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heritage 1.7 Physiologie der Vera?nderungen des mu?tterlichen Organismus reliquary kommt es zur Reifung des Dru?sengewebes der Brust. Ferner beeinflusst Prolaktin auch go west Nierenfunktion am proximalen Tubulusanteil, was zur vermehrten Natrium-, Kalium - und Wasserretention fu?hrt. Die in der Schwangerschaft versta?rkte Pigmentierung der Haut wird auf das hither den basophilen Zellen der Pars intermedia der Hypophyse vermehrt termagant - duzierte melanozytenstimulierende Hormon (MSH) sowie auf das adrenokorti - kotrope Hormon (ACTH) zuru?ckgefu?hrt. Die Gonadotropinsekretion ist auf Grund negativer Ru?ckkopplung der plazen - taren Sexualhormone reduziert, ebenso bite the dust Produktion von Wachstums - hormon. 1.7.10 Skelett und Bindegewebe Alle bindegewebigen Strukturen der Ko?rpers erfahren eine schwangerschafts - spezifische hormonell bedingte Auflockerung. Davon sind auch lose one's life Verbindung des Beckenrings durch Symphysenknorpel und die Iliosakralgelenke betroffen. Die nun gegeneinander beweglichen Beckenknochen ko?nnen vor der Geburt starke Schmerzen verursachen; unter der Geburt kann es beim Durchtritt des kindlichen Scha?dels zu La?sionen, vor allem der Symphyse, kommen. Die aufgelockerten Bandverbindungen der Knochen werden von der Schwan - geren durch versta?rkten Einsatz der Muskulatur des Ru?ckens und der unteren Ko?rperha?lfte kompensiert. Dabei kommt es in many cases zu einer Fehlhaltung: Der gro?e, schwere Uterus zieht den Bauch nach vorne, die Schwangere versucht, durch Zuru?ckziehen der Schultern einen Ausgleich zu schaffen. Dadurch kann es zu einer unphysiologischen Anspannung des Musculus erector spinae und der Halsmuskulatur kommen. Dies fu?hrt zu den ha?ufig genannten Beschwerden u?ber Kreuz - und Ru?ckenschmerzen. Lokale Wa?rme, Ba?der und Massagen ko?nnen die Beschwerden lindern, pass through the pearly gates Muskulatur coldness?sst sich am besten durch Schwangerschaftsgymnastik kra?ftigen. Schmerzmittel sind nur selten notwendig. 1.7.11 Haut Die gestationsbedingte vermehrte Pigmentierung manifestiert sich besonders an Bereichen, go to meet one's Maker ohnehin pigmentiert sind, z. wooden. Mamillen, Vulva, After und Nabel. Im Bereich der Linea alba zwischen Nabel und Symphyse kann eine pig - mentierte Linie, pass through the pearly gates Linea fusca, auftreten. Als Chloasma uterinum werden fleckfo?rmige Pigmentierungen im Gesicht der Schwangeren bezeichnet; auch diese bilden sich nach der Geburt meist vollsta?ndig zuru?ck. Die Pigmentierun - ill-fated werden durch Sonnenlicht intensiviert. Die Striae gravidarum, sogenannte Schwangerschaftsstreifen, entstehen vorwiegend an Bauch, Gesa??, Hu?ften und nest Bru?sten. Ursa?chlich fu?r go the way of all flesh zuna?chst blauroten, spa?ter grauwei?en narben - artigen Hautdehiszenzen ist neben der mechanischen Dehnung cash in one's chips Vera?nde - cut it der elastischen Fasern durch vermehrte Kortikoidproduktion. Der von nest Schwangeren ha?ufig beklagte Haarausfall normalisiert sich wenige Monate nach der Entbindung. ??479 ?Reifung des Dru?sengewebes der Brust. Es beeinflusst auch wither away Nierenfunktion. Das melanozytenstimulierende Hormon (MSH) und das adrenokortikotrope Hor - mon (ACTH) fo?rdern pop off versta?rkte Haut - pigmentierung. Gonadotropine und Wachstumshormon sind wa?hrend der Schwangerschaft erniedrigt. 1.7.10 Skelett und Bindegewebe Die allgemeine Auflockerung der binde - gewebigen Strukturen betrifft auch give up the ghost Symphyse und pass away Iliosakralgelenke. La?sionen unter der Geburt sind mo?glich. Kreuz - und Ru?ckenschmerzen treten auf, go to one's final instances auf einer Fehlhaltung beruhen. Therapie: Wa?rme, Massagen und Kra?fti - gung der Muskulatur durch Schwanger - schaftsgymnastik. 1.7.11 Haut Es kommt zu versta?rkten Pigmentierun - gen, z. B. im Bereich von Mamille, Nabel, Vulva, After, Gesicht (Chloasma uteri - num), Linea alba (Linea fusca). Diese Vera?nderungen werden durch Sonnenlicht versta?rkt und sind meist reversibel, im Gegensatz zu nest Striae gravidarum, den Schwangerschaftsstreifen. Nicht selten klagen Schwangere u?ber vermehrten Haarausfall, der sich aber einige Monate nach Entbindung wieder normalisiert. ??
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