Physiological changes in pregnancy

Major adaptation of maternal anatomy ,physiology and metabolism is required for normal pregnancy.

Undrestanding these changes help to differentite between the normal and pathology.

GIT changes Increase apetite. Nausea and vomitting. Gum hypertrophy. Gingivitis of pregnancy. Decrease GIT motilityand tone. Decrease incidence of peptic ulcer. Increase incidence of GERD.

Increase gallstone formation. Constipation. Haemorrhoid.

Urinary system: Enlarged kidnyes. Dilated ureters. Increase possibility of infection. 30%asymptomatic bacteruria. Urinary frequency. Glucosuria.

Changes of CVS Hypotension in first and second

trimester. Increase blood pressure in third

trimester. Increase heart rate. Dependent oedema. Increase cardiac output and stroke

volume.

Haematological changes Increase WBC. Decrease RBC. Decrease platelets count. Decrease blood urea and serum

creatinin. Hypercoagulable state.

Respiratory system: Hyperaemia of respiratory passages. Rib cage displaced upward. Chest circumferance expand. Respiratory rate is unchanged. Vital capacity is unchanged. Tidal volume is increased. Minute volume is increased.

Functional residual capacity is reduced. Increase dead volume. Hyperventilation.

Metabolism: Chronic water and sodium retaintion. Decrease plasma osmolality. Plasma lipid increased. Total body fat increased. Average weight gain is 12.5 kg.

Skeletal system: Total calcium level decreased. ionized calcium is unchanged. Phosphate and PTH level unchanged. Calcitonin level and vitamine D

unchanged.

Endocrine changes: Incresase thyroid binding globulin. Euthyroid state. Normal free thyroid hormones. Slightly thyromegaly.

Pituitary gland enlarged. Prolactin level increase. Increase in free cortisol. Increase corticosteroid binding globulin. Fasting hypoglycaemia. Post prandial hyperglycaemia.

Skin: Palmer erythema. Spider angioma. Linea negra. Stria gravidarum . Chloasma.