constant level with changes in systemic blood pressure. The vessels of the uterus and the placenta have low resistance and blood flow in them passively mainly due to the oscillations of systemic blood pressure. In the late period of pregnancy, the vessels of the uterus are maximally expanded. The mechanism of neurogenic regulation of uterine blood flow is mainly associated with adrenergic influences. Stimulation of alpha adrenergic receptors causes the narrowing of the vessels and a decrease in the uterine blood flow. Reducing the volume of the uterine cavity (prenatal oral influence, the appearance of bruises) is accompanied by a decrease in the uterine blood flow.

Despite existence separate circles of blood circulation in the uterus and placenta (On the path of two blood flows there is a placental membrane), the hemodynamics of the uterus is closely associated with the system of blood circulation of the fetus and placenta. The participation of the capillary bed of the placenta in the blood circulation of the fetus lies in the rhythmic active pulsation of the Calion capillaries in constant peristaltic movement. These vessels with a changing blood volume cause alienation and reducing Vorsin and their branches. Such a movement of the Vorsin has a significant impact not only on the blood circulation of the fetus, but also on the circulation of maternal blood through the intervalic space, therefore the capillary bed of the placenta can be completely able to consider as a "peripheral heart" of the fetus. All these features of the hemodynamics of the uterus and the placenta are made to unite under the name "uterine-placental blood circulation."

Changes in the body of a woman during pregnancy worn adaptation-adaptive character and are aimed at creating optimal conditions for the growth and development of the fetus. Consider what these changes are in various organs and systems.

NERVOUS SYSTEM

The concept of the dominant of pregnancy (gestational dominant) was put forward: the corresponding focus of the excitement arises in the CNS after the oxygen fence and implantation in the mucous membrane of the uterus; At the same time, a permanent source of afferent impulsation from the interior of the uterus is formed.

In the first months of pregnancy, a decrease in the excitability of the cerebral cortex is observed, which leads to an increase in the reflex activity of subcortical centers, as well as spinal cord. In the subsequent excitability of the cerebral cortex increases and remains high to the end of pregnancy. By the time of birth, the excitability of the cerebral cortex decreases sharply, accompanied by an increase in the excitability of the spinal cord, which leads to an increase in the spinal reflexes, an increase in the nervous eflex and muscle excitability of the uterus necessary for the beginning of the generic activity.

The tone of the vegetative nervous system changes, in connection with which the pregnant women often observe drowsiness, plasticity, increased irritability, sometimes dizziness and other disorders. These violations are usually inherent in the early period of pregnancy and then gradually disappear.

ENDOCRINE GLANDS. Endocrine changes

Understanding complex endocrine changes during pregnancy remains quite schematic and incomplete. Many of peptide and steroid hormones, which are produced by endocrine glands outside pregnancy, can be synthesized by the fabrics located in the uterus during pregnancy.

With the start of pregnancy, the ovaries increase somewhat, ovulation in them is terminated; In one of the ovaries there is a yellow body. Hormone allocated to them (progesterone; to a lesser extent - estrogens; relaxing) contribute to the creation of conditions for the development of pregnancy. The yellow body is subjected to reverse development after the 3-4th month of pregnancy due to the formation of the hormonal function of the placenta; Next, the function of the yellow body is insignificant. In vivo.surgical removal of the yellow body up to 7 weeks pregnancy leads to a rapid decrease in the level of progesterone and miscarriage; If you delete later, it is possible to preserve pregnancy. The yellow body is also produced by a polypeptide hormone relaxin, inhibiting the activity of myometrium; After stopping the function of the yellow body, relaxing is synthesized in the placenta.

Placentait is an organ uniting the functional systems of the mother and the fetus. It performs the following main functions.

The respiratory function provides transport from the mother to the fetus of oxygen and isolation in the opposite direction of carbon dioxide. Gas exchange is performed according to the laws of simple diffusion. The placenta contains enzymes involved in oxidative and recovery processes, splitting and synthesis of proteins, fats and carbohydrates necessary for the development of the fetus.

Possessing limited permeability, the placenta is able to protect the fetus body from a number of damaging factors (toxic products, microorganisms, medicinal substances, etc.), but not from all, and many of them have a direct impact on the embryo and fruit.

The excretory feature of the placenta is to eliminate the organism of the fetus of metabolic products.

The placenta is a powerful iron of internal secretion, in which the processes of synthesis, secretion and the conversion of a row of hormones (Fig. 20) as steroid (gestagens and estrogens) and protein nature (gg, pl) are intensively processed.

Hormones produced in the uterus during pregnancy.

Hormones specific to pregnancy.

Hormones hypothalamus.

Cortikoliberin. Hormones pituitary gland.

Prolactin.

Somatotropic hormone.

Other peptide hormones.

Insulin-like growth factor I and II.

Parathyroid-like peptide.

Angiotensin II.

Steroid hormones (estrogens, progesterone).

1.25-dihydroxycholecalciferol.

There is a functional dependence between the placenta and the fruit, which is considered as a single endocrine system - a "fetoplacentar system", which has some autonomy to a certain extent. Fruits, placenta and mate participate in steroidogenesis

the rinsky organism, which complement each other in such a way that the fetoplacentage system is able to maintain the synthesis of all biologically active steroid hormones.

The main hormone of the fetoplacentage system is an estrilla, called pregnancy protector. It is 85% of all estrogen during pregnancy. Its main role is regulation of uterine-placental blood circulation, i.e. Supplying the fetus by all the vital substances necessary for normal growth and development.

Synthesis and metabolism of estrogen

The estriol is synthesized in the placenta from dehydroepyondrosterone-sulfate, which has formed in the fetus adrenal cortex and to a lesser extent - in the cortex of adrenalities of a pregnant woman. 90% of blood estriol in the blood has fruit origins and only 10% - maternal. Part of the estriol is in a free state in the blood of a pregnant and fetus, performing its protector function, part enters the liver of a pregnant woman, where, connecting with glucuronic acid, is inactivated. Inactivated estrilla is derived from a pregnant woman with urine. With complicated course of pregnancy, the secretion of estriol with urine can decrease, which was previously used as a diagnosis

the ticial sign of the disorder of the development of the fetus (with the advent of more specific biophysical methods there is no need for this).

In much smaller quantity than estrius, other estrogens are formed in the fetoplacentage system - estrone and estradiol. They have a diverse action on the body of a pregnant woman: regulate water-electrolyte metabolism, cause sodium delay, increasing the volume of circulating blood (BCC), extension of vessels and an increase in the formation of steroid-binding plasma proteins. Estrogens cause an increase in pregnant uterus, cervix, vagina, contribute to the growth of the mammary glands, change the sensitivity of the uterus to progesterone, which plays an important role in the development of generic activities.

Fig. twenty.The content of hormones in the blood at various times of pregnancy

The mechanism of interaction between the mother's organism, the placenta and the fruit is described as the "theory of placental hours". Starting from the middle of pregnancy, Trofoblast is able to synthesize the corticoliberin, which stimulates the pituitary gland to increase the level of ACTH, due to which the synthesis of dehydroepiyndrosterone is increasing, the main precursor of placental estrogen, fetal adrenal glands. The high level of estrogen by the end of pregnancy stimulates the formation of slut contacts between cells of myometrium, contributing to the excitation and generic activity. Synthesis corticole

berin regulates the content of estrogen on the principle of positive feedback.

Such a mechanism by which the placenta regulates its own metabolism, influencing the fruit, which in turn, acting on the function of the uterus, possibly launches childbirth, received the name of placental hours. We sometimes break this thin mechanism in the late induction of childbirth.

Hormonal changes during pregnancy are reflected in Table. 3.

Table 3.

Hormonal changes during pregnancy

The second important steroid hormone of pregnancy is progesterone. The concentration of progesterone in blood with progression of pregnancy is significantly rising. The hormonal function of the yellow body, synthesizing progesterone in the first trimester of pregnancy, gradually moves to the placenta, already from 10 weeks the maximum amount of progesterone is produced by trophoblast. 50% of progesterone comes to the fruit, where it is metabolized and is used to synthesize corticosteroids in the adrenal glands. The rest across a series of transformations goes into estriol. Progesterone causes changes in the organism of the mother, contributing to the emergence and development of the Bere-

change. Under its influence, secretory processes occur, which are necessary for implantation and the development of the fruit egg. Progesterone also contributes to the growth of the genital organs of pregnant, growth and preparation of the mammary glands to lactation, is the main hormone that reduces the contractility of myometrium, reduces the tone of the intestine and ureters, has an inhibitory effect on the central nervous system, causing pregnant sleepiness, fatigue, disruption of the concentration of attention, and In addition, it helps to increase the number of adipose tissue due to hypertrophy of fat cells (adipocytes). The Metabolite of Progesterone is allocated with the Urine - Pregnandiol.

The main protein hormones of pregnancy are chorionic gonadotropin (xg) and placental lactogen (pl). Hg - glycoprotein, is produced by chorion even before the formation of the placenta. According to its biological properties, it is similar to the LG pituitary, it helps to preserve the function of the yellow bodies of the ovary, affects the development of adrenal glands and the gonad of the fetus, affects the process of exchanging steroids in the placenta. Xg is found in the urine already on the 9th day after fertilization, reaches a peak of concentration to 10-11 weeks of pregnancy (about 100,000 units), and then its level remains constantly low (10,000-20,000 units). Currently, the definition of XG is used to diagnose the early periods of pregnancy and its disorders, as well as for the diagnosis of trophoblast diseases.

PL - polypeptide hormone, in its chemical and immunological properties is approaching the growth hormone of the front lobe of the pituitary gland and prolactin. It is synthesized in the syntside of the trophoblast. 90% of the hormone enters the blood of a pregnant woman, and 10% in the blood of the fetus and amniotic fluid. PL can be detected in the blood with 5 weeks of pregnancy. A long-lasting low level of prolactin or a sharp drop in the hormone level indicate a violation of the state of the fetus up to its antenatal death.

PL influences the metabolic processes that are aimed at ensuring the growth and development of the fetus. PL gives an anabolic effect, delays in the body of nitrogen, potassium, phosphorus, calcium; It has a diabetes effect. SL due to its anti-characterulin action leads to an increase in the glyconegenesis in the liver, a decrease in the body tolerance to glucose, amplifying lipolysis.

The placenta produces a number of other protein-peptide hormones, such as melanocystimulating hormone, relaxing, vasopressin,

oxytocin. Slitted with insulin and insulin-like growth factor, relaxing is secreted by a yellow pregnancy body, a placenta and deciidua Parietalis.In the first trimester, it is a synthesis of XG synthesis. In addition, relaxing performs the following functions: the relaxation of the uterus, shortening and softening the cervix, regulation of the uterine-placental blood flow, softening the articulation of the pelvis.

Clinical application has found methods for studying specific pregnancy proteins, for they are produced directly in the trophoblast placenta and reflect the functional state of the fetoplacementar system. Embryospecific protein is α -Fetoprotein (AFP), which is synthesized mainly by embryonic cells and in the yolk bag. In the embryos, the Synthesis of AFP begins simultaneously with the embryonic blood formation, and its concentration in the blood plasma increases from the 6-7th week of pregnancy, reaching a peak of 14 weeks. In clinical practice, the definition of AFP is carried out for the prenatal diagnosis of anomalies of the development of the nervous system and the gastrointestinal tract in the fetus.

The placenta performs important functions of the immunological protection of the fetus. One of the components of this system is a fibrinoid layer located on the surface of the Vorsin and prevents the direct contact of the fabrics of the fetus and mother. Some substances are on the surface of the placenta in high concentrations (xg, progesterone, steroid hormones), as well as some proteins of fetal and placenta (AFP, trophoblastic r 1-Glycoproteide, etc.).

The placenta plays a big role in the transport of immunoglobulins. Of the immunoglobulins of the five classes, the transplacent transition is capable of implementing only IgG. The transfer of immunoglobulins in the Mathiplod system starts only after 12 weeks of pregnancy and has important biological significance.

Pituitary.The front proportion of the pituitary gland during pregnancy increases in the amount of 2-3 times due to the reproduction and hypertrophy of cells producing hormones:

Prolactin, contributing to the preparation of the mammary glands to lactation, by the end of pregnancy its concentration increases 10 times or more, it is also synthesized by the placenta and is detected in the amniotic fluid.

Thyrotropic hormone (TG), which leads to an increase in thyroxine products and increased the activity of the thyroid gland, which is necessary for the proper development of the fetus;

Adrenocorticotropic hormone (ACTH) contributes to the increase in the hormonal activity of adrenal glands;

Growth hormone (GR), affecting the growth processes of the uterus and other organs of the sexual system, as well as capable of causing transient acromegaloid features (increasing limbs, lower jaws, abnormal arcs) in some pregnant women, disappearing after delivery.

The formation and separation of gonadotropic pituitary hormones (luteinizing and follicle-suitimulating) decreases dramatically, which causes a reduction in hormone formation in the ovaries and the cessation of growth and development of follicles.

During pregnancy, the formation of suprasoptic and paravricular nuclei of the hypothalamus oxytocin and vasopressin is intensified. Oxytocin has a specific totomotor action on the myometrium. The accumulation and effect of oxytocin are directly dependent on the accumulation of estrogen and serotonin placenta, which blocked oxytocinase - an enzyme, inactivating oxytocin in the blood of a pregnant woman.

Adrenal glandsduring pregnancy, considerable changes are subjected. Education is intensified:

Glucocorticoids regulating carbohydrate and protein exchange;

Mineralocorticoids regulating mineral exchange;

Estrogen, progesterone and androgens in adrenal cortex. Increasing the concentration of corticosteroids during pregnancy

it causes severe clinical manifestations of hypercorticism, which is explained by the simultaneous increase in the concentration in the plasma of the Binding Globulin - TransCortin.

The increased function of the mother's adrenal cortex contributes to the delivery of the necessary quantities of nutrients, salts and hormones, which the embryo itself is not yet able to produce.

With the activities of adrenal glands, an increase in blood cholesterol and other lipids is associated.

In pregnancy, the secretion of insulin is intensified, which is determined by the physiological needs of the body, as well as the influence of placental lactogen.

Thyroidduring pregnancy, 35-40% of women increase due to hyperemia, increasing the number of follicles and the content of colloid. Hg has an action on a thyroid gland similar to that TTG. In the first months of pregnancy, there is often some increase in the function of the thyroid gland (Fig. 21), an increase in the content in the blood of iodine associated with protein, but there are no hyperthyroidism. In the second half of pregnancy, signs of increasing the function of the thyroid gland are not observed.

In the pancake glands, the tendency to hypofunction is often noted. In such cases, there are violations of calcium exchange, leading to spastic pensions (convulsions in the calf muscles, etc.).

Fig. 21.Changing the function of the thyroid gland during pregnancy

THE IMMUNE SYSTEM

With a normal pregnancy, the maternal immune system (Table 4) does not rejected the fetoplacentage complex, although it has alloantigentes of paternal origin, immunologically different from parental antigens. The existence of allogenic fetus is ensured by the development of metabolic immunosuppression in the body of a pregnant woman, there is an inhibition of cellular and to a lesser degree of humoral immunity. During pregnancy occurs a unique new

the equilibrium between the specific and non-specific immunity of the mother, at which the central cell of the immunological adaptation of the mother becomes not a lymphocyte, but monocyte. It is the factors of natural immunity send a specific immune response of Th1 (cellular, inflammatory) or TH2 (a humoral, immune) path.

From early pregnancy terms, an increase in the number of monocytes and granulocytes in the blood of the mother, the absorption activity of macrophages increases. These monocytes secrete a large number of cytokines, including interleukins - IL-12. Also increases the concentration of proteins of complement in serum.

Table 4.

Immune system during pregnancy

There is a hypothesis that the activation of congenital immunity in pregnant women occurs due to the flow of soluble placental products into the bloodstream of soluble placental products (Table 5), which have suppressive effect on lymphocytes and activating - on monocytes.

Table 5.

The effect of placental factors on the activity of the cells of the immune system

During normal pregnancy, system immunosuppression mechanisms are included. The negative side of the immunosuppression of pregnant women is increased susceptibility to infectious diseases.

METABOLISM

The metabolism during pregnancy is characterized by the following.

1. The number of enzymes (phosphatases, histamination, cholinesterase) increases and the activity of enzyme systems increases.

2. Protein exchange: The content of proteins in serum is slightly decreased due to amino acids and albumin; Specific proteins of pregnancy appear in the blood.

3. Carbohydrate exchange: glycogen accumulation occurs in liver cells, muscle tissue, uterus and placenta. To the fruit, carbohydrates are transmitted mainly in the form of glucose necessary to him as high-energy material and as a substance that ensures the processes of anaerobic glycolysis. Increased cortisol levels in the blood, somatotropic hormone and PL causes a compensatory increase in insulin content. Pregnancy is a diabetegenic factor, with a hidden inferiority of the inasurant apparatus of the pancreas or hereditary predisposition to diabetes, glucose tolerance is reduced.

4. Lipid exchange (Fig. 22): The number of free fatty acids, cholesterol, triglycerides, lipoproteins, mainly atherogenic (lipoproteins of low and very low density) increase in the blood. Frying fats are transferred in the form of glycerol and fatty acids. In the fetal body, these compounds are spent on building tissues;

great role of fatty substances as an energy material. The accumulation of lipids is also occurring in adrenal glands, placenta and lactic glands.

Fig. 22.Lipid exchange during pregnancy

5. Mineral and Water exchanges:

The absorption of phosphorus, calcium salts required for the development of the nervous system and the skeleton of the fetus, as well as for the synthesis of proteins in the body of a pregnant woman;

Iron consumption increases (pregnant should receive 4-5 mg of iron per day) and other inorganic substances: potassium, sodium, magnesium, chlorine, cobalt, copper, etc.;

Pregnant women slow down the sodium chloride from the body, which leads to a delay in water in the body necessary for the physiological hydration of tissues and the joints of the pelvic bones; In the regulation of water exchange during pregnancy, estrogens play, progesterone, sodium system (contributes to an increase in the renal blood flow, the velocity of glomerular filtering, as well as a decrease in the secretion of renin), the hormones of adrenal cortex (mineralocorticoids), in particular aldosterone, deoxyactorosterone;

The need for vitamins is increasing due to the need to supply the fetus and maintain intensive metabolism; Hypovitaminosis during pregnancy causes the occurrence of many forms of pathology of both the mother and the fetus.

Body mass (Table 6) increases over the entire period of pregnancy by 12-14%, i.e. On average, 12 kg. Normally, the weight gain in the second half of pregnancy should not exceed 300-350 g per week. Increased body weight due to:

Products of conception (Fruits, placenta and ferrous water);

Maternal factors (uterus, dairy glands, an increase in the BCC, an increase in fat deposits, fluid delay).

In the first 20 weeks of pregnancy, the contribution of the fetus to the weight gain is insignificant, but in the second half the mass of the fetus is growing faster. The mass of the placenta increases, respectively, the growth of the fetus, which is reflected in the graph (Fig. 23). The volume of accumulating waters is rapidly increasing with 10 weeks of pregnancy, accounted for 300 ml of 20 weeks, 600 ml of 30 weeks, reaches a peak of 1000 ml to 35 weeks. After that, the amount of accumulating waters slightly decrease.

Fig. 23.The dynamics of the mass of the fetus and placenta

Table 6.

Distribution of body weight gain during pregnancy

The mass of the uterus during pregnancy increases from 50 to 1000 g, the dairy glands also increase due to the growth of ferrous elements, fat deposition and fluid delay. The BCC increases, as well as the amount of fat deposits. With normal pregnancy, the total amount of fluid increases by 6-8 liters, of which 2-4 liters are extracellular. Most of the fluid is delayed up to 30 weeks, but even in women without clinically pronounced edema in the last 10 weeks of pregnancy, 2-3 liters of extracellular fluid are delayed.

THE CARDIOVASCULAR SYSTEM

During pregnancy, significant changes in the cardiovascular system are occurring, creating the possibility of developing the fetus and functionally providing the process of childbirth.

Increased loads on the cardiovascular system of the body of a pregnant woman depends on the following factors.

Mechanical factors - High standing diaphragms, restriction of respiratory movements, transverse position of the heart axis, change in the shape of the chest, an increase in intra-abdominal pressure, a total weight gain;

Hemodynamic factors - an increase in the capacity of the vascular system, the occurrence of the uterine-placental circle of blood circulation, an increase in the BCC, the rate of pulse and cardiac output, a change in arterial and venous pressure.

Fig. 24.Change BCC during pregnancy

During pregnancy, the BCC increases (Fig. 24), which causes physiological hypervolemia of pregnant women aimed at maintaining the optimal microcirculation conditions in the placenta and other vital organs of the mother during pregnancy. The protective effect of hypervolemia allows some pregnant women to lose 20-25% of blood volume without the development of pronounced hypotension.

The volume of blood plasma begins to increase from the 10th week of pregnancy and increases progressively until the 34th week, after which the increase in the intensity decreases. In general, the volume of circulating plasma (ODC) for pregnancy increases by 35-50%, and in repeated women, the ODC exceeds such at the primary-in-law by about 10%. During pregnancy, the twins increase the PCL is even more significant. Increased plasma volume (total water in the body)

due to endocrine changes in a pregnant woman, the increase in the secretion of aldosterone and the activity of the renin-angiotensin system, the secretion of placental hormones leading to sodium and water delay. An increase in the synthesis of albumin also leads to the rise of the PL.

During pregnancy, an increase in the volume of circulating erythrocytes by 11-40% occurs, but the intensity of the growth of erythrocytes is less pronounced compared with such a plasma volume. This causes the occurrence of physiological hemodilution of pregnant women and is characterized by a decrease in hematocrit to 0.32-0.36 and the concentration of hemoglobin to 110-120 g / l.

During pregnancy, an increase in the capacity of the vascular system occurs. With normally proceeding pregnancy, there is a decrease in the overall peripheral resistance of the blood, which is caused by physiological hemodilution, a decrease in blood viscosity and the vasodilatory action of estrogen and progesterone. With normally proceeding pregnancy in I and II trimesters there is a tendency to reduce diastolic blood pressure and to a lesser extent systolic (Fig. 25), resulting in a pulse pressure. In the third trimester, the blood pressure returns to the normal level. If the hell is pregnant higher than in the period preceding pregnancy, it testifies either about complications (prestal), or on the body's reaction to stress.

Fig. 25Dynamics of systolic and diastolic blood pressure during pregnancy

The individual level of blood pressure is determined by the interaction of the following main factors: a decrease in the total peripheral resistance of blood vessels and viscosity of blood, which contributes to a decrease in blood pressure, and increase blood volume and minute volume of the heart that promotes an increase in blood pressure. In the inadequacy of compensatory mechanisms, such as arteriolespazm and hypovolemia, the height of blood pressure is observed. For proper judgment on the level and dynamics of hell, it is necessary to know the initial value of hell to pregnancy (for example, for pregnant women with initial blood pressure 90/60 pressure 120/80 means undoubted hypertension). An increase in systolic pressure by 30% relative to the initial should be regarded as a pathological symptom. With normally proceeding pregnancy, the diastolic pressure must be no more than 75-80 mm Hg, and the pulse - at least 40 mm Hg.

Fig. 26.Dynamics of venous pressure in the elbow and femoral veins during pregnancy and postpartum period

The venous pressure (Fig. 26) in the lower limbs increases from the 5-6th month of pregnancy (it is especially great in the position of pregnant on the back) and by the end it exceeds the venous pressure in the upper limbs twice. This is due to the squeezing of the lower hollow vein in a pregnant uk in, relatively often causing edema of the legs and varicose veins of the foot and outdoor genital organs.

The most significant hemodynamic shift is considered an increase in cardiac ejection (Fig. 27) in the initial period of pregnancy: on the 4-8th week, it can exceed its average value in healthy non-embled women by 15%, the maximum increase is up to 40%.

Fig. 27.Change cardiac emission during pregnancy

In the first half of pregnancy, an increase in cardiac emission is due to the main increase in the impact volume of the heart by 30%. Later there is some increase in the heart rate (heart rate), which reaches a maximum in the third trimester of pregnancy, when the heart rate is more than a non-removed woman by 15-20 blows in 1 min (i.e. by 15%). With multipleness, the increase in heart rate reaches 20-30 shots in 1 min. It is believed that tachycardia is caused by a number of factors, including the strengthening of the secretion of progesterone, starting with the I trimester of pregnancy.

In addition, during pregnancy, there is a regional redistribution of blood. The influx for the uterus for 16 weeks per 400 ml / min is superior to those in non-empty and persisted at this level to the term of childbirth.

What are the main hemodynamic parameters for pregnancy, reflected in Fig. 28.

Fig. 28.Main hemodynamic indicators for pregnancy

The blood flow on the capillaries of the skin and mucous membranes is also increasing, reaching a maximum - 500 ml / min - to 36 weeks. Increasing skin blood flow is associated with dilatation of peripheral vessels. This explains the frequent occurrence of the heat of heat in pregnant women, high sweating, some pregnant women can complain about nasal congestion.

RESPIRATORY SYSTEM

During pregnancy, a number of adaptive reactions aimed at satisfying the increased activity of metabolism are arising. The development of compensatory reactions (they are similar to the mechanisms that contribute to the adaptation of the body to hypoxia) is primarily due to the activities of the lungs (hyperventilation, respiratory alkalosis), cardiovascular system (hemodynamic shifts, an increase in cardiovascular emission) and red blood systems (activation of erythropois, The increase in the volume of circulating erythrocytes).

With an increase in the uterus, there is a gradual displacement of the abdominal organs and a decrease in the vertical size of the chest, which is compensated by the expansion of its circle, amplifying the tours of the diaphragm. During pregnancy, there is an increase in the frequency of respiratory movements by 10%. All these factors lead to

gradual increase by the end of the pregnancy of respiratory volume by 30-40%.

Consumption of oxygen by the end of pregnancy becomes more by 30-40%, and during fence - by 150-250% of the original. Due to the fact that the need for oxygen during pregnancy increases, a pregnant woman is harder than non-empty, transfers hypoxia of any origin and severity. The physiological decrease in the level of PO 2 in the blood of the mother does not affect the saturation of fetal blood oxygen. This is due to a higher concentration of hemoglobin in the blood of the fetus and the higher affinity of the fetal hemoglobin to oxygen.

The main changes in the respiratory system during pregnancy are reflected in Table. 7.

Table 7.

Main changes in the respiratory system during pregnancy

Blood formation organs

Blood formation is enhanced; Increase: the number of erythrocytes, the amount of hemoglobin, leukocytes and blood plasma. ESP during pregnancy increases somewhat - up to 20-30 mm / h, which is mainly due to the increasing concentration of fibrinogen.

With normal pregnancy, changes in the acidic condition of the blood are observed, which is expressed in the accumulation of acidic

exchange products. As the pregnancy period increases the phenomenon of metabolic acidosis and respiratory alkalosis increase. The mother's acidosis can be believed to be a consequence of the primary acidosis of the fetus due to the prevalence of the processes of anaerobic glycolysis. Most pregnant women are compensated for these changes, and the pH shift does not occur, which indicates a sufficient capacity of the body buffer systems in physiological pregnancy.

Hemostasis system

In normal conditions, hemostasis depends on the state of the vascular wall, platelets, coagulation factors and fibrinolysis. During pregnancy, significant changes in the coagulation and fibrinolysis system occur. Hemostasiological status is characterized by an increase in blood coagulation potential, an increase in the structural properties of a bunch, inhibition of enzymatic fibrinolytic activity. These changes, together with an increase in the BCC, prevent bleeding when separating the placenta, the formation of intravascular thrombus, play an important role in the prevention of such complications of pregnancy, like thromboembolism, bleeding after the development of the twist. In normal pregnancy, there is an increase in the level of VII (Proconvelin), VIII (Antymemophilic Globulin), X (Stewart Factor) coagulation factors (from 50 to 100%), Promcrin level and IX factor (Christmas factor for 20-40% and especially plasma fibrinogen levels . The fibrinogen concentration increases by 50%, which is the main cause of a substantial increase in ESP during pregnancy. By 38-40 weeks of pregnancy, the prothrombin index is significantly increased. The number of platelets is somewhat reduced by increased consumption.

The fibrinolytic plasma activity is reduced during pregnancy, becomes the smallest during the birth period and returns to the initial level after 1 hour after the birth of the placenta.

Changes in the hemostasis system - a unique feature of the gestational process, they are supported by the existence of the fetoplacentage complex and after completion of pregnancy are exposed

regress. However, in the case of the development of pathological conditions during pregnancy, the hemostasis system universally and nonspecifically reacts to them in the form of the formation of the blood system of blood, the starting moments of which are lurted in physiological hemostatic reactions.

Digestive organs

Many women in the early periods of pregnancy are nauseous, vomiting in the morning, taste sensations change, these phenomena gradually disappear. Progesterone helps to reduce the tone of smooth muscles. Due to the relaxation of the lower esophageal sphincter, the low-pressure pressure is reduced, with an elevated intraper and intragastric pressure, heartburn appears. The listed factors determine the danger of endotracheal anesthesia in pregnant and feminine - regurgitation and aspiration of gastric content (Mendelssohn syndrome) are found with a frequency of 1: 3000. The mechanical compression of the large intestine of a growing uterus leads to stagnant phenomena and worsening peristaltics, constipation. Pregnant women often appear hemorrhoids, which is due to constipation and an increase in venous pressure below the level of the growing uterus. There is a shift of the anatomical structures that impede the diagnosis of abdominal diseases.

During pregnancy, the liver function changes. Laboratory tests give results similar sometimes with such a liver pathology:

The activity of alkaline phosphatase increases twice (IOBSIM alkaline phosphatase placenta;

Albumin levels and albumin-globulin coefficient are reduced.

The amount of glycogen in the liver slightly decreases, because a lot of glucose moves from the mother to the fetus. The intensity of fat metabolism changes (increased lipemia, high cholesterol content, enhanced fat deposition in hepatocytes). The protein-formative function of the liver changes, aimed at ensuring the fetus with the necessary amount of amino acids. The synthesis in the liver of fibrinogen increases, the processes of inactivating estrogen and other steroid hormones produced by the placenta are enhanced. In some

women with normal pregnancy are skin changes, such as palm erythema and phetechial hemorrhages. They are considered not a manifestation of liver disease, but only a sign of increasing the concentration of estrogen, and completely disappear by the 5-6th week after delivery. The disinfectant function of the organ is somewhat reduced. In addition, progesterone influence should be taken into account on the tone and motorcy of biliary tract, contributing to the emergence of choletiasis and cholestasis even in healthy women.

Urinary organs

The main changes in the function of the kidneys during pregnancy are as follows:

An increase in renal blood flow by 60-75%;

Increase in glomerular filtration by 50%;

Acceleration of the clearance of most substances;

Reducing the level of creatinine, urea and urates in blood plasma;

Possible glucose.

The urinating function of the kidneys is based on three main processes:

Glomerular filtration;

Tubing reabsorption;

Canal secretion.

The kidneys are functioning with an increased load, removing from the mother of the mother not only the products of its exchange, but also products of the metabolism of the fetus. Clushing filtration increases by 30-50%. Characteristic for physiological pregnancy reduced compared to the norm for non-refined values \u200b\u200bof creatinine and urea concentrations in blood plasma.

The increase in glomerular filtering with a decrease in the tube reabsorption of filter glucose may be accompanied by the development of glucosuria, even with the physiological flow of the gestational process, which is more often observed in the third trimester of pregnancy.

One of the main tests of the diagnosis of kidney pathology during pregnancy - proteinuria. It should be noted that in physiological pregnancy, the amount of protein, excreted in the daily urine, increased to 0.05 g / days, and therefore the diagnostic value of the specified test decreases.

The change in the concentration and clearance indicators of the kidney function is accompanied by an increase in the indicators of the coefficient of the coefficient / potassium urine, the clearance of endogenous creatinine, osmotically free water.

The tone of the urinary tract is reduced mainly as a result of the effect of progesterone placenta, the capacity of the bladder increases slightly. Atony and expanding the lumen of the ureters break the passage of urine and can cause or exacerbating infectious diseases. Mechanical pressure in combination with the action of progesterone can sometimes contribute to hydronephrosis, expanding the scope of the ureter (86% on the right).

Bone-muscular system

The load on the spine of a pregnant woman is increasing, a gait is changed ("Proudly" pregnant). Progressive lordosis with an increasing uterus shifts the center of gravity to the lower limbs. Changes during pregnancy are characterized by serous impregnation and dissection of articular ligaments, symphizar cartilage and synovial shells of LON and sacratral-iliac joints caused by the influences of the relaxin produced in the placenta. In this regard, there is a slight increase in mobility in the articulations of the pelvis and the possibility of a minor increase in the pelvic capacity during childbirth, including due to the discrepancy of the pubic bones (normally, no more than 1 cm).

LEATHER

Often in the skin of the face, the white line of the abdomen, nipples and the near-block circles, the deposition of brown pigment is observed (pregnancy mask - chloasma.or mELASMA GRAVIDARUM).The cause of pigmentation is a melanocystimulating hormone, a polypeptide similar to corticotropin, under its action in zona Reticularisthe adrenal glands are synthesized by a pigment close to melanin. Estrogens and progesterone

also give a melanocystimulating effect. In the same women, similar changes can cause hormonal contraceptives.

Under the action of mechanical stretching and under the influence of hypercorticism, bands of pregnancy appear (Striae Gravidarum)sinebagrous color localized around the navel, in the lower parts of the abdomen, often on the hips and on the lactic glands. These scars (a consequence of the discrepancy of connective tissue fibers) do not disappear after delivery, but acquire the type of whitewashed rings.

In 2/3 pregnant women appear angiomas, teleangectasses, neubs, also in 2/3 - Palmarn Erythema. They do not have clinical significance and most women disappear immediately after delivery, being a consequence of hyper ethrogenemia.

MAMMARY GLAND

Milk glands during pregnancy reach full morphological maturity, their dimensions increase due to the growth of iron tissue. The number of alveoli, polek, ducts increases. In the epithelium, lining alveoli, the secretion of colosure begins. These changes occur under the influence of estrogen, progesterone, pl and prolactin. The nipples are also growing, the nearly rock mugs are drifted. Montgomery glands appear on the aroles - hypertrophied sebaceous glands.

Sender organs

The genitals undergo significant changes, especially expressed in the uterus.

The magnitude, shape, position, consistency and excitability of the uterus changes. Its mass, equal to 50-100 g before pregnancy, increases to 1000 g (without a fetal egg) at the end of pregnancy. The volume of the uterus increases by the end of the pregnancy 500 times. The dynamics of an increase in the height of the bottom of the uterus is presented in the illustration (see below). After 12 weeks, the uterus goes beyond the limits of a small pelvis. Physiological decrarotation of the uterus is due to the presence in the left side of the sigmoid pelvic.

The mucous membrane of the uterus, which was in the secretion phase before the start of implantation, from the moment of attachment, blastocysts undergo a complex of complex morphological and biochemical changes and is called decidual - disappearing.

Hypertrophy of the nerve elements of the uterus is observed, increasing the number of receptors, the growth of the vascular network.

The amount of actomyosis (integrated compound of contractile proteins - actin and myosin increases), which reduces the motor function of the uterus.

The number of phosphoric compounds, as well as energy creatine phosphate and glycogen increases.

By the date of delivery, serotonin, catecholamines, is accumulated. Serotonin is an antagonist of progesterone and synergistic estrogenic hormones, contributes to the contractile activity of the uterus. Irregular, sporadic cuts of the uterus are called Bracston-Gyks (described in 1872).

Hypertrophy of the ligament apparatus of uterus occurs, especially round and sacratling ligaments.

In the cervix, the processes of hypertrophy and hyperplasia are less pronounced. Due to the significant development of the venous network, the neck resembles spongy fabric, becomes cyanotic, edema, softened. The cervical channel is filled with a thick mucus (mucous plug), the temps of the mucosa is a harbinger of labor. The outdoor and inner zev of the cervix from the primarmable is closed before delivery, repeatedly

outdoor zev in recent months of pregnancy during a vaginal study misses the finger. With 4 months of pregnancy, the lower pole of the fetal egg stretches the endings of the uterus and occupies it, the experiencing becomes part of the fruit and is called the lower segment of the uterus. The lower segment is limited to the line of attachment of the peritoneum of bubble-uterine folds from above and the level of the inner zea of \u200b\u200bthe cervix bottom. This volume of the uterus contains less muscles and vessels, thinner and is usually a case of a cut with a cesarean section.

"Norm of pregnancy"

Taking into account the foregoing in recent years, the concept of "pregnancy" began to apply in obstetric practice. Under the "norm of pregnancy" it is necessary to understand the average levels of homeostasis and functional tests, characteristic of the uncomplicated development of pregnancy in a practically healthy woman at different times of gestation.

To identify pathological disorders during pregnancy, it is necessary to clearly represent the permissible limits of oscillations of certain parameters. Previously, the main indicators of the homeostasis of pregnant and non-remote women were compared, which seems not entirely eligible, since it does not reflect the functional changes inherent in the gestation process.

Knowledge of physiological changes in the body during normal pregnancy is necessary to the doctor of any specialty, as it allows you to quickly identify the pathology preceding the complications of childbirth and the postpartum period or defining them. Ignoring the doctor of the above-mentioned changes can lead both the underestimation of the severity of the state and to the yathedral excess correction in the treatment of complications or critical states.

When a new life originates in the body of a woman, all organs and systems of the future mother begin to work in a completely new one. It seems to many that the changes concern only the critical organs and the endocrine system, but in fact there is not a single body in the female organism, which would not have undergone changes during this period. Of course, the activity of the central nervous system of a pregnant woman changes.

Changes in the nervous system of a pregnant woman

Pregnancy completely changes the life of the future mother, because now she lives not herself, but with the child, even if before his birth, there are still a few months. But the changes relate not only to the relationship with the outside world, but, above all, the relationship between the future mother and the future baby - everything that happens in the body of a pregnant woman, from the first days aims to harmonize relations between the two organisms - the organism of the mother and the organism of the fetus, - who have to be one for a long time.

In addition, from the very beginning of pregnancy, the woman's body begins to prepare for such important processes as childbirth, and then breastfeeding. Changes related to pregnancy, future birth and future breastfeeding are touched by almost all systems and organs of the female body. It is quite natural that the nervous system of the future mother should be rebuilt.

Often others suggest that a young woman is waiting for a kid, because they notice a sharp mood swings - the fun is replaced by tears, joy - irritation, calm can easily and quickly turn into nervousness. In addition, some incomprehensible desires appear, obscure sensations, whims, and then hysterics happen. On the one hand, all these changes are often charged to changes in the work of the hormonal system (the so-called hormonal storms), but there is another side of the question - the activities of the central nervous system, which undergo very significant changes.

It is well known that the central nervous system of the person consists of a head and spinal cord, which leads the activities of the whole organism. But everyone is known to everyone, it is in the central nervous system (CNS) with the onset of pregnancy begins to work very complex nervous processes (mechanisms of nervous activity), which should ensure normal development of the fetus in the maternal womb?

But for this it is necessary to maintain the necessary balance of various substances in the body, on which the development of the fetus and its safety depends. Moreover, it is easy to understand that the balance of these substances in virtually will necessarily differ from the balance on the last weeks of the baby tool.

Attention!During pregnancy, the most complicated mechanisms in the work of the central nervous system are aimed at the normal development of the fetus and to maintain the necessary level of all necessary substances that allow developing the baby in the intrauterine period.

Scientists who deal with the issues of gestation note a very interesting fact: impulses that enter the body of a pregnant woman from very sensitive uterus receptors are blocked by the central nervous system at the spinal cord level until the 39th week of pregnancy. It is such a CNS reaction (impulse blocking) that allows pregnancy to preserve during the programmed nature of time and avoid premature birth or miscarriage.

It is noted that in the cerebral cortex of large hemispheres during pregnancy, the so-called gestational dominant is formed as a focus of increased excitability of the CNS. At the same time, the excitability of the nervous system (nervous apparatus) of the uterus decreases, which allows it to remain at rest. The excitability of the nervous system of the uterus and the lower divisions of the CNS only in the period precedes childbirth than and the conditions necessary for the prosperous delivery is created.

The findings of researchers are no less interesting, which changes in behavior and in the mood of a pregnant woman, for example, increased fatigue, drowsiness and even irritability, is nothing more than the protective mechanisms that are produced by the central nervous system to protect a pregnant woman from overwork.

Attention!Morning nausea and vomiting, which often torment pregnant women, especially in the early rows, depend on changes in the tone of the wandering nerve, regulating the work of many internal organs. In addition, the changed tone of the wandering nerve is responsible for changing the perception of odors, taste perceptions and preferences, as well as for frequent dizziness.

Vegetative nervous system during pregnancy

It is known that a vegetative nervous system is of great importance for the work of the body, which is otherwise called the autonomous nervous system. It is the vegetative nervous system (VNS) that performs the most important functions in regulating the operation of all internal organs, including organs of nutrition, respiratory organs, bloodstream and blood circulation and lymph, and also regulates the activities of the excretory system, the operation of the sexual system and the biological specification function.

The work of the vegetative nervous system does not depend on human consciousness and therefore the consciousness and will do not obey. The reactions of the vegetative nervous system are objective and independent of external influences. The vegetative nervous system covers all organs and systems of the body and coordinates their work - it is from the activities of the VNS, the creation of optimal conditions for the body at every moment of time and in each situation depends.

Of course, the VNS is very important for the successful development of pregnancy: it is known that the innervation of the vegetative nervous system concerns all the bodies of a pregnant woman, except for the placenta. And even though the placenta is not part of the activities of the AUT, however, the blood supply to the uterus and its reduction depend on the vegetative nervous system.

It is very important to understand that the VNS works autonomously, that is, many pregnant women organs, including heart, bronchi, large and small blood vessels, smooth muscles of intestines, bladder, uterus and many other vitality in the sphere of its independent impact. Important for pregnant woman organs. It is the vegetative nervous system that regulates the activities (including the activity) of the cells that it is innervated and managed, therefore, it is precisely the work of many bodies and changes that occur during pregnancy.

It is noted that in the period of the child's nodding in the body of a pregnant woman, a sympathetic adrenal VNS department is more active and the work of the heart, the vascular system and the respiratory system is more active, which ensures the body of a pregnant woman and the fetus with a sufficient amount of oxygen and the necessary nutrients. In addition, in the same period, the blood supply to the kidneys is increasing, which should bring the products of vital activity not only a pregnant woman, but also her future child.

Gestational dominant in pregnant

During pregnancy, the formation of gestational dominant plays a huge role, which is a focus of increased excitability in the core of a large brain.

When forming a gestational dominant, the most important role is played by the fact that the nervous system of a pregnant woman constantly perceives numerous impulses that come from a developing fetus, and responds to them. Of course, the first on impulses that come from the fetal egg react to nervous receptors, which contains many different receptors that allow you to instantly respond to the state of the fetus. Any impact on any of the receptors located in the uterus becomes the cause of changes in the work of the parent central and vegetative nervous system, and any of such changes is designed to ensure the most correct development of the fetus and its safety.

It is known that during pregnancy, the most serious changes occur in the central nervous system of a pregnant woman. As soon as an egg fertilization occurs in the body of a woman, that is, from the start of pregnancy, the central nervous system of the mother begins to get a huge and constantly increasing flow of impulses, which leads to the formation of a hearth brain in the cortex, which has the ability to enhanced excitability - this is precisely this focus. The name of the gestational dominant.

It is very important that around the gestational dominant, that is, around the influence of the pregnancy of the focus in the brain, in accordance with the laws of induction, a certain field is created, in which the processes of braking nerve processes are created. When observing pregnant women, such clinical signs are noted, as a somewhat inhibited state of a woman, a change in priorities and interests that are shifted towards the future child, especially in the direction of everything that is associated with future childbirth and the health of the kid. Doctors leading pregnant observation notes that everything that is not related to the child and with pregnancy, pregnant women often go to the background and even loses their meaning.

However, doctors watching the course of pregnancy note that if a child is exposed to a strong stress, including fear, fright or any other strong emotional experiences, then in the central nervous system of a pregnant woman may arise, in addition to gestational dominants, other foci of persistent excitation which not only can weaken the gestation dominant, but also provoke the development of any pathology in the development of pregnancy.

Attention!It is the formation, along with the gestational dominant, another focus of persistent arousal, which often leads to pathological processes, confirms the urgent need to provide for a pregnant woman standing and maximum psychological comfort. The exit from the psychological comfort zone during pregnancy can have unpredictable negative consequences. The role of gestational dominant is to the child who is psychologically fenced from any trouble and shocks.

However, shortly before childbirth, some inhibition (reduced excitability of the large brain cortex), providing a relaxed state of the uterus and a favorable course of pregnancy, is replaced by an increase in the excitability of the nervous system (nerve elements) of the uterus, which is necessary for successful generic activities and successful childbirth.

Pregnancy This is a normal (physiological) process flowing in the body of a woman during the intrauterine development of the fetus. During pregnancy, the woman's body is subjected to deep transformations. With normal pregnancy development, all changes in the body of the body are aimed at creating a harmonious relationship between the organism of the mother and the body of a developing fetus. Also, from the very first days of pregnancy, the preparation of the body of a pregnant woman to future birth and breastfeeding begins.

Below we consider more details the most important changes in the body of a woman during pregnancy, as well as their value for normal evolution of pregnancy itselfGiving birth and breastfeeding period.

Organism systems subject to change during pregnancy
From the very first days of pregnancy, the body of a pregnant woman is subjected to deep transformations. These transformations are the result of the coordinated work of almost all organism systems, as well as the result of the interaction of the mother's organism with the child's body.

Changes in the nervous and endocrine system
The main roles in the implementation of the transformations of the female organism during pregnancy are the nervous and endocrine systems.

At the level central nervous system (Head and spinal cord) The complex nerve mechanisms are launched, aimed at preserving the constancy of substances in the body of a pregnant woman necessary for the normal development of the fetus. For example, it was noted that up to 39 weeks of pregnancy, impulses coming from sensitive uterus receptors are blocked at the spinal cord level, which allows pregnancy preservation 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 can celebrate increased irritability, fatigue, drowsiness - all these protection mechanisms developed by the central nervous system to prevent excessive fatigue of a pregnant woman. The changes of the sense of smell (intolerance of some odors), taste and gastronomic preferences, as well as coming nausea, vomiting and dizziness are associated with a change in the tone of the wandering nerve (nerve regulating the work of most of the internal organs).

Well known is the fact that the nervous and endocrine systems are in close cooperation. This interaction is particularly clearly manifested 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 until fertilization. The normal functioning of the hypothalamus (the center of the brain is responsible for the transfer of nerve signals from the nervous system in the endocrine), pituitary gland (central endocrine iron of a person) and the ovaries (sex glands of the body of a woman), make it possible to develop an egg and prepare the female sex system to fertilize. From the first days of pregnancy and up to 10 weeks, the development of pregnancy is maintained at the expense of hormones secreted by ovaries. Throughout this period, there is an intense growth of the fetus placenta. The placenta, as is known, in addition to the role of nutrition of the fetus, also performs the synthesis of hormones necessary for the normal development of pregnancy. The main hormones of the placenta is estriol (it is also called the defender of pregnancy). This hormone stimulates the development of blood vessels and improves the supply of fetus with oxygen and nutrients.

In a smaller amounts of placenta, estrone and estradiol synthesize. Under the action of these hormones there is an increase in the genital organs of a pregnant woman: the uterus, vagina, the mammary glands, an increase in the volume of circulating blood in the mother's body (to improve the nutrition of the fetus). In disruption of the functioning of the placenta (during various diseases of the mother or fetus), may come abortion or disruption of the development of the fetus (underdevelopment).

Also, the placenta synthesizes progesterone, stimulating the development of the mammary glands and the preparation of them to lactation. Under the influence of progesterone, the muscles of the uterus and intestines are relaxing. Progesterone has an inhibitory effect on the nervous system, determining the above, drowsiness and fatigue. The effect of progesterone on the development of a fat fabric of a pregnant woman is important. Power supply of nutrients in adipose tissue during pregnancy is necessary to ensure the nutrition of the fetus and the formation of milk in the postpartum period.

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

Different incoming changes as, for example, skin pigmentation and an increase in bone widths and face outlines arise due to the action of a pregnant woman's pituitary gland, synthesizing melanotropin (hormone, stimulating the production of skin pigment) and somatotropin (hormone, stimulating the growth of the body).

Changes in the metabolism process
Changes in metabolism during pregnancy are aimed at ensuring the needs of the developing organism of the fetus. It is clear that for the normal flow of metabolism, and, consequently, the development of the fetus requires the normal functioning of metabolic processes in the mother's body.

To increase the amount of assimilated food, the mother's body produces a greater number of digestive enzymes. At the level of the lungs, blood saturation is increased by oxygen. This is carried out mainly due to an increase in the number of erythrocytes, and increase the content of hemoglobin in them.

In the blood of a pregnant woman notes an increase in glucose and insulin concentration, as well as fatty acids, proteins and amino acids. All these nutrients penetrate the placenta into the blood of the fetus, thereby ensuring the developing body material for growth and development.

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

During pregnancy, the need of a woman's body in vitamins is increased. This is due to the enhancement of metabolic processes, both in the very body of a pregnant woman and with the fact that part of the vitamins, from the mother's body goes into the organism of the feed and is used to them for their own development.

Changes in internal organs during pregnancy
During pregnancy, many internal organs are subjected to significant restructuring. These changes are adaptive, and, in most cases, short-term and completely disappear after delivery.

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

All of the above changes in the cardiovascular system are completely disappearing after delivery.

Respiratory system During pregnancy, it works hard. The frequency of respiration increases. This is due to an increase in the need of the body of the mother and fetus in oxygen, as well as in limiting 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 a female sex system for childbirth and feeding the child.

Uterus Pregnant woman significantly increases in size. Its mass increases from 50 g. - At the beginning of pregnancy until 1200 g. - At the end of pregnancy. The volume of the uterus by the end of pregnancy increases more than 500 times! The blood supply to the uterus increases significantly. In the walls of the uterus, the amount of muscle fibers increases. Cervix Filled with a thick mucus, blocking the causta cavity of the cervix. Uterine pipes and ovaries Also increase in size. In one of the ovaries, the "yellow body of pregnancy" is observed - the place of synthesis of hormones supporting pregnancy.

The walls of the vagina are breaking, become more elastic.

Exterior genitals (Small and large sexual lips), also increase in size and become more elastic. Crab crotch fabrics. In addition, there is an increase in mobility in the joints of the pelvis and the discrepancy of the pubic bones. The above-described changes in the sex tract are extremely important physiological importance for childbirth. The breaking of the walls, an increase in the mobility and elasticity of the genital tract increases their throughput and facilitates the advancement of the fetus for them during childbirth.

Leather In the zone of the genital organs and in the middle line of the abdomen, it usually becomes darker. Sometimes on the skin of the side parts of the belly, "Stragia Gravidarum) is formed, which, after delivery, turn into whipless strips.

Mammary gland Increase in size, become more elastic, intense. When pressed on the nipple, a colostrum is observed (first milk).

Body mass of pregnant women increases in size. The normal increase in body weight at the end of pregnancy is 10-12 kg. Or 12-14% of the mass body of a pregnant woman.

All the changes described above, coming during pregnancy, should be distinguished from the signs of the so-called "imaginary" or "false pregnancy". False pregnancy arises with the conviction of a non-embled woman in the fact that she is pregnant. Such a situation is observed in some cases in patients with mental or endocrine disorders. At the same time, the power of self-sustaining of a woman is so large that there are some physiological changes characteristic of real pregnancy: an increase in the mammary glands, the appearance of a colostrum, the disappearance of menstruation. The patient's survey helps to make a 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 it is not pregnant, but based on some considerations, trying to convince others in the opposite.

Bibliography:

• Kokhanevich E.V. Actual issues of obstetrics, gynecology and reproductology, triad-X, 2006
• Savelyeva G.M. Okuchery, Medicine, M., 2000
• Carr F. Obstetrics, Gynecology and Health Women, Medpress-Inform 2005