Pregnancy is a crucial time in life. This period plays a significant role in the growth and development of the child. Therefore, it is crucial to maintain the mother's health during pregnancy.
Proses kehamilan dapat terjadi ketika terdapat pertemuan antara sel telur dari wanita dengan sel sperma dari pria yang kemudian melewati proses pembuahan. Hasil dari proses tersebut kemudian akan menempel pada dinding rahim dan terus melewati proses pertumbuhan dan perkembangan.
Uterine wall preparation process
The uterine lining undergoes several phases related to the menstrual cycle. These conditions are also related to a woman's hormonal balance during each phase.
Menstrual phase
At this stage, the uterine wall decays and then comes out through the menstrual process.
Proliferative phase
During this phase, the uterine wall begins to regrow the endometrial lining, which was previously shed during menstruation. This is influenced by increased estrogen levels. During this process, the uterine wall begins to thicken and prepare for implantation of a fertilized egg.
Secretory phase
At this stage, after ovulation, progesterone levels increase. This triggers thickening of the uterine wall and enriches it with blood vessels, which serve as nutrient delivery during pregnancy. At this stage, the uterine wall is increasingly ready for implantation of a fertilized egg.
Preparation for implantation
At this stage, the uterine wall is ready to become the site for the initial growth and development of the zygote, embryo, and fetus, as a result of fertilization. If fertilization does not occur, the cycle will return to the beginning, with the uterine wall shedding through menstruation.
Pregnancy program
If you want to try to conceive, you can do so by preparing your physical health with your partner. Maintaining a healthy lifestyle by eating a balanced diet and exercising regularly is crucial. You can also take folic acid three months before trying to conceive to prepare for pregnancy and avoid various potential complications associated with a folic acid deficiency. One of these can impact the development of fetal organs.
Furthermore, it's important to ensure that both the male and female reproductive systems are in good condition and fertile. To assess and confirm this, consult a doctor. To increase the chances of a successful pregnancy, have sexual intercourse during the fertile period. For women with regular menstrual cycles, the fertile period is usually 14 days before the next menstrual cycle. Sexual intercourse can occur during this fertile period.
The process of pregnancy
A pregnancy can occur if a woman's egg meets a man's sperm.
Egg cells
Every month, women go through a menstrual cycle. One of the stages is ovulation, the process by which an egg is released from the ovaries, which are part of the female reproductive system.
Each month, the ovaries release one mature egg into the fallopian tube. The number of eggs decreases with age. This is why a woman can experience menopause, or the absence of menstruation due to the absence of eggs.
Sperm cells
The male reproductive system produces sperm, which plays a role in fertilization. Unlike egg production, which decreases with age, sperm production is not affected by age.
Fertilization process
When a sperm cell meets an egg cell, fertilization can occur. This process usually occurs in the fallopian tube, the tube that connects the ovary to the uterus. After fertilization, a zygote is formed.
Implantation in the uterine wall
After forming a zygote, the fertilized egg will travel towards the uterus and attach to the uterine wall. However, if the process goes poorly, the zygote can remain in the fallopian tube and grow there.
The fallopian tubes are rigid. Therefore, when the fertilized egg increases in size, it puts pressure on the tube wall, which can cause severe pain. This condition is called a Disturbed Ectopic Pregnancy (ECT), where the pregnancy occurs outside the uterus. Usually, in this condition, the pregnancy must be terminated due to the potential complications.
During the process of attachment of the fertilized egg to the inner uterine wall, or endometrium, penetration occurs and the placenta forms. Circulation in the placenta is crucial for the growth and development of the embryo, as it supplies nutrients. Implantation occurs approximately 6-10 days after fertilization.
Pregnancy development
After the egg meets the sperm and undergoes fertilization, a zygote forms. The zygote then undergoes implantation in the uterine wall and develops into an embryo. This embryonic development typically occurs between 2 and 8 weeks of gestation.
The embryo then develops into a fetus at 9 weeks of gestation. At this stage, more complex organs and tissues are usually formed, leading to the birth process.
Signs of pregnancy
There are several signs that can detect pregnancy, such as a missed period, morning sickness and vomiting, increased breast tenderness, fatigue, mood swings, and changes in urination frequency. An initial self-examination is a pregnancy test.
A pregnancy test is usually recommended after a missed period of about two weeks. This test detects the hormone human chorionic gonadotropin (hCG) in the urine. In addition to a pregnancy test, it is crucial to have an ultrasound to help confirm the pregnancy and its location. This test can be performed between 6 and 8 weeks of pregnancy.
Trimester of pregnancy
The gestational period lasts approximately 38-40 weeks. Pregnancy can be divided into three trimesters: the first, second, and third.
First trimester
The first trimester is from 0-13 weeks of pregnancy. This period is crucial to ensure that the process of zygote formation and implantation in the uterine wall is proceeding smoothly. The formation of the amniotic sac and placenta has begun. Furthermore, major organs are beginning to form.
The organs that have begun to form are the brain, heart, and spine. The first trimester also sees the embryo develop into a fetus. During this phase, the fetal heartbeat can usually be detected. During this period, pregnant women often experience nausea and vomiting. An ultrasound examination is essential to confirm the pregnancy, determine the location of the pregnancy, and determine the gestational age.
Second trimester
The second trimester lasts from 14 to 26 weeks of pregnancy. During this period, the fetus is experiencing growth and development. Furthermore, during this trimester, the fetus is usually more active, and its movements are more frequently felt by the mother.
Ultrasound examinations can also detect fetal movement, and the facial features begin to become clearer. Furthermore, the fetus's hearing has begun to develop. During this phase, nausea and vomiting usually decrease. However, fatigue, back pain, and stretch marks may begin to appear due to the increasing size of the fetus.
Furthermore, varicose veins may also be found in pregnant women due to pressure on the veins caused by the growing fetus.
Third trimester
The third trimester lasts from 27 to 40 weeks of pregnancy. The fetus continues to grow and develop. As time passes and labor approaches, the fetus will shift position so that it is head down.
During this phase, the fetus's organs also mature. Furthermore, due to its increasing size, mothers typically complain of increasing back pain, swollen legs, frequent urination, and shortness of breath due to the pressure and size of the growing fetus.
Antenatal care
Prenatal care, or antenatal care, is a series of pregnancy checkups. Antenatal care plays a crucial role during pregnancy, monitoring the pregnancy's condition and fetal development.
First visit
Early in pregnancy, it's important to undergo antenatal care. This stage involves a medical interview, or anamnesis, and a physical examination. The mother's medical history will be collected, including any medical conditions and medications taken, previous pregnancies, and any comorbidities.
At the first visit, an ultrasound will be performed to confirm the pregnancy, its location, and its duration. Blood tests will also be performed to check blood type, rhesus, and hemoglobin. This is crucial for preparing for delivery, should a blood reserve be needed. Screening for infections such as HIV, hepatitis B, syphilis, and others is also crucial.
This is related to the delivery process chosen to ensure it is safe for the fetus, the mother, and the medical staff. The mother will also receive counseling regarding nutrition and lifestyle needs during pregnancy. Pregnant women are usually advised to consume folic acid, which is essential for organ development, and iron supplements to prevent anemia.
Routine visits
Beyond the initial visit, it is highly recommended to have antenatal care every trimester.
- First trimester (0-13 weeks)
On arrival, an ultrasound examination will be performed and, if necessary, genetic testing can be performed to screen for trisomy 21 (Down syndrome), trisomy 18 and trisomy 13.
- Second trimester (14-26 weeks)
At this visit, a detailed examination will be performed to assess the fetus's anatomy. Additionally, a preeclampsia risk screening will be performed by assessing hemoglobin and proteinuria levels. A blood sugar test may also be performed to rule out gestational diabetes.
- Third trimester (27-40 weeks)
At this visit, the fetus' growth, position, and amniotic fluid will be examined. As labor approaches, the fetus will be assessed for proper positioning, with the head down. Furthermore, the amniotic fluid volume will be assessed for adequate delivery and for any signs of infection. This is crucial for determining the preferred delivery method. Prenatal care will typically become more frequent as labor approaches. Prenatal care can be performed weekly during the third trimester until delivery.
Additional examination
If certain risk factors are present, a series of additional tests may be performed. If the mother experiences signs of infection during pregnancy, a TORCH test may be performed if necessary. Furthermore, if specific conditions, such as placenta previa or other conditions requiring regular follow-up, are identified, additional ultrasound examinations may be performed.
Counseling
In addition to physical examinations and additional checkups, education also plays a crucial role during pregnancy. During the antenatal period, education related to nutrition and mental health will be provided. As a pregnant woman, it is crucial to maintain a healthy lifestyle by consuming a balanced diet.
Besides physical health, mental health is also crucial during pregnancy. Pregnant women experience hormonal changes and changes in body shape, which can significantly impact their mental health. Therefore, it is crucial to receive support from their family and receive sound education regarding stress and depression management.
In addition, education will be provided regarding childbirth, breastfeeding, and newborn care. This activity is crucial, especially for first-time mothers. This session can also include discussions regarding birth preferences, if possible.
Danger signs during pregnancy
It's crucial to undergo a series of antenatal care sessions to ensure the health of both mother and fetus is properly monitored and ensure a smooth delivery. Here are some warning signs to watch for during pregnancy.
First trimester
During pregnancy, vaginal bleeding is not normal. Therefore, at any stage of pregnancy, if vaginal bleeding occurs, it is crucial to immediately seek further evaluation from an obstetrician-gynecologist (OB-GYN).
Furthermore, if you experience severe abdominal pain or cramps, dizziness leading to fainting, or excessive nausea and vomiting, you should also consult a doctor.
Especially in early pregnancy, there is a high risk of hyperemesis gravidarum, a condition characterized by excessive nausea and vomiting that can lead to dehydration and malnutrition in pregnant women.
Second trimester
If you experience vaginal bleeding, consult your ob-gyn immediately, especially if you experience severe abdominal pain. Furthermore, fetal movement is usually felt during this phase.
If fetal movement tends to decrease, further examination by your doctor is recommended to determine the possible cause.
If a pregnant woman experiences pain, especially if it is accompanied by a high fever that does not subside with medication, she should immediately consult a doctor to assess and determine the source of the infection.
Third trimester
As with the previous phase, if vaginal bleeding occurs, you should see a doctor immediately to determine the cause. It's also possible that it could be a sign of labor, especially if it's accompanied by contractions.
If a pregnant woman experiences severe headaches, blurred vision, and swelling, which are signs of preeclampsia, immediate treatment is required. Furthermore, if there is amniotic fluid and decreased fetal movement, it's crucial to see a doctor immediately.
Postpartum
Postpartum care is just as important as pregnancy preparation and the pregnancy itself. Postpartum checkups are conducted to monitor the mother's recovery process and the baby's health.
Even after receiving antenatal counseling, mothers usually still need postpartum support to effectively put the theory they have learned into practice. Through counseling, mothers can receive support and guidance on breastfeeding issues.
Written by Dr. Valda Garcia. Reviewed by Dr. Ernest Eugene.
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