A normal pregnancy lasts for between 37 and 42 weeks, an average of 40 weeks from the first day of the last menstrual period.
Pregnancy is divided into three periods of three months each. The period of pregnancy, or gestation, is divided into three trimesters. It's a useful way to help describe the changes that happen during pregnancy.
*The first trimester is week 1- week 12,
*Tthe second is week 13 to week 27 *The third is week 28 to week 40.
In the first trimester, your baby’s body and organs develop, in the second trimester, your baby’s organs mature and in the third trimester, your baby gets bigger and lays down stores of fat.
In Pregnancy Pregnancy is a period of considerable changes in a woman´s body. These changes, affecting virtually every part of the body, are all geared towards growing and delivering a healthy baby, without harming the mother.
Pregnancy is divided into three periods of three months each. Each trimester brings with its own unique set of experiences.
Some changes that occur during pregnancy may take months to revert to normal after delivery such as;
+ Pigmentation changes,
+Loss of abdominal muscle tone
+ weight gain
last for some years after birth. Interestingly, you may even find that the hormones that soften your cartilage to allow for easier deliver have left your hips slightly wider and your feet a size bigger. If you have concerns about the way in which your body has changed, ask your doctor for advice on exercise and diet plans to help you bounce back faster.
What happen after delivery?Your shape in the first few days after delivery.Your body will have seen some significant changes over the past few days.
Your breasts will be larger at first and while you’re breastfeeding regularly. If you don’t intend to breastfeed from the start, you needn’t do anything. But on the third or fourth day, your breasts may be tender because the milk is still being produced. Wearing a firm, supportive bra may help. Your breasts will get smaller again in a week or so. Speak to your midwife if you’re very uncomfortable.
Your abdomen will probably be quite baggy after delivery. Despite delivering your baby, plus the placenta and a lot of fluid, you’ll still be quite a lot bigger than you were before pregnancy. This is partly because your muscles have stretched. If you eat a balanced diet and get some exercise, your shape should soon return to normal.
Breastfeeding helps because it makes the womb (uterus) contract. Because of this, you may sometimes feel quite a painful twinge in your stomach or period-type pain while you are feeding.
It’s quite common after having a baby to leak urine accidentally if you laugh, cough or move suddenly. Pelvic floor exercises can help prevent this. If the problem lasts for more than three months, see your doctor, who may refer you to a physiotherapist.
The abdominal wall encloses the abdominal cavity, and can be divided into anterolateral and posterior sections. Its key functions include:
Superficial FasciaThe superficial fascia consists of fatty connective tissue. The composition of this layer depends on its location:
Fig 1 – The layers of the anterolateral abdominal wall. Below the umbilicus, there are two layers of superficial fascia – Camper’s and Scarpa’s.
Muscles of the Abdominal WallThe muscles of the anterolateral abdominal wall can be divided into two main groups:
In the anteromedial aspect of the abdominal wall, each flat muscle forms an aponeurosis(a broad, flat tendon), which covers the vertical rectus abdominis muscle. The aponeuroses of all the flat muscles become entwined in the midline, forming the linea alba (a fibrous structure that extends from the xiphoid process of the sternum to the pubic symphysis).
The external oblique is the largest and most superficial flat muscle in the abdominal wall. Its fibres run inferomedially.
The internal oblique lies deep to the external oblique. It is smaller and thinner in structure, with its fibres running superomedially (perpendicular to the fibres of the external oblique).
Picture: The muscles of the anterolateral abdominal wall. Note how the flat muscles form aponeuroses medially.
The transversus abdominis is the deepest of the flat muscles, with transversely running fibres. Deep to this muscle is a well-formed layer of fascia, known as the transversalis fascia.
The rectus abdominis is long, paired muscle, found either side of the midline in the abdominal wall. It is split into two by the linea alba. The lateral border of the two muscles create a surface marking, known as the linea semilunaris.
At several places, the muscle is intersected by fibrous strips, known as tendinous intersections. The tendinous intersections and the linea alba give rise to the ‘six pack’ seen in individuals with a well-developed rectus abdominis.
This is a small triangular muscle, found superficially to the rectus abdominis. It is located inferiorly, with its base on the pubis bone, and the apex of the triangle attached to the linea alba.
Clinical Relevance: Surgical Incisions in Abdominal Wall
Vertical Incisions Median
An incision that is made through the linea alba. It can be extended the whole length of the abdomen, by curving around the umbilicus. The linea alba is poorly vascularised, so blood loss is minimal, and major nerves are avoided. All can be used in any procedure that requires access to the abdominal cavity.
Similar to the median incision, but is performed laterally to the linea alba, providing access to more lateral structures (kidney, spleen and adrenals). This method ligates the blood and nerve supply to muscles medial to the incision, resulting in their atrophy.
Transverse Incisions Transverse
This incision is made just inferior and laterally to the umbilicus. This is a commonly used procedure, as it causes least damage to the nerve supply to the abdominal muscles, and heals well. The incised rectus abdominis heals producing a new tendinous intersection. It is used in operations on the colon, duodenum and pancreas.
Suprapubic incisions are made 5cm superior to the pubis symphysis. They are used when access to the pelvic organs is needed. When performing this incision, care must be taken not the perforate the bladder (especially if it is not catheterised), as the fascia thins around the bladder area.
This incision starts inferior to the xiphoid process, and extends inferior parallel to the costal margin. It is mainly used on the right side to operate on the gall bladder, and on the left to operate on the spleen.
This is a ‘grid iron’ incision, because it consists of two perpendicular lines, splitting the fibres of the muscles without cutting them – this allows for excellent healing. McBurney incision is performed at McBurney’s point (1/3 of the distance between the ASIS and the umbilicus). It is mostly used in appendectomies.
Q & A
Contraindication for a postnatal / postpartum massage?
A massage will not be performed with:
video of Abdominal Wall