Ques. 1 Describe the Maternal Physiology in Pregnancy?
Ans. Duration of Pregnancy – The average duration of human pregnancy counting from the first day of the last menstrual period is about 280 days or 10 lunar months or 40 weeks. Ovulation delivery interval is 267 days (as ovulation occurs on 13th or 14th day in 28 days cycle). Expected date of delivery (EDD) is calculated by counting back 3 months and adding 7 days or by counting forward 9 months and 7 days. This rule is know as “Nagele’s Rule”. Pregnancy prolonged beyond 42 weeks is known as post term or prolonged pregnancy.
One third of post term pregnancies are also associated with placental insufficiency and they are called post-maturity.
- OVARIES TUBES – The corpus luteum of pregnancy increases. Ovulation ceases. The atretic follicles show lutein like cells in theca folliculi.
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- NERVOUS SYSTEM –There is a craving for abonormal articles of diet and this known as pica. Also may be a change in disposition and in patients with psychotic disturbance emotional equilibrium is disturbed. Generally mild mental disturbances are common in pregnancy.
Ques. 2 What is Placenta ? Describe its development & functions.
Ans. This is developed during pregnancy being primarily a chorionic structure and lies implanted on the uterin wall; it is connected with foetus through the umbilical cord; it maintains pregnancy and carries the vital foetal functions.
It is a wonderful organ development as a part of conceptus, is unique for its multiplicity of function inspite of simplicity in structure. It brings enormous changes in mother, mainly through its diverse hormones, to adapt the mother to the foetal needs. It grows along with foetus to maintain adequate channels of oxygen and nutrition, and protects foetus from noxious agents. A well developed healthy placenta ensures to a large extent a healthy foetus.
Ques. 3 What are the functions of placenta?
Ans. The placenta serves the following purposes –
- Foetal excretory system – This removes waste metabolic substances from the foetus.
- Foetal barrier action due to placental membrane – This prevents any substance of large molecular size to pass from mother to the foetus, but sedatives and pain relieving drugs, hormones, volatile anaesthetic, antibiotics or chemotherapeutic agents, viruses particularly small pox, poliomyelitis, bacteria and parasites, antitoxins and antibodies cross placental membrane to reach foetus.
- Endocrine functions – Placenta acts as an additional endocrine gland during pregnancy.
- Enzyme function – various enzymes have been demonstrated in the placenta.
- Foetal respiratory organ – This supplies oxygen to and removes carbon dioxide from the foetus by a process of simple diffusion.
- Foetal alimentary organ- Water, glucose, amino acids, lipids, iron, calcium, sodium, vitamins are transferred from maternal circulation to the foetal circulation for foetal nutrition.
Ques. 4 What are the functions of placenta for the growing child in the mother’s womb?
Ans. Placenta thus (i) maintains pregnancy and (ii) causes maternal changes for purpose of reproduction. Placenta is considered important component of the “foeto-placental unit”. (iii) serves vital foetal functions,
Development – The growing embryo in compact layer of the deciduas throws out the chorionic buds on all sides. Those towards deciduas capsularis, the chorion leave atrophy mainly due to lack of nutrition. Those in contact & attached to deciduas basalis, chorion frondosum proliferate, multiply & form the placenta. The formation of placenta occurs during 6th to 12th weeks of pregnancy. By 4th months, placenta has attained its definite form; thereafter it continues to grow throughout pregnancy..
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