Reproductive Physiology

Pregnancy and Parturition:

Pregnancy is a complex physiological process that involves the development of a fertilized egg into a fetus within the mother's womb. Parturition, or childbirth, marks the end of pregnancy and involves the expulsion of the fetus from the uterus.

Embryonic Development:

• Fertilization occurs in the fallopian tube.
• Zygote undergoes mitotic divisions and forms a blastocyst.
• Implantation of the blastocyst in the uterus initiates pregnancy.

Trimesters of Pregnancy:

1. First Trimester:

   • Critical period for organ development.
   • Formation of basic structures: neural tube, heart, limbs.

2. Second Trimester:

   • Rapid fetal growth.
   • Maternal physiological adjustments.

3. Third Trimester:

   • Continued fetal growth and organ maturation.
   • Preparation for labor and delivery.

Labor and Delivery:

• Initiated by hormonal and mechanical factors.
• Stages: dilation, expulsion, placental.

Hypertension During Pregnancy:

Hypertensive disorders during pregnancy include gestational hypertension, preeclampsia, and eclampsia.

Gestational Hypertension:

• Elevated blood pressure after 20 weeks without proteinuria.
• Monitoring and management crucial to prevent complications.

Preeclampsia:

• Hypertension with proteinuria.
• Can lead to serious complications for both mother and baby.

Eclampsia:

• Seizures in a woman with preeclampsia.
• Medical emergency requiring prompt intervention.

Gestational Diabetes:

A condition where blood sugar levels become elevated during pregnancy.

Risk Factors:

• Obesity, family history, age.
• Previous gestational diabetes.

Complications:

• Increased risk of macrosomia (large baby).
• Higher likelihood of cesarean section.
• Risk of type 2 diabetes in mother post-pregnancy.

Management:

• Dietary modifications.
• Insulin therapy if needed.
• Regular monitoring of blood glucose levels.

Complications During Pregnancy:

Various complications can arise during pregnancy, impacting both maternal and fetal health.

Miscarriage:

• Spontaneous loss of pregnancy before 20 weeks.
• Often due to chromosomal abnormalities.

Ectopic Pregnancy:

• Implantation outside the uterus.
• Can be life-threatening if not detected early.

Placental Disorders:

• Placenta previa and placental abruption.
• Can lead to bleeding and compromise fetal oxygenation.

Infections:

• Rubella, toxoplasmosis, cytomegalovirus.
• May cause congenital abnormalities.

Lactation: Synthesis, Composition, and Secretion of Milk:

Lactation is the process of producing and secreting milk from the mammary glands.

Galactopoiesis:

• Maintenance of milk production.
• Stimulated by frequent and effective breastfeeding.

Milk Composition:

• Water, proteins, fats, carbohydrates, vitamins, minerals, antibodies.
• Changes in composition to meet the baby's nutritional needs.

Milk Letdown:

• Controlled by the hormone oxytocin.
• Release of milk in response to the baby's suckling.

Maternal Health: Pre-conception and Prenatal:

Ensuring maternal well-being before and during pregnancy is crucial for a healthy pregnancy.

Pre-conception Health:

• Adequate folic acid intake.
• Managing chronic conditions like diabetes and hypertension.

Prenatal Care:

• Regular check-ups to monitor maternal and fetal health.
• Screening for gestational diabetes and hypertensive disorders.

Postpartum Health:

The period after childbirth involves physical and emotional recovery for the mother.

Physical Recovery:

• Uterine involution and healing of perineal tissues.
• Resumption of normal menstrual cycle.

Emotional Well-being:

• Postpartum depression and anxiety.
• Support networks and counseling are essential.

Birth Outcomes: Stillbirth, Preterm Birth, Low Birth Weight, SGA, Macrosomia, Neonatal Death, Congenital Anomaly:

Various factors can influence the outcome of pregnancy and birth.

Stillbirth:

• Loss of a baby after 20 weeks of pregnancy.
• Multiple causes including genetic factors and placental issues.

Preterm Birth:

• Birth before 37 weeks of gestation.
• Can lead to developmental issues and health complications.

Low Birth Weight:

• Babies weighing less than 2,500 grams.
• Associated with increased risk of health problems.

Small for Gestational Age (SGA):

• Below average weight for the gestational age.
• May indicate growth restriction.

Macrosomia:

• Large birth weight, often associated with gestational diabetes.
• Increased risk of birth complications.

Neonatal Death:

• Death within the first 28 days of life.
• Can result from various factors, including prematurity and congenital anomalies.

Congenital Anomaly:

• Structural or functional abnormalities present at birth.
• Genetic and environmental factors contribute.