Nomad : Physiology of Pregnancy

transcript

NOMAD: REP PHYSIOL: PREGNANCY

PHYSIOLOGY OF PREGNANCY

ByDr.M.Anthony David MDProfessor of Physiology

WHEN DOES LIFE BEGIN?: EMBRYOGENESIS

MANY SPERMS BIND TO ZONA PELLUCIDA

SPERMS MOVE THROUGHTHE ZONA PELLUCIDA

ONE SPERM BINDS TO THE OVUM

IT IS DRAWN INTO THE OVUM

OVUM RELEASESVESICLE CONTENTS

OVUM ENZYMES ACTIVATED

OVUM COMPLETESII MEIOSIS

ENZYMES BLOCKPOLYSPERMY

NUCLEI OF OVUM & SPERM UNITE

ZYGOTE FORMED

EMBRYOGENESIS: AN ANIMATION

PREGNANCY BEGINS THIS RESULTS IN THE ONSET OF A

NINE-MONTH RELATION SHIP BETWEEN THE EMBRYO-FETUS, AND THE MOTHER.

THIS PHYSIOLOGICAL STATE IS CALLED PREGNANCY.

IT IS DIVIDED INTO THREE TRIMESTERS OF THREE MONTHS EACH.

PREGNANCY: URINARY HORMONES

FETO PLACENTAL UNITPLACENTA FETAL ADRENAL

CHOLESTEROL

PREGNENOLONE

PROGESTERONE

16-OH- DHEAS

CORTISOL &CORTICOSTERONE

ESTRADIOL

ESTRIOL

16-0H-DHEAS

TESTS OF PREGNANCY1. ASCHEIM ZONDEK TEST2. FRIEDMAN TEST3. GALLI-MAININI TEST4. IMMUNOLOGICAL TESTS

a) SHEEP RBC AGGLUTINATIONb) LATEX PARTICLE AGGLUTINATIONc) GRAVINDEX TEST

1. ASCHEIM ZONDEK TEST URINE FROM THE WOMAN IS

INJECTED INTO IMMATURE MICE 0.5 ml b.d FOR THREE DAYS ON THE FIFTH DAY THE MICE ARE

SACRIFICED. THEY ARE DISSECTED TO LOOK FOR

CORPUS HEMORRHAGICUM. IF IT IS THERE, THE WOMAN IS

PREGNANT.

2. FRIEDMAN TEST 10 -15 ml OF THE WOMANS URINE

IS GIVEN I.V TO A MATURE FEMALE RABBIT.

THE RABBITS OVARIES ARE EXAMINED AFTER 24/48 HRS FOR EVIDENCE OF OVULATION.

RABBITS HAVE REFLEX OVULATION.

3. GALLI – MAININI TEST A SIMPLE AND INEXPENSIVE

TEST. 5 ml OF THE WOMAN’S URINE IS

PUT INTO THE DORSAL LYMPH SAC OF A MALE TOAD.

1-2 HRS LATER, IT’S CLOACAL FLUID IS EXAMINED FOR SPERMATOZOA.

4. IMMUNOLOGICAL TESTS

MOSTLY BEING USED THESE DAYS. BASIS:

REACTION BETWEEN ANTIGENS AND ANTIBODIES OF HUMAN CHORIONIC GONADOTROPHIN (HCG)

HCG ANTIBODIES ARE PRODUCED FROM RABBITS

4. IMMUNOLOGICAL TESTS

a) SHEEP RBC AGGLUTINATION TEST: Sheep RBCs are coated with the antibodies. They get agglutinated when exposed to

urine containing HCG.

b) LATEX PARTICLE AGGLUTINATION.

c) GRAVINDEX TEST:

Most commonly used test today.

GRAVINDEX: HCG TEST KIT

PHYSIOLOGICAL CHANGES IN PREGNANCY

CNS:I Trimester:

Excitement Depression Irritability

II Trimester: Euphoria: a sense of ‘well

being’III Trimester:

Worries and anxieties

CHANGES IN CARDIOVASCULAR SYSTEM

BLOOD VOLUME INCREASED BY 25% HEMODILUTION. ANEMIA CARDIAC OUTPUT INCREASED BY 30% PULSE RATE INCREASED. PERIPHERAL RESISTANCE DECREASES BP IS MAINTAINED NORMAL.

CHANGES IN GASTROINTESTINAL SYSTEM

MORNING SICKNESS: HYPEREMESIS GRAVIDARUM

CONSTIPATION HEARTBURN ACIDITY DUE TO LES TONE

CUTANEOUS CHANGES

INCREASED PIGMENTATION PURPLE STRIA: STRIAE

GRAVIDARUMRENAL CHANGES

INCREASED FREQUENCY. SLIGHT ALBUMINURIA. SODIUM & WATER RETENTION.

CHANGES IN RESPIRATORY SYSTEM

TIDAL VOLUME. PULMONARY VENTILATION OXYGEN UTILISATION INCREASES.

BLOOD CHANGES ERYTHROCYTE SEDIMENTATION RATE. COLLOID ONCOTIC PRESSURE EDEMA LOSS OF 1/8th TO 1/10th IRON.

CHANGES IN ENDOCRINES

HYPOTHALAMO-HYPOPHYSIAL AXIS STOPPED.

HCG TAKES OVER. CORPUS LUTEUM AND PLACENTA

BECOME MAJOR ENDOCRINE GLANDS PRODUCING ESTROGENS & PROGESTERONE.

INCREASED LEVELS OF: PTH, CORTISOL, PROLACTIN & OXYTOCIN.

CHANGES IN METABOLISM

BMR INCREASED BY 25%. WEIGHT GAIN: 12.5 kg. POSITIVE CALCIUM BALANCE. PROTEIN ANABOLISM POSITIVE NITROGEN BALANCE. HYPER GLYCEMIA INABILITY TO TOLERATE

FASTING.

CHANGES IN MAMMARY GLANDS

BREASTS ARE ENLARGED. THE AREOLA AND NIPPLES ARE

DARKENED & SWOLLEN.

CHANGES IN REPRODUCTIVE ORGANS

PROFOUND CHANGES OCCUR. UTERUS INCREASES IN WEIGHT &

SIZE. BOTH HYPERPLASIA & HYPERTROPHY

OCCUR OF BOTH ENDO & MYOMETRIA.

WEAK CONTRACTIONS OCCUR IN THE UTERUS

CERVIX BEGINS TO SOFTEN. OVARIES: NO OVULATION CORPUS LUTEUM OF PREGNANCY

INCREASES IN SIZE WITHIN THE OVARY.

VAGINA BECOMES HYPERVASCULAR.

MUCOSA BECOMES PURPLISH ACIDITY IN THE VAGINA.

CHANGES IN REPRODUCTIVE ORGANS contd.

Nomad : Physiology of Pregnancy

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