4. Organ systems
Cardiovascular system
Pulmonary system
Genital tract
Urinary system
Endocrine system
Gastrointestinal Tract
Skin
5. CHANGES ARE DUE TO
ALTERATIONS IN
HORMONAL PRODUCTION
CIRCULATION
METABOLISM
6. HORMONES
OESTROGEN
Produced in corpus luteum
Produced by placenta after 12 weeks
Responsible for growth particularly of
uterus and breasts
7. progesterone
Produced in corpus luteum and then the
placenta
Relaxes smooth muscle
Inhibits uterine contractions until uterus is
prepared for labour
Regulates storage of body fat
8. Maternal changes - anatomical
and physiological
Cardiovascular changes
increase in SV
increase in cardiac output
increase in HR at given work load
increase in blood volume (mostly during
latter half of pregnancy)
Uterus may compress large blood vessels
reducing venous return
11. Total body water
Increases 6-8 L
Increases by 40 %
Normal body water
2/3 intracellular
1/3 extracellular
¾ interstitial
¼ intravasular
2/3 increase is extravascular
13. Respiratory Changes
Respiratory Changes
Respiratory capacity
Respiratory capacity
increases
increases
Shortness of breath
Shortness of breath
Pulmonary reserve
Pulmonary reserve
decreases
decreases
Increased risk of
Increased risk of
muscle soreness
muscle soreness
Tendency to
Tendency to
hyperventilate
hyperventilate
RESULT
RESULT adjust the intensity level and duration of exercise
adjust the intensity level and duration of exercise
14. Physiologic changes -
RESPIRATORY SYSTEM
increase respiratory rate
increased oxygen consumption
common are nasal stuffiness,
nosebleeds due to Increased
vascular swelling to nose
15. Respiratory
Consumption
O2 consumption Increases 15-20 %
50 % of this increase is required by the uterus
Despite increase in oxygen requirements, with the
increase in Cardiac Output and increase in
alveolar ventilation oxygen consumption exceeds
the requirements.
.
16. Physiologic changes -
GASTROINTESTINAL
Digestive system slow due to
progesterone
Nausea and vomiting
Ptyalism: increase salivation
Heartburn
Hemorrhoids
Prolonged gallbladder emptying time
may lead to gall stones
Bile salt buildup may lead to itching.
17. Gastrointestinal Tract
Displacement of the stomach and intestines
Appendix can be displaced to reach the right
flank
Gastric emptying and intestinal transit times
are delayed secondary to hormonal and
mechanical factors
Vascular swelling of the gums
Hemorrhoids due to elevated pressure in
veins
18. Digestive Changes
Digestive Changes
Digestive system slows
Digestive system slows
Intestines are pushed up
Intestines are pushed up
and to the sides
and to the sides
Smooth muscle of the
Smooth muscle of the
stomach relaxes and can
stomach relaxes and can
cause heartburn
cause heartburn
Constipation and hemorrhoids are
Constipation and hemorrhoids are
common during pregnancy
common during pregnancy
Morning sickness
Morning sickness
19. Physiologic changes -
METABOLISM
BMR increases by 20-25 % during
pregnancy
Recommended weight gain – 25-35
lb
Overweight – 15-25 lb
Underweight – 25-35 lb
Need for increased iron, calcium,
20. Genital Tract
Increased vascularity and hyperemia
Vagina
Perineum
Vulva
Increased secretions
Characteristic violet color of the vagina
Chadwick’s sign
Increased length to the vaginal wall
Hypertrophy of the papillae of the vaginal
mucosa
21. Changes in the cervix
Length remains the same
Increase in width
Softening after third month due to
oestrogen
Increased vascularity
Increased cervical mucosa
Increased glandular function
22. uterus grows to 30x23x20 at term
weight increases to 900gms
hypertrophy.. Oestrogen causes cells to
increase until 20 weeks gestation
Hyperplasia:- number of cells increase
under the influence of oestrogen
.
24. PLASMA VOLUME
Increases from 10th week of pregnancy
variable related to parity, fetal weight and
number
Reaches maximum level approx 50%
above non-pregnant levels at 32-34 weeks
then maintained
25. 50% rise in plasma volume
20% rise in red cell mass
Heamodilution: Physiological anaemia
Most apparent at 32-34 weeks
26. RENAL SYSTEM
DILATION OF THE RENAL VESSELS
DUE THE EFFECTS OF
PROGESTERONE
INCREASED RENAL BLOOD FLOW
GFR INCREASES BY 60% IN EARLY
PREGNANCY
27. Urinary Changes
Kidneys grow and filter more
blood as the blood volume
increases
Become more susceptible to
bladder and kidney infections
Bladder becomes compressed
causing frequent urination and
incontinence
31. Skin Changes
Stretch marks
Dark pigmented line on there abdomen
which is called Linea Nigra
Pigment changes on their face and neck
Small blood vessels in the face, neck
and upper chest
MOST OF THESE RESOLVE AFTER
PREGNANCY
34. Melasma
Also known as the mask of pregnancy
More common in dark skin people
More pronounced in the summer
Fades a few months after delivery
Repeated pregnancy can intensify
Can occur in normal non-pregnant
women with harmless hormonal
imbalances or women on OCPs or depo
