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| Pregnancy |
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Pregnancy
is the carrying of one or more embryos or fetuses
by female mammals, including humans, inside their
bodies. In a pregnancy there can be multiple gestations
(for example, in the case of twins, or triplets).
Human pregnancy is the most studied of all mammalian
pregnancies. |
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Human
pregnancy lasts approximately 40 weeks between the time of
the last menstrual cycle and birth (38 weeks from fertilisation).
The medical term for a pregnant woman is "genetalian,"
just as the medical term for the unborn
human is an embryo (early weeks) and then "foetus"
(until birth). A woman who is pregnant for the first time
is known as a primigravida or gravida 1: a woman who has never
been pregnant is known as a gravida 0; similarly, the terms
para 0, para 1 and so on are used for the number of times
a woman has given birth.
In many societies' medical and legal definitions, human
pregnancy is arbitrarily divided into three trimester periods,
as a means to simplify reference to the different stages
of fetal development. The first trimester period carries
the highest risk of miscarriage (natural death of embryo
or fetus), while during the second trimester the development
of the fetus can start to be monitored and diagnosed. The
third trimester marks the beginning of viability, which
means the fetus can survive if an early natural or induced
birth occurs. Because of the possible viability of developed
fetus, cultural and legal definitions of life often consider
a fetus in the third trimester to be a distinct living person
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| Detection
and dating |
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The
beginning of pregnancy may be detected in a number of
ways, including various pregnancy tests which detect
hormones generated by the newly-formed placenta. Clinical
blood and urine tests can detect pregnancy as early
as 6-8 days after date of conception. Home pregnancy
tests are personal urine tests, which normally can't
detect a pregnancy until at least 12-15 days after conception.
Both clinical and home tests can only detect the state
of pregnancy, and cannot detect the actual date of conception. |
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| A blastocyst. |
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In
practice, for the purpose of giving a date for a conception
(i.e. an "age" for an embryo), doctors typically
date the pregnancy by "menstrual date," based
on the first day of a woman's last menstrual period,
as the woman reports it. Unless a woman's recent sexual
activity has been limited, the exact date of conception
or implantation are unknown. And absent any symptoms
of morning sickness, the only visible |
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| A human embryo,
two weeks after implantation. |
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sign
of a pregnancy is often an interruption of her normal
monthly menstruation cycle, (i.e. a "late period").
Hence, the "menstrual date" is simply a common
educated estimate for the age of a fetus, which is an
average of two weeks later than conception, (the margin
of error considers 0 to 30 days after last menstruation,
hence a 14 day average). The term "conception date"
may sometimes be used when that date is more certain,
though even medical professionals can be imprecise with
their use of the two distinct terms. An unknown date
for conception means that in practice the distinction
between embryo and fetus is a clinical one only, and
not used as to refer to stages of development of a particular
pregnancy.
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There
are likewise finer distinctions between the concepts
of fertilization (conception) and the actual state of
pregnancy. In a normal pregnancy, the fertilization
of the egg usually will have occurred in the Fallopian
tubes or in the uterus. (In women with fertility problems,
an egg may become fertilized yet fail to become implanted
in the uterus.) If the pregnancy is the result of in-vitro
fertilization the fertilization will have occurred in
a Petri dish, after which "pregnancy" begins
when one or more zygotes implants after being transferred
by a physician in the woman's uterus. |
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| An ultrasound
of a developing fetus. |
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In
the context of political debates regarding a proper
definition of life, the terminology of pregnancy can
be confusing. Because precise assessment of a pregnancy
as being at the "embryo" or "fetus"
stage is usually undeterminable, the terms (though more
clinically precise) are less commonly used than terms
like "baby" or "child." The medically
and politically neutral term which remains is simply
"pregnancy," though this can be problematic
as it only refers indirectly to the embryo or fetus.
In the context of personal treatment, bedside manner
generally dictates that doctors make sparse use of clinical
language like "fetus" and "embryo,"
and instead simply refer to the developing child as
a "baby." |
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| Timeline
of a typical pregnancy |
Pregnancy
is typically broken into three periods, or trimesters, each
of about three months. While there are no hard and fast rules,
these distinctions are useful in describing the changes that
take place over time. |
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| First trimester |
| Fertilization |
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Before
pregnancy begins, a female oocyte (egg) must be fertilized,
by male sperm in a process referred to in medicine
as "fertilization," or commonly as "conception."
Pregnancy is usually dated as beginning on the first
day of a woman's last menstrual period. This date
is used to estimate an EDD, or Estimated Date of Delivery.
Traditionally (according to Naegele's Rule, which
is used to calculate the estimated date of delivery
(EDD)), a human pregnancy is considered to last
approximately 40 weeks (280 days) from the last
menstrual period (LMP), or 37 weeks (259 days) from
the date of conception. However, a pregnancy is
considered to have reached term between 37 and 43
weeks. Babies born before the 37 week mark are considered
premature, while babies born after the 43 week mark
are considered postmature
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| Conception
(fertilization). |
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| Implantation |
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However,
the average length of pregnancy depends on ethnic background
of the mother (Caucasian women are more likely to have
a longer pregnancy than other women) and if it is a
first pregnancy (which tend to last longer than subsequent
pregnancies). For example, a Caucasian woman's first
pregnancy lasts an average 274 days from conception
(288 days from the last menstrual period)[1]. |
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An
accurate date of conception is important, because it
is used in calculating the results of various prenatal
tests (for example, in the triple screen test). A decision
may be made to induce labour if a baby is perceived
to be overdue. Due dates are only a rough estimate,
and the process of accurately dating a pregnancy is
complicated by the fact that not all women have 28 day
menstrual cycles, or ovulate on the 14th day following
their last menstrual period. Approximately 3.6% of all
mothers deliver on the due date predicted by LMP, and
only 4.7% give birth on the day predicted by ultrasound.
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| Implantation |
In
medicine, pregnancy is defined as beginning when the developing
embryo becomes implanted into the endometrial lining of a
woman's uterus. The outer layers of the embryo grow and form
a placenta, for the purpose of receiving essential nutrients
through the uterus wall. The umbilical cord in a newborn child
signifies the remnants of the connection to the placenta.
The developing baby undergoes tremendous growth and changes
during the process of embryonic and fetal development.
Morning sickness aflicts about half of all
pregnant women, typically only in the first trimester.
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| Second trimester |
Most
women feel more energised in this period, and begin to seriously
put on weight. The first movement of the baby, often referred
to as "quickening", can be felt, as the baby begins
to form into a recognisable shape. |
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| Third trimester |
| Final weight
gain takes place, and the baby begins to move regularly. This
can be uncomfortable, causing symptoms like weak bladder control
and back-ache. |
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| Medical aspects
of pregnancy |
Diagnostic
criteria are: In a woman who has regular menstrual cycles
and is sexually active, a period delayed by a few days or
weeks is suggestive of pregnancy; elevated B-hcG to around
100,000 mIU/mL by 10 weeks of gestation. |
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| Birth |
Childbirth
is the process in which the baby is born. It is considered
by many to be the beginning of a person's life, where
age is defined relative to this event in most cultures.
A woman is considered to be in labour when she begins
experiencing regular painful 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.
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| Stages of
birth process. |
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| Postnatal
Period |
| For topics following
on from a successful pregnancy and birth, see: |
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