PHYSIOLOGICAL CHANGES IN BODY

MODIFIED CHANGES IN PREGNANCY
During pregnancy, there are various changes in the body in almost every organ and system.

Because of the weight of both the baby and the baby and the appendages of the baby, the mother gets weight due to the increase of the fat, the increase of the blood volume and the enlargement in the breast.

- Pregnancy increases water retention in the mother's body.
- Blood volume increases. There is a volume increase of about 1500 ml, which consists of 1200 ml plasma and 300 ml erythrocytes. As the plasma increases, dilutional anemia occurs. Hemoglobin and hematocrit values ​​are reduced.
- In pregnancy, triglycerides and total cholesterol, HDL, LDL, VLDL and free fatty acids increase.
- The iron needs are increasing and can not be met with nutrients, additional iron pills are required.
- Normally, a woman's blood volume, which is 3.5 liters, increases by about 5 liters.
- In pregnancy, the white blood cell (leukocyte) increases. Leukocyte increase is due to neutrophil, lymphocytes do not change.
- The platelet level is reduced.
- Sedimentation rate and acute phase reactors such as C-reactive protein rise. The parameter that is primarily responsible for the increased sedimentation is the increase in fibrinogen.
- In pregnancy the immune system (humoral and cellular immunity) is suppressed, ie suppressed.
- In pregnancy, the tendency to coagulate coagulation increases.
- In pregnancy, the heart rate increases by 10 beats / min. The amount of blood pumped by the heart increases.
- Breast augmentation in pregnancy, diaphragm rise.
- A small amount of glucose (sugar) is excreted in the urine, which means that glycosuria is normal in pregnancy.
- Due to the pressure of the uterus and the effect of the progesterone hormone, it may cause enlargement in the urine (ureters).
- Daily urine output increases and frequent urination occurs.
- Gum hypertrophy (epulis) and bleeding may occur.
Hemorrhoids (hemorrhoids) may increase during pregnancy.
- The risk of developing gallstones increases.
- The slope of the lumbar region of the spine increases (lordoz).
- The pelvis (pelvic) joints come to relax.
- In pregnancy, the tidal volume increases and the residual volume decreases in the lungs.
Glomerular filtration rate increases.
- Plasma creatinine is reduced.
- Plasma urea is reduced.
- Alkaline phosphatase (ALP) increases physiologically.
- Plasma total protein and albumin decrease. Total globulin increases.
- Biliribin levels in maternal serum decrease during pregnancy, bile acids increase.
- Liver enzyme levels (ALT, AST) decrease in maternal serum during pregnancy.
- The intraocular pressure decreases during pregnancy. Corneal thickness may increase due to edema.
- Bicarbonate threshold decreases during pregnancy, blood level decreases (respiratory alcohol to compensate)
- Lipolytic activity in fat tissue increases in pregnancy
- Lipoprotein lipase activity in the liver decreases.
- Uterus size has a volume of 5 liters in the last month of your pregnancy. In the near future, the weight of the uterus reaches about 1000 gr.
- In pregnancy, blood pressure (especially diastolic pressure) falls in the first trimester, and it increases to pre-pregnancy level in the last few months. During birth, both systolic and diastolic blood pressures are elevated.
- In pregnancy, heart rate and cardiac output increase, even more during birth. The first and third heart sounds get harder. Systolic murmur may be normal in pregnancy, but diastolic murmur should always be considered pathologic.
- A slight left-hand axis deviation appears on the ECG.
- Kidney size increases slightly in pregnancy. Glomerular filtration rate increases. Urea, creatinine, uric acid levels in maternal serum decrease. Creatinine clearance increases.
- Daily urine volume increases.
- Ureter widen slightly (especially right)
- In pregnancy serum total calcium level decreases but free calcium level does not change. Calcium excretion increases with urine.
- In pregnancy, sodium (Na) and potassium (K) levels decrease in maternal plasma.
- Breathing rate does not change during pregnancy. The increase in diaphragm reduces total lung capacity and residual capacities. Minute ventilator volume increases. Lung compliance does not change, but total lung resistance decreases and airway conduction increases.
- In pregnancy, arterial pCO2 decreases slightly, compensatory respiratory alkalosis occurs. HCO3 (bicarbonate) decreases. Plasma pH increases slightly, alkaline.
- The hemoglobin-oxygen dissociation curve slides to the left for increased Kanda pH, increasing the oxygen affinity of the hemoglobin in the mother.
 - In pregnancy, acid secretion decreases and mucus secretion increases, which is why patients with peptic ulceration recover during pregnancy.
- Burning pyrosis (heartburn, pregnancy reflux) may come to the fore with the stomach contents coming back towards the neck.
- There is a slight growth in the pituitary gland during pregnancy.
- Total T3 and T4 increases in pregnancy, free T3 and free T4 invariant (thyroid hormones). TRH and TSH do not change. The T3 resin uptake is reduced.
- Increase cortisone hormone levels in pregnancy.
- Physiological hyperparathyroidism comes to the fore. Calcitonin and 1.25 dihydroxy vitamin D3 levels are also increased.
- Testosterone and androstenedione increase. DHEA-Sulfate

PREGNANCY (PREGNANCY) ULTRASON

ULTRASON EVALUATION IN PREGNANCY PERIOD
Today, ultrasonography is the most important part of pregnancy examination.
Even if there is no problem in pregnancy, ultrasonography control is performed at certain intervals at certain intervals. Different evaluations are done ultrasonically at different months of pregnancy. For example, in the first month of pregnancy, baby's weight is not measured but only evaluations such as heart rate and pouch size are made. In the 5th month of gestation, more detailed evaluation such as weight, water, placentan's condition and structure of organs are made and different evaluations are made in different months. You can find ultrasonographic measurements made in pregnancy by clicking here.

Ultrasonography may not detect an approximately 30-35% of the baby's anomaly. In other words, although most of the developmental disorders in the ultrasonic baby are detected, it is impossible to always detect all of them.

Ultrasonography has no harm to the baby. It does not contain radiation. If it is done even at frequent intervals, it does not harm baby.

For purposes of ultrasound in pregnancy:
Ultrasound in pregnancy is used to answer the following questions
- Is there a pregnancy? Is he in normal position? In the womb?
- Is pregnancy alive?
- How many months of pregnancy? How many weeks?
- Is your baby's nape thick?
- How much is your baby's estimated weight? Is weight gain normal for a week?
- Is your baby straight?
- Is your baby's placenta normal? Is your wife settlement normal? Is it closing the birth route?
- Is the baby's head diameter and leg length normal?
- Is baby's water normal?
- Does the baby have an anomaly? By detailed ultrasonography performed around 18-20 weeks, it is investigated whether there is a developmental disorder in baby's organs. Detailed information about detailed ultrasonography can be found by clicking here.
- Biophysical profile assessment of baby movements, muscle tone and respiration are evaluated.
- In the presence of preterm birth, the length of the cervix can be measured.
- Is there a fibroid or cyst in the uterus and ovaries?
- What is sex?
- Doppler examination (blood flow) is assessed where necessary.
- Used in interventions such as amniocentesis or CVS.

It is not routinely necessary to make a 3 or 4 dimensional ultrasound during pregnancy, it is only the face, the hands, etc. of the family baby. It is useful if you want to see it, it is not useful to investigate the baby's condition and the existence of apology. The use of normal 2D ultrasound routinely is sufficient for pregnancy.

MEDICINES AND VITAMINS USED FOR PREGNANCY (PREGNANCY)

During pregnancy, the mother has some medications and vitamins that she should routinely use even if she has no complaints. In addition, there are some medications that are used when necessary in the face of complaints and some diseases during pregnancy. Every medicine used in normal people can not be used easily in pregnancy because most drugs can go from placenta to baby and harm the baby and some medicines do not go to babies or even do not harm and it can even be beneficial. For this reason, even the simplest medicines, including vitamins in pregnancy, should never be used without consulting a doctor. This topic is explained under a separate heading here.

Vitamins used in pregnancy:
Vitamins that should be used in pregnancy are FOLIC ACID. Even the most correct and useful thing is to start using folic acid before pregnancy, not after it starts pregnancy. It is recommended to use folic acid at least 3 months before pregnancy and continue until the end of the 3rd month after the pregnancy. For this reason, the person planning the pregnancy should start taking folic acid before conception. Folic acid is for the prevention of anomalies in the baby called neural tube defect. Normally 0.4 mg (400 mcg) folic acid per day is sufficient, but this dose should be 4 mg (4000 mcg) for those who have previously given birth to neural tube defects and who are in the risk group (epilepsy drug users, diabetics using insulin). If folic acid is forgotten for 1-2 days, it is advisable to take it regularly. Read more >>

Vitamins other than folic acid and MULTIVITAMIN preparations are drugs that are not required to be used in pregnancy. These medicines are widely available on the market and are widely taught in terms of their use in pregnancy. However, these multivitamins do not necessarily have to be used unless there is severe malnutrition in the mother, and no benefit has been shown. There is no objection to their use. However, taking these vitamins more than once a day may be objectionable, so you should not take more than your doctor recommended, because some of the vitamins can cause harm to the baby. Vitamin A, for example. Vitamins such as vitamin A are therefore found in low doses in vitamins produced for pregnancies. These vitamin medicines can cause stomach upset from time to time.

Other medicines:
It is strongly recommended that iron (blood) drugs should be used until birth even if they are not anemic during pregnancy. Pregnancy is a predisposition to cancer, and there is also blood loss during labor. Iron preparations prevent this irritation.

Other than these, a group of drugs commonly used in pregnancy are MAGNESIUM and CALCIUM (click for detailed information) preparations. Use of these medicines during pregnancy is not necessary, but there is no harm in using them. Routine use in every pregnancy is not recommended. They are usually preferred when there is slight contractions and cramps.

Medicines containing the PROGESTERON hormone are not recommended for routine use in every pregnancy. However, bleeding is used when the doctor feels appropriate, such as low risk. Even in the prevention of abortions, they are not proven drugs that are effective.

In pregnancy, pain relievers are not a group of drugs that can be used easily. Except for paracetamol derivatives, painkillers are not usually used in pregnancy unless it is necessary and often necessary. The majority of the fetuses have potentially harmful effects. For this reason, do not use any pain medication without consulting your doctor in pregnancy.

Apart from these, as nausea and vomiting complaints are frequently seen in pregnancy, medicines for these are prescribed by the doctor if necessary. Urinary tract infection, a common condition in pregnancy, can sometimes require medication. If the mother has diseases such as goiter, hypertension, diabetes, asthma, migraine, medicines for these are recommended by specialists. These medicines are selected from medicines that are not harmful to the gestation or may be the least harmful.

PREGNANCY (PREGNANCY) FOLLOW-UP

Pregnancy follow-up examinations are carried out from the beginning of pregnancy to postpartum period to assess the condition of the mother and baby, to inform the mother, to prevent or detect possible problems with mother and baby. It is more appropriate that these tests begin before the pregnancy occurs, since the couple is informed about the pregnancy and the vitamin is prepared for the pregnancy, the family is informed about the pregnancy, so that the mother starts the pregnancy in the healthiest way It is provided.

In case of pregnancy planned:
When you consult your doctor before the pregnancy has started, you will be given various surveys to your mother and try to avoid the risk of pregnancy according to their results. For example, if mother is anemic, it will be corrected before pregnancy. It is investigated whether or not infectious diseases such as rubella and the like have passed. If the mother does not have rubella, she should be very careful not to have it during pregnancy because rubella infection in pregnancy can cause problems. Pregnancy weight loss is recommended if the mother is overweight. In the case of diabetes mellitus, blood sugar should be regulated before pregnancy. The mother is informed about drug, smoking and alcohol use. For all women planning pregnancy, prophylactic dose of folic acid is recommended for NTD (neural tube defect) prophylaxis. Carriers are investigated for diseases such as hemoglinopathies, cystic fibrosis in risky regions.

Then your doctor will examine you and evaluate you almost once a month, depending on the condition of your pregnancy. At each visit the blood pressure and weight of the mother is measured. (Weight gain in pregnancy) There are some months of surveillance, these are done. Whether or not the baby's weight is normal for the month is evaluated by ultrasonography. The presence of abnormality in the baby is investigated, especially at the end of 5th month, the patient is directed to detailed ultrasonography. In the case of recent births, maternal birth and bone structure is compared with the baby's posture and weight by vaginal examination, and an approximate estimate of normal birth fulfillment is made. However, it is not and can not be guaranteed that normal birth will occur precisely until the moment of birth. In some cases, the baby is not expected to be upside down, or for other reasons, the birth of the normal birth is scheduled on the day of the cesarean section and the delivery is performed with the cesarean section.

Routine multivitamin supplements are not recommended for every pregnancy unless the mother's nutrition is not excessive. Multivitamin pills are given to those who have nutritional problems or to vegetarians. Medicines and vitamins used in pregnancy are explained on a separate topic.

HBsAg is performed to determine if the mother has passed hepatitis (jaundice). If the mother is HBsAg (+), the vaccine should be given to the baby immediately after birth in order to prevent the risk of passing to the baby during childbirth. The vaccination should be repeated at 2 and 6 months after birth. Hepatitis B vaccine is given to all newborns by the recommendation of the Ministry of Health. Patients with HBsAg (-) are advised to take hepatitis B vaccine as a preventive measure against the disease.

During the pregnancy, you can read in detail what kind of surveys will be made during which weeks and in what months.

PREGNANCY TEST (PREGNANCY TEST)



PREGNANCY TESTS (PREGNANCY TESTS)
Pregnancy starts from the moment that the sperm from a man fertilize the egg cell thrown from the ovaries. The baby is called the embryo in the period up to the end of the 8th week and the fetus in the period from birth until the 8th birth.

From the moment the embryo is placed into the endometrium, which is called the endometrium (5-6 days after fertilization), the pregnancy hormone called HCG (human chorionic gonadotropin) begins to be secreted into the cells surrounding the embryo. In pregnancy tests, it is the detection of this pregnancy hormone.

As the pregnancy progresses, the gradually increasing β-HCG starts to rise after a certain threshold level, and allows the pregnancy test to be positive in the urine. The pregnancy test performed by the Kandan also detects the amount of the adjacent B-HCG. For this reason, the blood test can detect the presence or absence of pregnancy without further delay. The urine test can never reach the reliability of the blood test. The probability of error is low when the presence of pregnancy in the urine test is detected; but if the absence is detected, it is necessary to repeat the test after a while considering the possibility of premature pregnancy. (In very early pregnancies, the urine test may not be able to show gestation, which may be very low for the blood test.)

The striking BETA-HCG hormone is a valuable test used in the detection and follow-up of conditions such as ectopic pregnancy, low molar pregnancy (also known as grape gestation), as well as being used to detect pregnancies not detected by the urine test or not visible by ultrasound. Kanda pregnancy test and B-HCG

PREGNANCY (PREGNANCY) SYMPTOMS

The following situations require a woman to suspect pregnancy:
- The delay of the expected period: This is the most important situation that creates the suspicion of pregnancy and it is mostly the first journalist of your pregnancy. Even though a woman with a delay of some time is using a contraceptive such as a contraceptive, she should still be suspicious of pregnancy and should have a pregnancy test or an ultrasonic examination to be certain. Detailed information about pregnancy tests can be found by clicking here. Of course, every delay does not mean pregnancy.
- Nausea, vomiting

- intolerance to food smells
- Fullness and sensitivity in the breasts
- Frequent urination

- Fatigue, fatigue

- The tendency to sleep

- inguinal pain

For a definite pregnancy diagnosis, pregnancy test and ultrasound examination should be done. Positive pregnancy in pregnancy test does not necessarily mean that there is a normal pregnancy, so ultrasound diagnosis of pregnancy must be confirmed. There is a possibility that your pregnancy may not be seen on the ultrasound because it is too small in the first days or even in the first weeks. However, if 5-6 weeks have passed since the last menstrual period, pregnancy reaches the visible size with ultrasound. In the caloric pregnancy test, when the HCG level reaches 1200-1500, the pregnancy comes to a size that can be seen with vaginal ultrasound.

PREGNANCY (PREGNANCY) PREGNANCY

PREGNANCY BEFORE PREGNANCY (PREGNANCY)

Some of the couple decide to have children without marrying marriage, and some decide to have children after a while from marriage. Couples who decide to have a child have some points to look out for. The most important of these are the substances listed below:

- You should consult your doctor when you decide not to become pregnant, not after you become pregnant. You will be given information about pregnancy, what you need to look out for during the pregnancy preparation period. Some surveys will be done before pregnancy.

- Every couple planning a pregnancy should begin using folic acid before they become pregnant to prevent anomalies called neural tube defects in the baby. You can find detailed information on this subject by clicking here.

- In order to make it easier to get pregnant, you have to be in close contact with the spawning days. Detailed information on the factors that make pregnancy easier can be reached by clicking here.

- Considering the possibility of getting pregnant at any time, it is important to pay attention not to use medications that can harm pregnancy. You should not use any medication without consulting your doctor.
- You should not be in X-rays (radiation) areas in a similar way.

- If you have habits such as cigarettes and alcohol, you need to prepare them for pregnancy and leave it in pregnancy (or even entirely if possible).

- A new married couple should stay away from the worry and stratagem as "why is not pregnancy yet" until 1 year of marriage has expired. Stress and anxiety will cause harm to a couple seeking pregnancy. Normally the expected duration for pregnancy in couples is 1 year (12 months uninterrupted regular sexual intercourse)

- The ideal sexual intercourse rate for pregnancy is 2 weeks per week.

Regular exercise and sports will make you feel physically and psychologically well before your pregnancy. Also, taking such activities before pregnancy will make it easier to exercise during pregnancy.

- If you have excess weight, you will benefit from pregnancy and childbirth with the help of a dietician who is in the process of preparing for pregnancy.

- If your age is greater than 35, it is recommended that you consult a gynecologist to assess your potential for over pregnancy (over reserve). You should not wait a year for your pregnancy to occur and for your doctor to refer you to younger ages.

- If you have hypertension, diabetes, goiter, anemia or any other systemic disease, you should refer to your doctor again and you will have to see the treatment planned during the pregnancy preparation period and during the pregnancy. For example, some medicines may need to be replaced.

- Care should be taken to ensure a balanced and regular diet during the pregnancy preparation period. As long as pregnancy is possible, a normal weight should be started. Obesity that develops after excessive caloric intake will bring some troubles during pregnancy.
- It will be useful to get information about pregnancy in advance, you should not expect to get pregnant for it