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A step by step approach on the physiological state of Pregnancy
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NOMAD: REP PHYSIOL: PREGNANCY
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PHYSIOLOGY OF PREGNANCY
ByDr.M.Anthony David MDProfessor of Physiology
NOMAD: REP PHYSIOL: PREGNANCY
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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
NOMAD: REP PHYSIOL: PREGNANCY
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EMBRYOGENESIS: AN ANIMATION
NOMAD: REP PHYSIOL: PREGNANCY
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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.
NOMAD: REP PHYSIOL: PREGNANCY
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PREGNANCY: URINARY HORMONES
NOMAD: REP PHYSIOL: PREGNANCY
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FETO PLACENTAL UNITPLACENTA FETAL ADRENAL
CHOLESTEROL
PREGNENOLONE
PROGESTERONE
DHEAS
16-OH- DHEAS
CORTISOL &CORTICOSTERONE
ESTRADIOL
ESTRIOL
DHEAS
16-0H-DHEAS
NOMAD: REP PHYSIOL: PREGNANCY
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TESTS OF PREGNANCY1. ASCHEIM ZONDEK TEST2. FRIEDMAN TEST3. GALLI-MAININI TEST4. IMMUNOLOGICAL TESTS
a) SHEEP RBC AGGLUTINATIONb) LATEX PARTICLE AGGLUTINATIONc) GRAVINDEX TEST
NOMAD: REP PHYSIOL: PREGNANCY
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TESTS OF PREGNANCY1. ASCHEIM ZONDEK TEST2. FRIEDMAN TEST3. GALLI-MAININI TEST4. IMMUNOLOGICAL TESTS
a) SHEEP RBC AGGLUTINATIONb) LATEX PARTICLE AGGLUTINATIONc) GRAVINDEX TEST
NOMAD: REP PHYSIOL: PREGNANCY
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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.
NOMAD: REP PHYSIOL: PREGNANCY
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TESTS OF PREGNANCY1. ASCHEIM ZONDEK TEST2. FRIEDMAN TEST3. GALLI-MAININI TEST4. IMMUNOLOGICAL TESTS
a) SHEEP RBC AGGLUTINATIONb) LATEX PARTICLE AGGLUTINATIONc) GRAVINDEX TEST
NOMAD: REP PHYSIOL: PREGNANCY
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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.
NOMAD: REP PHYSIOL: PREGNANCY
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TESTS OF PREGNANCY1. ASCHEIM ZONDEK TEST2. FRIEDMAN TEST3. GALLI-MAININI TEST4. IMMUNOLOGICAL TESTS
a) SHEEP RBC AGGLUTINATIONb) LATEX PARTICLE AGGLUTINATIONc) GRAVINDEX TEST
NOMAD: REP PHYSIOL: PREGNANCY
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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.
NOMAD: REP PHYSIOL: PREGNANCY
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TESTS OF PREGNANCY1. ASCHEIM ZONDEK TEST2. FRIEDMAN TEST3. GALLI-MAININI TEST4. IMMUNOLOGICAL TESTS
a) SHEEP RBC AGGLUTINATIONb) LATEX PARTICLE AGGLUTINATIONc) GRAVINDEX TEST
NOMAD: REP PHYSIOL: PREGNANCY
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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
NOMAD: REP PHYSIOL: PREGNANCY
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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.
NOMAD: REP PHYSIOL: PREGNANCY
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GRAVINDEX: HCG TEST KIT
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PHYSIOLOGICAL CHANGES IN PREGNANCY
CNS:I Trimester:
Excitement Depression Irritability
II Trimester: Euphoria: a sense of ‘well
being’III Trimester:
Worries and anxieties
NOMAD: REP PHYSIOL: PREGNANCY
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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.
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CHANGES IN GASTROINTESTINAL SYSTEM
MORNING SICKNESS: HYPEREMESIS GRAVIDARUM
CONSTIPATION HEARTBURN ACIDITY DUE TO LES TONE
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CUTANEOUS CHANGES
INCREASED PIGMENTATION PURPLE STRIA: STRIAE
GRAVIDARUMRENAL CHANGES
INCREASED FREQUENCY. SLIGHT ALBUMINURIA. SODIUM & WATER RETENTION.
NOMAD: REP PHYSIOL: PREGNANCY
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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.
NOMAD: REP PHYSIOL: PREGNANCY
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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.
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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.
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CHANGES IN MAMMARY GLANDS
BREASTS ARE ENLARGED. THE AREOLA AND NIPPLES ARE
DARKENED & SWOLLEN.
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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
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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: REP PHYSIOL: PREGNANCY
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