Normal Limits

"Chance is the very guide of life"

"In practical medicine the facts are far too few for them to enter into the calculus of probabilities... in applied medicine we are always concerned with the individual" -- S. D. Poisson

December 12, 2005

Pregnancy and diseases

Fascinating summary in JAMA on pregnancy and the associated medically relevant physiological changes, by Profs Risto Kaaja of Helsinki University Hospital and Ian Greer of University of Glasgow.

In order to optimize the delivery of nutrients and oxygen to the fetus, the removal of fetal waste, the preparation for labor, and the peaceful co-existence of fetal tissue within the body, a variety of coordinated physiological changes occur during pregnancy:

These perturbations--traumatic as they already are for the healthy mom--represent an even more severe challange to those with diseases or those with otherwise-hidden propensities towards developing diseases.

For instance, during pregnancy the mom's immune system, in order to develope tolerance to the fetus, shifts towards a TH2-dominant state. Correspondingly, TH1-dominant diseases such as rheumatoid arthritis (RA), multiple sclerosis (MS), and thyroiditis all improve during pregnancy. In constrast, systemic lupus erythematosis (SLE), a TH2-dominant disease, tends to deteriorate.

Other diseases of the endocrine and the cardiovascular systems are also perturbed by the pregnant state:

Based on these findings, Profs Kaaja and Greer, both obstetricians, recommend screening protocols to be performed peri-partum to screen for these diseases.

We note also recent work with stem cells have found neurons of fetal origin to be present in the maternal brain, such that in parts of the maternal brain a portion of the mom's nervous system is contributed by their children! (it's important to note that it's not clear these neurons of fetal origin participate in the maternal brain or are just idle bystanders. See also Parasitic Hairworm Charms Grasshopper Into Taking It for a Swim)

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