Physiological

Changes During

Pregnancy

Presented by :-

Mansuri Asma

Weight gain

First 20weeks – 2.0kg

After 20weeks – 0.5kg per week

Total weight increase 12kg

Weight Gain – 10-12 kg

Fetus - 3.3kg

Uterus - 0.9kg

Placenta - 0.6kg

Liquor amni -

0.8kg

Breast - 0.4kg

Increase in bldvolume – 1.3kg

Increase in extracellular fluid – 1.2kg

Accumulation of fat & protein –3.5kg

Reproductive

weight gain

Net maternal

weight gain

Breast Changes

Skin changes

Linea

Nigra

Straie

Gravidarum

CHANGES OF THE

CARDIOVASCULAR SYSTEM

DURING PREGNANCY

Size of heart : increases about 12%.

Cardiac Capacity :- increases 70-80ml.

Cardiac Output :- increases by 30-40% till 30weeks

increases15% till term

White Blood Cells :- increases

Clotting Time :- 8minute

POSITION OF HEART :-

Due to elevation of diaphragm, the

heart pushed upward & outward with

slight rotation to left.

A. BLOOD VOLUME :-

o Increases gradually by 30 to 50

percent.

o This results in decrease concentration

of red blood cells and hemoglobin.

B. CARDIAC OUTPUT :-

o Increases about 30 percent during the

first and second trimester.

o Change in output is reflected in the

heart rate. It usually increases by 10

beats per minute.

C. BLOOD PRESSURE.

o Normally, the patient's blood pressure

will not rise.

Systemic blood pressure declines

slightly.

Diastolic blood pressure is reduced 5-

10mm of Hg from

D. VENOUS RETURN.

The lower extremities are often

hampered in the last months of

pregnancy due to the expanding uterus

restricting physical movement and

interfering with the return of blood flow.

This results in swelling of the feet and

legs.

CHANGES OF THE

RESPIRATORY SYSTEM DURING

PREGNANCY Respiratory Rate : - Not alter

Amount of air exhaled per minute

increases from 7 to11 litres.

Increased Vascularity :- Nasal

Congetion.

Nose bleed

CHANGES OF THE URINARY

SYSTEM DURING PREGNANCY

Each Kidney :- Increases in length 1-

1.5cm

Ureters :- Elongate, widen & curved

Increase urinary stasis

Bladder : Increased Vascularity

Decreased muscle tone

Edamtous bladder Mucosa.

Increased Frequency of Urine

G.F.R. :- Increases by 50%

CHANGES OF THE G.I. SYSTEM

DURING PREGNANCY

Oral Cavity :-

increaesed Saliva & saliva become

more acidic which promotes tooth

decay.

Gums – more sensitive, swell easily &

bleed.

Morning Sickness may present –

characterised by vomiting & poor

appetite.

Heart burn may present

CHANGES IN ENDOCRINE

SYSTEM

Placental Hormones :-

Human Chorionic

Gonadotrophin(hCG) : secreted by

syncytiotrophoblast.

It can be detected in maternal urine

after 8-9days of fertilization.

It helps in maintaining the secretion of

progesterone by the corpus luteum

Human placental lactogen

(HPL)

Acts like growth hormone.

Important for increasing maternal blood

free fatty acids, glucose & insulin

concentration, increasing lipolysis

Maternal Endocrine glands

PITUITARY GLAND – enlarges &

cause headache.

Secretion of FSH & LH inhibited.

Posterior lobe secrets Oxytocin & it

increases in second stage of labour.

Thyroid gland

Enlarged & palpated.

Increased GFR.

Rise in BMR by 3rd month onwards.

Heart may beat faster causing

palpitation.

PARATHYROID HORMONE increases

throughout pregnancy.

ADRENAL GLAND

Slighlty enlarge.

Rise in ACTH, aldosterone, cortisol.

PANCREASE

Glucose level in blood may slightly

decreased in early pregnancy.

In last half, level may increase.

Steroidal Hormone

Main hormones are – progesterone &

oestrogen.

Progesterone & oestrogen level

increase in early pregnancy.

These hormones stimulate growth of

uterus.

They help in starting of the normal

labour.

Also help in development of breasts

during pregnancy.

CHANGES OF THE SKELETAL

SYSTEM DURING PREGNANCY

There is alteration in the posture.

Later in pregnancy, it can lead to

numbness, aching & weakness in arms.

Hormones in pregnancy such as

progesterone , oestrogen & relaxin

helps in relaxation of pelvic joints.

Oestrogen makes pelvic joints movable

Progesterone relaxes & weaknes pelvic

ligamnets.

Relaxin soften pelvic joints & ligaments.