Obstetrics & Gynecology
Normal Pregnancy
정상임신
Implantation of fertilized ovum in endometrium with fetal development over ~40 weeks
- How common
- Natural physiologic state in reproductive-age women
- Typical age
- Ages 15–49
What is it?
Fertilization → implantation → placental formation → hormonal milieu (hCG, progesterone, estrogen) sustains pregnancy.
Commonly affected: Uterus, placenta, fetus, systemic maternal adaptation
How it develops
- Fertilization & implantationFertilization in ampulla; implantation 6–10 days post-ovulation
- hCG secretionTrophoblast secretes hCG, maintains corpus luteum and progesterone
- Placental developmentPlacenta complete by 12 wk; takes over hormones, nutrients, gas exchange
- Fetal growth & term37–42 wk term; oxytocin surge initiates labor
Symptoms
- Nausea/vomiting (morning sickness)Peaks 6–12 weeks
- FatigueProgesterone-induced sedation
- AmenorrheaFirst diagnostic clue
- Breast tenderness/enlargementEstrogen/progesterone effect
- Urinary frequencyEnlarged uterus compresses bladder
How it is examined
- Urine/serum β-hCGPositive 8–10 days post-fertilization
- Transvaginal USGestational sac at 5 wk, fetal cardiac activity at 6 wk
- Prenatal panelType/Rh, CBC, rubella/HBV/HIV/syphilis, glucose
Imaging
X-ray avoided in pregnancy; US is standard.
- Gestational sac
- Fetal heartbeat
- Placental location
MRI without contrast available if needed; useful for fetal anomaly evaluation.
- Fetal anatomy
- Placental attachment
Non-surgical care
- Folic acid0.4–0.8 mg/day from preconception (NTD prevention)
- Prenatal visitsQ4w until 28 wk → Q2w until 36 wk → weekly
- VaccinationsInfluenza (any time), Tdap (27–36 wk), COVID-19
- LifestyleNo smoking/alcohol, caffeine <200 mg, balanced diet
- Weight gain11–16 kg for normal BMI per IOM
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Cesarean only for obstetric indications (malpresentation, previa, fetal distress)
Procedures that may be discussed
- Vaginal delivery
- Elective or emergency cesarean section
- Episiotomy/operative vaginal (forceps/vacuum)
Outlook
Most reach term without complications; maternal/neonatal mortality very low with prenatal care.