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Pregnancy


If you are a job applicant or an employee who believes that an employer has discriminated against you because of your pregnancy or your pregnancy-related disability, you can file a charge of discrimination with the EEOC. Learn more about filing a charge of discrimination.




pregnancy


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Pregnancy is the time during which one or more offspring develops (gestates) inside a woman's uterus (womb).[4][13] A multiple pregnancy involves more than one offspring, such as with twins.[14]


Prenatal care improves pregnancy outcomes.[9] Nutrition during pregnancy is important to ensure healthy growth of the fetus.[16] Prenatal care may also include avoiding recreational drugs (including tobacco and alcohol), taking regular exercise, having blood tests, and regular physical examinations.[9] Complications of pregnancy may include disorders of high blood pressure, gestational diabetes, iron-deficiency anemia, and severe nausea and vomiting.[3] In the ideal childbirth, labor begins on its own "at term".[17] Babies born before 37 weeks are "preterm" and at higher risk of health problems such as cerebral palsy.[4] Babies born between weeks 37 and 39 are considered "early term" while those born between weeks 39 and 41 are considered "full term".[4] Babies born between weeks 41 and 42 weeks are considered "late term" while after 42 weeks they are considered "post term".[4] Delivery before 39 weeks by labor induction or caesarean section is not recommended unless required for other medical reasons.[18]


About 213 million pregnancies occurred in 2012, of which, 190 million (89%) were in the developing world and 23 million (11%) were in the developed world.[11] The number of pregnancies in women aged between 15 and 44 is 133 per 1,000 women.[11] About 10% to 15% of recognized pregnancies end in miscarriage.[2] In 2016, complications of pregnancy resulted in 230,600 maternal deaths, down from 377,000 deaths in 1990.[12] Common causes include bleeding, infections, hypertensive diseases of pregnancy, obstructed labor, miscarriage, abortion, or ectopic pregnancy.[12] Globally, 44% of pregnancies are unplanned.[19] Over half (56%) of unplanned pregnancies are aborted.[19] Among unintended pregnancies in the United States, 60% of the women used birth control to some extent during the month pregnancy began.[20]


Associated terms for pregnancy are gravid and parous. Gravidus and gravid come from the Latin word meaning "heavy" and a pregnant female is sometimes referred to as a gravida.[21] Gravidity refers to the number of times that a female has been pregnant. Similarly, the term parity is used for the number of times that a female carries a pregnancy to a viable stage.[22] Twins and other multiple births are counted as one pregnancy and birth.


A woman who has never been pregnant is referred to as a nulligravida. A woman who is (or has been only) pregnant for the first time is referred to as a primigravida,[23] and a woman in subsequent pregnancies as a multigravida or as multiparous.[21][24] Therefore, during a second pregnancy a woman would be described as gravida 2, para 1 and upon live delivery as gravida 2, para 2. In-progress pregnancies, abortions, miscarriages and/or stillbirths account for parity values being less than the gravida number. Women who have never carried a pregnancy more than 20 weeks are referred to as nulliparous.[25]


A pregnancy is considered term at 37 weeks of gestation. It is preterm if less than 37 weeks and postterm at or beyond 42 weeks of gestation. American College of Obstetricians and Gynecologists have recommended further division with early term 37 weeks up to 39 weeks, full term 39 weeks up to 41 weeks, and late term 41 weeks up to 42 weeks.[26] The terms preterm and postterm have largely replaced earlier terms of premature and postmature. Preterm and postterm are defined above, whereas premature and postmature have historical meaning and relate more to the infant's size and state of development rather than to the stage of pregnancy.[27][28]


The usual signs and symptoms of pregnancy do not significantly interfere with activities of daily living or pose a health-threat to the mother or baby. However, pregnancy complications can cause other more severe symptoms, such as those associated with anemia.


The chronology of pregnancy is, unless otherwise specified, generally given as gestational age, where the starting point is the beginning of the woman's last menstrual period (LMP), or the corresponding age of the gestation as estimated by a more accurate method if available. This model means that the woman is counted as being "pregnant" two weeks before conception and three weeks before implantation. Sometimes, timing may also use the fertilization age, which is the age of the embryo since conception.


Naegele's rule is a standard way of calculating the due date for a pregnancy when assuming a gestational age of 280 days at childbirth. The rule estimates the expected date of delivery (EDD) by adding a year, subtracting three months, and adding seven days to the origin of gestational age. Alternatively there are mobile apps, which essentially always give consistent estimations compared to each other and correct for leap year, while pregnancy wheels made of paper can differ from each other by 7 days and generally do not correct for leap year.[40]


Fertility and fecundity are the respective capacities to fertilize and establish a clinical pregnancy and have a live birth. Infertility is an impaired ability to establish a clinical pregnancy and sterility is the permanent inability to establish a clinical pregnancy.[41]


The capacity for pregnancy depends on the reproductive system, its development and its variation, as well as on the condition of a person. Women as well as intersex and transgender people who have a functioning female reproductive system are capable of pregnancy. In some cases, someone might be able to produce fertilizable eggs, but might not have a womb or none that can sufficiently gestate, in which case they might find surrogacy.[42]


Fertilization (conception) is sometimes used as the initiation of pregnancy, with the derived age being termed fertilization age. Fertilization usually occurs about two weeks before the next expected menstrual period.


A third point in time is also considered by some people to be the true beginning of a pregnancy: This is time of implantation, when the future fetus attaches to the lining of the uterus. This is about a week to ten days after fertilization.[44]


During pregnancy, a woman undergoes many physiological changes, which are entirely normal, including behavioral, cardiovascular, hematologic, metabolic, renal, and respiratory changes. Increases in blood sugar, breathing, and cardiac output are all required. Levels of progesterone and estrogens rise continually throughout pregnancy, suppressing the hypothalamic axis and therefore also the menstrual cycle. A full-term pregnancy at an early age (


The fetus is genetically different from its mother, and can be viewed as an unusually successful allograft.[52] The main reason for this success is increased immune tolerance during pregnancy.[53] Immune tolerance is the concept that the body is able to not mount an immune system response against certain triggers.[52]


During the first trimester, minute ventilation increases by 40%.[54] The womb will grow to the size of a lemon by eight weeks. Many symptoms and discomforts of pregnancy like nausea and tender breasts appear in the first trimester.[55]


During the second trimester, most women feel more energized, and begin to put on weight as the symptoms of morning sickness subside and eventually fade away. The uterus, the muscular organ that holds the developing fetus, can expand up to 20 times its normal size during pregnancy.


Final weight gain takes place during the third trimester, which is the most weight gain throughout the pregnancy. The woman's abdomen will transform in shape as it drops due to the fetus turning in a downward position ready for birth. During the second trimester, the woman's abdomen would have been upright, whereas in the third trimester it will drop down low. The fetus moves regularly, and is felt by the woman. Fetal movement can become strong and be disruptive to the woman. The woman's navel will sometimes become convex, "popping" out, due to the expanding abdomen.


Head engagement, also called "lightening" or "dropping", occurs as the fetal head descends into a cephalic presentation. While it relieves pressure on the upper abdomen and gives a renewed ease in breathing, it also severely reduces bladder capacity resulting in a need to void more frequently, and increases pressure on the pelvic floor and the rectum. It is not possible to predict when lightening occurs. In a first pregnancy it may happen a few weeks before the due date, though it may happen later or even not until labor begins, as is typical with subsequent pregnancies.[57]


Events after 42 weeks are considered postterm.[62] When a pregnancy exceeds 42 weeks, the risk of complications for both the woman and the fetus increases significantly.[66][67] Therefore, in an otherwise uncomplicated pregnancy, obstetricians usually prefer to induce labour at some stage between 41 and 42 weeks.[68]


The postpartum period also referred to as the puerperium, is the postnatal period that begins immediately after delivery and extends for about six weeks.[59] During this period, the mother's body begins the return to pre-pregnancy conditions that includes changes in hormone levels and uterus size.[59]


The beginning of pregnancy may be detected either based on symptoms by the woman herself, or by using pregnancy tests. However, an important condition with serious health implications that is quite common is the denial of pregnancy by the pregnant woman. About 1 in 475 denials will last until around the 20th week of pregnancy. The proportion of cases of denial, persisting until delivery is about 1 in 2500.[69] Conversely, some non-pregnant women have a very strong belief that they are pregnant along with some of the physical changes. This condition is known as a false pregnancy.[70] 041b061a72


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