Pregnancy and childbirth

Main article: Human body

Genetics

Main article: Genetics

Gynecology

Main article: Gynecology

Sperm, uterus, egg, conception

• Sperm
• Woman's uterus

How Sperm Understand Where to Move Them

• Rheotaxis

Egg chooses which sperm to let in

Previously, it was believed that in the process of fertilization, the egg does not show itself in any way, only expects a sperm running towards it.

But studies of the early 2020s show that, despite its size, the egg is quite active and it is it that decides which specific sperm will penetrate it to merge genetic materials.

The task of the egg is to select a sperm with undisturbed DNA.

How a sperm enters an egg

For successful conception, at least 10 million sperm must enter the uterus. Almost all of them meet with an egg, but only one penetrates inside. The fact is that after meeting an egg, sperm still need to overcome certain barriers.

Directly, to merge with the egg, the sperm must pass two shells: a radiant crown and a shiny shell. To overcome the radiant crown - the layer of cells surrounding the egg cell, the sperm uses a special enzyme located on the surface of the head and splitting structures connecting the cells of the radiant crown.

One sperm is incapable of destroying the radiant crown, requiring exposure to 300 sperm to loosen and disperse the cells of the radiant crown. The sperm that first reaches the shiny membrane is most likely to undergo fertilization. If it turns out to be defective, then fertilization will not take place.

Thus, 10 million male germ cells get to the egg, but only one penetrates inside - the most lucky.

What depends on the sex of the child

The baby's sex is determined as soon as the egg is fertilized. In humans, the sex is determined by sperm, not the egg.

All normal human eggs contain an X chromosome. Spermatozoa may contain either the X- or Y-chromosome.

If the sperm contains a Y chromosome, then the infant will be male, and if X - then female.

Days most likely to be pregnant

The most likely days for pregnancy are 10 days around the day of ovulation. With a 28-day cycle, these will be from the 9th to the 19th days of the cycle. The countdown is from the 1st day of menstruation.

Infertility and IVF

Main article: Infertility

• IVF (in vitro fertilization)

How the internal organs of the mother are displaced during pregnancy

Many pregnancy symptoms occur due to hormonal changes. However, many of them also arise as a result of the fact that the child begins to occupy more and more space inside the mother's body.

The animation shows how a growing child compresses the lungs, bladder and intestines of the mother.

Fetal formation

While the fetus is in the womb, every minute is formed to 250,000 new cells, and each a second creates 1.8 million new connections.

About half will be lost later, only fortified will be saved and used

Fetal development by week

Day 6

Day 23: The Heart Starts Working

On about the 23rd day of pregnancy, the heart begins to work for the future baby.

At this gestation point, the embryo's heart is slightly smaller than the rice grain.

Embryo Development Week 4

The child is formed head. Heart, handles and legs form.

Blood circulation is established, which is visible on ultrasound. The brain and spine form.

Day 28: Nerve tube splits into three primary bubbles that will become the brain

The middle brain is only about 2 centimeters long and is located at the very end of the cerebral column. This is the smallest part of the pillar, but it plays a decisive role in the embryonic development of the future person.

On about the twenty-eighth day of intrauterine embryo development, the neural tube splits into three primary bubbles, which will later become the brain.

These are the diamond brain, the midbrain and the anterior brain. After a few weeks, the secondary brain, or posterior brain, subsequently developing into the bridge and cerebellum, and the oblong brain separate from the midbrain.

And from the forebrain, the cerebral hemispheres covered with the cortex and the intermediate brain (hypothalamus, thalamus, etc.) are formed. And the middle brain is really in the middle and remains the middle brain.

Week 5: The beginning of intensive formation of internal organs

From the 5th to the 16th week of intrauterine development, the stage of intensive formation of all internal organs and systems of the future person lasts.

At this stage of development, the embryo has a tail and the smallest grooves in the neck, resembling the gills of an embryonic fish.

Flexor folds on the palms, the pattern of which is different in each person, form by the third month of fetal development in the womb and never change.

And only after this time does the fruit take on the look that we used to imagine.

The appearance of eyelashes in humans occurs in the womb at 15-16 weeks.

Bending features, number of rows, and length are determined by genetic predisposition.

In the 21st week of pregnancy, you can watch a baby "cry" in the womb. He makes the same movements as when crying, but does not make sounds. By the third trimester of pregnancy (weeks 26-40), the child develops vocal cords, but amniotic fluid still does not allow him to produce sounds.

Fingerprints

The fetus acquires fingerprints at the age of three months.

Even in the early stages of development, fruits have one of the most unique human features - fingerprints. In the 6-13 weeks of development, they are already taking on a clear shape. These prints will not change throughout life and will be one of the last things that will disappear after death.

How a person's face develops in the womb

The face begins to form from tubercles called visceral arches. They form, starting from the outside inwards, from the sides to the middle. In the process of transformation, which lasts 4.5 months of pregnancy, the baby's face will gradually acquire nostrils, eyes, eyelids, lips, and so on.

Tail

Human embryos in the early stages of development have a noticeable tail.

However, even during embryogenesis, the parts of the embryo surrounding it overtake it in growth, and it ceases to protrude above the surface of the body.

Although as a rare deviation in development, a person may develop a short tail.

Fetal behavior in the womb

In the uterus, the fruit sleeps most of the time.

Due to low oxygen levels and placental sedatives, it is awake for no more than 10% of the total time. The rest of the time, he alternates phases of calm and active sleep.

At the same time, the child in the stomach of the mother moves almost constantly.

At the 20th week of pregnancy, the fetus makes about 200 movements per day, and between the 28th and 32nd weeks, the number of movements reaches 600 per day.

A fight between twins in the womb, recorded during an ultrasound examination.

A pregnant woman does not feel all the movements of the fetus, but only a small part of them. So, after 28 weeks, the frequency of movement of the fetus according to the woman's sensations is usually from 4 to 8 times per hour, with the exception of periods of fetal sleep (3-4 hours in a row). In the third trimester, a pregnant woman may notice that the baby has certain sleep and wake cycles. Children are usually most active from 7 p.m. to 4 a.m., and the "rest" period occurs more often from 4 a.m. to 9 a.m.

Of course, the movements of the fetus depend on the mood of the mother, if the mother is worried or happy, the baby can move more actively, or vice versa, calm down. The fact is that when mom rejoices, the amount of joy hormones in her body significantly increases - endorphins, which regulate the work of the heart and blood vessels, including the vessels of the placenta. During stress or pronounced negative emotions, biologically active substances are also produced - stress hormones, they also act on the work of the heart and blood vessels. It is thanks to this biological interaction between the organisms of mom and baby that the fetus feels the condition of the mother.

When it got too boring in the womb.

When the expectant mother rests, the baby usually becomes more active, if the pregnant woman is active, busy with any work, the child most often subsides. The movement also changes depending on the fullness of the expectant mother. Usually the baby begins to move actively after the mother eats, especially something sweet. At the same time, the level of glucose in the blood increases sharply, which makes the fetus be more active.

In the video below, the baby in the womb warms up before being born.

Hormones

Oxytocin

Main article: Oxytocin

The content of oxytocin in the brain increases sharply when breastfeeding an infant - both in the mother's brain and in the baby's brain.

This hormone provides a number of important physiological functions: from pregnancy, uterine contractions during childbirth to the production of breast milk.

Effects of maternal health on child health

2023: Development of schizophrenia linked to maternal vitamin D levels

On May 24, 2023, Australian neuroscientists from the University of Queensland published the results of a study suggesting that the development of schizophrenia is associated with maternal vitamin D levels. Read more here.

Pregnant women's caffeine intake affects children's growth

In early November 2022, the American College of Obstetricians and Gynecologists recommends that pregnant women limit their caffeine intake to 200 mg per day. In women who received at least moderate amounts of caffeine during the first trimester of pregnancy, babies of slightly smaller average height are born, and by the age of eight, the difference can reach a couple of centimeters.

In animal studies, this led to a change in normal growth patterns. Moreover, excess caffeine could also lead to increased fetal insulin sensitivity, potentially having long-term effects on normal growth, scientists said. The study takes into account all caffeine, including decaffeinated foods and foods that may contain caffeine. This list includes chocolate, tea, energy drinks and soda.

In the course of the study, scientists analyzed the concentration of caffeine and the product of its decay, paraxanthine, in blood samples of more than 2.4 thousand pregnant women who participated in two studies. The scientists looked for a correlation between future moms' caffeine intake and height, weight, body mass index and obesity risk.

Children of women with low caffeine intake during pregnancy were slightly shorter than their peers born to women who did not consume caffeine during pregnancy. The difference in height increased between the ages of 4 and 8, the study showed. The analysis took into account several other factors that may have influenced the baby's height, including maternal height, pre-pregnancy weight, and smoking status. The researchers found only an association between caffeine intake and childhood growth, not a causal relationship.

The study's lead author Jessica Gleeson explains this impact by the fact that caffeine is able to pass from mother to fetus, which is not yet able to dispose of it in the way that the adult body does. As a result, caffeine can accumulate in embryo tissues and disrupt their normal response to growth hormones. However, according to Jessica Gleason, so far this is only an assumption: the study itself does not demonstrate either mechanisms or a causal relationship, but only indicates a correlation between moderate and large amounts of caffeine in the blood of pregnant women and the growth of babies born to them.^[1]

Maternal microflora affects the development of the baby's brain and immune system

In 2019, the claim that the development of a child in the womb occurs in sterile conditions was refuted.

Studies conducted in Austria confirm that the first contact of the child with bacteria occurs in the womb. The discovery was made following the analysis of samples of amniotic fluid, which enveloped the fetus. All samples taken contained traces of bacterial DNA. This cover forms a huge value for medicine. After all, the peculiarities of the mother's microflora can directly affect the development of the child's brain and immune system.

Effect of alcohol on foetal neurons

In moderate doses, alcohol does not kill adult neurons, but it can have a strong effect on developing nerve cells.

Since almost all neurons form and move to their places before birth, the fetal brain is very susceptible to alcohol.

Alcohol can kill newly born neurons, hinder their birth, and prevent them from moving from their birthplace to their final residence.

Even a short-term increase in blood alcohol levels can be enough for some fetal nerve cells to die.

Maternity leave

Main article: Maternity leave

Pregnancy TECont

2024: Moscow clinics have received a unique technology that accelerates MRI of pregnant women and makes it more accurate

Moscow medical institutions have received at their disposal an innovative technology that significantly increases the efficiency and accuracy of magnetic resonance imaging (MRI) for pregnant women. This became known on July 9, 2024.

According to the Moscow Department of Health, the new technology was created by researchers at the Moscow Center for Diagnostics and Telemedicine. The fetal phantom is a special device that mimics the organs and tissues of the fetus at the 21st week of pregnancy. This invention allows setting and working out the scanning technology during MRI diagnostics of pregnant women without the need to involve volunteers.

Moscow clinics use technology that accelerates and improves the accuracy of MRI scans for pregnant women

Anastasia Rakova, Deputy Mayor of Moscow for Social Development, noted that the introduction of this technology is designed to make MRI studies more accessible and informative for pregnant patients. This is especially important in cases where the diagnosis needs to be clarified after performing an ultrasound or planning in utero surgery.

Yuri Vasiliev, chief freelance specialist in radiation and instrumental diagnostics of the Moscow Department of Health, director of the Center for Diagnostics and Telemedicine, explained that the fetal phantom was created using specially selected materials that imitate various organs and tissues. To achieve maximum similarity with the actual fetus, gel compositions were used, the signal intensity of which is identical to the internal organs of the fetus.

The use of a fetal phantom solves a number of problems associated with setting up scanning protocols. Previously, pregnant women volunteers were involved for these purposes, which was not always convenient and effective due to the duration of the procedure and possible interference caused by fetal movements and maternal breathing.^[2]

2023

Genetic pathologies in the fetus are now detected by a blood test - you no longer need to pierce the mother's womb

On November 22, 2023, American specialists from Massachusetts General Hospital and the Broad Institute announced the development of a new non-invasive method for testing pregnant women to detect genetic pathologies in the fetus. To conduct the test, it is enough to take a blood sample - it is not necessary to pierce the mother's womb.

Traditionally, amniocentesis is performed in the fetus for early diagnosis of chromosomal and genetic diseases. This is an invasive procedure consisting of puncture of the amniotic membrane in order to obtain amniotic fluid for subsequent laboratory examination. However, such an intervention may present certain risks to both the mother and the fetus. The new method allows you to do without amniocentesis.

The study involved staff at Boston Children's Hospital and other health facilities. Project participants called the proposed technology "non-invasive fetal sequencing" (NIFS). The blood-based method demonstrated high sensitivity in detecting single substitutions of DNA bases, inserts and deletions in the fetal genome that were absent from the mother regardless of the amount of fetal DNA detected.

The study analyzed blood samples from 51 pregnant women in different trimesters of pregnancy. The method made it possible to identify and predict variants of DNA sequences with sensitivity of more than 99% in the initial analysis and more than 90% based on the processed data. In 14 women who underwent a standard invasive procedure, NIFS was able to identify all clinically relevant variants found in a routine study. The method was effective in identifying new mutations that occur only in the fetal genome.^[3]

The blood test of a pregnant woman can now assess the risks of autism in a child

In mid-April 2023, scientists from Columbia University's Mailman School of Public Health and the Norwegian Institute of Public Health developed a technology in which a pregnant woman's blood test can assess the risks of autism in a child. Read more here.

A device has been developed to measure pressure on the head of the fetus during childbirth

Researchers at University College London have developed a low-cost sensor device to help reduce the risk of stillbirth and maternal mortality during childbirth. The results of the work are published on January 30, 2023 in the journal Frontiers in Global Women's Health. Read more here.

DNA Technology has developed tests to assess the risk of having a child with hereditary diseases

The metropolitan company "DNA-Technology" has developed three types of tests to assess the risk of giving birth to a child with hereditary diseases. This was announced on January 27, 2023 by the head of the Department of Investment and Industrial Policy of Moscow, which is part of the Complex of Economic Policy and Property and Land Relations of the capital, Vladislav Ovchinsky. Read more here.

2022

Artificial intelligence taught to predict birth outcomes

On September 2, 2022, researchers from the Mayo Clinic reported that they had developed an artificial intelligence (AI) system that can predict birth outcomes. The technology has already begun to be used in clinical practice.

AI algorithms have been developed as a potential replacement for traditional pregnancy schedules, which can provide a general idea of how childbirth proceeds, but cannot account for all the numerous variables that may affect the ultimate success of childbirth.

The researchers built the model using data already collected by the child health and human development arm of the National Institutes of Health (NIH). This information collected in the database included the results of 66,586 births, about 22% of which ended in so-called "adverse outcomes," such as emergency caesarean section, postpartum bleeding, infectious infection or death of a newborn.

Algorithms were trained to take into account more than 700 variables related to childbirth and the delivery process. This included information collected both before the birth, including the patients' baseline clinical data and the results of their last pre-birth clinical examinations, and throughout the process illustrating their condition from admission to hospital to delivery.

Given all these variables, the AI model was able to assign an almost accurate risk score to each patient starting at the time of admission to the hospital. At this baseline, patients who subsequently experienced adverse outcomes had a risk score above 35%, while those who had a healthy birth had a score below 25%.

The model continues to be tested in real-world maternity wards, researchers said in a news release from the Mayo Clinic.

{{quote 'After confirming the results of further studies, it can be assumed that the algorithm will function in real time, which means that with each new receipt of data during childbirth, a woman will automatically recalculate the risk of developing adverse outcomes, says Abinbola Famuide, MD, senior author of the study. In the future, the algorithm will help reduce the frequency of caesarean birth, as well as maternal and infant complications^[4] }}

The first automated solution of non-invasive prenatal testing has been released in Russia

On September 7, 2022, R-Pharm announced the registration of the first automated solution for non-invasive prenatal testing (NIPT) in Russia - VeriSeq NIPT Solution. It was developed by Illumina. Read more here.

"Goodwin" registered in Roszdravnadzor an updated version of the portable fetal monitor "Ilifia"

The company Yusontek"," a resident, Skolkovo Foundation registered Roszdravnadzor in the updated version of the portable fetal monitor under the trade brand name "" (Ilifia registration number: RZN 2021/16054). The introduction of the device into the system health care will help reduce perinatal. mortality in the country Skolkovo reported this on January 12, 2022. More. here

2021

Using a new technique for ultrasound examination of the placenta to detect fetal circulation problems

In late May 2021, a team of researchers funded by the National Institute health care USA developed a new technique ULTRASONOGRAPHY to monitor the placenta for impaired fetal blood flow early in pregnancy. The authors argue that their technique makes it possible to diagnose circulatory problems that could harm the fetus and otherwise go unnoticed until late in pregnancy. More. here

Detection of child malformations in utero via MRI

In mid-March 2021, researchers demonstrated that MRI can more accurately detect and detect malformations of the head, neck, chest, abdomen and spine of the fetus than traditional methods of examining children in the womb.

Staff at King's College London, Evelina London Children's Hospital, Great Ormond Street Hospital and University College London conducted a major interdisciplinary study, the findings of which are published in the journal Lancet Child and Adolescent Health. A team of researchers and clinicians has shown how MRI scans can detect malformations with high accuracy, as well as assess their impact on surrounding structures. At the same time, the researchers note that MRI is safe for pregnant women and their future children.

Until now, ultrasound was considered the method of choice for diagnosing these anomalies. However, sometimes the possibilities of ultrasound are limited, and MRI scans should come to the aid of doctors, the researchers say. For example, in fetal neck tumors, MRI has a clear advantage over conventional ultrasound, since it allows accurate assessment of the area of tumor spread and provides three-dimensional imaging of the tumor in relation to the respiratory tract. In addition, MRI is better suited than ultrasound to distinguish between normal and pathological pulmonary tissue and to make other diagnoses, such as diaphragmatic hernia, especially in late pregnancy.

New approaches to imaging the fetal body using MRI allow correction of fetal movements, increasing the clarity of images, as well as volumetric reconstruction of organs and body defects. The researchers note that these technologies improve image quality and overall imaging, and therefore the detectability and characterization of anomalies. ^[5]

2020

Samsung BiometryAssist announcement - technology for quick and accurate measurement of the fetus of pregnant women

In September 2020, Samsung Medison and Intel announced an updated BiometryAssist technology designed to measure the fetus of pregnant women as part of ultrasound examinations. The development takes advantage of the capabilities of the Intel Core i3 processor and the Intel Distribution of OpenVINO and OpenCV toolkits, which provide automatic measurement and estimation of fetal sizes with an accuracy of 97% in just 85 milliseconds. This speed of work allows the doctor to receive more patients and devote more time to communicate with them, the developers note. Read more here.

Jada Announcement - Postpartum Bleeding Stop Systems

In mid-September 2020, California-based Alydia Health introduced the Jada system to stop postpartum bleeding. It is a thin tube with a silicone tip that is inserted into the uterus and gently sucked to its wall to quickly stop bleeding. Read more here.

Announcement of an AI system for predicting risks in pregnant women

In early September 2020, researchers at Carnegie Mellon University presented a machine learning technique that allows you to analyze placental samples and calculate a woman's health risk in future pregnancies. The system is designed to help obstetricians-gynecologists, who will be very useful for the forecast of possible complications of future women in labor. According to the authors of the project, their development has already begun to be used in clinical practice. Read more here.

Diseases during pregnancy

2021

Ministry of Health: In Russia, the number of births from mothers with HIV is growing by 13-14 thousand per year

On December 20, 2021, it became known about the annual increase in the number of children born from HIV-infected mothers in the Russian Federation by 13-14 thousand people. With such dynamics, in 5-6 years, the total number may exceed 300 thousand, said Ministry of Health Russia Yevgeny Voronin, chief freelance children's specialist in HIV infection. More. here

In Russia, maternal mortality from COVID-19 increased by 3 times

In 2021, the mortality rate of pregnant women and women who gave birth from coronavirus COVID-19 tripled compared to 2020. This data was published in early December 2021 by the chief freelance specialist Ministry of Health Russia in obstetrics, Professor Roman Shmakov. More. here

The number of pregnant women who died from COVID-19 in Russia reached 149 women

On June 29, 2021, it became known about the number of pregnant women in Russia who died from the coronavirus COVID-19. Due to the consequences associated with this infection, 149 women in the situation died. Read more here.

Operations during pregnancy

Main article: Operations during pregnancy

Childbirth

Why contractions begin

When the fetus in the uterus notes that the mother can no longer provide the growing organism with sufficient nutrition, the stress axis is activated in the fetal hypothalamus.

Adrenocorticotropic hormone (ACTH) stimulates adrenal cortisol production, which reduces progesterone exposure from the placenta and increases estrogen production. The uterus becomes more sensitive to oxytocin, this stimulates contractions, and labor begins.

Biomechanism of childbirth

C-section

Main article: Caesarean section

Preterm birth

Main article: Preterm birth

Twins

2021

South African woman gives birth to 10 live children at the same time

In early May 2021, a resident of YUARGosiame Sithoul set a new world record by giving birth to ten children at once, thereby breaking the maximum of 25-year-old Halima Cisse with Mali, who had previously given birth to nine babies at the same time. Read more here.

Mali woman gives birth to 9 live children at the same time

On May 4, 2021, a 25-year-old resident of Mali set a new world record for the number of living children born at the same time. Nine babies were born at one time. The former maximum dated 2009 - then the American gave birth to eight children. Read more here.

Abortions

Main article: Abortion

Maternal mortality

Main article: Maternal mortality

Documents

Main article: Electronic birth certificate

Newborns

Main article: Newborns

Notes