Pregnancy

Pregnancy, also known as gravidity or gestation, is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy can occur by sexual intercourse or assisted reproductive technology. It usually lasts around 40 weeks from the last menstrual period (LMP) and ends in childbirth. This is just over nine lunar months, where each month is about 29½ days. When measured from conception it is about 38 weeks. An embryo is the developing offspring during the first eight weeks following conception, after which, the term fetus is used until birth. Symptoms of early pregnancy may include missed periods, tender breasts, nausea and vomiting, hunger, and frequent urination. Pregnancy may be confirmed with a pregnancy test.

Pregnancy is typically divided into three trimesters. The first trimester is from week one through 12 and includes conception. Conception is when the sperm fertilizes the egg. The fertilized egg then travels down the fallopian tube and attaches to the inside of the uterus, where it begins to form the fetus and placenta. The first trimester carries the highest risk of miscarriage (natural death of embryo or fetus). The second trimester is from week 13 through 28. Around the middle of the second trimester, movement of the fetus may be felt. At 28 weeks, more than 90% of babies can survive outside of the uterus if provided high-quality medical care. The third trimester is from 29 weeks through 40 weeks.

Prenatal care improves pregnancy outcomes. Prenatal care may include taking extra folic acid, avoiding drugs and alcohol, regular exercise, blood tests, and regular physical examinations. Complications of pregnancy may include high blood pressure of pregnancy, gestational diabetes, iron-deficiency anemia, and severe nausea and vomiting among others. Term pregnancy is 37 to 41 weeks, with early term being 37 and 38 weeks, full term 39 and 40 weeks, and late term 41 weeks. After 41 weeks, it is known as post term. Babies born before 37 weeks are preterm and are at higher risk of health problems such as cerebral palsy. Delivery before 39 weeks by labor induction or caesarean section is not recommended unless required for other medical reasons.

About 213 million pregnancies occurred in 2012, of which, 190 million were in the developing world and 23 million were in the developed world. The number of pregnancies in women ages 15 to 44 is 133 per 1,000 women. About 10% to 15% of recognized pregnancies end in miscarriage. In 2013, complications of pregnancy resulted in 293,000 deaths, down from 377,000 deaths in 1990. Common causes include maternal bleeding, complications of abortion, high blood pressure of pregnancy, maternal sepsis, and obstructed labor. Globally, 40% of pregnancies are unplanned. Half of unplanned pregnancies are aborted. Among unintended pregnancies in the United States, 60% of the women used birth control to some extent during the month pregnancy occurred.

One scientific term for the state of pregnancy is gravidity (adjective "gravid"), Latin for "heavy" and a pregnant female is sometimes referred to as a gravida. Similarly, the term parity (abbreviated as "para") is used for the number of times a female has given birth. Twins and other multiple births are counted as one pregnancy and birth. A woman who has never been pregnant is referred to as a nulligravida. A woman who is (or has been only) pregnant for the first time is referred to as a primigravida, and a woman in subsequent pregnancies as a multigravida or as multiparous. Therefore, during a second pregnancy a woman would be described as gravida 2, para 1 and upon live delivery as gravida 2, para 2. In-progress pregnancies, abortions, miscarriages and/ or stillbirths account for parity values being less than the gravida number. In the case of twins, triplets, etc., gravida number and parity value are increased by one only. Women who have never carried a pregnancy achieving more than 20 weeks of gestation age are referred to as nulliparous.

Recent medical literature prefers the terminology preterm and postterm to premature and postmature. Preterm and postterm are defined above, whereas premature and postmature have historical meaning and relate more to the infant's size and state of development rather than to the stage of pregnancy.

The symptoms and discomforts of pregnancy are those presentations and conditions that result from pregnancy but do not significantly interfere with activities of daily living or pose a threat to the health of the mother or baby. This is in contrast to pregnancy complications. Sometimes a symptom that is considered a discomfort can be considered a complication when it is more severe. For example, nausea can be a discomfort (morning sickness), but if, in combination with significant vomiting, it causes water-electrolyte imbalance it is a complication (hyperemesis gravidarum).

Common symptoms and discomforts of pregnancy include:
Tiredness.
Constipation
Pelvic girdle pain
Back pain
Braxton Hicks contractions. Occasional, irregular, and often painless contractions that occur several times per day.
Edema (swelling). Common complaint in advancing pregnancy. Caused by compression of the inferior vena cava (IVC) and pelvic veins by the uterus leads to increased hydrostatic pressure in lower extremities.
Increased urinary frequency. A common complaint referred by the gravida, caused by increased intravascular volume, elevated GFR (glomerular filtration rate), and compression of the bladder by the expanding uterus.
Urinary tract infection
Varicose veins. Common complaint caused by relaxation of the venous smooth muscle and increased intravascular pressure.
Haemorrhoids (piles). Swollen veins at or inside the anal area. Caused by impaired venous return, straining associated with constipation, or increased intra-abdominal pressure in later pregnancy.
Regurgitation, heartburn, and nausea.
Striae gravidarum, pregnancy-related stretch marks
Breast tenderness is common during the first trimester, and is more common in women who are pregnant at a young age.

In addition, pregnancy may result in pregnancy complication such as deep vein thrombosis or worsening of an intercurrent disease in pregnancy.