Teenage pregnancy generally sets in before the age of 20 years. Although most of the pregnancies are normal, still in some of the cases, there are many underlying complications observed such as irregular menstrual cycles, postpartum infection, and eclampsia and so on. The body goes through a significant change during pregnancy and breast tissue is one of the major structure to be observed to be changing drastically.
The glandular tissue in the breast are modified sweat glands that are responsible for causing milk production in the body. The main function is to supply the infant milk through the process of lactation (Sosa, 2017). The patient in our case study is in her puberty stage. The development of breasts are at peak at this stage under the influence of estrogen. The same can be hampered with the milk production and development of breast with the current pregnancy status. Oxytocin is another hormone that has a direct impact on the breast tissue during pregnancy. This plays a major role in lactation, with the help of promoting milk ejection. The hormone brings about the contraction of myoepithelial cells that help in releasing milk secretion (Sriraman, 2017). The levels of oxytocin are observed in mixed capacity during pregnancy.
However, studies have shown that there is a rise in the level of oxytocin observed in pregnancy, especially during term. The level also rises constantly and reaching a peak value till 36 weeks of gestation are completed. The levels are also observed at peak in some individuals, just before the time of delivery. It is also important from the point of view of facilitating coordinated uterine contractions, thus, helping in expelling the fetus out at the time of parturition. The secretion of oxytocin, however, reduced post pregnancy (Uvnäs, 2019). Studies have shown that that the females observe a post-partum depression which can be attributed to inadequate oxytocin secretion during pregnancy as well in post-partum period (Moura, 2016). This is also commonly observed in females who had difficulty in lactation as well as had episodic events of depression during their previous pregnancies.
The fluid in the body is mainly adjusted by the means of electrolytes movements in and out of the body. The kidney are the main organs that are responsible for maintaining this balance. They help in filtering the electrolytes from the body and helping in excreting out the additional residual amount through the passage of urine. The main action of ADH is to help the kidneys in regulating the amount of water excreted (Bankir, 2017). It also helps in absorbing certain amount of water in the capillaries to ensure the blood osmolality is maintained at all times. The patient in the given case study is having high glucose content which is normal for a pregnant lady. However, the patient is also having high protein content in urine, depicting that the kidneys are not able to excrete out metabolites efficiently. The patient might be at a risk of developing kidney disease, if left untreated. The patient in the given case scenario will not be able to maintain a fluid homeostasis.
Gut mobility mainly includes movements of the gut wall. It can be inclusive of contraction and stretching of the muscles of the gastrointestinal tract. The synchronized movements of the muscles of gastrointestinal track is also known as peristalsis (Sinnott, 2017). During pregnancy, some of the muscles tend to lose their tone and their contractibility also reduces. This leads to delay and prolongs the emptying of the gastric content. As the pregnancy progresses the abdominal cavity is also pushed upwards. This loss of muscle tone, decrease in acidity and the change in position of the abdominal muscles restricts the flow of intestinal content and thus, leading to irregularity in the peristalsis of the gut wall (Soma, 2016). There is an additional demand placed in pregnancy for protein required for appropriate growth of fetus as well as placenta. The additional protein content is also required for promoting growth of maternal tissues as well for expanding the blood volume. So it is required to maintain substantial amount of protein in the body during pregnancy, both for fetus as well as mother.
The route of drug administration is oral in the given case scenario. Bioavailability of the paracetamol drug is usually 100 %, but if administered through the oral route, its bioavailability can be reduced up to 70-80% only. The drug of paracetamol is very easily absorbed in the gastrointestinal tract (Dallmann, 2018). Oral bioavailability is also dependent on the dose administered. If the drug is taken in larger doses the hepatic first pass is usually observed to be reduced. This is mainly brought by the overwhelming effect of the enzymatic activity of the liver capacity. This helps in increasing the bioavailability of the drug in the patient’s body. However, in pregnancy as the metabolism is high, the first pass will be balanced out in relation with the bioavailability of the drug. Half-life of the drug is mainly important for analyzing the pharmacokinetic parameter. This is helpful in defining as to how long the effect of drug will persist in the patient. It is also vital for examining the amount of drug accumulation, if the same drug is consumed in multiple doses or given tagged along with other drugs. The percentage amount of drug present in the body after 2 hours will be 2.5%.
There is usually a decrease in the mean as well as central arterial pressure during pregnancy. This can also be attributed to the altered myocardial contractibility as well as ventricular ejection fractions. This is also due to increased load on the heart vessels due to weight increment during pregnancy. There also detrimental effect of increased blood pressure during pregnancy on kidney function test. Hypertension during pregnancy can increase the risk of development of chronic kidney disease. Preeclampsia and eclampsia also increases the risk of end stage renal disease in individuals (Dai, 2018). During pregnancy there is an increase in the plasma volume. This is due to increased vasodilation in the body. The renin-angiotensin system helps in increasing the sodium retention and plasma volume as well. This is useful in maintaining the blood pressure by the means of regulating vasodilation in the body (Kurlak, 2016).
During pregnancy the body goes through various physiological changes. The examination tests can also be reflecting upon an abnormal values in comparison to the normal ranges. Pregnancy is also marked by increased metabolism which can be both harmful and beneficial for the body in different case scenarios.
Bankir, L., Bichet, D. G., & Morgenthaler, N. G. (2017). Vasopressin: physiology, assessment and osmosensation. Journal of Internal Medicine, 282(4), 284-297.
Dai, L., Chen, Y., Sun, W., & Liu, S. (2018). Association between hypertensive disorders during pregnancy and the subsequent risk of end-stage renal disease: a population-based follow-up study. Journal of Obstetrics and Gynaecology Canada, 40(9), 1129-1138.
Dallmann, A., Ince, I., Coboeken, K., Eissing, T., & Hempel, G. (2018). A physiologically based pharmacokinetic model for pregnant women to predict the pharmacokinetics of drugs metabolized via several enzymatic pathways. Clinical Pharmacokinetics, 57(6), 749-768.
Kurlak, L. O., Mistry, H. D., Cindrova‐Davies, T., Burton, G. J., & Pipkin, F. B. (2016). Human placental renin–angiotensin system in normotensive and pre‐eclamptic pregnancies at high altitude and after acute hypoxia–reoxygenation insult. The Journal of Physiology, 594(5), 1327-1340.
Moura, D., Canavarro, M. C., & Figueiredo-Braga, M. (2016). Oxytocin and depression in the perinatal period—a systematic review. Archives of Women's Mental Health, 19(4), 561-570.
Sinnott, M. D., Cleary, P. W., & Harrison, S. M. (2017). Peristaltic transport of a particulate suspension in the small intestine. Applied Mathematical Modelling, 44, 143-159.
Soma-Pillay, P., Catherine, N. P., Tolppanen, H., Mebazaa, A., Tolppanen, H., & Mebazaa, A. (2016). Physiological changes in pregnancy. Cardiovascular journal of Africa, 27(2), 89.
Sosa-Castillo, E., Rodríguez-Cruz, M., & Moltó-Puigmartí, C. (2017). Genomics of lactation: Role of nutrigenomics and nutrigenetics in the fatty acid composition of human milk. British Journal of Nutrition, 118(3), 161-168.
Sriraman, N. K. (2017). The nuts and bolts of breastfeeding: anatomy and physiology of lactation. Current Problems in Pediatric and Adolescent Health Care, 47(12), 305-310.
Uvnäs-Moberg, K., Ekström-Bergström, A., Berg, M., Buckley, S., Pajalic, Z., Hadjigeorgiou, E., ... & Magistretti, C. M. (2019). Maternal plasma levels of oxytocin during physiological childbirth–a systematic review with implications for uterine contractions and central actions of oxytocin. BMC Pregnancy and Childbirth, 19(1), 285.
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