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Physiological Changes In Pregnancy   DR.FATMA AL-DAMMAS
Changes In Pregnancy Pregnancy brings about many physical changes.  These changes can be divided into 3 area –  Anatomical Physiological  Biomechanical.
Changes In Pregnancy Pregnancy brings about many physical changes.  These changes can be divided into 3 area –  Anatomical Physiological  Biomechanical.
Physiological Changes In Pregnancy ,[object Object],[object Object],[object Object]
1. What are physiological changes during labour ?
Average maximum physiological changes  associated with Pregnancy Parameter   Change Neurologic MAC  (minimum alveolar   concentration )
Average maximum physiological changes  associated with Pregnancy Parameter   Change Neurologic MAC  (minimum alveolar   concentration )   - 40% 1.(MAC) progressively decreases during pregnancy—at term, by as much as 40%—for all general anesthetic agents  2.MAC returns to normal by The third day after delivery.
Neurologic ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
2. What are Respiratory physiological changes during labour ?
Average maximum physiological changes  associated with Pregnancy Respiratory  Oxygen consumption  Minute ventilation  Tidal volume  Respiratory rate  PaO 2   PaCO 2   HCO 3   FRC  (functional residual capacity )
Average maximum physiological changes  associated with Pregnancy Respiratory  Oxygen consumption  + 20 to 50% Minute ventilation  Tidal volume  Respiratory rate  PaO 2   PaCO 2   HCO 3   FRC  (functional residual capacity )
Average maximum physiological changes  associated with Pregnancy Respiratory  Oxygen consumption  + 20 to 50% Minute ventilation  + 50% Tidal volume  Respiratory rate  PaO 2   PaCO 2   HCO 3   FRC  (functional residual capacity )
Average maximum physiological changes  associated with Pregnancy Respiratory  Oxygen consumption  + 20 to 50% Minute ventilation  + 50% Tidal volume  + 40% Respiratory rate  PaO 2   PaCO 2   HCO 3   FRC  (functional residual capacity )
Average maximum physiological changes  associated with Pregnancy Respiratory  Oxygen consumption  + 20 to 50% Minute ventilation  + 50% Tidal volume  + 40% Respiratory rate  + 15% PaO 2   PaCO 2   HCO 3   FRC  (functional residual capacity )
Average maximum physiological changes  associated with Pregnancy Respiratory  Oxygen consumption  + 20 to 50% Minute ventilation  + 50% Tidal volume  + 40% Respiratory rate  + 15% PaO 2   + 10% PaCO 2   HCO 3   FRC  (functional residual capacity )
Average maximum physiological changes  associated with Pregnancy Respiratory  Oxygen consumption  + 20 to 50% Minute ventilation  + 50% Tidal volume  + 40% Respiratory rate  + 15% PaO 2   + 10% PaCO 2   - 15% HCO 3   FRC  (functional residual capacity )
Average maximum physiological changes  associated with Pregnancy Respiratory  Oxygen consumption  + 20 to 50% Minute ventilation  + 50% Tidal volume  + 40% Respiratory rate  + 15% PaO 2   + 10% PaCO 2   - 15% HCO 3   - 15% FRC  (functional residual capacity )
Average maximum physiological changes  associated with Pregnancy Respiratory  Oxygen consumption  + 20 to 50% Minute ventilation  + 50% Tidal volume  + 40% Respiratory rate  + 15% PaO 2   + 10% PaCO 2   - 15% HCO 3   - 15% FRC  (functional residual capacity )  - 20%
Respiratory Effects   ,[object Object],[object Object],[object Object],[object Object]
Respiratory Effects ,[object Object],[object Object],[object Object]
Respiratory Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Respiratory Effects ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Respiratory: Importance for Anaesthesia ,[object Object],[object Object]
Following adequate preoxygenation, the PaO 2  in apnoeic pregnant women falls  ~ 80 mmHg/min more than in the nonpregnant state
Respiratory: Importance for Anaesthesia ,[object Object],[object Object],[object Object],[object Object]
Respiratory: Importance for Anaesthesia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Respiratory: Importance for Anaesthesia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Alteration of Lung Volume in Pregnancy Functional Residual Capacity  FVR  Residual Volume  RV  ~ 20% decrease Expiratory Reserve Volume  ERV Vital Capacity  VR  Inspiratory Reserve Volume  IRV  unchanged Closing Volume  CV Total Lung Capacity  TLC  ~ 5% decrease Inspiratory Capacity  IC  ~ 5% increase
[object Object]
Average maximum physiological changes  associated with Pregnancy Parameter   Change Cardiovascular Blood volume  Plasma volume  Cardiac output     Stroke volume   Heart rate   Peripheral resistance
Average maximum physiological changes  associated with Pregnancy Parameter   Change Cardiovascular Blood volume  + 35% Plasma volume  Cardiac output     Stroke volume   Heart rate   Peripheral resistance
Average maximum physiological changes  associated with Pregnancy Parameter   Change Cardiovascular Blood volume  + 35% Plasma volume  + 45% Cardiac output     Stroke volume   Heart rate   Peripheral resistance
Average maximum physiological changes  associated with Pregnancy Parameter   Change Cardiovascular Blood volume  + 35% Plasma volume  + 45% Cardiac output     + 40% Stroke volume   Heart rate   Peripheral resistance
Average maximum physiological changes  associated with Pregnancy Parameter   Change Cardiovascular Blood volume  + 35% Plasma volume  + 45% Cardiac output     + 40% Stroke volume   + 30% Heart rate   Peripheral resistance
Average maximum physiological changes  associated with Pregnancy Parameter   Change Cardiovascular Blood volume  + 35% Plasma volume  + 45% Cardiac output     + 40% Stroke volume   + 30% Heart rate   + 15 to 30% Peripheral resistance
Average maximum physiological changes  associated with Pregnancy Parameter   Change Cardiovascular Blood volume  + 35% Plasma volume  + 45% Cardiac output     + 40% Stroke volume   + 30% Heart rate   + 15 to 30% Peripheral resistance   - 15%
Cardiovascular Effects ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiovascular Effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cardiovascular Effects ,[object Object],[object Object],[object Object],[object Object]
Cardiovascular Effects ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CVS: Importance for Anaesthesia ,[object Object],[object Object],[object Object],[object Object]
CVS: Importance for Anaesthesia ,[object Object],[object Object]
CVS: Importance for Anaesthesia ,[object Object]
CVS: Importance for Anaesthesia ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
CVS: Importance for Anaesthesia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Average maximum physiological changes  associated with Pregnancy Parameter   Change Renal GFR
Average maximum physiological changes  associated with Pregnancy Parameter   Change Renal GFR    + 50%
Renal Effects ,[object Object],[object Object],[object Object],[object Object],[object Object]
Renal Effects ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Gastrointestinal  changes ,[object Object],[object Object],[object Object],[object Object],[object Object]
Gastrointestinal  changes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Hepatic effeccts ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hepatic effeccts ,[object Object],[object Object],[object Object],[object Object]
Hepatic effeccts ,[object Object],[object Object]
[object Object]
Average maximum physiological changes  associated with Pregnancy Parameter   Change Hematologic Hemoglobin  Platelets  Clotting factors
Average maximum physiological changes  associated with Pregnancy Parameter   Change Hematologic Hemoglobin  - 20% Platelets  Clotting factors
Average maximum physiological changes  associated with Pregnancy Parameter   Change Hematologic Hemoglobin  - 20% Platelets  - 10 to 20% Clotting factors
Average maximum physiological changes  associated with Pregnancy Parameter   Change Hematologic Hemoglobin  - 20% Platelets  - 10 to 20% Clotting factors  + 50 to 250%
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
Foetal functions  Foetus depends on the placenta for 1.Gas exchange – Respiration 2. Nutrition 3. Waste product elimination
PHYSIOLOGIC ANATOMY ,[object Object],[object Object]
PHYSIOLOGIC ANATOMY ,[object Object],[object Object]
PLACENTAL EXCHANGE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PLACENTAL EXCHANGE ,[object Object],[object Object],[object Object],[object Object],[object Object]
Respiratory Gas Exchange ,[object Object],[object Object],[object Object],[object Object]
Respiratory Gas Exchange ,[object Object],[object Object],[object Object],[object Object]
Respiratory Gas Exchange ,[object Object],[object Object],[object Object],[object Object]
[object Object]
Stages of Labour
Effect of Labor on Maternal Physiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pain pathways during labor
[object Object]
FETAL PHYSIOLOGY ,[object Object],[object Object],[object Object],[object Object]
FETAL PHYSIOLOGY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
“   A Pregnant Lady Is Like A Ticking Bomb That Can Burst Into Fatality Any Moment” Channa A B
THANK YOU

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Physiological Changes In Pregnancy

  • 1. Physiological Changes In Pregnancy DR.FATMA AL-DAMMAS
  • 2. Changes In Pregnancy Pregnancy brings about many physical changes. These changes can be divided into 3 area – Anatomical Physiological Biomechanical.
  • 3. Changes In Pregnancy Pregnancy brings about many physical changes. These changes can be divided into 3 area – Anatomical Physiological Biomechanical.
  • 4.
  • 5. 1. What are physiological changes during labour ?
  • 6. Average maximum physiological changes associated with Pregnancy Parameter Change Neurologic MAC (minimum alveolar concentration )
  • 7. Average maximum physiological changes associated with Pregnancy Parameter Change Neurologic MAC (minimum alveolar concentration ) - 40% 1.(MAC) progressively decreases during pregnancy—at term, by as much as 40%—for all general anesthetic agents 2.MAC returns to normal by The third day after delivery.
  • 8.
  • 9.
  • 10.
  • 11. 2. What are Respiratory physiological changes during labour ?
  • 12. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption Minute ventilation Tidal volume Respiratory rate PaO 2 PaCO 2 HCO 3 FRC (functional residual capacity )
  • 13. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation Tidal volume Respiratory rate PaO 2 PaCO 2 HCO 3 FRC (functional residual capacity )
  • 14. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume Respiratory rate PaO 2 PaCO 2 HCO 3 FRC (functional residual capacity )
  • 15. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate PaO 2 PaCO 2 HCO 3 FRC (functional residual capacity )
  • 16. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate + 15% PaO 2 PaCO 2 HCO 3 FRC (functional residual capacity )
  • 17. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate + 15% PaO 2 + 10% PaCO 2 HCO 3 FRC (functional residual capacity )
  • 18. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate + 15% PaO 2 + 10% PaCO 2 - 15% HCO 3 FRC (functional residual capacity )
  • 19. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate + 15% PaO 2 + 10% PaCO 2 - 15% HCO 3 - 15% FRC (functional residual capacity )
  • 20. Average maximum physiological changes associated with Pregnancy Respiratory Oxygen consumption + 20 to 50% Minute ventilation + 50% Tidal volume + 40% Respiratory rate + 15% PaO 2 + 10% PaCO 2 - 15% HCO 3 - 15% FRC (functional residual capacity ) - 20%
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27. Following adequate preoxygenation, the PaO 2 in apnoeic pregnant women falls ~ 80 mmHg/min more than in the nonpregnant state
  • 28.
  • 29.
  • 30.
  • 31. Alteration of Lung Volume in Pregnancy Functional Residual Capacity FVR Residual Volume RV ~ 20% decrease Expiratory Reserve Volume ERV Vital Capacity VR Inspiratory Reserve Volume IRV unchanged Closing Volume CV Total Lung Capacity TLC ~ 5% decrease Inspiratory Capacity IC ~ 5% increase
  • 32.
  • 33. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume Plasma volume Cardiac output Stroke volume Heart rate Peripheral resistance
  • 34. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume Cardiac output Stroke volume Heart rate Peripheral resistance
  • 35. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume + 45% Cardiac output Stroke volume Heart rate Peripheral resistance
  • 36. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume + 45% Cardiac output + 40% Stroke volume Heart rate Peripheral resistance
  • 37. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume + 45% Cardiac output + 40% Stroke volume + 30% Heart rate Peripheral resistance
  • 38. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume + 45% Cardiac output + 40% Stroke volume + 30% Heart rate + 15 to 30% Peripheral resistance
  • 39. Average maximum physiological changes associated with Pregnancy Parameter Change Cardiovascular Blood volume + 35% Plasma volume + 45% Cardiac output + 40% Stroke volume + 30% Heart rate + 15 to 30% Peripheral resistance - 15%
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.
  • 52.
  • 53.
  • 54. Average maximum physiological changes associated with Pregnancy Parameter Change Renal GFR
  • 55. Average maximum physiological changes associated with Pregnancy Parameter Change Renal GFR + 50%
  • 56.
  • 57.
  • 58.
  • 59.
  • 60.
  • 61.
  • 62.
  • 63.
  • 64.
  • 65.
  • 66. Average maximum physiological changes associated with Pregnancy Parameter Change Hematologic Hemoglobin Platelets Clotting factors
  • 67. Average maximum physiological changes associated with Pregnancy Parameter Change Hematologic Hemoglobin - 20% Platelets Clotting factors
  • 68. Average maximum physiological changes associated with Pregnancy Parameter Change Hematologic Hemoglobin - 20% Platelets - 10 to 20% Clotting factors
  • 69. Average maximum physiological changes associated with Pregnancy Parameter Change Hematologic Hemoglobin - 20% Platelets - 10 to 20% Clotting factors + 50 to 250%
  • 70.
  • 71.
  • 72.
  • 73.
  • 74.
  • 75.
  • 76.
  • 77.
  • 78.
  • 79.
  • 80. Foetal functions Foetus depends on the placenta for 1.Gas exchange – Respiration 2. Nutrition 3. Waste product elimination
  • 81.
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  • 96.
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  • 99.
  • 100.
  • 101.
  • 102.
  • 103. A Pregnant Lady Is Like A Ticking Bomb That Can Burst Into Fatality Any Moment” Channa A B

Editor's Notes

  1. The combination of a decreased FRC and increased oxygen
  2. The combination of a decreased FRC and increased oxygen