The document summarizes the physiological changes that occur in the reproductive system of a pregnant woman. It describes changes in the genital organs like the vulva, vagina, uterus, fallopian tubes and ovaries. It also discusses changes in the breasts and endocrinology related to reproduction. The uterus increases greatly in size and the cervix softens. Hormones produced by the corpus luteum and later the placenta take over control of the hypothalamic-pituitary axis and maintain the pregnancy.

1. PHYSIOLOGICAL CHANGES
DURING PREGNANCY IN THE
REPRODUCTIVE SYSTEM OF A
PREGNANT WOMAN

2. GENITAL ORGANS
• VULVA – odematous ,
-more vascular,
-superficial varicosities
-labia minora pigmented and hypertrophied
• VAGINA – increased blood supply (jacquemiers sign)
- anterior wall lenth increases
- secretions become copius ,thin, curdy ,white
- ph becomes acidic(3.5-6)

4. UTERUS
• Weight of the uterus increases to 1000g and capacity to 500-1000ml
• BODY- Muscle hypertrophy and hyperplasia(oestrogen and
progesterone)
- Stretching (wall thickness 1.5cm)
- Muscles fiber arrangement :Outer longitudinal
:inner circular
:intermediate oblique (living
ligature)
-fibrous and elastic tissue increase in size and number

5. • Vascular system (most pronounced at placental site)
– uterine and ovarian branches
- diameter almost doubles
- blood flow increases by eight fold
- veins become dilated and valveless
Position – normal anteverted position is exaggerated (8wks)
- becomes erect later along the longitudinal axis(INLET)
- primi has good tone to hold whereas in multi it goes
back to anteverted
• Lateral obliquity- dextro rotation (uterus)
- levo rotation(cervix)

6. • Contractions( braxton–hicks)
- irregular , infrequent ,spasmodic ,painless
- on palpation
• Endometrium(decidua)
- superficial compact layer
- intermediate spongy layer
- thin basal layer
• ISTHMUS – elongates to about 3cm in the fist trimester
- later unfolds and becomes a part of the uterine cavity
• CERVIX- Hypertrophy , hyperplasia, increased vascularity
- softening of the cervix (goodells sign)

7. ISTHMUS
CERVIX

8. • FALLOPIAN TUBE – hypertrophy of muscles
- total length increases
- tubes become congested
• OVARY – growth and function reach maximum at the 8
week(2.5cm)
- regression occur following secretion of HCG
from the placenta (12th week)
- patchy sheet of decidual cells and the outer
surface.

9. BREAST
Best evident in primigravida.
Hypertrophy and proliferation of the ducts and the alveoli
Hypertrophy of the connective tissue stroma
Increased vascularity( blue veins visible)
Striation due to stretching of cutis
Nipples and areola become larger ,erectile ,deeply pigmented
Sebaceous glands get hypertrophied (montgomerys tubercle)
Secretion can be squeezed out(colostrum), yellowish .

10. symptoms experienced as pain and tenderness
(relaxin)
weight increases to 500-800g

11. ENDOCRINOLOGY
IN RELATION TO REPRODUCTION

12. • IT INCLUDES THE KNOWLEDGE OF :
- HORMONES IN MATURATION OF GRAAFIAN FOLLICLES
- OVULATION AND MAINTENANCE OF CORPUS LUTEUM
AFTER FERTILIZATION
- CONCEPTION, TRANSFER OF FUNCTION OF PITUITARY-
OVARIAN AXIS TO PLACENTA
- ALTERATION IN PITUITARY, THYROID, PARATHYROID ,
ADRENALS, PANCREAS.

13. • MATURATION OF GRAAFIAN FOLLICLE –
- Follicular stimulating hormone and luteinizing
hormone
- oestrogen is necessary for continued FSH
activity
• MAINTENANCE OF CORPUS LUTEUM-
- corpus luteum secretes progesterone,
oestradiol, androstenedione ,
- after implantation HCG , placental lactogen
secreted by placenta maintain the functions of
corpus luteum

14. • HORMONES OF PLACENTA
- OF WHICH PROTEIN AND STEROID HORMONES ARE
IMPORTANT
- TRANSFER OF FUNCTION AT 6-8 WEEKS
PROTEINS STEROIDS
RELAXIN OESTROGEN
PROLACTIN PROGESTERONE
ATRIAL NATRIURETIC PEPTIDE CORTISOL
EARLY PREGNANCY FACTOR

15. • HYPOTHALAMIC LIKE PITUITARY LIKE
 CORTICOTROPIN RELEASING ADRENOCORTICOTROPHIC
GONADOTROPIN RELEASING HUMAN CHORIONIC
GONADOTROPHIN
THYROTROPIN R HUMAN CHPRIONIC
THYROTROPHIN
GROWTH HORMONE R HUMAN PLACENTAL
LACTOGEN

18. Thank
you