Physiological changes during pregnancy can be extensive. The uterus grows dramatically in size and the cervix softens. The breasts enlarge and darken. Throughout pregnancy, the body retains more fluid and blood volume increases. Respiration increases to support higher oxygen needs. The heart works harder pumping more blood. The kidneys and liver increase in size. Many hormonal changes prepare the body for childbirth and nurturing a baby.
This document discusses breech presentation, including its definition, types, diagnosis, and management. Some key points:
- Breech presentation is when the buttocks or lower limbs present first. It occurs in 3.5% of term deliveries and up to 25% of preterm deliveries.
- Types include complete breech, frank breech, and footling breech. Diagnosis is made through inspection, palpation, auscultation, and ultrasound.
- Management options are external cephalic version, vaginal delivery for some cases, or caesarean section which is recommended for complicated breeches or large babies. Vaginal delivery carries risks of complications for
During pregnancy, the female body undergoes many physiological changes to support the growing fetus. The genital organs like the uterus, cervix, and breasts enlarge and the vascularity increases. The cardiovascular system works harder - blood volume, heart rate, and cardiac output increase. Respiration also increases to supply more oxygen to the mother and fetus. Hormonal changes driven by the placenta result in further physical adaptations like skin pigmentation and breast development. These changes help create a healthy environment for the baby to develop over the 9 months of pregnancy.
The document discusses Caesarean section, including indications, types, procedure, complications, and mode of delivery in subsequent pregnancies. A Caesarean section is a surgical procedure to deliver one or more babies through incisions in the abdomen and uterus. The rate of Caesarean sections has increased from 5% in 1970 to 25% in 1990 due to factors such as abandoning difficult procedures in favor of C-sections and increased use for breech births. Complications can include hemorrhage, infections, and injuries to the mother or baby.
Hypertension is a common pregnancy complication and can be pregnancy-induced or pre-existing. Preeclampsia is defined as new hypertension with proteinuria after 20 weeks of gestation. It has various risk factors and causes damage through abnormal placentation. Clinically, it ranges from mild to severe based on blood pressure and can cause maternal organ damage. It is managed through blood pressure control, delivery once stabilized, and monitoring for complications like eclampsia. Preventing measures include calcium, anti-thrombotics and screening high risk women.
The third stage of labor involves the separation and expulsion of the placenta after childbirth. The placenta separates from the uterine wall due to uterine contraction. The uterus then contracts further to aid the descent and expulsion of the placenta through the birth canal. Midwives monitor for signs of separation and use techniques like controlled cord traction or fundal pressure to deliver the placenta if needed. Oxytocic drugs may also be used to aid delivery or prevent hemorrhage. Care of both mother and newborn continues for at least an hour after completion of the third stage to ensure uterine contraction and monitor for complications.
This document discusses anemia in pregnancy. It defines anemia as having insufficient red blood cells or hemoglobin. Anemia is common in pregnancy, affecting 18-75% of pregnant women globally. Anemia is classified as mild, moderate or severe based on hemoglobin levels. Common causes of anemia in pregnancy include iron deficiency, folic acid deficiency, vitamin B12 deficiency, and genetic disorders like sickle cell anemia. Left untreated, anemia can negatively impact both mother and baby by increasing risks of infection, hemorrhage, low birth weight, and other complications. Routine screening and treatment with iron, folic acid and other supplements can help prevent and manage anemia during pregnancy.
Shoulder dystocia occurs when the baby's shoulders become stuck after delivery of the head. It has a low incidence rate of 0.2-1% and risk factors include fetal macrosomia, obesity, diabetes and others. Diagnosis is made when normal maneuvers by the midwife fail to deliver the baby. Management involves calling for help, clearing the baby's airways, and performing maneuvers like McRoberts and Rubin's to rotate the shoulders and decrease their diameter in order to allow delivery. More invasive maneuvers like cleidotomy may be needed if these fail to deliver the anterior shoulder.
This document discusses breech presentation, including its definition, types, diagnosis, and management. Some key points:
- Breech presentation is when the buttocks or lower limbs present first. It occurs in 3.5% of term deliveries and up to 25% of preterm deliveries.
- Types include complete breech, frank breech, and footling breech. Diagnosis is made through inspection, palpation, auscultation, and ultrasound.
- Management options are external cephalic version, vaginal delivery for some cases, or caesarean section which is recommended for complicated breeches or large babies. Vaginal delivery carries risks of complications for
During pregnancy, the female body undergoes many physiological changes to support the growing fetus. The genital organs like the uterus, cervix, and breasts enlarge and the vascularity increases. The cardiovascular system works harder - blood volume, heart rate, and cardiac output increase. Respiration also increases to supply more oxygen to the mother and fetus. Hormonal changes driven by the placenta result in further physical adaptations like skin pigmentation and breast development. These changes help create a healthy environment for the baby to develop over the 9 months of pregnancy.
The document discusses Caesarean section, including indications, types, procedure, complications, and mode of delivery in subsequent pregnancies. A Caesarean section is a surgical procedure to deliver one or more babies through incisions in the abdomen and uterus. The rate of Caesarean sections has increased from 5% in 1970 to 25% in 1990 due to factors such as abandoning difficult procedures in favor of C-sections and increased use for breech births. Complications can include hemorrhage, infections, and injuries to the mother or baby.
Hypertension is a common pregnancy complication and can be pregnancy-induced or pre-existing. Preeclampsia is defined as new hypertension with proteinuria after 20 weeks of gestation. It has various risk factors and causes damage through abnormal placentation. Clinically, it ranges from mild to severe based on blood pressure and can cause maternal organ damage. It is managed through blood pressure control, delivery once stabilized, and monitoring for complications like eclampsia. Preventing measures include calcium, anti-thrombotics and screening high risk women.
The third stage of labor involves the separation and expulsion of the placenta after childbirth. The placenta separates from the uterine wall due to uterine contraction. The uterus then contracts further to aid the descent and expulsion of the placenta through the birth canal. Midwives monitor for signs of separation and use techniques like controlled cord traction or fundal pressure to deliver the placenta if needed. Oxytocic drugs may also be used to aid delivery or prevent hemorrhage. Care of both mother and newborn continues for at least an hour after completion of the third stage to ensure uterine contraction and monitor for complications.
This document discusses anemia in pregnancy. It defines anemia as having insufficient red blood cells or hemoglobin. Anemia is common in pregnancy, affecting 18-75% of pregnant women globally. Anemia is classified as mild, moderate or severe based on hemoglobin levels. Common causes of anemia in pregnancy include iron deficiency, folic acid deficiency, vitamin B12 deficiency, and genetic disorders like sickle cell anemia. Left untreated, anemia can negatively impact both mother and baby by increasing risks of infection, hemorrhage, low birth weight, and other complications. Routine screening and treatment with iron, folic acid and other supplements can help prevent and manage anemia during pregnancy.
Shoulder dystocia occurs when the baby's shoulders become stuck after delivery of the head. It has a low incidence rate of 0.2-1% and risk factors include fetal macrosomia, obesity, diabetes and others. Diagnosis is made when normal maneuvers by the midwife fail to deliver the baby. Management involves calling for help, clearing the baby's airways, and performing maneuvers like McRoberts and Rubin's to rotate the shoulders and decrease their diameter in order to allow delivery. More invasive maneuvers like cleidotomy may be needed if these fail to deliver the anterior shoulder.
1. An episiotomy is a surgically planned incision made in the perineum during the second stage of labor to enlarge the vaginal opening and facilitate delivery while minimizing perineal tearing.
2. It is most commonly done for primigravid women, those with a rigid perineum, or those requiring forceps delivery or breech birth.
3. The incision is usually mediolateral, extending from the midline outwards, and is repaired in three layers after delivery to restore anatomy and function.
This document provides information on gestational diabetes mellitus (GDM), including its definition, causes, physiological changes during pregnancy that can lead to GDM, effects on pregnancy, fetal and neonatal hazards, diagnosis, screening recommendations, treatment including medical nutrition therapy and insulin management, monitoring during labor and delivery, and postpartum care considerations. GDM is defined as glucose intolerance that begins or is first recognized during pregnancy and results from changes in insulin resistance and secretion during pregnancy. Left untreated, GDM can increase risks for the mother and fetus, so proper screening, diagnosis, and treatment are important aspects of prenatal care.
Puerperal sepsis is a serious infection of the genital tract occurring during childbirth or within 42 days postpartum. It is usually caused by bacteria that normally inhabit the vagina, such as Group A streptococcus or E. coli, entering the uterus and surrounding tissues through lacerations or surgical incisions during delivery. Signs include fever, abdominal pain, foul-smelling discharge. Diagnosis involves cultures of vaginal discharge and blood. Treatment consists of intravenous antibiotics, with sometimes surgery to drain abscesses. Nursing care focuses on isolation, hygiene, monitoring for complications like septic shock. Prophylaxis includes good nutrition, infection screening and surgical asepsis during delivery.
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in the fallopian tubes. Risk factors include age over 35, previous pelvic or abdominal surgeries, STDs, and fertility treatments. Symptoms can include abdominal pain, vaginal bleeding, and shoulder pain. Diagnosis involves testing hCG levels in blood and transvaginal ultrasound. Treatment options are medication with methotrexate or laparoscopic surgery to remove the embryo and repair any damage, as rupture can cause life-threatening bleeding.
Antenatal care involves systematic supervision of a pregnant woman from conception until delivery. It aims to ensure a healthy pregnancy and delivery of a healthy baby by screening for risks, preventing/treating complications, educating the mother, and providing ongoing medical supervision. Key aspects of antenatal care include regular checkups, history taking, physical examinations, investigations, health advice, and monitoring the health of the mother and fetus throughout pregnancy. Preconceptional care aims to optimize a woman's health before pregnancy to ensure a safe pregnancy.
The puerperium is defined as the 6-week period following childbirth when the body recovers from pregnancy and returns to the non-pregnant state. This involves the involution of the uterus and other reproductive organs. The puerperium involves 3 stages - the immediate (first 24 hours), early (first week), and remote (weeks 2-6) periods. During this time the uterus decreases in size, the breasts produce milk, the vagina and perineum heal, and other systems such as the cardiovascular and respiratory systems return to normal. Proper care, rest, perineal exercises, and breastfeeding can help support the mother's recovery.
This document provides an overview of the signs and symptoms of pregnancy presented by Nidhi Maurya. It begins with objectives to define pregnancy and explain signs and symptoms in each trimester. Common early signs include missed period, nausea, frequent urination and breast changes. Objective signs assessed include uterine size and fetal heart sound detectable after 18 weeks. Signs in the second trimester include quickening and skin changes. Third trimester brings prominent fetal movement and engagement of the presenting part. Fundal height increases throughout pregnancy.
This document discusses hypertension in pregnancy and preeclampsia. It begins with definitions and classifications of hypertension in pregnancy. Preeclampsia is defined as new onset hypertension and proteinuria after 20 weeks of gestation. Risk factors for preeclampsia are discussed. The pathogenesis involves placental ischemia leading to endothelial dysfunction. Clinical manifestations in the mother can include issues in cardiovascular, respiratory, neurological, renal and hepatic systems. Management involves controlling blood pressure, preventing seizures with magnesium sulfate, and timely delivery of the baby.
Dr. Sourav Chowdhury provides a detailed overview of ectopic pregnancy in 3 pages of text. Some key points:
- An ectopic pregnancy is when a fertilized egg implants outside the uterus, usually in the fallopian tubes.
- Risk factors include previous pelvic inflammatory disease, tubal surgery or infertility treatments. The most common site is the fallopian tube (95-96% of cases).
- Clinical signs can range from asymptomatic to acute abdominal pain and bleeding. Diagnosis involves transvaginal ultrasound, serum hCG levels and laparoscopy.
- Treatment depends on stability but may include expectant management, systemic or local methotrexate, or surgical
It is a composite graphical recording of cervical dilatation and descent of head against duration of labour in hours.
It also gives information about fetal and maternal condition that are all recorded on single sheet of paper.
Multiple pregnancies can involve twins, triplets or more. Twin pregnancies are the most common type and can be either dizygotic (fraternal) or monozygotic (identical). Risk factors include advanced maternal age, fertility treatments and genetic factors. Complications of twin pregnancies include preterm birth and low birth weight. Specific complications include twin-twin transfusion syndrome and discordant growth. Care involves monitoring for complications and intervening if needed to improve outcomes for both fetuses.
This document discusses various topics related to abortion including definitions, incidence rates, classifications, etiology, clinical features, management, and complications. Some key points:
- Abortion is defined as the expulsion of an embryo or fetus weighing less than 500g. Common classifications include threatened, inevitable, incomplete, complete, missed, and septic abortion.
- Incidence rates are 10-20% of clinical pregnancies, with 75% occurring before 16 weeks. Rates vary by maternal age and history of miscarriage.
- Etiology can include fetal factors like genetic abnormalities and maternal factors like endocrine/metabolic issues, infections, immunological disorders, and environmental exposures.
- Clinical features
physiology of labor includes the contraction and retraction of the muscles of uterus. I hope this presentation will help the persons of concerned subject.
Labor is defined as the rhythmic contractions of the uterine muscles that cause effacement and dilation of the cervix, leading to the expulsion of the fetus and placenta. The mechanism of labor involves a series of passive movements where the fetus adjusts its position through the birth canal, starting with engagement of the fetal head in the pelvis and ending with lateral flexion of the shoulders and body. Key movements include engagement, descent, flexion, internal rotation of the head, crowning, extension, restitution, and external rotation of the head and shoulders.
Postpartum hemorrhage is a leading cause of maternal mortality, accounting for over 100,000 deaths per year globally. It is defined as blood loss exceeding 500 mL after delivery. The main causes are uterine atony, trauma, and retained placental tissue. Management involves uterine massage, uterotonic drugs like oxytocin and prostaglandins, repair of lacerations, and conservative surgical procedures if bleeding cannot be controlled. Significant blood loss can result in complications like shock and death.
This topic contains detailed description regarding Normal puerperium, it's definition, duration, phases, involution of uterus and other pelvic organs, lochia, general physiological changes of puerperium, lactation, management of normal puerperium, management of ailments and postnatal care.
Induction of labor involves initiating uterine contractions through medical, surgical, or combined methods to facilitate vaginal delivery after the fetus reaches viability. Common reasons for induction include preeclampsia, post-term pregnancy, premature rupture of membranes, and non-reassuring fetal status. It is important to confirm the indication for induction and rule out any contraindications. The document then discusses various methods for induction, including medical induction using prostaglandins or mifepristone, surgical induction through artificial rupture of membranes or membrane stripping, and combined methods. Risks of induction include iatrogenic prematurity and increased cesarean rates if induction fails. Proper patient counseling and assessment of cervical ripeness are important factors for
This document provides an overview of Cesarean section (C-section) including:
- Definition, types (elective vs emergency; lower segment vs upper segment incisions), indications, complications, technique, and management both pre-operatively, intra-operatively, and post-operatively.
The presentation covers the objective, definition, types according to timing and uterine incision, common indications for C-section, potential complications, surgical technique during and after delivery, and guidelines for pre-op, intra-op, and post-op patient care and medication administration.
The document summarizes the major physiological changes that occur during pregnancy across multiple body systems. Hormonal changes including increased progesterone, estrogen, prolactin, and cortisol levels help prepare the body for pregnancy. The pancreas produces higher insulin levels to regulate increased blood sugar levels and fuel metabolism. The uterus grows substantially larger to accommodate the fetus, and other organs like the cervix, vagina, blood vessels, and respiratory system also undergo changes. Weight gain during pregnancy of 11-16 kilograms is distributed between increased fluid, tissues, the placenta and developing baby. Most systems return to their pre-pregnancy state after delivery.
Maternal changes during pregnancy can affect many body systems. The reproductive tract undergoes significant changes, including enlargement of the uterus from 50g to 1100g and a change in shape from pyriform to globular. The cardiovascular system also changes substantially, with a 40% increase in cardiac output and a 10-15% decrease in blood pressure. Renal changes include a 50% increase in glomerular filtration rate and increased frequency of urination. Many other systems are impacted as well, such as a slight enlargement of the kidneys and changes in skin pigmentation and elasticity.
1. An episiotomy is a surgically planned incision made in the perineum during the second stage of labor to enlarge the vaginal opening and facilitate delivery while minimizing perineal tearing.
2. It is most commonly done for primigravid women, those with a rigid perineum, or those requiring forceps delivery or breech birth.
3. The incision is usually mediolateral, extending from the midline outwards, and is repaired in three layers after delivery to restore anatomy and function.
This document provides information on gestational diabetes mellitus (GDM), including its definition, causes, physiological changes during pregnancy that can lead to GDM, effects on pregnancy, fetal and neonatal hazards, diagnosis, screening recommendations, treatment including medical nutrition therapy and insulin management, monitoring during labor and delivery, and postpartum care considerations. GDM is defined as glucose intolerance that begins or is first recognized during pregnancy and results from changes in insulin resistance and secretion during pregnancy. Left untreated, GDM can increase risks for the mother and fetus, so proper screening, diagnosis, and treatment are important aspects of prenatal care.
Puerperal sepsis is a serious infection of the genital tract occurring during childbirth or within 42 days postpartum. It is usually caused by bacteria that normally inhabit the vagina, such as Group A streptococcus or E. coli, entering the uterus and surrounding tissues through lacerations or surgical incisions during delivery. Signs include fever, abdominal pain, foul-smelling discharge. Diagnosis involves cultures of vaginal discharge and blood. Treatment consists of intravenous antibiotics, with sometimes surgery to drain abscesses. Nursing care focuses on isolation, hygiene, monitoring for complications like septic shock. Prophylaxis includes good nutrition, infection screening and surgical asepsis during delivery.
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, usually in the fallopian tubes. Risk factors include age over 35, previous pelvic or abdominal surgeries, STDs, and fertility treatments. Symptoms can include abdominal pain, vaginal bleeding, and shoulder pain. Diagnosis involves testing hCG levels in blood and transvaginal ultrasound. Treatment options are medication with methotrexate or laparoscopic surgery to remove the embryo and repair any damage, as rupture can cause life-threatening bleeding.
Antenatal care involves systematic supervision of a pregnant woman from conception until delivery. It aims to ensure a healthy pregnancy and delivery of a healthy baby by screening for risks, preventing/treating complications, educating the mother, and providing ongoing medical supervision. Key aspects of antenatal care include regular checkups, history taking, physical examinations, investigations, health advice, and monitoring the health of the mother and fetus throughout pregnancy. Preconceptional care aims to optimize a woman's health before pregnancy to ensure a safe pregnancy.
The puerperium is defined as the 6-week period following childbirth when the body recovers from pregnancy and returns to the non-pregnant state. This involves the involution of the uterus and other reproductive organs. The puerperium involves 3 stages - the immediate (first 24 hours), early (first week), and remote (weeks 2-6) periods. During this time the uterus decreases in size, the breasts produce milk, the vagina and perineum heal, and other systems such as the cardiovascular and respiratory systems return to normal. Proper care, rest, perineal exercises, and breastfeeding can help support the mother's recovery.
This document provides an overview of the signs and symptoms of pregnancy presented by Nidhi Maurya. It begins with objectives to define pregnancy and explain signs and symptoms in each trimester. Common early signs include missed period, nausea, frequent urination and breast changes. Objective signs assessed include uterine size and fetal heart sound detectable after 18 weeks. Signs in the second trimester include quickening and skin changes. Third trimester brings prominent fetal movement and engagement of the presenting part. Fundal height increases throughout pregnancy.
This document discusses hypertension in pregnancy and preeclampsia. It begins with definitions and classifications of hypertension in pregnancy. Preeclampsia is defined as new onset hypertension and proteinuria after 20 weeks of gestation. Risk factors for preeclampsia are discussed. The pathogenesis involves placental ischemia leading to endothelial dysfunction. Clinical manifestations in the mother can include issues in cardiovascular, respiratory, neurological, renal and hepatic systems. Management involves controlling blood pressure, preventing seizures with magnesium sulfate, and timely delivery of the baby.
Dr. Sourav Chowdhury provides a detailed overview of ectopic pregnancy in 3 pages of text. Some key points:
- An ectopic pregnancy is when a fertilized egg implants outside the uterus, usually in the fallopian tubes.
- Risk factors include previous pelvic inflammatory disease, tubal surgery or infertility treatments. The most common site is the fallopian tube (95-96% of cases).
- Clinical signs can range from asymptomatic to acute abdominal pain and bleeding. Diagnosis involves transvaginal ultrasound, serum hCG levels and laparoscopy.
- Treatment depends on stability but may include expectant management, systemic or local methotrexate, or surgical
It is a composite graphical recording of cervical dilatation and descent of head against duration of labour in hours.
It also gives information about fetal and maternal condition that are all recorded on single sheet of paper.
Multiple pregnancies can involve twins, triplets or more. Twin pregnancies are the most common type and can be either dizygotic (fraternal) or monozygotic (identical). Risk factors include advanced maternal age, fertility treatments and genetic factors. Complications of twin pregnancies include preterm birth and low birth weight. Specific complications include twin-twin transfusion syndrome and discordant growth. Care involves monitoring for complications and intervening if needed to improve outcomes for both fetuses.
This document discusses various topics related to abortion including definitions, incidence rates, classifications, etiology, clinical features, management, and complications. Some key points:
- Abortion is defined as the expulsion of an embryo or fetus weighing less than 500g. Common classifications include threatened, inevitable, incomplete, complete, missed, and septic abortion.
- Incidence rates are 10-20% of clinical pregnancies, with 75% occurring before 16 weeks. Rates vary by maternal age and history of miscarriage.
- Etiology can include fetal factors like genetic abnormalities and maternal factors like endocrine/metabolic issues, infections, immunological disorders, and environmental exposures.
- Clinical features
physiology of labor includes the contraction and retraction of the muscles of uterus. I hope this presentation will help the persons of concerned subject.
Labor is defined as the rhythmic contractions of the uterine muscles that cause effacement and dilation of the cervix, leading to the expulsion of the fetus and placenta. The mechanism of labor involves a series of passive movements where the fetus adjusts its position through the birth canal, starting with engagement of the fetal head in the pelvis and ending with lateral flexion of the shoulders and body. Key movements include engagement, descent, flexion, internal rotation of the head, crowning, extension, restitution, and external rotation of the head and shoulders.
Postpartum hemorrhage is a leading cause of maternal mortality, accounting for over 100,000 deaths per year globally. It is defined as blood loss exceeding 500 mL after delivery. The main causes are uterine atony, trauma, and retained placental tissue. Management involves uterine massage, uterotonic drugs like oxytocin and prostaglandins, repair of lacerations, and conservative surgical procedures if bleeding cannot be controlled. Significant blood loss can result in complications like shock and death.
This topic contains detailed description regarding Normal puerperium, it's definition, duration, phases, involution of uterus and other pelvic organs, lochia, general physiological changes of puerperium, lactation, management of normal puerperium, management of ailments and postnatal care.
Induction of labor involves initiating uterine contractions through medical, surgical, or combined methods to facilitate vaginal delivery after the fetus reaches viability. Common reasons for induction include preeclampsia, post-term pregnancy, premature rupture of membranes, and non-reassuring fetal status. It is important to confirm the indication for induction and rule out any contraindications. The document then discusses various methods for induction, including medical induction using prostaglandins or mifepristone, surgical induction through artificial rupture of membranes or membrane stripping, and combined methods. Risks of induction include iatrogenic prematurity and increased cesarean rates if induction fails. Proper patient counseling and assessment of cervical ripeness are important factors for
This document provides an overview of Cesarean section (C-section) including:
- Definition, types (elective vs emergency; lower segment vs upper segment incisions), indications, complications, technique, and management both pre-operatively, intra-operatively, and post-operatively.
The presentation covers the objective, definition, types according to timing and uterine incision, common indications for C-section, potential complications, surgical technique during and after delivery, and guidelines for pre-op, intra-op, and post-op patient care and medication administration.
The document summarizes the major physiological changes that occur during pregnancy across multiple body systems. Hormonal changes including increased progesterone, estrogen, prolactin, and cortisol levels help prepare the body for pregnancy. The pancreas produces higher insulin levels to regulate increased blood sugar levels and fuel metabolism. The uterus grows substantially larger to accommodate the fetus, and other organs like the cervix, vagina, blood vessels, and respiratory system also undergo changes. Weight gain during pregnancy of 11-16 kilograms is distributed between increased fluid, tissues, the placenta and developing baby. Most systems return to their pre-pregnancy state after delivery.
Maternal changes during pregnancy can affect many body systems. The reproductive tract undergoes significant changes, including enlargement of the uterus from 50g to 1100g and a change in shape from pyriform to globular. The cardiovascular system also changes substantially, with a 40% increase in cardiac output and a 10-15% decrease in blood pressure. Renal changes include a 50% increase in glomerular filtration rate and increased frequency of urination. Many other systems are impacted as well, such as a slight enlargement of the kidneys and changes in skin pigmentation and elasticity.
Detailed account of the various changes that occur in maternal anatomy, physiology, and metabolism of pregnant women. These physiological changes are often very precise, and deviations of physiological responses can be a prelude to possible disease/infectious states. In this second part of Labor, we will examine the various systems of the human body,its altered states during pregnancy, and how those changes affect the woman preparing for delivery. Special care is imperative in properly determining the needs of an expecting mother, so developing an intimate, trusting relationship between the mother and fully understanding her physiological output will lead to the best chances of a successful delivery.
Physiological changes in pregnancy include changes in the central nervous, respiratory, and cardiovascular systems. The minimum alveolar concentration of anesthetic gases decreases by up to 40% due to hormonal and endogenous changes. Oxygen consumption and minute ventilation increase while functional residual capacity decreases, increasing the risk of desaturation. Blood volume and plasma volume increase substantially, elevating cardiac output and stroke volume and decreasing systemic vascular resistance.
Physiological Changes in Pregnancy and Its Anaesthetic Implications.Mohtasib Madaoo
This document summarizes the physiological changes in pregnancy and their implications for anesthesia. It discusses how pregnancy causes increased blood volume, cardiac output, oxygen consumption and acidity levels. These changes can cause issues like supine hypotension syndrome when the mother lies on her back. The document also covers respiratory, coagulation, gastrointestinal and central nervous system changes in pregnancy and how they impact drug dosages and anesthesia techniques. Special considerations are discussed for intubation, regional anesthesia and placental drug transport.
Physiological changes in pregnancy & its anaesthetic implicationsSwadheen Rout
This document discusses the physiological changes that occur during pregnancy and how they impact anesthesia practice. It notes that pregnancy results in increased blood volume, cardiac output, respiratory rate and oxygen consumption to support the growing fetus. Regional and general anesthesia can impact the mother's cardiovascular and respiratory physiology, with risks of supine hypotension, hypoxemia and decreased uterine blood flow. Careful anesthetic management is needed to support both mother and fetus simultaneously during pregnancy and delivery.
Pregnancy Week by Week guides women through each of the 40 weeks of pregnancy, giving details on developmental milestones in both Mom and Baby, practical advice and words of encouragement.
Fertilization occurs when a sperm meets and fertilizes an egg, usually in the fallopian tubes. The fertilized egg then divides as it travels to the uterus, where it implants and receives nourishment from the mother via the placenta and umbilical cord. Over about 38 weeks, the fetus develops fully into a baby that is ready to be born.
The document discusses various physiological changes that occur in pregnancy across multiple body systems. The uterus increases dramatically in size from 70g and 10mL non-pregnant to approximately 1100g and 5L by the end of pregnancy. Hormonal changes include increased estrogen, progesterone, hCG, hPL, prolactin, IGF, and decreased hGH levels. This leads to adaptations in various organ systems like increased blood volume by 45%, enlarged heart and increased cardiac output, mild anemia and thrombocytopenia, immunosuppression to tolerate the fetus, and metabolic changes in carbohydrate and fat metabolism. Respiration is also altered to support higher oxygen demands.
obstetric and gyneacology; Changes in pregnancy, cardiovascular changes, respiratory changes, endocrine changes, gastrointestinal changes, related organ changes in pregnancy. hormonal changes during pregnancy.
This document discusses the physiological changes that occur during pregnancy to promote maternal health and support fetal development. It covers changes in various body systems including the reproductive, cardiovascular, respiratory, renal, gastrointestinal, endocrine, integumentary, and musculoskeletal systems. Key changes include increased blood volume and cardiac output, skin pigmentation, weight gain, and adaptations in organs and tissues to accommodate the growing fetus. The document provides information on signs and symptoms of pregnancy and details nutritional needs that increase to support the demands of pregnancy.
Physiological changes during pregnancy allow the mother's body to support fetal growth and development. The cardiovascular, respiratory, gastrointestinal, urinary, and endocrine systems undergo remodeling. The cardiovascular system increases blood volume and cardiac output by 40% by the third trimester. Respiration increases to meet higher oxygen needs. Hormonal changes, like increased progesterone and estrogen, prepare the uterus and breasts for birth. Overall, the adaptations sustain a healthy environment for the fetus throughout pregnancy.
This document describes the physiological changes that occur in a woman's body during pregnancy. It discusses changes in the vulva, vagina, uterus, breasts, skin, blood, metabolism, respiratory and cardiovascular systems, urinary system, alimentary system, nervous system, and weight gain. The major changes include increased blood volume and cardiac output, softening of tissues like the cervix, hypertrophy of organs like the breasts, and temporary changes to skin pigmentation and the distribution of weight gain.
Pregnancy usually lasts about 40 weeks and is divided into three trimesters of about 3 months each. In the first trimester, the major organs form and early pregnancy symptoms like fatigue and nausea may occur. In the second trimester, the risk of miscarriage decreases and the mother can start to feel the baby move. By the third trimester, the baby is fully grown and the mother experiences physical changes like shortness of breath as the baby's size increases. A healthy pregnancy diet focuses on fruits, vegetables, whole grains, proteins and calcium to support the growth and development of the baby.
Physiological changes in pregnancy affect many body systems. The cardiovascular system adapts to support the growing fetus through increased blood volume, cardiac output, and stroke volume. The respiratory system increases minute ventilation and oxygen consumption while functional residual capacity decreases. The placenta allows passage of most anesthetic drugs from mother to fetus through passive diffusion. Anesthesiologists must consider these physiological alterations when planning anesthetic care for pregnant patients.
Physiological changes during pregnancy can be extensive. The document summarizes several key changes:
1) The uterus grows enormously in size and weight to accommodate the growing fetus. Other genital organs like the cervix and breasts also see significant changes to support pregnancy and birth.
2) Extensive changes occur in many body systems like the cardiovascular, respiratory, urinary and endocrine systems to support the nutritional and oxygen needs of the mother and fetus. This includes increases in blood volume, cardiac output, kidney size and lung capacity.
3) Hormonal changes are also profound, with high levels of progesterone, estrogen and other placental hormones influencing many processes and organs across the body to sustain the pregnancy.
Physiological changes during pregnancy include:
1. Enlargement of the uterus, cervix, breasts, and other reproductive organs.
2. Increased blood volume, heart rate, and respiration to support the growing fetus and maternal organs.
3. Hormonal changes like increased progesterone and estrogen from the placenta lead to changes in metabolism, immune function, and other systems throughout the body.
During pregnancy, the body undergoes many physiological changes to support the growing fetus. The uterus enlarges significantly in size and weight. The cervix softens and the vagina increases in blood flow. The breasts enlarge and develop features to support lactation. Throughout pregnancy, the cardiovascular and respiratory systems work to increase blood and oxygen supply for the mother and fetus. Hormone levels also change dramatically, with high levels of progesterone, estrogen, and placental hormones that prepare the body for childbirth and breastfeeding.
Physiological changes in pregnancy include increased blood volume, cardiac output, and respiration. The uterus grows significantly to accommodate the fetus, while other systems like renal and endocrine adapt to support the demands of pregnancy. Diagnosis involves tests to detect hCG in urine or blood from very early pregnancy, and ultrasound to visualize the developing fetus.
The document provides an overview of the physiological changes that occur throughout the maternal body during pregnancy. Key changes discussed include:
- Uterine growth and changes to support fetal development.
- Increased cardiac output, blood volume, and vascular changes to support nutrient/waste exchange between mother and fetus.
- Respiratory changes like increased tidal volume to support oxygen demands.
- Renal changes like increased GFR and kidney size to excrete wastes and support calcium/electrolyte balance.
- Metabolic changes to support fetal growth including increased lipids, proteins, and iron.
- Skin changes like line striae and pigmentation due to hormonal influences.
- Central nervous
Physiological changes during pregnancy allow the mother's body to support fetal growth and development. The cardiovascular, respiratory, gastrointestinal, urinary, and endocrine systems undergo remodeling. The cardiovascular system increases blood volume and cardiac output by 40% by the third trimester. The respiratory system compensates for increased oxygen needs through hyperventilation. Hormonal changes, like increased estrogen and progesterone, prepare the breasts, uterus, and other organs for childbirth. These adaptations maintain a healthy environment for the developing fetus.
Physiological changes during pregnancy include changes in the genital organs, breasts, skin, abdomen, blood, metabolism, cardiovascular and urinary systems. The genital organs like the uterus, cervix and breasts enlarge and the blood volume increases significantly. Metabolism increases to support the growth of the fetus. The heart enlarges and cardiac output increases. Kidney function is enhanced and urinary frequency rises, especially later in pregnancy. Respiration is also impacted with higher oxygen needs.
Maternal Physiology & Related Conditions refers to the physiological changes that occur in a woman's body during pregnancy, childbirth, and the postpartum period. These changes include hormonal fluctuations, cardiovascular and metabolic changes, and structural changes in the reproductive system. Maternal physiology also encompasses the study of any potential complications that may arise during this time, such as gestational diabetes or preeclampsia.
The document summarizes various anatomical, physiological, and biochemical changes that occur during pregnancy across multiple body systems. Key anatomical changes include uterine enlargement, breast changes, skin changes like lineae nigra and striae gravidarum. Physiological changes impact the cardiovascular, respiratory, renal and endocrine systems to support the nutritional and oxygen needs of the growing fetus. Hematological changes include increased blood volume and mild anemia. Biochemical changes involve iron metabolism and increased production of hormones like estrogen, progesterone, human placental lactogen and relaxin.
The document summarizes several physiological changes that occur during pregnancy. The uterus enlarges significantly from 30-60 grams to 800-1100 grams due to stretching, hypertrophy, increased tissue, and accumulation of fibrous tissue stimulated by estrogen. The cervix and vagina undergo changes like increased vascularity and thickness. Other systems affected include increased blood volume, cardiovascular changes like lower blood pressure, respiratory changes like increased ventilation, and renal changes like increased glomerular filtration rate. Hormonal changes induce thyroid and adrenal gland enlargement along with increased secretions. Psychological changes can include mood alterations and sleep decreases. The document also briefly outlines metabolic changes like increased weight gain and retention of water and sodium. Pregnancy tests
Maternal physiological changes in pregnancy are the adaptations during pregnancy that a woman's body undergoes to accommodate the growing embryo or fetus. ... The pregnant woman and the placenta also produce many other hormones that have a broad range of effects during the pregnancy.
Physiological changes during pregnancy by Harrison MboheHarrisonMbohe
The document summarizes many of the physiological changes that occur in a woman's body during pregnancy. Key changes include enlargement and increased blood flow to the uterus, breasts, kidneys and other organs. The cardiovascular system adapts with increased blood volume and heart rate. Hormonal changes impact metabolism, thyroid and cortisol levels. Other changes involve the skin, respiratory and musculoskeletal systems to accommodate the growing fetus.
Physiology of Pregnancy for Undergraduatesthezaira
The document summarizes the physiological changes that occur throughout a woman's body during pregnancy. Key changes include enlargement and increased blood flow to the uterus, breasts, and major organs. Other changes are weight gain and fluid retention, increased blood volume and altered metabolism to support the growing fetus. The various body systems also adapt to pregnancy through respiratory alkalosis, circulatory adjustments and neurological/hormonal responses.
Hormonal changes during pregnancy cause physiological changes in multiple body systems. Progesterone, estrogen, and relaxin are the three main hormones. They cause increased blood volume, uterine growth accommodating the fetus, softening of tissues, and postural changes. Specific effects include relaxation of smooth muscles, increased temperature and breathing rate, breast growth in preparation for lactation, skin pigmentation, and softening of joints. These changes help support the developing fetus and prepare the mother's body for childbirth and nursing.
changes in cardiovascular system during pregnancyChinjuJoseSajith
The cardiovascular system undergoes several changes during pregnancy to support the growing fetus. The heart enlarges and its rate and output increase to accommodate greater blood volume and oxygen demands. Blood pressure is maintained despite increased cardiac output due to reduced peripheral resistance. Blood volume increases up to 100% by the third trimester to supply the placenta and fetus, and enhance kidney and organ perfusion. Clotting factors increase in preparation for delivery while immunity is reduced during pregnancy.
Physiological changes in pregnancy.pptxfarhafatima11
1) Physiological changes in pregnancy include increased weight, blood volume, cardiac output and decreased FRC.
2) Respiratory changes include increased oxygen consumption and minute ventilation but decreased FRC leading to risk of atelectasis.
3) Renal changes involve increased GFR and decreased resorption causing mild glycosuria and proteinuria.
4) Hematological changes result in a hypercoagulable state with increased clotting factors and decreased platelets.
Laura is 34 weeks pregnant and experiencing common discomforts of late pregnancy like heartburn, diarrhea/constipation, edema, and fatigue. Her hematocrit is 31%, which is within the normal range for pregnancy.
During pregnancy, the placenta secretes hormones like hCG, estrogen, progesterone, and others that prepare the body for pregnancy and support fetal development. This causes physiological changes in many body systems. The uterus and breasts enlarge, blood volume increases, and the metabolism and respiration rates rise to meet increased demands. These changes help the fetus receive nutrients and oxygen from the mother.
physiological changes during pregnancy
effect of pregnancy on physiological functions during pregnancy
cardiovascular, respiratory and hormonal changes
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gynecology
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physiological effects on different systems of body during pregnancyshifanoor4
The document summarizes various physiological changes that occur during pregnancy across multiple body systems. Key changes include:
- Increased blood volume, cardiac output, and respiratory rate to support growth of the fetus and placenta.
- Softening of ligaments and joints due to relaxin to accommodate birth.
- Enlargement and changes in position of organs like the uterus, kidneys, and breasts to make room for the growing fetus.
- Increased progesterone and estrogen levels impacting muscles, metabolism, and other functions to sustain pregnancy.
- Common symptoms like nausea and back pain emerge from these systemic adaptations during each trimester.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
2. Genital changes
• The body of the uterus
- Height and weight (hyperplasia)
the height increases from 7.5 cm to 35cm
the weight increases from 50g to 1000g at term
- Uterine ligaments
show hypertrophy
- Dextro-rotation
the uterus is tilted and twisted to the right in 80% of cases
- Lower uterine segment (LUS)
the LUS is formed from the isthmus
formed from the 4th month to reach 10 cm at full term
3. Genital changes
• The cervix
- edema and congestion, and becomes soft
- mucus plug (operculum): cervical mucus closing the cervical
canal
- increased secretion from its glands
• The vulva
shows increased vascularity and varicosities
4. Genital changes
• The vagina
- shows increased vascularity soft, moist and bluish
- distention of vagina at birth
• The ovary
shows increased vascularity and size
one ovary contains the corpus luteum
• Pelvic ligaments
- relaxation of the ligaments
- relaxation of the pelvic joints
- the pelvis become more mobile and increases in capacity
5. Breast changes
• Increased size and vascularity
warm, tense and tender
• Increased pigmentation of the nipple and areola
• Secondary areola appear
(light pigmentation around the 1ry areola)
• Montgomery tubercules appear on the areola
(dilated sebaceous glands)
• Colostrum like fluid is expressed at the end of the 3rd month
6. Skin changes
• Pigmentation
due to increased melanocyte stimulating hormone:
- linea nigra: pigmentation of the linea alba, more marked below
the umbilicus
- chloasma gravidarum: Butterfly pigmentation of the face (mask
of pregnancy)
• Striae gravidarum
- stretch of the abdominal wall
rupture of the subcutaneous elastic fibers
pink lines in flanks
- become white after labor
7. Weight increase
• There is an increase weight of approximately 12.5 Kg at term
• The main increase occurs in the 2nd half of the pregnancy, 0.5
Kg/week
• Causes:
growth of the conceptus
enlargement of the maternal organs
maternal storage of fat
increase in maternal blood and interstitial fluid
8. Skeletal changes
• Increased lumbar lordosis
• Relaxation of pelvic joints and ligaments
due to progesterone and relaxin
9. Urinary changes
• Kidneys
- increase in size
- hydronephrosis
- effective renal plasma flow is increased
• Dilatation of the ureters
- Atony of the ureteric muscles caused by progesterone and relaxin
hydro-ureter
- vesico-ureteric reflux increased - pressure of the uterus on the ureter
affects more the right ureter due to the dextro-rotation of the uterus
Changes in the ureter in pregnancy leads to urinary stasis and pyelitis
10. Urinary changes
• Frequency of micturation
causes: 1st trimester: pressure of the uterus on the bladder
late in pregnancy: engagement of the head
• Urinary output
- diminished on a normal fluid intake
- increase in tubular reabsorption
- 100 extra liters of fluid pass into the renal tubules each day
- extracellular water is increased by 6 to 7 liters during pregnancy
- this is due to increased amounts of
aldosterone progesterone and oestrogen
11. Gastro-intestinal changes
• Increased salivation (ptyalism)
• Taste is often altered very early in pregnancy
• Increase appetite & thirst frequent small snacks
• Heart burn (reflux oesophagitis)
relaxation of the cardiac sphincter due to progesterone and relaxin
• Emesis gravidarum, morning sickness in 50 %
• Decreased gastric acidity, which interfere with iron absorption
• Constipation
reduced gut motility due to progesterone
increased water and salt absorption
12. Gastro-intestinal changes
• Liver
- Hepatic synthesis of albumin, plasma globulin and fibrinogen
increases
- Total hepatic synthesis of globulin increases stimulated by
estrogen
- Hormone-binding globulins rise
- gall bladder increases in size and empties more slowly
- relaxation of gall bladder increases the tendency of stone
formation
- cholestasis is almost physiological
- secretion of bile is unchanged
13. Cardiovascular changes
• Fall in total peripheral resistance by 6 weeks gestation to a nadir ~
40% by mid gestation
• Circulatory underfilling
activation of renin-angiotensin- aldosterone system
necessary expansion of the plasma volume
the bigger the expansion, the bigger the baby birthweight
• Total extracellular volume 16% by term
• Plasma osmolality by 10mOsm/Kg as water is retained
14. Cardiovascular changes
• The heart
- the heart rate rises synchronously by 10-15 b.p.m.
from 70 to 85 b.p.m.
- stroke volume rises
- cardiac output begins to rise by 35-40% in a first pregnancy
and ~ 50% in later pregnancies
15. Cardiovascular changes
• The blood pressure
- Korotkoff 5 used with auscultatory techniques
- slight drop in the 2nd trimester
small fall in systolic, greater fall in diastolic B.P.
opening of arterio-venous shunts at the placenta
increased pulse pressure
- supine hypotension syndrome in 8% of the women
2nd half of the pregnancy:
maternal hypotension occurs in the supine position due to pressure of
the uterus on the inferior vena cava
decreased venous return and cardiac output
16. Cardiovascular changes
• Noradrenaline
- pressor response to angiotensin II reduced in normal
pregnancy, unchanged to noradrenaline
- plasma noradrenaline is not increased in normal pregnancy
• Pulmonary circulation
- able to absorb high rate of flow without an increase in pressure
- pressure in right ventricle, pulmonary arteries and capillaries
does not change
- pulmonary resistance falls in early pregnancy
- progressive venodilatation + rises in venous distensibility +
capacitance throughout a normal pregnancy
17. Respiratory changes
• Tidal volume rises by 30% in early pregnancy
40-50% by term
Driven by
• Fall in expiratory reserve and residual volume progesterone
decrease the threshold
increase the sensitivity of medulla oblongata to CO2
• Respiratory rate does not change
the minute ventilation rises by a similar amount
from 7.25L to 10.5L
• Elevation of the diaphragm in late pregnancy
dyspnea
18. Respiratory changes
• Carbon dioxide production rises sharply during the 3rd trimester
as fetal metabolism increases
• The fall in maternal P CO2
- allows more efficient placental transfer of CO2 from the fetus
- results in a fall in plasma bicarbonate concentration
( from 24-28 mmol/L to 18-22 mmol/L)
fall in plasma osmolality
venous pH rises slightly ( from 7.35 to 7.38)
19. Respiratory changes
• The increased alveolar ventilation small rise in PCO2
(from 96.7 to 101.8 mmHg)
• Rightward shift of the maternal oxyhaemoglobin dissociation curve
( due to an increase in 2,3-DPG in erythrocytes)
oxygen unloading to the fetus which has:
- lower PCO2 (25-30 mmHg, 3.3-4 KPa)
- marked leftward shift of the oxyhaemoglobin dissociation curve,
(due to lower sensitivity of fetal haemoglobin to 2,3-DPG)
20. Respiratory changes
• Increase of 16% in oxygen consumption by term
• Fall in arterio-venous oxygen difference
• Pregnancy places greater demands on the cardiovascular than the
respiratory system
21. Haematological changes
• Circulating red cell mass increases by 20-30%
( rises more in multiple pregnancies and iron supplement)
• Serum iron concentration falls
absorption from gut and iron-binding capacity rise
• Plasma folate concentration halves by term ( renal clearance)
red cell folate concentration falls less
• Mild maternal anaemia associated with
increased placental/birthweight ratio
decreased birthweight
22. Haematological changes
• Erythropoietin rises especially if iron supplement not taken
• Human placental lactogen may stimulate haematopoiesis
• Fall in packed cell volume from 36% in early pregnancy to 32% in the 3rd
trimester ( normal plasma volume expansion)
• WBC count rises ( increase in polymorphonuclear leucocytes)
• Neutrophil number rises with oestrogen
peak at 33 weeks
stabilizing after that
until labour and the puerperium, when they rise sharply
23. Haematological changes
• T and B lymphocyte counts do not change but their function is
suppressed
( women become more susceptible to viral infections, malaria and
leprosy)
• Platelet count and platelet volume are largely unchanged
24. Haematological changes
• Coagulation
- factors VII, VIII and X rise
- absolute plasma fibrinogen doubles
- antithrombin III falls
- erythrocyte sedimentation rates increase
- Protein C unchanged
- Protein S concentrations, co-factor of protein C, fall in 1st & 2nd
trimesters
- plasma fibrinolytic activity decreases during pregnancy & labour
returns to normal values within an hour of delivery of placenta
25.
26. Endocrinal changes
• Pituitary
- anterior pituitary increases in size and activity
- posterior pituitary releases oxytocin on the onset of labor
• Thyroid
- increases in size and activity: physiological goiter
- most pregnant women are euthyroid
- thyroid binding globulin concentrations double (not other thyroid
binding proteins)
- total T3, T4 are increased (not the free T3 ,T4)
• Parathyroid
increases in size and activity to regulate calcium metabolism
27. Endocrinal changes
• Adrenals
- increases in size and activity
- total cortisol is increased (free cortisol unchanged)
• Placental hormones
Progesterone
- produced by the corpus luteum
- levels rise steadily during pregnancy, output reaches 250mg/day
- actions:
colon activity reduced, nausea, constipation
reduced bladder and ureteric tone
diastolic pressure reduced, venous dilatation
raises temperature
28. Endocrinal changes
• Placental hormones
Oestrogens
- source:
ovary in early pregnancy
later, oestrone and oestradiol produced by the placenta
increased a hundredfold
oestriol produced by the placenta and fetal adrenals
increased thousandfold
- levels: output of oestrogens reaches a maximum of at least 30-40mg/day
oestriol accounts 85%
levels increase up to term
29. Endocrinal changes
• Placental hormones
Oestrogens
- possible actions:
1- induce growth of uterus and control its function
2- responsible for the development of breasts ( with progesterone)
3- alter chemical constitution of connective tissue, become more pliable
4- cause water retention
5- reduce sodium excretion
30.
31. Metabolic changes
• Carbohydrate metabolism
- pregnancy is hyperlipidaemic and glucosuric
- after mid-pregnancy, resistance of insulin develops
- plasma glucose concentrations rise, maintained between 4.5-5.5 mmol/L
- glucose crosses the placenta, the fetus uses glucose as primary energy
substrate, transport occurs by carrier mediated mechanism
- the insulin resistance is endocrine-driven, via increase in cortisol and hPL
- concentrations of glucagons and the catecholamines are unaltered
32. Metabolic changes
• Carbohydrate metabolism
- carbohydrate deposited in the liver as glycogen
- some escapes to general circulation
- portion metabolised by the tissues:
converted to depot fat
stored as muscle glycogen
- first noticeable change occurs in blood sugar
- tested by giving a load of oral glucose (glucose tolerance test)
- the blood sugar, after meal, remains high facilitating placental
transfer
33. Metabolic changes
• Carbohydrate metabolism
- with increased placental production of steroid, less glycogen
deposited in liver and muscles
- the effect of fasting is pronounced in pregnancy
overnight fast of 12hrs
hypoglycaemia, production of ketone bodies
34. Metabolic changes
• Protein metabolism
- positive nitrogen balance
- on average 500 g of protein retained by the end of pregnancy
- blood and urine urea are reduced
• Fat metabolism
- by 30 weeks, 4Kg are stored in form of
depot fat in the abdominal wall, back and thights
modest amount in breasts