正常妊娠

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Maternal physiology during pregnancy

Genital Tract
Uterus Ovaries Vagina and perineum

Pulmonary system


Gastrointestinal Tract
endocrine system urinary system Skin Skeleton
Immune function
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Fetal membranes

Including
Chorion Amnio

Function
Protection for the fetus onset of labor
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Umbilical cord

Including：
Amnion Yolk bag Allantois One umbilical vein and two umbilical arteries Wharton jelly

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Fetal appurtenances
Placenta Fetal membranes


Umbilical cord
Amniotic fluid
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Placenta
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Placenta include

Decidua basalis Chorion frondosum Amnion

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The three stages of the implantation

Adplantation of the blastocyst on the endometrium Adhesion of the blastocyst to the endometrium Invasion of the trophoblast and embedding
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Ultrasonography

Type B ultrasound
fast and accurate gestational sac, GS the earliest sign of pregnancy

Doppler ultrasound
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Cervical mucus examination
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BBT （Basal Body Temperature）
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Diagnosis of the second- and third-trimester pregnancy

Symptoms and Signs
Undergoing the first trimester Uterine enlargement Fetal movement (FM) • usually started at 20 weeks • normally ≥30/12h,or ≥4/h Fetal heart tones: normal rate 120-160 beats/min Palpation of Fetus: after 20 weeks
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Diagnosis of the first-trimester pergnancy

Assistant examinations


Pregnancy test
Ultrasonography Type B ultrasound Doppler ultrasound Cervical mucus examination BBT Progesterone test
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Fetal attitude

Fetal lie
Longitudinal lie Transverse lie

Fetal presentation
Head presentation
• • • • Occiput presentation Bregma presentation Brow presentation Face presentation
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Fertilization, the zygote development and migration
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The condition of implantation

Zone pellucida disappear The formation of syncytiotrophoblast cell Blastula and Endometrium developed in the same time and well correspond with each other Mother has enough progestin in the body
Characters
from conception to about the 12th week of pregnancy
from about 13 to 27 weeks of pregnancy
from about 28 weeks of pregnancy until birth
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Diagnosis of the first-trimester pergnancy

Breasts Cardiovascular system Hematologic system
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Three stages of the pregnancy
Stage First trimester (the early stage) Second trimester (the middle stage) Third trimester (the late stage)
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Placenta function
Function Metabolism Protection Endocrine function Gas exchange Nutrition support discharge waste placental barrier, IgG HCG, HPL, Estrogen, Progestin, Oxytocinase, HSAP, cytokines and Growth factor Fetus is an allograft for the mother, the placenta can inhibit the rejection Characters
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Uterine enlargement during pregnancy
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Diagnosis of the second- and third-trimester pregnancy

Assistant examination
Ultrasound examination Fetal electrocardiography (FECG)
One umbilical vein and two umbilical arteries Exchange the O2 and CO2 through the placent during the fetus stage All the respiratory organ will be matured before birth

Digestive system Urinary system Endocrine system Reproduction system
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Fetal Circulation
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The formation and the function of fetal appurtenances
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The development characters of embryo and fetus
Week 24 week 28 week 32 week 36 week 40 week Characters
All the visceras have been developed, viability is reached by the 24th week, but survival at this stage is still relatively rare
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The development characters of embryo and fetus
Week
8 week
Characters
The embryo head makes up almost half the bulk The heart beat can be detected by ultrasound
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The development characters of embryo and fetus
Embryo
the early 8 weeks in pregnancy
Fetus
from 9 weeks until get birth
Gestational age
4 weeks as one gestational age

History and symptoms


Cessation of menstration
Morning sickness Bladder Frequency

Physical sign: Changes in the Genital Organs
Vagina: vasculature Cervix: Hegar sign Uterus: soft Changes in breasts: Mastodynia, Enlargement, Linea Nigra
12 week
16 week 20 week
The fingers and toes have nails, and the external genitalia may be recognizable
The sex is discernible as male or female Heart tones can often be detected by stethoscope
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The development characters of embryo and fetus
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The development characters of embryo and fetus
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Fetus physiological characteristics

Circulation system and Respiration system

Length: 30～70cm The life chain for the fetus, very important!
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Amniotic fluid

What’s amniotic fluid? Different source from different stage of pregnancy Absorbed by fetal members, umbilical cord, skin and swallowed by fetus Volume, characters, components Functions
Conceptions about Pregnancy

What’s pregnancy
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Embryo formation

The two important processes
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Zygote Formation

What’s fertilization? Where dose the fertilization happen? Capacitation and Acrosome reaction Zygote
The lungs are now capable of breathing If born at this stage, about 5 of 6 infants survive the chances for survival are go averages 50cm in length, 3000g in weight, biparietal diameter >9.0cm

Fetal position

Breech presentation

Shoulder presentation
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Fetal lie