Start of Pregnancy and Predicting Date of Birth

Before pregnancy begins, a female oocyte (egg) must join, by spermatozoon in a process referred to in medicine as "fertilization", or commonly known as "conception" (though the definition of the English word "conception" is somewhat controversial). Fertilization occurs usually through the act of sexual intercourse, in which a man ejaculates inside a woman, thus releasing his sperm; however, the advent of artificial insemination has made it possible for women to become pregnant if pre-existing medical conditions from either the woman or the man make fertilization through sexual intercourse difficult, or if a woman chooses to become pregnant without a male partner, for any number of reasons. Though pregnancy begins at implantation, it is often convenient to date from the first day of a woman's Last Menstrual Period (LMP). This is used to calculate the Expected Date of Delivery (EDD).

Traditionally a human pregnancy is considered to last approximately 40 weeks (280 days) from the LMP, or 38 weeks (266 days) from the date of fertilization. The 38 weeks of gestation is 10 lunar months, i.e. 27.3 days/lunar-month x 10 = 273 days. In the more familiar Gregorian calendar, the 40 weeks dating from the LMP is equivalent to a little more than nine months and six days, and this forms the basis of Naegele's rule of approximating the EDD. A pregnancy is considered to have reached term between 37 and 43 weeks from the beginning of the last menstruation. Babies born before the 37 week mark are considered premature, while babies born after the 43 week mark are considered postmature.

Though these are the averages, the actual length of pregnancy depends on various factors. For example, the first pregnancy tends to last longer than subsequent pregnancies. Fewer than 10% of births occur on the due date; 50% of births are within a week of the due date, and almost 90% within two weeks. The due date is typically calculated as 40 weeks from the last menstrual period.

An accurate date of fertilization is important, because it is used in calculating the results of various prenatal tests (for example, in the triple test). A decision may be made to induce labour if a fetus is perceived to be overdue. Due dates are only a rough estimate, and the process of accurately dating a pregnancy is complicated by the fact that not all women have 28 day menstrual cycles, or ovulate on the 14th day following their last menstrual period. Approximately 3.6% of all women deliver on the due date predicted by LMP, and 4.7% give birth on the day predicted by sonograph.[citation needed]

The beginning of pregnancy may be detected in a number of ways, including various pregnancy tests which detect hormones generated by the newly-formed placenta. Clinical blood and urine tests can detect pregnancy soon after implantation, which is as early as 6-8 days after fertilization. Home pregnancy tests are personal urine tests, which normally cannot detect a pregnancy until at least 12-15 days after fertilization. Both clinical and home tests can only detect the state of pregnancy, and cannot detect its age.

In the post-implantation phase, the blastocyst secretes a hormone named human chorionic gonadotropin which in turn, stimulates the corpus luteum in the woman's ovary to continue producing progesterone. This acts to maintain the lining of the uterus so that the embryo will continue to be nourished. The glands in the lining of the uterus will swell in response to the blastocyst, and capillaries will be stimulated to grow in that region. This allows the blastocyst to receive vital nutrients from the woman. Pregnancy tests detect the presence of human chorionic gonadotropin. An early sonograph can determine the age of the pregnancy fairly accurately. In practice, doctors typically express the age of a pregnancy (i.e. an "age" for an embryo) in terms of "menstrual date" based on the first day of a woman's last menstrual period, as the woman reports it. Unless a woman's recent sexual activity has been limited, the exact date of fertilization is unknown. Absent symptoms such as morning sickness, often the only visible sign of a pregnancy is an interruption of her normal monthly menstruation cycle, (i.e. a "late period"). Hence, the "menstrual date" is simply a common educated estimate for the age of a fetus, which is an average of two weeks later than the first day of the woman's last menstrual period. The term "conception date" may sometimes be used when that date is more certain, though even medical professionals can be imprecise with their use of the two distinct terms. The due date can be calculated by using Naegele's rule.



Ref : http://en.wikipedia.org/wiki/Pregnancy