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Pregnancy is a period that is normally associated with joy, excitement, sense of accomplishment and memories that are cherished, framed and kept forever. It begins as a union between male and female reproductive cells, sperm cell and ova respectively and normally ends with the conception of a term baby. Often seen as a symbol of womanhood, pregnancy elevates the social status of women in a marital setting in a number of cultures.   It is a period typically spanning nine months or approximately 40 weeks within which a fetus develops in the womb. It is divided into 3 developmental stages known as trimesters: 1, 2 and 3. This process is arguably the most incredible, complex and delicate capabilities of the human body. Pregnancy involves a cascade of events set into motion by the union of the male and female sex gametes, sperm cell and ovule respectively, in the uterus commonly called womb. Of the approximately 211 million annual pregnancies globally, a larger percentage occurs in developing countries. This is more likely to be due to cultural and religious dynamics surrounding pregnancy in developing countries..

Early signs of pregnancy

Early signs can differ from woman to woman and it is possible that some may not even show these signs. Symptoms of pregnancy do not appear immediately after conception but rather, a few weeks down the line. Nonetheless, these are among the most noticeable signs that may indicate pregnancy:

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Missing a period while in a childbearing age could be the strongest indication of pregnancy.

Enlargement and increased tenderness of the breasts

Unexplained tiredness

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Nausea and vomiting

Increased frequency of urination as the developing fetus compresses on the bladder.

Craving and eating bizarre things you may not normally consider edible. This anomally is known as pica

Mood swings

The above mentioned signs merely cause suspicion of pregnancy but they are not confirmatory symptoms of pregnancy. Upon noticing these symptoms, one needs to do a home pregnancy test if you can or go have a check up at a hospital. Late signs of pregnancy are the obvious gross changes in the shape of the abdomen, skin changes, and excessive salivation among many others.

Risk factors affecting pregnancy

There are a wide range of factors that may affect pregnancy; a few major ones are:

Age: it is a major determinant of fertility and to some extent, predicts the outcome of a pregnancy. The ideal age for conception is usually between the range of  20-35 years. Any age outside of this age comes with different risks attached. Pregnant young women below the age of 20 are at an increased risk of developing severe pregnancy complications such as: preeclampsia, premature delivery and low birth weight. Additionally, teenage pregnancy has a hallmark of underdeveloped reproductive organs; this may end up causing both prenatal and postnatal complication.  Pregnancy above the age of 35 equally comes along with its own risks. Mothers above 35 years are more likely to have had underlying chronic disease, more likely to have babies with chromosomal problems and are more likely to have miscarriage, although the basis of this is unclear.

Socioeconomic status: studies have shown that low socioeconomic status is associated with increased risks of preeclampsia, ecclamsia and gestational diabetes. Education, income, employment and social support are important determinates of the way we live our lives and impact the decisions we make.

Nutritional status: balance diet is vital to human development and health in general. Poor nutrition is associated with increased risk of infection, decreased fertility and could cause complications for both mother and child. Pregnant women thus need to take healthy and balanced diets to able to put up with the adverse strains of pregnancy on their bodies.

Unhealthy lifestyle: this encompasses all activities of pregnant women that negatively impacts pregnancy. It ranges from poor personal hygiene, smoking and, alcohol and drug abuse.

Pre-existing health conditions increase the risk of developing complications like low birth weight, miscarriage, premature delivery, etc, during pregnancy. These underlying conditions include: high blood pressure, polycystic ovary syndrome, autoimmune disease, kidney and thyroid diseases, asthma, uterine fibroids and multiple pregnancies.

Other risk factors are multiple-birth pregnancies, previous complications of pregnancy, if you had any, and lack of physical activity.

Common complications

Ectopic pregnancy: this is pathological and possibility lethal condition in which a fertilized egg implants itself in the fallopian tube, a tube that leads to the womb. It means that the zygote implants outside the womb and begins to develop.

Gestational diabetes: defined as glucose intolerance with onset or first recognition during pregnancy: Occurs in approximately 3 to 8% of all pregnancies, with marked worldwide variations reported. It is associated with an increased risk of fetal macrosomia, as well as prenatal morbidity and mortality. It is linked with future developments of diabetes mellitus in women post-pregnancy.

Anemia: mild anemia during pregnancy is considered normal. Increased blood volume during pregnancy triggers a compensatory increased demand of iron for hemoglobin in red blood cell production. If there is a shortage of iron it would therefore lead to anemia. Though mild anemia isn’t harmful, a more severe anemia could lead to low birth weight of the baby. Some studies show an increased risk of infant death immediately before or after birth. Pregnant women are given folic acid supplements as prophylaxes to prevent anemia.

Preeclampsia: usually first detected and characterized by hypertension, preeclampsia is a pregnancy complication that shows signs of damage on other organs of the mother; most often on kidneys and liver. It typically begins after 20 weeks of pregnancy in women with no previous history of hypertension. With sustained increased blood pressure, preeclampsia could lead to brain injury and cause damage to other vital organs. It is very important to take note of your blood pressure during pregnancy.

Preterm labor: the normal period of labor is after 40 weeks of pregnancy. It is a preterm labor when uterine wall contractions happen after week 20 and before week 37 of pregnancy. It leads to premature birth, a condition in which the fetus is born before it is due. The severity of the condition depends on how early the premature birth occurs.

Miscarriage: spontaneous abortion is the lost of a fetus before week 20 of pregnancy, typically within the first trimester. Miscarriages could be caused by many conditions, some of which are beyond the control of the pregnant woman.

Pedal edema: it is simply edema or swelling in the ankles and feet. There is an increased body fluid during pregnancy. This increases the tendency of fluid accumulating in tissues and causing them to swell. It may be facilitated by lack of mobility or physical exercise.

Many common complications of pregnancy develop in a gradual and subtle way. This makes it extremely difficult to detect and manage on time. The bottom line is to do regular prenatal checkups and stick to medical advice given by your healthcare provider.

An important concept to take note of is the issue of teratogens, agents or factors that causes congenital malformations in the baby. They include certain infections, some medications, recreational drugs, tobacco, alcohol, chemicals and x-ray. The period at which the fetus is most susceptible to teratogens is the period of organogenesis, around week 5 of pregnancy, during which the organs of the fetus are formed. It is advisable not to take any medications during pregnancy unless your healthcare provider gives you the green light  

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