Physiological changes in pregancy
• During pregnacy there are progress anatomical and psychological changes
• These changes does not occur at the general organs but also to all the system of the body.
• This is due to increasing demands of the growing fetus
I. Changes in gential organs
– It becomes edematous and hyperemic
– The labia minora become pigmented and hypertrophed.
– It becomes hypertrophied vascular and edematous
– The vaginal secretion becomes coupon, thin and curly white
– The PH becomes more acidic
– There is increase in size of uterus
– It measures 35 cms in length and 900-1000 gms
– Changes occurs in all the parts of uterus
– The uterine muscles undergo hypertrophied and hyperplasia
– The fundus enlarged more than the body of the uterus.
– The 3 distinct layer if uterus muscles can be made out.
– In a turn the uterus differentiate into an active upper segment which is more muscluar and a passive lower segment which is least muscular.
– The cervix is deviated to the left side, bringing it closer to the ureter due to lateral obliquity.
• There is increase in the size of the breast due to hypertrophy and proliferation of the ducts alveoli.
• The vascularity increase which result in the appearance of bluish vein running under the skin.
• The nipple becomes larger, erctile and are deeply pigmented.
• The sebaceous glands which remains invisible in the non- pregnant state becomes hyoertropheid over the aerola during pregnancy and are called as montgomery’s tubercles.
• Secondary areola is seen in the 2nd trimester.
• Secretions may also been seen at about 12 week of pregnacy
• Breast weight is increased approximately to 500-800gm.
III. Endocrine system
– Changes are brought about by progesterone, estrogen and relaxin hormones.
a. Effect of progesterone
– Reduction in tone of smooth muscles resulting in nausea, reduced peristalsis, constipation, bladder toned is decreased, dilation of veins and decreased diastolic pressure.
– Increased in body temperature
– Development of breast alveolar & glandular milk producing cells.
b. Effects estrogen
– Increased growth of uterus and breat duct
– Increased levels of prolaction for lactation
– Material calcium metabolism
– Higher level may result in increased vaginal glycogen resulting in thrush
c. Effects of relaxin
– Replacement of collagen in pelvic joint, capsule, cervix, resulting in greater extensibility, liability.
– Inhalation of myometrial activity.
– Helps in distension of uterus and provides additional supporting connective tissues.
– Has a role in cervix ripening
IV. Cutaneous changes:
• There is formation of cholsma gravidum or pregnacy mark in the form of pigmentation around the check which us patchy or diffused and it disappears after delivery.
• It also shows formation of linea nigra which is a brownish black pigmentation in the midline of the abdomen stretching from the xiphisternum to the public symphysis.
• It is usally disapper after delivery.
• Striae gravidarum are normally slightly depressed linear marks with varying length & breath. These are seen just below the umbilicus.
• These are pinkish during delivery which becomes glistening white after pregnacy and is then called as striae albicans.
V. Weight gain
• A pregnant lady puts on about 10-12 kg of weight.
• In early pregnancy the lady may loose weight due to nausea and vomiting but later the weight gains is progressively imcreased to about 2 kg every month.
VI. CVS changes
• Increase in blood volume by 40%
• Increased in plasma level than red cells and Hb level falls by 80%. This is called as physiological anemia due to pregnacy.
• During 3rd trimester, the weight of fetus may compress the aorta and IVC against the lumbar spine in lying position causing dizziness, unconsciousness and is called as pregnacy hypertensive syndrome.
• Increased in cardiac output by 40%
• Stroke volume increased by 30%
• Heart rate increased by 30%
• Heart rate increased by 15 beats / min
VII. Respiratory system
• Respiratory rate increases from 15-18 breath/min
• Alveolar ventilation increases
• Tidal volume increased upto 40%
• Diaphragm is raised by 40 mm
• Chest diameter is increased by 20 mm
• Co2 tension is decreased
• PaO2 – 92 mm of Hg
• PaCo2 – 30 mm of Hg
VIII. GIT and uninary system
• Nausea and vomiting due to response by human chronic gonadotrophin.
•Delayed gastric emptying and thus shows constipation
• Increased concentration of bile in gall bladder.
• There is increased in the size and weight of kidney and dilation of the renal pelvis.
• Dilation of ureter causes pooling and stagnation of urine resulting in U.T.I
IX. Musculoskeletal system
• Increased joint laxity
• Increased lumbar lordosis due it changes in COG and pelvic tilting.
• The distance between the two rectus abdominal muscles widens and the linea alba may split under the strain called as diastasis recti.
• Edema of ankle due to water retention
• Compression of nerves causing carpel tunnel syndorme.
X. Psychological and emotional changes
• Mood swings