Physiologic Maternal Changes

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Created by
Irene Aguado

Cards (14)

  • Cardiovascular System
    • Total cardiac output and blood volume increase to meet greater metabolic demands
    • Lower extremities, bipedal is normal, while upper extremities, facial, preorbital, and anasarca edema is pregnancy-induced HTN
    • The heart is displaced upward, to the left, and forward ( uterus enlarges - diaphragm displacement)
    • The pressure of the enlarged uterus on the cava = supine hypotension (when lies supine) Position: Left Lateral or sim's position
    • Heart rate increases 10 bpm
  • Respiratory System
    • SOB due to uterine enlargement and compression of the diaphragm occurs.
    • Oxygen consumption increased by 15 to 20 %
  • GI System
    Pica - medical disorder characterized by an appetite for substances largely non-nutritive. Cause - hypersalivation
  • GI System
    Epulis - swelling of gums = gingival hyperplasia (increased estrogen)
  • GI System
    Ptyalism - hypersalivation
  • GI System
    Hemorrhoid - dt increased venous pressure
  • GI system
    Flatulence and heartburn - due to decreased GI motility
  • Renal System
    Urinary Frequency (1st and 2nd trimesters) - pressure of enlarged uterus on the bladder
    Glucosoria - due to decrease renal threshold for glucose
    Urinary Stagnation - due to relax renal pelvis and ureter = prone to UTI
  • Endocrine System
    • Increased BMR
    • Adenohypophysis (APG) enlarges. This causes increased secretion of hormones, including MSH. This results to hyperpigmentation of skin, e.g. chloasma.
    • Thyroid gland enlarges. This leads to increased activity of the gland. c.g. increased BMR.
    • Aldosterone level increases due to increased adrenocorticotropic hormone (ACTH) secretion by the adenohypophysis. This leads to sodium and water retention.
    • Increase in the size of parathyroid gland. This leads to increased secretion of parathormone. Thus, there is increased withdrawal of calcium from the bones.
  • Weight Gain
    1st trimester - 1 lb/m = 3 lbs
    2nd trimester - 1 lb/wk = 12 lbs
    3rd trimester - 1 lb/wk = 12 lbs
    Total wg gain: 25 to 35 lbs
  • Reproductive System
    • Uterus - enlargement and thickening + Hegar's sign
    • Cervix - thick mucus plug (operculum) + Chadwick and Goodell's sign
    • Ovaries - cease ovum production
    • Vagina - vaginal secretion (thick, white, acidic)
    • Breast - increased in size, tender, and feel full + colostrum may leak + elevated glands of Montgomery (hypertrophic sebaceous glands)
  • Integumentary System
    Increased estrogen plus increased progesteron = increased MSH
    1. increased pigmentation
    2. Linea nigra - dark streak down the midline of abdomen
    3. Chloasma (mask of pregnancy) a blotchy brownish hyperpigmentation over the forehead, cheeks, and nose
    4. Striae gravidarum - reddish-purple stretch marks
  • Skeletal System
    • Placental produce relaxin hormone = relaxes pelvic joints
    • Lordosis - (pride of pregnancy) to counteract the weight of the gravid uterus
  • Hematologic
    • Physiologic anemia