Abstract | Trudnoća je razdoblje ženina života u kojem oplođeno jajašce nidira, raste i razvija
se. U devet mjeseci razvoja plod prolazi različita razdoblja. Embrijsko razdoblje je
razdoblje u kojem je embrij najosjetljiviji, izlaganje nepovoljnim okolišnim
čimbenicima i infekciji može dovesti do spontanog pobačaja. Fetalno razdoblje
počinje od devetog tjedna trudnoće i od tada organi postupno preuzimaju svoju
funkciju. Rast i sigurnost embrija a kasnije fetusa potpomaže potporni sustav koji mu
osigurava zaštitu i opskrbljuje ga hranjivim tvarima. Potporni sustav čini posteljica,
pupkovina, plodova ovojnica i plodova voda. Umanjivanje rizika trudnoće i rođenje
zdravoga djeteta zahtjeva aktivno sudjelovanje majke. Antenatalna skrb je sustav
zaštite materinstva tijekom trudnoće, poroda i babinja. Nepravilnosti trudnoće,
trudnice ili fetusa, otkrivanje malformacijskog sindroma i kromosomopatija otkriva se i
potvrđuje prenatalnom dijagnostikom. Prenatalni testovi ne sprječavaju prirođene
greške, ali pokazuju da li postoji neka abnormalnost prije nego što se dijete rodi.
Anomalije mogu biti genetske, uzrokovane nekim bolestima majke, mogu nastati
zbog uzimanja nekih lijekova, a najveći broj nastaje iz nepoznatog razloga ili zbog
djelovanja više faktora. Anomalije su češće kod višeplodne trudnoće. Višeplodna
trudnoća nastaje kada se oplodi više od jedne jajne stanice ili kada se jajna stanica
neposredno poslije oplodnje podijeli. Osnova pravilnog vođenja višeplodne trudnoće
je rana dijagnoza. U višeplodnoj trudnoći često se događa zastoj u fetalnom rastu, a
zbog nedostatka prostora u maternici blizanci su izloženi opasnosti od mehaničkih
oštećenja. Isto tako može doći do toga da blizanici budu spojeni, iako je rijetko
događa se zbog nepotpunog razdvajanja embrionalne osnove na jednom polu ili u
kojoj drugoj točki između dva pola stanične mase. Fetusi mogu biti spojeni glavama,
abdomenom, prsnim košem, stražnjicom i donjim dijelom kralješnice, donjim dijelom
sakruma i trticom. Preživljavanje spojenih blizanaca ovisi o tipu spojenosti i
postojanju pridruženih anomalija. Kako raste broj fetusa u višeplodnoj trudnoći
smanjuje se prosječno trajanje trudnoće. Trudnoća traje 280 dana, odnosno 40
tjedana ili 9 kalendarskih mjeseci ili 10 lunarnih mjeseci. Porod počinje kada se
maternica počne spontano stezati, vodenjak pukne, a fetus zauzme položaj
porodnog valjka. |
Abstract (english) | Pregnancy is a time of a woman`s life, when the fertilized egg starts dividing, growing
and developing. In nine months of development, it is going through different periods.
The embryo period is the time when the embryo is the most vulnerable, exposure to
unfavorable surrounding influences and infections, can lead to miscarriages. The
fetal period begins in the ninth pregnancy week, and since this period the organs
start to overtake their functions. The growth and security of the embryo, and later the
fetus is supported by the support system, which insures its protection and supplies it
with nutrients. The support system consists of the placenta, the navel cord,
membranes and the amniotic fluid. To mitigate the risks during pregnancy and in
order to give birth to a healthy child, the mother has to actively participate. The
prenatal care is a protective system of the motherhood during the pregnancy, delivery
and confinement. Pregnancy irregularities, irregularities with the expectant mother or
the fetus, discovering of malformation syndromes and chromosomal abnormalities,
are discovered and confirmed by the prenatal diagnostic. Prenatal tests do not
prevent congenital defects, but they show if some abnormalities exist before the child
birth. The anomalies can be genetic, issued by some diseases of the mother,
because of some taken drugs, but most of them are issued by unknown reasons, or
by action of several factors. Anomalies are more frequent with multiple pregnancies.
Multiple pregnancies occur when more than one egg is fertilized, or if the egg divides
immediately after the fertilization. The foundation of a leading regular pregnancy is an
early diagnostic. In multiple pregnancies stagnation in the fetal growth is a frequent
happening, because of lack of space in the uterus, the twins are exposed to the
danger of mechanical damages. It also happens that the twins are connected,
although it is seldom because of the incomplete separation of the embryonic basis on
one pole or on any other spot between two poles of the cell mass. The fetuses can
be connected with their heads, abdomens, breast cages, buts and lower spines,
lower parts of the sacrum and coccyx. The survival of the twins depends of the type
of connection and existence of adjoined anomalies. As the number of fetuses grows
in a multiple pregnancy, the shorter is the average duration of the pregnancy. The
pregnancy lasts for 280 days, or 40 weeks, or 9 calendar months or 10 lunar months.
The delivery starts when it comes to spontaneous spasms of the uterus, the water
breaks and the fetus takes the position for the delivery. |