I heard that God cannot be everywhere, so he created mothers, who remain the patron saint of mothers when they reach the age of motherhood. And as a doctor, we see more of the physiological changes of a pregnant woman during pregnancy, and with every inch the fetus grows, the pregnant woman bears more discomfort and risk. Yes, it is necessary to bear these pains to become a mother, and as an obstetrician and gynecologist, we are always struggling with these pregnancy complications and comorbidities in order to ensure as smooth a delivery as possible. 1. Hyperemesis gravidarum The fluctuation of estrogen and HCG levels during pregnancy is the main cause of hyperemesis gravidarum, which is characterized by frequent nausea and vomiting, inability to eat, significant weight loss, electrolyte imbalance and metabolic disorders in the body, requiring hospitalization for rehydration. Severe cases can cause metabolic acidosis, and there are also cases of renal failure due to severe drop in blood pressure. After pregnancy, peripheral vascular resistance decreases, heart rate increases, blood volume increases, and cardiac output increases. Due to the increased cardiac load and hemodynamic changes during pregnancy, pregnant women are at higher risk of heart failure and various cardiac pathologies than the average woman. During pregnancy, the blood of pregnant women is in a hypercoagulable state, mainly to facilitate the rapid formation of blood clots in the blood vessels of the detached surface after placental abruption during delivery and to prevent postpartum hemorrhage, which is a protective mechanism. If this protective mechanism is “insufficient”, it will lead to postpartum hemorrhage, and if it is “overprotected”, it will lead to the formation of large thrombus emboli, which will travel to the lungs to form pulmonary embolism and endanger life. 4. physiological diabetes and acute pyelonephritis During pregnancy, the kidneys of pregnant women will be slightly larger than normal, and the filtration function of the glomerulus will also increase compared to the non-pregnant, resulting in an increase in urea, creatinine and other metabolites, and the risk of physiological diabetes during pregnancy will increase. Elevated levels of progesterone cause a decrease in ureteral smooth muscle tone, thickening of the ureter, decreased peristalsis, and slow urine flow. In addition, the compression of the right ureter by the right-sided uterus can lead to pelvic effusion. Susceptible to acute pyelonephritis and urinary stones. 5. susceptible to upper respiratory tract infection During pregnancy, due to changes in the anatomical position of the uterus and changes in hormone levels, pregnant women have increased ventilation, reduced residual air volume, increased air exchange, thickened upper respiratory tract mucosa, mild congestion and edema, and susceptible to upper respiratory tract infection. 6. easy to induce cholecystitis and cholelithiasis Influenced by hormones, the tension of various muscular tissues in the digestive tract decreases during pregnancy, and the digestive function decreases, which makes it easy for the gastric sphincter to relax and gastric contents to reflux, resulting in heartburn, prolonged gastric emptying time and abdominal distension, and prolonged gallbladder emptying time resulting in bile stasis inducing cholecystitis and cholelithiasis. In addition, the weakening of intestinal peristalsis can easily induce constipation, and the increase in intestinal venous pressure can easily induce hemorrhoids. 7. gestational diabetes and thyroid abnormalities During pregnancy, the increased demand for nutrients by the fetus and the elevated levels of estrogen and progesterone increase the utilization of glucose by the mother. Low blood glucose in pregnant women during fasting can cause hypoglycemic coma and ketoacidosis. By the middle and late stages of pregnancy, the sensitivity of pregnant women to insulin decreases. Gestational diabetes may occur if the pregnant woman’s islet function is not very “strong”. During pregnancy, the form and function of the thyroid gland change significantly due to changes in hormone levels, mainly in the form of increased function and increased physiological demand for thyroxine during pregnancy, making it prone to hyperthyroidism or hypothyroidism, which can be aggravated for those who are suffering from hyperthyroidism or hypothyroidism. 8. chloasma and stretch marks The change of hormone level during pregnancy will stimulate the secretion of a large amount of melanin, resulting in pigmentation of various organs of pregnant women. When the hyperpigmentation is more obvious on the face, butterfly-shaped brown chloasma may be formed. In addition, due to the increased secretion of glucocorticoids by the adrenal cortex during pregnancy, it can prompt the decomposition, degeneration and breakage of elastin, resulting in a large number of purple or light red stretch marks. 9. lumbosacral pain The relaxin secreted by the placenta can make the pelvic ligaments and intervertebral joints, ligaments and pubic symphysis of pregnant women relax, and some pregnant women will have more obvious discomfort of lumbosacral pain. 10. Postpartum pelvic floor dysfunction Pelvic floor dysfunction mainly includes two categories: stress urinary incontinence and pelvic organ prolapse. About more than one third of women suffer from pelvic floor dysfunction in their lifetime, and the incidence is increasing year by year, which is not fatal but seriously affects women’s physical and mental health and quality of life, and is called “social cancer”. Pregnancy itself has a significant impact on pelvic floor muscle function, and even cesarean delivery inevitably produces varying degrees of damage to the pelvic floor muscles. Stress incontinence, pelvic organ prolapse, sexual dysfunction and other symptoms can occur when muscle strength reaches below level 4. Not to mention the possibility of postpartum hemorrhage, amniotic fluid embolism, perineal laceration during childbirth, postpartum puerperal infection and postpartum depression, etc. I heard that God cannot be everywhere, so He created mother, mother guarded me, and obstetrician and gynecologist guarded mother.