Progesterone causes many changes to the genitournary system. A pregnant woman may experience an increase in the size of the kidneys and ureter due to the increase blood volume and vasculature. Later in pregnancy, the woman might develop physiological hydronephrosis and hydroureter, which are normal. Progesterone causes vasodilatation and increased blood flow to the kidneys, and as a result glomeruler filtration rate (GFR) commonly increases by 50%, returning to normal around 20 weeks postpartum. The increased GFR increases the excretion of protein, albumin, and glucose. The increased GFR leads to increased urinary output, which the woman may experience as increased urinary frequency. Progesterone also causes decreased motility of the ureters, which can lead to stasis of the urine and hence an increased risk of urinary tract infection.
Pregnancy alters the vaginal microboita with a reduction in species/genus diversity. Physiological hydronephrosis may appear from six weeks.
Swimming whilst pregnant is an effective, safe form of exercise.
A few tips can help you stay safe when exercising.
Always:
begin by warming up for 5 minutes and stretching for 5 minutes
finish with 5 to 10 minutes of gradually slower exercise that ends with gentle stretching.
Here are some useful tips:
Wear loose-fitting, comfortable clothes, and a good support bra.
Choose supportive shoes designed specifically for the exercise you have chosen, to help prevent injury.
Exercise on a flat, level surface to avoid injury.
Eat small, frequent meals throughout the day, and don’t exercise for at least 1 hour after eating.
Drink plenty of water before, during and after exercise, to keep hydrated.
Get up slowly and gradually to prevent dizziness.
Remember that:
The body needs more oxygen and energy during pregnancy.
The hormone relaxin, produced during pregnancy, causes the ligaments that support the joints to stretch, increasing the risk of injury.
The mother’s changing weight alters the center of gravity, putting extra strain on the joints and muscles in the lower back and the pelvis and increasing the chance of losing balance.
Pregnancy causes many changes in the body, making people more susceptible to complications from many infections.
For example, hormone-related skin changes during pregnancy can cause conditions such as eczema or severely dry skin. If the skin cracks open and bleeds, a serious skin infection, such as cellulitis, can develop. A rare skin disorder called Sweet’s syndrome is also more common during pregnancy than at other times.
Some other infections that may be more serious during pregnancy include:
the flu
hepatitis E, which is a typically mild viral form of hepatitis
herpes, including herpes simplex virus (HSV) and varicella zoster virus (VZV)
Listeria, which can cause food poisoning
measles
HIV
The increased risk of these infections during pregnancy is not well understood but may be due to hormone and other changes that alter the number of blood cells in the body. For example, late in pregnancy, T cells that help fight infection decrease in number.
Pregnancy also causes increased blood circulation and demands on the heart. These demands can also worsen complications. For example, if a pregnant person develops pneumonia from the flu, they may have more difficulty breathing because of the increased demands the fetus places on the heart and lungs.
Some medications that can effectively treat common infections may be less safe during pregnancy. So it is essential that pregnant people who have an infection talk to their doctor or midwife to weigh up the benefits and risks of various treatment options.
During pregnancy the plasma volume increases by 40-50% and the red blood cell volume increases only by 20–30%. These changes occur mostly in the second trimester and prior to 32 weeks gestation. Due to dilution, the net result is a decrease in hematocrit or hemoglobin, which are measures of red blood cell concentration. Erytheopeotien, which stimulates red blood cell production, increases throughout pregnancy and reaches approximately 150 percent of their pregnancy levels at term. The slight drop in hematocrit or hemoglobin is most pronounced at the end of the second trimester and slowly improves when reaching term.
Platelet and white cell count
The effect of pregnancy on platelet count is unclear, with some studies demonstrating a mild decline in platelet count and other studies that show no effect. The white blood cell count increases with occasional appearance of myelocytes or metamyelocytes in the blood. During labor, there is a rise in leukocyte count.
Hypercoagulability
A pregnant woman will also become hypercoaguable, leading to increased risk for developing blood clots and embolisms, such as deep vein thrombosis and pulmonary embolism. Women are 4-5 times more likely to develop a clot during pregnancy and in the postpartum period than when they are not pregnant. Hypercoagulability in pregnancy likely evolved to protect women from hemorrhage at the time of miscarriage or childbirth. In third world countries, the leading cause of maternal death is still hemorrhage. In the United States 2011-2013, hemorrhage made up of 11.4% and pulmonary embolisms made up of 9.2% of all pregnancy-related deaths.
The increased risk of clots can be attributed to several things. Plasma levels of pro-coagulantion factors increased markedly in pregnancy. Both the production of prostacyclin (an inhibitor of platelet aggregation) and thromboxane (an inducer of platelet aggregation and a vasoconstrictor) are increased, but overall there is an increase in platelet reactivity which can lead to a predisposition to clots. There is also increased blood stasis due to the compression of the vena cava by the enlargening uterus. Many factors have been shown to increase the risk of clots in pregnancy, including baseline thrombophillia, cesarean section, preeclampsia, etc. Clots usually develop in the left leg or the left iliac/ femoral venous system. Recently, there have been several case reports of May-Thurner Syndrome in pregnancy, where the right common iliac artery compresses the below left common iliac vein.
Edema
Edema, or swelling, of the feet is common during pregnancy, partly because the enlarging uterus compresses veins and lymphatic drainage from the legs.
The heart adapts to the increased cardiac demand that occurs during pregnancy in many ways.
Cardiac output (Lit./Min.): 6.26
Stoke Volume (Ml.): 75
Heart Rate (Per min.): 85
Blood Pressure: Unaffected
Cardiac output increases throughout early pregnancy, and peaks in the third trimester, usually to 30-50% above baseline. Estrogen mediates this rise in cardiac output by increasing the pre-load and stroke volume, mainly via a higher overall blood volume (which increases by 40–50%). The heart rate increases, but generally not above 100 beats/ minute. Total systematic vascular resistance decreases by 20% secondary to the vasodilatory effect of progesterone. Overall, the systolic and diastolic blood pressure drops 10–15 mm Hg in the first trimester and then returns to baseline in the second half of pregnancy. All of these cardiovascular adaptations can lead to common complaints, such as palpitations, decreased exercise tolerance, and dizziness.
Uterine Compression of IVC and Pelvic Veins. Displacement of PMI by Uterus
Uterine enlargement beyond 20 weeks’ size can compress the inferior vena cava, which can markedly decrease the return of blood into the heart or preload. As a result, healthy pregnancy patients in a supine position or prolonged standing can experience symptoms of hypotension.
Before you begin exercising, remember it is important to talk to your health care provider. If you typically get little or no activity, walking is a great exercise to start with. Walking is usually safe for everyone, it is easy on your body and joints, and it doesn’t require extra equipment. It is also easy to fit into a busy schedule.
Squatting during labor may help open your pelvic outlet to help your baby descend, so practice squatting during pregnancy. To do a squat, stand with feet shoulder width apart and slowly lower into a squat position. You should keep your back straight, heels on the floor and your knees shouldn’t protrude in front of your feet. Hold the squat for 10 to 30 seconds; you can rest your hands on your knees.
Then slowly stand back up, pushing up from your knees with your arms, if you need to. Repeat this 5 times working up to more.
Pelvic tilts strengthen the muscles in your abdomen and help alleviate back pain during pregnancy and labor. To do pelvic tilts get on your hands and knees. Tilt your hips forward and pull your abdomen in. Your back should slightly round. Stay in this position for a few seconds then relax without letting your back sag. Repeat a couple of times, working up to 10.
Exercising for 30 minutes on most, or all, days can benefit your health during pregnancy. Exercising for just 20 minutes, 3 or 4 days a week, is still beneficial, as well. The important thing is to be active and get your blood flowing.
To have success in completing exercises during pregnancy, it is a good idea to plan the days and times during the week when you will exercise. As shown in the photo above, prenatal yoga is a great, low impact exercise that can be highly beneficial for pregnant women.
Here are some of the benefits from exercise during pregnancy you may experience:
Helps reduce backaches, constipation, bloating, and swelling
May help prevent, or treat, gestational diabetes
Increases your energy
Improves your mood
Improves your posture
Promotes muscle tone, strength, and endurance
Helps you sleep better
Regular activity also helps keep you fit during pregnancy and may improve your ability to cope with labor. This will make it easier for you to get back in shape after your baby is born.
Calcium is the mineral needed for the baby’s bone and teeth development. An expectant mother needs more than 1,000 milligrams of calcium each day. This is for women ages 19 and above. But for teenage mom to be’s, they need at least 1,000 milligrams according to Academy of Nutrition and Dietetics. If you will be calcium deficient, the baby will get the calcium from her mother’s bone. Food rich in calcium are yogurt, milk, cheese, green-leafy vegetables like kale, and calcium-fortified juices.
2. Add Folic Acid in Pregnancy Diet
Folic acid or folate prevents birth defects specifically on the baby’s spinal cord and brain. It is a type or B vitamin which might be a bit harder to find in food alone. It is for this reason that doctors recommend a folic acid supplement (600 microgrmas per day). Folate rich foods are found in breads, pasta, beans, citrus fruits, and leafy green vegetables.
3. Iron-Rich Foods
Iron in pregnancy diet makes additional hemoglobin for you and your child. Iron aids oxygen’s movement from your lungs to your baby’s. It will also prevent fatigue, infection and iron deficiency anemia. Pregnant women need 27 mg of iron every day. Combine vitamin C-rich foods with iron-rich to improve iron absorption. Pair meat, fish, chicken, dried beans or iron-fortified cereal with orange juice.
4. Protein-Rich Foods
Protein has amino acids which are the building block of cells of your baby’s body. It will help in the baby’s vital organ’s development like the heart and brain. Its intake should be increased in the second and third trimesters. Pregnant woman should take 40 to 70 grams of protein but depending on the weight. Protein-rich foods include dairy, beans, legumes, nuts, fish, meat, and poultry.
How do I know if I have the symptoms of bacterial vaginosis?
One of the symptoms of BV is a gray or whitish discharge that has a foul fishy odor. However, some women do not experience any symptoms. Diagnosis is made through a pelvic exam.
Vaginal discharges is tested through a wet mount (microscopic slide test), pH test (BV often causes a pH level of 4.5 or higher), KOH slide (microscopic slide test) or a whiff test (a mixture that causes a strong fishy odor).
What causes bacterial vaginosis?
Bacterial vaginosis is an imbalance of bacteria which leads to an over growth of bacterial species. The cause has not clearly been identified. It is not transmitted sexually, but it is associated with having vaginal sex. Therefore, it may be listed under sexually transmitted diseases when you research it.
How can bacterial vaginosis affect my pregnancy?
There is significant evidence that links bacterial vaginosis with preterm labor. Many recent studies have been conducted to verify this information and to find a method of prevention. Other studies have also shown a possible link to miscarriages, low birth weight, and premature rupture of membranes.
If I am pregnant, will I be screened for bacterial vaginosis?
It is not necessary to screen non-symptomatic pregnant women for BV. When obtaining your prenatal care, you are not routinely screened for bacterial vaginosis. It is important that you discuss any concerns you may have about BV with your health care provider.
Why am I being screened for bacterial vaginosis?
The U.S Centers for Disease Control and Prevention (CDC) advises that all pregnant women with symptoms of bacterial vaginosis be screened and treated. The CDC also supports screening women who have had a previous preterm labor. Screening for BV is left up to your healthcare provider to decide.
What treatments are available for pregnant women with bacterial vaginosis?
Treatment is highly recommended to avoid any chance of preterm labor.
There are various treatments which include:
Oral medications – Clindamycin 300 mg or Metronidazole 500 mg twice daily for 7 days
Topical medications – Clindamycin 5 g or Metronidazole at bedtime for 5 days (This treatment may give symptomatic relief, but it is insufficient in preventing pregnancy complications.)
Pregnant women experience numerous adjustments in their endocrine system that help support the developing fetus. The fetal-placental unit secretes steroid hormones and proteins that alter the function of various maternal endocrine glands. Sometimes, the changes in certain hormone levels and their effects on their target organs can lead to gestational diabetes and gestational hypertension.
Fetal-placental unit
Graph of the levels of estrogen, progesterone, beta-hcg throughout pregnancy
Levels of progesterone and estrogen rise continually throughout pregnancy, suppressing the hypothalamic axis and subsequently the menstrual cycle. The progesterone is first produced by the corpus luteum and then by the placenta in the second trimester. Women also experience increased human chroinic gonadotropin (β-hCG), which is produced by the placenta.
Pancreatic Insulin
The placenta also produces human placental lactogen (hPL), which stimulates maternal lipolysis and fatty acid metabolism. As a result, this conserves blood glucose for use by the fetus. It can also decrease maternal tissue sensitivity to insulin, resulting in gestational diabetes.
Pituitary gland
The pituitary glands grows by about one-third as a result of hyperplasia of the lactrotrophs in response to the high plasma estrogen. Prolactin, which is produced by the lactrotrophs increases progressively throughout pregnancy. Prolactin mediates a change in the structure of the breast mammary glands from ductal to lobular-alveolar and stimulates milk production.
Parathyroid
Fetal skeletal formation and then later lactation challenges the maternal body to maintain their calcium levels. The fetal skeleton requires approximately 30 grams of calcium by the end of pregnancy. The mother’s body adapts by increasingparathyroid hormone, leading to an increase in calcium uptake within the gut as well as increased calcium reabsorption by the kidneys. Maternal total serum calcium decreases due to maternal hypoalbuminemia, but the ionized calcium levels are maintained.
Adrenal goals
Total cortisol increases to three times of non-pregnant levels by the third trimester. The increased estrogen in pregnancy leads to increase corticosteroid-binding globulin production and in response the adernal glad produces more cortisol. The net effect is an increase of free cortisol. This contributes to insulin resistance of pregnancy and possibly striae.Despite the increase in cortisol, the pregnant mom does not exhibit Cushing syndrome or symptoms of high cortisol. One theory is that high progesterone levels act as an antagonist to the cortisol.
The adrenal gland also produces more aldosterone, leading to an eight-fold increase in aldosterone. Women do not show signs of hyperaldosterone, such as hypokalemia, hypernatremia, or high blood pressure.
The adrenal gland also produces more androgens, such as testosterone, but this is buffered by estrogen’s increase in sex-hormone binding globulin (SHBG). SHBG binds avidly to testosterone and to a lesser degree DHEA.
Thyroid
The thyroid enlarges and may be more easily felt during the first trimester. The increase in kidney clearance during pregnancy causes more iodide to be excreted and causes relative iodine deficiency and as a result an increase in thyroid size. Estrogen-stimulated increase in thyroid-binding globulin (TBG) leads to an increase in total thyroxine (T4), but free thyroxine (T4) and triiodothyronine (T3) remain normal.
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Pregnancy world 