Manual Of High Risk Pregnancy And Delivery 5th Edition

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[] Pregnancy, also known as gestation, is the time during which one or more develops inside a. A involves more than one offspring, such as with. Pregnancy can occur.

Maternal and perinatal infection-viral in obstetrics. Normal and Problem Pregnancies, 5th edition. Steven Gabbe, Jennifer R Niebyl, JL Simpson (Eds). Philadelphia: Churchill Livingstone Elsevier; 2007. Fernando, Daftary, Bhide. Fetal Infections—in Practical Guide to High Risk Pregnancy and Delivery.

Manual Of High Risk Pregnancy And Delivery 5th Edition

Typically occurs around 40 weeks from the (LMP). This is just over nine, where each month averages 29½ days. When measured from it is about 38 weeks.

An is the developing offspring during the first eight weeks following conception, after which, the term is used until birth. Symptoms of early pregnancy may include, tender breasts,, hunger, and frequent urination. Pregnancy may be confirmed with a. Pregnancy is typically divided into three trimesters.

The is from week one through 12 and includes conception. Conception is when the sperm fertilizes the egg. The then travels down the and attaches to the inside of the, where it begins to form the and. The first trimester carries the highest risk of (natural death of embryo or fetus). The second trimester is from week 13 through 28. Around the middle of the second trimester, movement of the fetus may be felt. At 28 weeks, more than 90% of if provided with high-quality medical care.

The third trimester is from 29 weeks through 40 weeks. Improves pregnancy outcomes.

Prenatal care may include taking extra, avoiding drugs and alcohol, regular exercise, blood tests, and regular. May include,,, and among others. Term pregnancy is 37 to 41 weeks, with early term being 37 and 38 weeks, full term 39 and 40 weeks, and late term 41 weeks. After 41 weeks, it is known as. Babies born before 37 weeks are and are at higher risk of health problems such as.

Before 39 weeks by or is not recommended unless required for other medical reasons. About 213 million pregnancies occurred in 2012, of which, 190 million were in the and 23 million were in the developed world. The number of pregnancies in women ages 15 to 44 is 133 per 1,000 women.

About 10% to 15% of recognized pregnancies end in miscarriage. In 2013, complications of pregnancy resulted in 293,000 deaths, down from 377,000 deaths in 1990. Common causes include, complications of, high blood pressure of pregnancy,, and. Globally, 40% of pregnancies are.

Half of unplanned pregnancies are. Among unintended pregnancies in the United States, 60% of the women used to some extent during the month pregnancy occurred.

Anatomia uteri humani gravidi tabulis illustrata, 1774 Associated terms for pregnancy are gravid and parous. Gravidus and gravid come from the for 'heavy' and a pregnant female is sometimes referred to as a.

Is a term used to describe the number of times that a female has been pregnant. Similarly, the term is used for the number of times that a female carries a pregnancy to a. Twins and other multiple births are counted as one pregnancy and birth. Download Camfrog Di Android. 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, and a woman in subsequent pregnancies as a or as multiparous. 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,, and/ or account for parity values being less than the gravida number. In the case of a the gravida number and parity value are increased by one only. Women who have never carried a pregnancy achieving more than 20 weeks of gestation age are referred to as nulliparous. 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. Signs and symptoms. Pigment changes to the face due to pregnancy The are those presentations and conditions that result from pregnancy but do not significantly interfere with or pose a threat to the health of the mother or baby.

This is in contrast to. Sometimes a symptom that is considered a discomfort can be considered a complication when it is more severe.

For example, nausea () can be a discomfort, but if, in combination with significant vomiting it causes a, it is a complication known as. Common symptoms and discomforts of pregnancy include: • Tiredness. Occasional, irregular, and often painless contractions that occur several times per day. • (swelling). Common complaint in advancing pregnancy. Caused by compression of the and pelvic veins by the leads to increased hydrostatic pressure in lower extremities.

A common complaint, caused by increased intravascular volume, elevated, and compression of the by the expanding uterus. Common complaint caused by relaxation of the venous and increased intravascular pressure. Swollen veins at or inside the anal area. Caused by impaired venous return, straining associated with constipation, or increased intra-abdominal pressure in later pregnancy. • • is common during the first trimester, and is more common in women who are pregnant at a young age. In addition, pregnancy may result in such as or worsening of an.

Chronology The chronology of pregnancy is, unless otherwise specified, generally given as, where the starting point is the woman's last normal (LMP), or the corresponding age of the gestation as estimated by a more accurate method if available. Sometimes, timing may also use the which is the age of the embryo.

Start of gestational age. Main article: According to, the main methods to calculate gestational age are: • Directly calculating the days since the beginning of the.

• Early, comparing the size of an or to that of a of pregnancies of known gestational age (such as calculated from last menstrual periods), and using the mean gestational age of other embryos or fetuses of the same size. If the gestational age as calculated from an early ultrasound is contradictory to the one calculated directly from the last menstrual period, it is still the one from the early ultrasound that is used for the rest of the pregnancy. • In case of, calculating days since or and adding 14 days. Estimation of due date. Main article: Due date estimation basically follows two steps: • Determination of which time point is to be used as for, as described in section above. • Adding the estimated gestational age at childbirth to the above time point.

Childbirth on average occurs at a gestational age of 280 days (40 weeks), which is therefore often used as a standard estimation for individual pregnancies. However, alternative durations as well as more individualized methods have also been suggested. 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, which essentially always give consistent estimations compared to each other and correct for, while pregnancy wheels made of paper can differ from each other by 7 days and generally do not correct for leap year. Furthermore, actual childbirth has only a certain probability of occurring within the limits of the estimated due date.

A study of singleton live births came to the result that childbirth has a of 14 days when gestational age is estimated by first trimester, and 16 days when estimated directly by last menstrual period. Fertilization and implantation in humans Through an interplay of hormones that includes that stimulates and creates a mature, the female.

Is the event where the egg cell fuses with the male gamete,. After the point of fertilization, the fused product of the female and male gamete is referred to as a or fertilized egg.

The fusion of male and female gametes usually occurs following the act of. Fertilization can also occur by such as and. Fertilization (conception) is sometimes used as the initiation of pregnancy, with the derived age being termed. 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. In this model, during the time between conception and implantation, the future fetus exists, but the woman is not considered pregnant. Development of embryo and fetus. The initial stages of The sperm and the egg cell, which has been released from one of the female's two, unite in one of the two.

The fertilized egg, known as a, then moves toward the uterus, a journey that can take up to a week to complete. Cell division begins approximately 24 to 36 hours after the male and female cells unite. Cell division continues at a rapid rate and the cells then develop into what is known as a.

The blastocyst arrives at the uterus and attaches to the uterine wall, a process known as. The development of the mass of cells that will become the infant is called during the first approximately ten weeks of gestation.

During this time, cells begin to differentiate into the various body systems. The basic outlines of the organ, body, and nervous systems are established. By the end of the embryonic stage, the beginnings of features such as fingers, eyes, mouth, and ears become visible. Also during this time, there is development of structures important to the support of the embryo, including the and.

The connects the developing embryo to the uterine wall to allow nutrient uptake, waste elimination, and gas exchange via the mother's blood supply. The is the connecting cord from the embryo or fetus to the placenta.

After about ten weeks of gestational age, the embryo becomes known as a. At the beginning of the fetal stage, the risk of miscarriage decreases sharply. At this stage, a fetus is about 30 mm (1.2 inches) in length, the heartbeat is seen via ultrasound, and the fetus makes involuntary motions. During continued fetal development, the early body systems, and structures that were established in the embryonic stage continue to develop.

Sex organs begin to appear during the third month of gestation. The fetus continues to grow in both weight and length, although the majority of the physical growth occurs in the last weeks of pregnancy. Electrical is first detected between the fifth and sixth week of gestation. It is considered primitive neural activity rather than the beginning of conscious thought. Synapses begin forming at 17 weeks, and begin to multiply quickly at week 28 until 3 to 4 months after birth. Breast changes as seen during pregnancy. The areolae are larger and darker.

During pregnancy, the woman undergoes many changes, which are entirely normal, including,,,, and changes. Increases in blood sugar, breathing, and cardiac output are all required. Levels of progesterone and oestrogens rise continually throughout pregnancy, suppressing the hypothalamic axis and therefore also the menstrual cycle. The fetus is genetically different from the woman and can be viewed as an unusually successful.

The main reason for this success is increased during pregnancy. Immune tolerance is the concept that the body is able to not mount an immune system response against certain triggers. Pregnancy is typically broken into three periods, or trimesters, each of about three months. Each trimester is defined as 14 weeks, for a total duration of 42 weeks, although the average duration of pregnancy is 40 weeks. While there are no hard and fast rules, these distinctions are useful in describing the changes that take place over time.

First trimester. By the end of the second trimester, the expanding uterus has created a visible 'baby bump'. Although the breasts have been developing internally since the beginning of the pregnancy, most of the visible changes appear after this point. Weeks 13 to 28 of the pregnancy are called the second trimester. Most women feel more energized in this period, 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.

Although the fetus begins to move during the first trimester, it is not until the second trimester that movement, often referred to as ', can be felt. This typically happens in the fourth month, more specifically in the 20th to 21st week, or by the 19th week if the woman has been pregnant before. It is common for some women not to feel the fetus move until much later.

During the second trimester, most women begin to wear. Third trimester. The expands making up a larger and larger portion of the woman's abdomen. At left anterior view with months labeled, at right lateral view labeling the last 4 weeks.

During the final stages of gestation before childbirth the fetus and uterus will drop to a lower position. Final weight gain takes place, 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 will sometimes become convex, 'popping' out, due to the expanding., where the fetal head descends into, relieves pressure on the upper abdomen with renewed ease in breathing. It also severely reduces bladder capacity, and increases pressure on the pelvic floor and the rectum. It is also during the third trimester that maternal activity and sleep positions may affect fetal development due to restricted blood flow. For instance, the enlarged uterus may impede blood flow by compressing the when lying flat, which is relieved by lying on the left side. Main article: Childbirth, referred to as labor and delivery in the medical field, is the process whereby an infant is born. A woman is considered to be in labour when she begins experiencing regular uterine contractions, accompanied by changes of her cervix – primarily effacement and dilation.

While childbirth is widely experienced as painful, some women do report painless labours, while others find that concentrating on the birth helps to quicken labour and lessen the sensations. Most births are successful vaginal births, but sometimes complications arise and a woman may undergo a. During the time immediately after birth, both the mother and the baby are hormonally cued to bond, the mother through the release of, a hormone also released during. Studies show that skin-to-skin contact between a mother and her newborn immediately after birth is beneficial for both the mother and baby. A review done by the found that skin-to-skin contact between mothers and babies after birth reduces crying, improves mother–infant interaction, and helps mothers to breastfeed successfully. They recommend that be allowed to bond with the mother during their first two hours after birth, the period that they tend to be more alert than in the following hours of early life.

Childbirth maturity stages. Further information: and Stages of pregnancy term stage starts ends Preterm - at 37 weeks Early term 37 weeks 39 weeks Full term 39 weeks 41 weeks Late term 41 weeks 42 weeks Postterm 42 weeks - In the ideal labor begins on its own when a woman is 'at term'. Pregnancy is considered at term when gestation has lasted between 37 and 42 weeks. Events before completion of 37 weeks are considered preterm. Is associated with a range of complications and should be avoided if possible. Sometimes if a woman's or she has before 39 weeks, birth is unavoidable. However, spontaneous birth after 37 weeks is considered term and is not associated with the same risks of a pre-term birth.

Planned birth before 39 weeks by or, although 'at term', results in an increased risk of complications. This is from factors including, infection due to underdeveloped immune system, feeding problems due to underdeveloped brain, and from underdeveloped liver. Babies born between 39 and 41 weeks gestation have better outcomes than babies born either before or after this range.

This special time period is called 'full term'. Whenever possible, waiting for labor to begin on its own in this time period is best for the health of the mother and baby. The decision to perform an induction must be made after weighing the risks and benefits, but is safer after 39 weeks. Events after 42 weeks are considered.

When a pregnancy exceeds 42 weeks, the risk of complications for both the woman and the fetus increases significantly. Therefore, in an otherwise uncomplicated pregnancy, obstetricians usually prefer to at some stage between 41 and 42 weeks. Postnatal period.

Main article: The postnatal period, also referred to as the puerperium, begins immediately after delivery and extends for about six weeks. During this period, the mother's body begins the return to pre-pregnancy conditions that includes changes in hormone levels and uterus size. Diagnosis The beginning of pregnancy may be detected either based on symptoms by the woman herself, or by using.

However, an important condition with serious health implications that is quite common is the by the pregnant woman. About one 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. 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. Physical signs.

In a woman at 22 weeks pregnant Most pregnant women experience a number of symptoms, which can signify pregnancy. A number of early are associated with pregnancy. These signs include: • the presence of (hCG) in the blood and urine • missed • implantation bleeding that occurs at of the embryo in the uterus during the third or fourth week after last menstrual period • increased sustained for over 2 weeks after • (darkening of the,, and ) • (softening of the vaginal portion of the cervix) • (softening of the ) • Pigmentation of the –, (darkening of the skin in a midline of the, caused by resulting from hormonal changes, usually appearing around the middle of pregnancy). • Darkening of the nipples and areolas due to an increase in hormones. Further information: Pregnancy detection can be accomplished using one or more various, which detect hormones generated by the newly formed, serving as of pregnancy. Blood and urine tests can detect pregnancy 12 days after implantation.

Blood pregnancy tests are more sensitive than urine tests (giving fewer false negatives). Home are tests, and normally detect a pregnancy 12 to 15 days after fertilization. A quantitative blood test can determine approximately the date the embryo was conceived because HCG doubles every 36 to 48 hours.

A single test of levels can also help determine how likely a fetus will survive in those with a (bleeding in early pregnancy). Main articles: and is care that is provided to a woman and/ or couple to discuss conception, pregnancy, current health issues and recommendations for the period before pregnancy. Is the medical and nursing care recommended for women during pregnancy, time intervals and exact goals of each visit differ by country. Women who are high risk have better outcomes if they are seen regularly and frequently by a medical professional than women who are low risk. A woman can be labeled as high risk for different reasons including previous complications in pregnancy, complications in the current pregnancy, current medical diseases, or social issues. The aim of good prenatal care is prevention, early identification, and treatment of any medical complications. A basic prenatal visit consists of measurement of blood pressure,, weight and fetal heart rate, checking for symptoms of labor, and guidance for what to expect next.

Main article: during pregnancy is important to ensure healthy growth of the fetus. Nutrition during pregnancy is different from the non-pregnant state. There are increased energy requirements and specific micronutrient requirements.

Women benefit from education to encourage a balanced energy and protein intake during pregnancy. Some women may need professional medical advice if their diet is affected by medical conditions, food allergies, or specific religious/ ethical beliefs. Adequate periconceptional (time before and right after conception) (also called folate or Vitamin B 9) intake has been shown to decrease the risk of fetal neural tube defects, such as.

The neural tube develops during the first 28 days of pregnancy, a urine pregnancy test is not usually positive until 14 days post-conception, explaining the necessity to guarantee adequate folate intake before conception. Folate is abundant in,, and. In the United States and Canada, most wheat products (flour, noodles) are fortified with folic acid. Is a major structural fatty acid in the brain and retina, and is naturally found in breast milk.

It is important for the woman to consume adequate amounts of DHA during pregnancy and while nursing to support her well-being and the health of her infant. Developing infants cannot produce DHA efficiently, and must receive this vital nutrient from the woman through the placenta during pregnancy and in breast milk after birth. Several are important for the health of the developing fetus, especially in areas of the world where insufficient nutrition is common. Women living in low and middle income countries are suggested to take multiple micronutrient supplements containing iron and folic acid. These supplements have been shown to improve birth outcomes in developing countries, but do not have an effect on perinatal mortality. Adequate intake of folic acid, and iron is often recommended.

In developed areas, such as Western Europe and the United States, certain nutrients such as and, required for bone development, may also require supplementation. Vitamin E supplementation has not been shown to improve birth outcomes. Zinc supplementation has been associated with a decrease in preterm birth, but it is unclear whether it is causative.

Daily iron supplementation reduces the risk of maternal anemia. Studies of routine daily iron supplementation for pregnant women found improvement in blood iron levels, without a clear clinical benefit. The nutritional needs for women carrying twins or triplets.

Are higher than those of women carrying one baby. Women are counseled to avoid certain foods, because of the possibility of contamination with bacteria or parasites that can cause illness. Careful washing of fruits and raw vegetables may remove these pathogens, as may thoroughly cooking leftovers, meat, or processed meat.

Unpasteurized dairy and deli meats may contain, which can cause neonatal meningitis, stillbirth and miscarriage. Pregnant women are also more prone to infections, can be in eggs and poultry, which should be thoroughly cooked. Cat feces and undercooked meats may contain the parasite and can cause. Practicing good hygiene in the kitchen can reduce these risks. Women are also counseled to eat seafood in moderation and to eliminate seafood known to be high in mercury because of the risk of birth defects.

Pregnant women are counseled to consume caffeine in moderation, because large amounts of caffeine are associated with miscarriage. However, the relationship between caffeine, birthweight, and preterm birth is unclear. Weight gain The amount of healthy weight gain during a pregnancy varies. Weight gain is related to the weight of the baby, the placenta, extra circulatory fluid, larger tissues, and fat and protein stores. Most needed weight gain occurs later in pregnancy.

The recommends an overall pregnancy weight gain for those of normal weight ( of 18.5–24.9), of 11. Mess System Bios Roms For Ps2. 3–15.9 kg (25–35 pounds) having a singleton pregnancy. Women who are underweight (BMI of less than 18.5), should gain between 12.7–18 kg (28–40 lbs), while those who are (BMI of 25–29.9) are advised to gain between 6.8–11.3 kg (15–25 lbs) and those who are (BMI>30) should gain between 5–9 kg (11–20 lbs). These values reference the expectations for a term pregnancy. Provides a more accurate calculation of weight gain by gestational age. During pregnancy, insufficient or excessive weight gain can compromise the health of the mother and fetus. The most effective intervention for weight gain in underweight women is not clear. Being or becoming overweight in pregnancy increases the risk of complications for mother and fetus, including,,, and.

Excessive weight gain can make losing weight after the pregnancy difficult. Around 50% of women of childbearing age in developed countries like the United Kingdom are overweight or obese before pregnancy.

Diet modification is the most effective way to reduce weight gain and associated risks in pregnancy. A diet that has foods with a low may help prevent the onset of gestational diabetes. Main article: Drugs used during pregnancy can have temporary or permanent effects on the fetus. Anything (including drugs) that can cause permanent deformities in the fetus are labeled as. In the U.S., drugs were classified into categories A, B, C, D and X based on the (FDA) rating system to provide therapeutic guidance based on potential benefits and fetal risks. Drugs, including some, that have demonstrated no fetal risks after controlled studies in humans are classified as Category A. On the other hand, drugs like with proven fetal risks that outweigh all benefits are classified as Category X.

Recreational drugs The use of in pregnancy can cause various. • during pregnancy can cause and. Studies have shown that light to moderate drinking during pregnancy might not pose a risk to the fetus, although no amount of alcohol during pregnancy can be guaranteed to be absolutely safe. • can cause a wide range of behavioral, neurological, and physical difficulties. Smoking during pregnancy causes twice the risk of, and. Smoking is associated with 30% higher odds of preterm birth.

• is associated with, and. • can cause and. Short-term neonatal outcomes show small deficits in infant neurobehavioral function and growth restriction. Long-term effects in terms of impaired brain development may also be caused by methamphetamine use. • has been shown to be teratogenic in large doses in animals, but has not shown any teratogenic effects in humans.

Exposure to toxins. A video describing research on N95 respirator use during advanced pregnancy Intrauterine exposure to has the potential to cause adverse effects on the of the / and to cause. Air pollution has been associated with low birth weight infants. Conditions of particular severity in pregnancy include and. To minimize exposure to environmental toxins, the American College of Nurse-Midwives recommends: checking whether the home has, washing all fresh and thoroughly and buying produce, and avoiding cleaning products labeled 'toxic' or any product with a warning on the label. Pregnant women can also be exposed to, including airborne particles. The effects of wearing N95 filtering facepiece are similar for pregnant women as non-pregnant women, and wearing a respirator for one hour does not affect the fetal heart rate.

Sexual activity. Main article: Most women can continue to engage in sexual activity throughout pregnancy. Most research suggests that during pregnancy both sexual desire and frequency of sexual relations decrease. In context of this overall decrease in desire, some studies indicate a second-trimester increase, preceding a decrease during the third trimester. Sex during pregnancy is a low-risk behavior except when the healthcare provider advises that sexual intercourse be avoided for particular medical reasons.

For a healthy pregnant woman, there is no safe or right way to have sex during pregnancy. Pregnancy alters the with a reduction in microscopic species/genus diversity. Exercise Regular aerobic exercise during pregnancy appears to improve (or maintain) physical fitness. During pregnancy does appear to decrease the risk of., outside of research studies, is not recommended as there is no evidence of benefit and potential harm. The Clinical Practice Obstetrics Committee of Canada recommends that 'All women without contraindications should be encouraged to participate in aerobic and strength-conditioning exercises as part of a healthy lifestyle during their pregnancy'.

Although an upper level of safe exercise intensity has not been established, women who were regular exercisers before pregnancy and who have uncomplicated pregnancies should be able to engage in high intensity exercise programs. In general, participation in a wide range of recreational activities appears to be safe, with the avoidance of those with a high risk of falling such as horseback riding or skiing or those that carry a risk of abdominal trauma, such as soccer or hockey. The American College of Obstetricians and Gynecologists reports that in the past, the main concerns of exercise in pregnancy were focused on the fetus and any potential maternal benefit was thought to be offset by potential risks to the fetus. However, they write that more recent information suggests that in the uncomplicated pregnancy, fetal injuries are highly unlikely. They do, however, list several circumstances when a woman should contact her health care provider before continuing with an exercise program: vaginal bleeding, before exertion, dizziness, headache, chest pain, muscle weakness, preterm labor, decreased fetal movement, amniotic fluid leakage, and calf pain or swelling (to rule out ).

Sleep It has been suggested that and exposure to bright light at night should be avoided at least during the last trimester of pregnancy to decrease the risk of psychological and behavioral problems in the newborn. Main article: Each year, ill health as a result of pregnancy is experienced (sometimes permanently) by more than 20 million women around the world. In 2013 complications of pregnancy resulted in 293,000 deaths down from 377,000 deaths in 1990. Common causes include (44,000), complications of abortion (44,000), (29,000), (24,000), and (19,000). The following are some examples of pregnancy complications: • • • • • Thromboembolic disorders. These are the leading cause of death in pregnant women in the US. • (Pruritic Urticarial Papules and Plaques of Pregnancy), a skin disease that develops around the 32nd week.

Signs are red plaques, papules, and itchiness around the belly button that then spreads all over the body except for the inside of hands and face. •, implantation of the embryo outside the uterus. •, excessive nausea and vomiting that is more severe than normal morning sickness. •, blood clots that form in the legs that can migrate to the lungs. There is also an increased.

Intercurrent diseases. Main article: A pregnant woman may have, defined as disease not directly caused by the pregnancy, but that may become worse or be a potential risk to the pregnancy. • deals with the interactions of (not restricted to ) and pregnancy. Risks for the child include miscarriage, growth restriction, growth acceleration, fetal obesity (macrosomia), (too much amniotic fluid), and birth defects. • can, if uncorrected, cause adverse effects on fetal and maternal well-being. The deleterious effects of thyroid dysfunction can also extend beyond pregnancy and delivery to affect neurointellectual development in the early life of the child.

Demand for thyroid hormones is increased during pregnancy which may cause a previously unnoticed thyroid disorder to worsen. • Untreated can cause (miscarriage),,, and. Often are the only manifestation of undiagnosed celiac disease and most cases are not recognized.

Complications or failures of pregnancy cannot be explained simply by malabsorption, but by the autoimmune response elicited by the exposure to, which causes damage to the. The avoids or reduces the risk of developing reproductive disorders in pregnant women with celiac disease. Also, pregnancy can be a trigger for the development of celiac disease in genetically susceptible women who are consuming gluten. • confers an increased rate of fetal death in utero, spontaneous abortion, and of. • is the propensity of pregnant women to develop (blood clots). Pregnancy itself is a factor of (pregnancy-induced hypercoagulability), as a physiologically adaptive mechanism to prevent.

However, in combination with an underlying hypercoagulable states, the risk of thrombosis or embolism may become substantial. Medical imaging. See also: and About 213 million pregnancies occurred in 2012 of which 190 million were in the and 23 million were in the developed world.

This is about 133 pregnancies per 1,000 women between the ages of 15 and 44. About 10% to 15% of recognized pregnancies end in miscarriage. Globally 40% of pregnancies are.

Half of unplanned pregnancies are. Of pregnancies in 2012 120 million occurred in Asia, 54 million in Africa, 19 million in Europe, 18 million in Latin America and the Caribbean, 7 million in North America, and 1 million in. Pregnancy rates are 140 per 1000 women of childbearing age in the developing world and 94 per 1000 in the developed world. The rate of pregnancy, as well as the ages at which it occurs, differ by country and region. It is influenced by a number of factors, such as cultural, social and religious norms; access to contraception; and rates of education. The (TFR) in 2013 was estimated to be highest in (7.03 children/woman) and lowest in (0.79 children/woman).

In Europe, the average childbearing age has been rising continuously for some time. In Western, Northern, and Southern Europe, first-time mothers are on average 26 to 29 years old, up from 23 to 25 years at the start of the 1970s. In a number of European countries (Spain), the mean age of women at first childbirth has crossed the 30-year threshold. This process is not restricted to Europe. Asia, Japan and the United States are all seeing average age at first birth on the rise, and increasingly the process is spreading to countries in the developing world like China, Turkey and Iran.

In the US, the average age of first childbirth was 25.4 in 2010. In the United States and United Kingdom, 40% of pregnancies are, and between a quarter and half of those unplanned pregnancies were. Globally, an estimated 270,000 women die from pregnancy-related complications each year. Society and culture. Circa 1305 In most cultures, pregnant women have a special status in society and receive particularly gentle care. At the same time, they are subject to expectations that may exert great psychological pressure, such as having to produce a son and heir.

In many traditional societies, pregnancy must be preceded by marriage, on pain of ostracism of mother and. Overall, pregnancy is accompanied by numerous customs that are often subject to ethnological research, often rooted in or religion. The is an example of a modern custom. Pregnancy is an important topic in. The prospective child may preliminarily be placed into numerous. The parents' relationship and the relation between parents and their surroundings are also affected. A may be made during pregnancy as a keepsake.

Main article: Images of pregnant women, especially small, were made in traditional cultures in many places and periods, though it is rarely one of the most common types of image. These include ceramic figures from some cultures, and a few figures from most of the ancient Mediterranean cultures. Many of these seem to be connected with. Identifying whether such figures are actually meant to show pregnancy is often a problem, as well as understanding their role in the culture concerned.

Among the oldest surviving examples of the depiction of pregnancy are prehistoric found across much of and collectively known as. Some of these appear to be pregnant. Due to the important role of the in, the Western visual arts have a long tradition of depictions of pregnancy, especially in the biblical scene of the, and devotional images called a. The unhappy scene usually called Diana and Callisto, showing the moment of discovery of 's forbidden pregnancy, is sometimes painted from the Renaissance onwards. Gradually, portraits of pregnant women began to appear, with a particular fashion for 'pregnancy portraits' in elite portraiture of the years around 1600. Pregnancy, and especially pregnancy of unmarried women, is also an important motif in literature.

Notable examples include Hardy's and Goethe's. • Pregnancy in art •. Main article: An abortion is the termination of an embryo or fetus, either naturally or via medical methods. When done electively, it is more often done within the first trimester than the second, and rarely in the third. Not using contraception, contraceptive failure, poor family planning or rape can lead to.

Legality of socially indicated abortions varies widely both internationally and through time. In most countries of Western Europe, abortions during the first trimester were a criminal offense a few decades ago [ ] but have since been legalized, sometimes subject to mandatory consultations. In Germany, for example, as of 2009 less than 3% of abortions had a medical indication. Legal protection Many countries have various legal regulations in place to protect pregnant women and their children. Ensures that pregnant women are exempt from activities such as night shifts or carrying heavy stocks. Typically provides paid leave from work during roughly the last trimester of pregnancy and for some time after birth. Notable extreme cases include Norway (8 months with full pay) and the United States (no paid leave at all except in some states).

Moreover, many countries have laws against. In 2014, the American state of passed a law which allows prosecutors to charge a woman with criminal assault if she uses illegal drugs during her pregnancy and her fetus or newborn is considered harmed as a result. In the United States, laws make some actions that result in miscarriage or stillbirth crimes. One such law is the federal.