The presence of a child for each couple is a joy because the child is the successor generation, both male and female. For a woman who was the first time through periods of pregnancy often do not know the various changes in the body. As for a doctor, than to see the pregnancy as something normal but need to also consider a false pregnancy (pseudosiesis) because there are also women who really want the pregnancy causes symptoms such as pregnancy, sistoma ovarii, myoma uteri, menopause, urinary or vesika with retention of urine. In this article we will discuss about the process of pregnancy and diseases that might arise.
Basically the pregnancy represents a physiological condition but can be followed by a pathological state of a very threatening situation of mother and fetus. All parties must be able to recognize changes that may occur during pregnancy that can be known disorders that arise early.
Before we further study the pregnancy it is better to know earlier titles premature pregnancy, premature and postmature and distribution of gestational age. In medicine, pregnancy mature / a month lasts about 40 weeks and not more than 42 weeks. While the so-called premature pregnancy if a long pregnancy lasts between 28 weeks and 36 weeks. For pregnancies of more than 42 weeks of pregnancy is called postmature. According to age, pregnancy is divided into the first trimester of pregnancy ie 0-14 weeks, starting the second trimester of pregnancy is 14-28 weeks and third trimester from 28 weeks to 42 weeks.
There are signs and symptoms that must be understood by pregnant women or young couples that is definitely not pregnancy symptoms, pregnancy signs and certainly not a sure sign of pregnancy. Especially for doctors and health professionals need to also know the appeal of pregnancy diagnosis.
There are at least 7 (seven) symptoms of pregnancy is uncertain, namely:
- Cravings. Often pregnant women wanting a certain food or beverage in this state.
- Fainting and easily tired. Often pregnant women will experience a fainting when you're on a crowded places and this happens in the first months of pregnancy and disappears after 18 weeks of pregnancy.
- Constipation / obstipation. The rationality of this situation could be explained by a decrease in intestinal peristalsis and steroid hormones.
- Amenorrhea or referred to by laymen as the absence of menstruation. For women who are pregnant need to know the date of the first day of last period to determine the estimated gestational age and parturition. There are several formulas estimated pregnancy but is most common is the formula Naegele. If the menstrual cycle is 28 days ± +7 date, month and year +1 -3.
- Frequent urination. Occurs because the bladder in the first months of pregnancy by uterine pressure grows. This situation will be reduced gradually and then arose again in late pregnancy.
- Nausea (feel sick) with or without symptoms of vomitus (vomit). This situation generally occurs in the morning and in the first months of pregnancy, or commonly called morning sickness.
- Anorexia or no appetite. There are groups of women who experience decreased appetite weeks of pregnancy but others are only experienced during the first months of pregnancy.
While certainly not a sign of pregnancy can be described as follows:
- Leukore. Where cervical secretions increase because the effect of increasing the hormone progesterone.
- Skin pigmentation. This situation usually occurs at 12 weeks gestation or more. Could arise on the cheeks, nose and forehead and is known as kloasma gravidarum. This situation occurs because of the influence of placental hormones that stimulate melanofor and skin.
- Papilla epulis or gingival hypertrophy. Often occurs in the first trimester of pregnancy.
- Changes in the breast. Pregnancy can create a tense and enlarged breasts because of the influence of estrogen and progesterone, which stimulates breast duktuli and alveoli. Aerola become more black areas because of the excessive deposit of pigment. In many women there is usually a colostrum when entering more than 12 weeks gestation.
- Basal temperature continues to rise by between 37.2 to 37.8 degrees Celsius.
- Enlargement of the abdomen clearly visible after 14 weeks of pregnancy.
- The changes in the pelvic organs such as vagina livid marks Chadwick took place about six weeks; sign Hegar like lower uterine segment softening palpability; signs such as the uterus enlarged Piscaseck into one department; sign that Braxton-Hicks contractions of the uterus when stimulated . Distinctive mark on this one to the uterus during pregnancy.
- Pregnancy test. Many tools can be used to detect pregnancy. A widely used tool is based on antigen-antibody reaction with the hormone chorionic gonadotropin (hCG) as an antigen. The most widely used is hemagglutination. On the first day of menstruation does not come normally has the lowest detectable levels of at least 50 iu / L hCG. Yet to be considered by all parties, both pregnant women and doctors are false positive results caused by malignant trophoblastic disease. Before there cangging test tools are often used reaction-Mainini Galli, Friedman and Ascheim-Zondek.
After seeing the symptoms and signs are not sure there is also a sure sign of pregnancy that includes:
- On Auscultation fetal heart sound will be heard. With Laennec stethoscope, fetal heart sounds heard at 18-20 weeks of pregnancy. While with the Doppler fetal heart sound will be heard at 12 weeks of gestation.
- Will be felt on palpation of the fetus and balotemen and fetal motion.
- With ultrasound or scanning can be seen the picture of the fetus. In the first weeks of pregnancy are often only seen a black dot. Doctors could not diagnose pregnancy in the first weeks of using this tool as a black point is nearly equal to the blood vessels.
- In X-ray examination but the use of fetal skeleton appeared this tool does not do much now because of the impact of radiation on the fetus.
The objective of antenatal care is to prepare physically and mentally as well mothers to save the mother and child in pregnancy, childbirth and postpartum period so that a healthy and normal after delivery. On the first visit of pregnant women need to be considered risk factors that may exist by performing a physical examination, laboratory and special interviews. Health workers should provide in-depth information on pregnancy, birth place and also baby care and feeding methods. Information that can be given as the election has many nutritional food and fiber, the use of drugs that must be consulted beforehand with the doctor or nurse the family, avoiding cigarettes and alcoholic beverages (including husbands are smokers), physical activity can be performed within normal limits, and also cleanliness especially personal genetalia should be maintained because during pregnancy there was an increase secretions.
The important thing to the Notice of Pregnant Women
- Body weight and height. on the first visit of pregnant women need to be considered in accordance with the high weight and gestational age mother's body. If the mother's weight is less or more then locate and resolve the cause. Weight gain during pregnancy increases 0.5 kg per week or 6.5 kg to 16 kg during pregnancy. When the increase in body weight of less than 0.5 kg per week to note the existence of malnutrition, malabsorbsi, the use of alcohol, drugs or cigarettes. Watch the stunted fetal growth, placental insufficiency, the possibility of premature birth. Conversely, if the increase in body weight of more than 0.5 kg per week, note the presence of diabetes mellitus, multiple pregnancy, hidramnion or edema. Watch for macrosomia, disproportion sefalopelvik or distosia shoulder.
- Blood Pressure. If the increase in systolic blood pressure of more than 30 mm Hg or reached ≥ 140 mm Hg, or diastolic blood pressure increase of more than 15 mm Hg or achieving ≥ 90, consider the existence of pre eclampsia, eclampsia, or hypertension in pregnancy.
- Fundus Height. Gland size would increase in line with gestational age. Fundus uteri particularly high increase in the third trimester.
- Fetal Heart Sound. In addition to showing a baby in the womb, fetal heart sound can also be observed for diagnosis. Fetal heart sound is less than 120 beats per minute is called bradikardi and more than 160 beats per minute (tachycardia) when his mother showed that there was no fetal distress. If there are no fetal heart sounds at the back of the fetus so it must consider the existence of fetal death, hydatidiform mole or stunted fetal growth. Found that there are two heart sounds in a different place with a frequency difference of at least 10 beats per minute is one of multiple pregnancy definitive diagnosis.
- Edema. lower leg edema in the last trimester may be the result of physiological but if accompanied by edema in the upper body like the face and arms, especially when followed by an increase in blood pressure, pre eclampsia is suspected.
- Large and Fetal Position. fetuses that are smaller than gestational age may be caused stunted fetal growth or intrauterine fetal death. While if the fetus is larger than gestational age may be due makrosomia, molar pregnancies, or multiple pregnancy. After 34 weeks of pregnancy, normal fetal position is the elongated head downward. Abnormalities that can occur is the location of latitude, where the oblique or breech position (buttocks presentation).
- Bleeding. in the first trimester may be a physiological thing, but a pathological namely abortion, ectopic pregnancy or hydatidiform mole. After 22 weeks of pregnancy, the bleeding that occurs is called ante partum hemorrhage, placenta previa and caused many solusio plasentae.