Pregnancy, Stages of Pregnancy (Trimesters), Physiological Changes During Pregnancy, Signs and Symptoms of Pregnancy, Nutrition in Pregnancy, High-Risk Pregnancy Conditions

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Pregnancy 🍼

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🌼 Definition of Pregnancy

Pregnancy is the state of carrying a developing fetus within the uterus, typically lasting about 40 weeks from the first day of the last menstrual period (LMP) to delivery.

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🔢 Stages of Pregnancy (Trimesters)

1️⃣ First Trimester (0–13 weeks)

• Major organ development (heart, brain, limbs)

• Morning sickness (nausea/vomiting)

• Breast tenderness

• Fatigue

• Risk of miscarriage is highest

2️⃣ Second Trimester (14–26 weeks)

• Fetus grows rapidly

• Mother feels baby’s movement (quickening)

• Uterus expands, visible bump

• Lesser nausea, more energy

• Gender may be identified via ultrasound

3️⃣ Third Trimester (27–40 weeks)

• Baby gains weight and prepares for birth

• Braxton Hicks contractions may occur

• Discomfort due to uterus size

• Cervix softens and dilates

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🧬 Physiological Changes During Pregnancy

🩸 Cardiovascular

• Blood volume ↑ by 30–50%

• Increased cardiac output

• Mild anemia common (due to hemodilution)

🌬️ Respiratory

• Tidal volume ↑

• Oxygen demand ↑

🧂 Renal

• Increased glomerular filtration rate (GFR)

• Frequent urination

🍽️ Gastrointestinal

• Delayed gastric emptying → Constipation

• Morning sickness

🦴 Musculoskeletal

• Pelvic joints loosen (relaxin hormone)

• Back pain due to posture changes

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👶 Signs and Symptoms of Pregnancy

✅ Presumptive Signs (Subjective)

• Missed period (amenorrhea)

• Nausea/vomiting

• Fatigue

• Breast changes

• Frequent urination

• Quickening

✅ Probable Signs (Objective)

• Positive pregnancy test (hCG)

• Hegar's sign (soft uterus)

• Goodell's sign (soft cervix)

• Chadwick's sign (bluish cervix)

✅ Positive Signs (Confirmed)

• Fetal heart tones (via Doppler)

• Ultrasound showing fetus

• Palpable fetal movement

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📅 Important Tests & Antenatal Checkups

Time	Tests/Checkups
6–8 weeks	Confirm pregnancy (USG, hCG)
11–14 weeks	Nuchal translucency scan (genetic issues)
16–18 weeks	Anomaly scan
24–28 weeks	Glucose tolerance test (GDM screening)
36 weeks	Position of baby & delivery plan

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🍎 Nutrition in Pregnancy

• Folic Acid: Prevents neural tube defects (start preconception)

• Iron: Prevents anemia

• Calcium: For bones and fetal growth

• Balanced diet with fruits, vegetables, lean protein

• Hydration is key

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⚠️ High-Risk Pregnancy Conditions

• Gestational diabetes

• Pregnancy-induced hypertension (PIH)

• Pre-eclampsia (BP ↑ + proteinuria)

• Ectopic pregnancy

• Placenta previa or abruption

• Multiple pregnancy

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🛠️ Role of Nursing/Paramedics

• Patient education (nutrition, hygiene, danger signs)

• Monitoring vitals and fetal heart rate

• Assisting in antenatal visits

• Emergency response (bleeding, eclampsia, labor)

• Psychological support

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🚨 Danger Signs in Pregnancy

Must be reported immediately

• Severe abdominal pain

• Vaginal bleeding

• Blurred vision or severe headache

• Sudden swelling of hands/face

• Decreased fetal movements

• High fever

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💬 Mnemonic Tips for Quick Recall

GTPAL - Pregnancy history:

• G - Gravida (total pregnancies)

• T - Term births (≥37 weeks)

• P - Preterm births (<37 weeks)

• A - Abortions (before 20 weeks)

• L - Living children

"PERFECT BABY" - Antenatal care essentials:

• P – Prenatal vitamins

• E – Education about delivery

• R – Regular checkups

• F – Fetal monitoring

• E – Eating healthy

• C – Control chronic diseases

• T – Tests (blood/urine/ultrasound)

• B – Blood pressure checks

• A – Avoid smoking, alcohol

• B – Be physically active (if safe)

• Y – Your mental health matters