The circle of life Shielamae V.

Delos Reyes Introduction Pregnancy is a normal physiological changes process that begins with conception, follows through development and growth of the fetus and delivery, and ends with return to a fully normal state approximately six weeks after birth. Pregnancy causes physiological changes in the mothers bodily functions allow for growth and development of the fetus. Physiology of pregnancy is determined the maternal physiological changes, embryonic and fetal development. In some study of obstetrics and gynecology they deals with the care of women and their children during pregnancy (pre-natal), childbirth and the post natal. The maternal physiological changes during pregnancy can be determined by physical, hormonal, cardiovascular and respiratory which really affect the woman body to easily adopt the growing fetus inside the mothers womb. In writing this paper, the researcher interviewed two OB-GYNE, Marofe M. Bajar, M.D. and Milagros A. Aguilar, M.D. The purpose of this study is to know certain things about the physiological changes in womens during pregnancy. The researcher really interested to perceive how embryo develops and after a weeks or months it will call a fetus. Anecdote Pregnancy is a memorable experience of being a mom, I cherish every moment when my baby is still in my tummy. Almost nine months Im carrying my little angel I cannot believe that I could be a mother at very early age. And its true life is tough enough without having someone kick you from the inside. Im only seventeen years old when Ive got pregnant, at this an idea of being pregnant. It was last week of January, Im one month pregnant, and through using pregnancy test I confirmed that Im having my first child. At this stage of pregnancy I experience discomforts, includes nausea and vomiting (so called morning sickness), frequency of urination and breast soreness. This stage is really hard for me especially if I can smell foods that arouse my stomach, my husband are always there to support me and my parents who always guide me and understand me all the time. I consult my physician once a week to ensure the health of my baby, for me to be prepared in giving birth. Dra. Aguilar told me that my due date will be October 04, 2009. The first three months of pregnancy I was sensitive even physical and emotional, on the coming months I just enjoy being pregnant eating sweets and the food that I really love (cheese dog). Otherwise my body totally adopts many physiological changes which are entirely normal in a pregnant woman. It was August 31, 2009 its my first time to have an ultrasound session; the baby inside my tummy is almost 8 months. During the ultrasound Im praying to god that it would be a healthy baby. My husband told me that everything will be ok, just calm. As we start I cant control my tears dropping because of gladness, she is a bouncing baby girl weighing 2.63 kilograms and 18.2 cm long, I see her on the monitor, her movements, her little fingers and her cute little toes.
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The doctor told me and my husband that our baby is so healthy shes showing active movements. After that I start to buy her clothes and other things that we will be needed, I just wait for one month and four days to give birth on my first child. Im a little bet excited and still nervous because some told me that giving birth is so painful but all the pain will disappear if you see and hold your baby. It was October 04, 2009, Sunday and its my due date according to my doctor but I dont feel anything sign giving birth. Everybody in the house is excited for my delivery, we wait for the whole day but still Im not laboring. So I decide to prepare the things that I will be needed in the hospital such clothes of mine and for the baby, towels, personal things, toilet articles and blankets. its around 3:00 oclock in the afternoon of October 05, 2009 I feel discomfort in sleeping and my pelvis are aching I didnt mind it so I continue to sleep, when I woke up I went directly in the comfort room and I saw my underwear it has a spot of blood I calm myself and call my husband immediately. We call DRA. Aguilar to tell her that I start spotting, she told me to go in her clinic to check if the baby is really coming up, she told me to walk and walk so it will not hard for me to deliver a baby. I start my labor at 11:00 oclock; the pain is almost there I still continue walking so that the babys head move lower. At 8:30 oclock in the evening we went to the hospital I cannot control the pain anymore, I feel the baby is coming out. The nurses and my doctor help me to deliver easily, at exactly 9:40 oclock in the evening I born my baby weighing 3.25kilograms. Finally, I see my baby she is so beautiful and very healthy. I have mixed emotion that time I start crying then I smile, I look like crazy but thats what I really feel when I see my baby. I named her ALTHEA SAMANTHA, now shes one year and three months. She loves playing dolls and xylophone, and she likes eating chocolate. I spend my vacant time playing with her even though Im busy in the school. I just manage my time very well. I share this story as a part of my paper. The physiological changes happen in my body and the development of the baby takes time to develop which could be related in my topic. This anecdote or short story can help the readers to understand this paper all about. Determines of pregnancy physiology Maternal Physiological changes Maternal physiological changes in pregnancy are the normal adaptation that a woman undergoes during pregnancy to better accommodate the embryo or fetus. The body must change its physiological and homeostatic mechanisms in pregnancy to ensure the fetus is provided what they need. This paper is very useful reference in dealing about the hormonal changes, physical changes, cardiovascular changes and respiratory changes during the pregnancy. Hormonal changes The changes in hormonal levels in pregnant woman are truly profound. Other find it difficult to comprehend what is causing all these changes from mood swings to constipation, extra sleep to food cravings. It simply tells that the effect of various hormones that is the main contributor in these changes, these same hormone changes that enable the gravida to carry the baby for nine months and assist it to develop. In changes of the skin,
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hormonal balance and mechanical stretching are responsible for several changes that occurs during pregnancy like stretch marks, sweat glands, and the Linea Nigra or the dark line that runs from the umbilicus to the symphysis pubis and may extend high as the sternum. (Dra. Aguilar) .

Stretch marks after pregnancy.

Linea Nigra in a woman at 22 weeks pregnant.

Physical changes The most noticeable alteration in pregnancy is gaining weight and the other one is breast increasing. In a pregnant woman its easily to gain weight due of food craving and having extra sleep, a pregnant always feel of sleepiness due to hormonal changes. The breast increases its size as pregnancy progresses. The areola of the nipples and the diameter increases. In the early pregnancy you may feel breast soreness or tingle. In the second trimester the breast can produce colostrums or yellowish secretion its high in protein, and a new born baby needs that because it contains antibodies to protect the newborn against diseases. (Hughey)

Pregnant woman weighing

Physical changes occurred in breast during pregnancy Cardiovascular changes The woman is the sole provider of nourishment for the embryo and later, the fetus and so her plasma and blood volume slowly increase by 40-50% over the course of the pregnancy to accommodate the changes. The increase is mainly due to an increase in plasma volume through increased aldosterone. It results in an increase in heart rate increase at fifteen beats per minute than usual, stroke volume, and cardiac output. Cardiac output increases by about 50%, mostly during the first trimester. The systemic vascular resistance also drops due to the smooth muscle relaxation and overall vasodilatation caused by elevated progesterone, leading to a fall in blood pressure. Diastolic blood pressure consequently decreases between 1226 weeks, and increases again to pre-pregnancy levels by 36 weeks. If the blood pressure becomes abnormally high, the woman should be investigated for pre-eclampsia and other causes of hypertension. (Guyton and Hall) This is due to an increase in plasma volume through increased aldosterone. Blood pressure also fluctuates. In the first trimester it falls, so some pregnant woman become low blood and feels dizzy at the first trimester of pregnancy. Respiratory changes The respiratory rises to eighteen to twenty to compensate for increases maternal oxygen consumption, which is needed for demands of the uterus, the placenta, and the fetus. Women may feel out of breath and may need to sit a moment to catch their breath. Dyspnea (shortness of breath) is a symptom reported by the majority of women at some point during pregnancy. It typically begins during the first or second trimester, before chest volume is significantly restricted by growth of the uterus, so decreased lung capacity is not the primary cause. Possible factors include slightly decreased PaCO2 and the effects of progesterone on respiration, as well as the woman's subjective interpretation of increased respiratory rate in pregnancy. (Simpson p.65-66) Embryonic and fetal development Prenatal development is divided into two primary biological stages. The first is the embryonic stage, which lasts for about two months. At this point, the fetal stage begins. At the beginning of the fetal stage, the risk of miscarriage decreases sharply, all major structures including the head, brain, hands, feet, and other organs are present, and they continue to grow
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and develop. When the fetal stage commences, a fetus is typically about thirty millimeter in length, and the heart can be seen beating via sonograph; the fetus bends the head, and also makes general movements and startles that involve the whole body. Fertilization it is the stage of sexual reproduction in which a male reproductive cell, or sperm, fuses with a female reproductive cell, or egg, resulting in the mixing of the genetic information carried in the parent cells. Fertilization takes place when sperm enter the womans body during sexual intercourse. The mans penis becomes stiff and is put inside the womans vagina. Semen, a fluid containing the sperm, is squirted from the penis into the womans vagina. The fertilized egg travels on to the womb, where the baby grows. Three million sperm may released, but only a few hundred get close to the egg and the only one will fertilize it it fertilization happens. (Miles and Royston-editors, p.180) Every baby begins life when a single egg cell from the mother and a tiny sperm cell from the father join together inside the mothers body. This is called fertilization. The fertilized egg grows and divides, and after nine months the baby is born. (Dra. Aguilar)

Embryonic period The embryonic period in humans begins at fertilization. Twelve to twenty four hours after ovulation, generally between the second and third week of gestation age and it continues until the end of the tenth week of gestation (eight week by embryonic age). The zygote spends the next few days traveling down the Fallopian tube. Meanwhile it divides several times to form a ball of cells called a morula. Further cellular division is accompanied by the formation of a small cavity between the cells. This stage is called a blastocyst. Up to this point there is no growth in the overall size of the embryo, so each division produces successively smaller cells. Rapid growth occurs and the embryo's main external features begin to take form. This process is called differentiation, which produces the varied cell types (such as blood cells,
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kidney cells, and nerve cells). A spontaneous abortion, or miscarriage, in the first trimester of pregnancy is usually due to major genetic mistakes or abnormalities in the developing embryo. (Gould, p.206) Changes by weeks of gestation are the process of cell division and cellular differentiation of the human embryo that occurs during early stages of this development. To be exact, it spans from the moment when a spermatozoon meets and fuses with an ovum which is called fertilization to the end of the 8th week of development. The most spectacular changes occur in this first two months during which the developing baby acquires its main organs and just begins to be recognizable as human. This process represents a masterpiece of spatial and temporal control of gene expression. Most of the genes governing human development also operate in other animals across a wide range of species. From the ninth week until birth the term becomes fetus. (Maton) Gestation age vs. embryonic age The initiation and termination of gestation are signaled, and its maintenance regulated, by hormones produce principally in the pituitary gland, the ovaries, and the placenta. Gestational age is the time that has passed since the onset of the last menstruation, which generally or as standard occurs two weeks before the actual fertilization. Embryonic age, in contrast measures the actual age of the embryo or fetus from the time of fertilization. Nevertheless, menstruation has historically been the only means of estimating embryo/fetal age, and is still the presumed measure if not else specified. However, the actual duration between last menstruation and fertilization may in fact differ from the standard two weeks by several days. The following table summarizes the various expression systems during week number x of gestation. Week Reached age number (whole weeks)

Gestational

x-1

Embryonic

x-2

x-3

One to four weeks old embryo One to two weeks of gestational age are merely theoretical extrapolations of embryonic age, since the fertilization hasnt actually occurred yet. The zygote undergoes mitotic cellular divisions, but does not increase in size. This mitosis is also known as cleavage. A hollow cavity forms marking the blastocyst stage.
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The blastocyst contains only a thin rim of trophoblast cells and a clump of cells at one end known as the "embryonic pole" which include embryonic stem cells. The embryo hatches from its protein shell (zona pellucid) and performs implantation onto the endometrial lining of the mother's uterus. Trophoblast cells surrounding the embryonic cells proliferate and invade deeper into the uterine lining. They will eventually form the placenta and embryonic membranes. The blastocyst is fully implanted in seven to twelve days of fertilization. Formation of the sac, the embryonic cells flatten into a disk, two cells thick. The primitive streak develops and the primary stem villi appear. (Larsen)

At four weeks, the embryo is no bigger than a grain of rice; it has head and a tail.

Five to nine weeks old embryo A notochord forms in the center of the embryonic disk. A neural groove (future spinal cord) forms over the notochord with a brain bulge at one end, neuromenes appear. The primitive heart tube is forming and vascular begins to develop in embryonic disk. The embryo measures four millimeter in length and begins to curve into a C shape. The heart bulges, further develops, and begins to beat in a regular rhythm. Septum primum appear. Branchial arches, grooves which will form structures of the face and neck, form. The neural tube closes. The ears begin to form as otic pits. Arm buds and a tail are visible. Pulmonary primordium, the first traits of the lung appear. Hepatic plate, the first traits of the liver appear. Urorectal septum begins to form. Anterior and posterior horns differentiate in the spinal cord. The embryo measures eight millimeter in length. Lens pits and optic cups form the start of the developing eye. Nasal pits form. The brain divides into 5 vesicles, including the early telencephalon. Leg buds form and hands form as flat paddles on the arms. Rudimentary blood moves through primitive vessels connecting to
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the yolk sac and chorionic membranes. The metanephros, precursor of the definitive kidney, starts to develop. The embryo measures thirteen millimeter in length. Lungs begin to form. The brain continues to develop. Arms and legs have lengthened with foot and hand areas distinguishable. The hands and feet have digits, but may still be webbed. The gonadal ridge begins to be perceptible. The lymphatic system begins to develop. Main development of external genitalia starts. The embryo measures eighteen millimeter in length. Fetal heart tone (the sound of the heart beat) can be heard using Doppler. Nipples and hair follicles begin to form. Location of the elbows and toes are visible. Spontaneous limb movements may be detected by ultrasound. All essential organs have at least begun. (Larsen)

This embryo is about five weeks old.

This fetus starts to develop his hands and feet. This is about seven weeks old.

For the first two months the developing baby is called an embryo. After this, when the organs are working, it is called a fetus. Fetal period the embryo grows quickly. Between the fourth and eight week of pregnancy, its hands feet and facial features develop. By twelve weeks the embryo looks human and its major organs are developing. At this period the organs of the fetus start to develop at the end of tenth of gestation. Because the precursors of the organs are formed, fetus also is not as sensitive to damage from environmental exposures as the embryo. Instead, toxic exposures often cause physiological abnormalities or minor congenital malformation. During fetal period each organ has its own development, in the circulatory system the heart develops because its the first functional organ in a vertebrate embryo. In digestive system the tooth develops. Each system in fetus body starts to develop such as endocrine system, muscular system, nervous system and the urinary and reproductive system. (Dra. Bajar)

This fetus is about fifteen weeks old. His ears are already develop and the eyelid, with adequate amniotic fluid.

Conclusion Pregnancy is a normal physiological process; it begins with a single egg cell and tiny sperm. When it joins together the fertilization happen, and the fertilized egg will grow and divide then it will be develop as an embryo to fetus. The symptoms of pregnancy are nausea or socalled morning sickness, change of appetite and frequency of urinations. Pregnancy will cause maternal physiological changes in womans body. These changes occurred in respiratory; cardiovascular, hormone and in the physical. Either it changes the mothers bodily functions it allows for the growth and development of the fetus. The development of the baby inside the mothers womb is classified by its stages or period; it is the embryonic and fetal development. For others its hard to understand why is it important to study this matter regarding pregnancy and the developmental period of the baby. It helps womens to be informed about important thing in pregnancy. Having a baby is a great miracle and blessing from the God. Bibliography Books: Gould, Stephen jay. Ontogeny and Phylogeny. Belknap press, 1987. Grolier Encyclopedia of Knowledge. Academic American encyclopedia: U.S.A. 2000. Miles, Kate and Royston, Angela Editors. Encyclopedia of Question and Answer. Kingfisher publication: High Holborn London, 1997. Nelson, Reuben E. Dear Mother to Be. Philippine publishing house: Manila, 1972. Simpson, Kathleen. Pre-natal Nursing, Third edition. Lippincott Williams and Wilkins, 2007.

Internet:
Cells: Building blocks of Life. Maton, Anthea; (1997)

Human Embroyology. Larsen, William J. (2001) Medical Education Division. Hughey Mike M.D. (2007) Textbook of medical physiology. Guyton and Hall (2005) Interviews: Aguilar, Milagros A. MD License number: 62630 OB-GYN Bajar, Marofe M. MD, FPOGS Obstetrics and gynecology OB-GYN sonology License number: 87983

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