-
Uterus changes
- -increase size to 20x that of nonpregnant size
- -weight increases from 2 oz. to about 2 lbs. at term
- -walls thin to 1.5 cm or less from a solid globe to a hollow vessel
- -volume capacity increases from 2 tsp to 1 gallon
- -1/6 total maternal blood volume is contained within the vasculat system of the uterus by term
-
Ovarian Changes
- -cease ovum production
- -corpus luteum persists til 12 weeks to secrete progesterone until the placenta takes over
-
Vaginal Changes
- -increased vascularity & hyperplasia (increase in the number of normal cells in a tissue or organ)
- -increased vaginal secretions & decreased pH to prevent infections
-
Cervical Changes
- -increased mucous froms plug to seal off the cervix
- -softens b/c of progesterone
-
Breast Changes
- -increase in size & nodularity to prepare for lactation (~1-1.5 lbs each)
- -Nipples increase in size, become more erect & more pigmented
- -Colostrum is produced - antibody-rich yellow fluid that can be expressed after the 12th week
-
Cardiovascular Changes
- -Blood Volume increses rapidly in 2nd trimester (25-30 weeks)
- -continues into 3rd trimester, reaching 40-45% above nonpregnant levels
- -plasma volume increases 50%
- -erythrocytes increase 30%
- -physiologic anemia of pregnancy (pseudoanemia) b/c plasma increases more that RBCs
- -Clotting factor changes: fibrin and fibrinogen increase
- -BP decreases during 2nd trimester - gradually increases to prepregnant level by end of 3rd trimester
- -Increased supine hypotensive syndrom - when you lie on your back the baby obstructs the great vessels - left lateral position (LLP) is best for perfusion to the baby
-
Respiratory Changes
- -Increased O2 needs
- -Increased air volume exchange
- -Growing uterus elevates diaphragm - SOB esp when sitting (26-27 weeks)
- -Rate increases as pregnancy progresses
-
GI Tract Changes
- -Reflux of gastric contents common due to relaxation of smooth muscles by progesterone
- -Ptyalism (excessive salivation) is a common condition of pregnant women
- -Decrease in intestinal motility causes constipation
- -N&V (morning sickness) is due to high hCG levels from 6-12 weeks
- -Appearance/aggrevation of hemorrhoids
- -Metalic taste in the mouth
-
Renal Changes
- -Urinary frequency
- -Glomerular Filtration Rate (GFR) - increases by 50% by 2nd trimester and remains elevated until delivery
- -Renal tubular reabsorption - increases during 2nd and 3rd trimester
- -Glucosuria: if present may indicate development of gestational diabetes - should not eliminate glucose, protein or ketones
-
Skin & Hair Changes
- -Darkening of already dark areas: nipples, areola, vulva, perineal area
- -Linea Nigra: pigmented line along middle of abdomen from umbilicus to above pubic area
- -Chloasma: darkened spots on face = mask of pregnancy
- -Striae
- -Vascular Spider veins
- -Hyperactive sebaceous glands
-
Endocrine Changes
Thyroid gland enlargement, pancreas, anterior pituitary
-
Metabolism Changes
- -CHO metabolism altered
- -BMR increases
-
Musculoskeletal Changes
- -Pelvic joints relax = waddling gait
- -Lumbodorsal spinal curve
- -due to increased size of uterus, may result in backache
- -Diastasis Recti: separation of abdominal muscles from pressure of enlarging uterus on abdominal muscles
-
Mobility Changes
- -gait changes
- -center of gravity shift esp in late 2nd and 3rd trimester
-
Psychological Response to Pregnancy
- -Ambivalence
- -Introversion
- -Acceptance
- -Mood Swings
|
|
