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PHYSIOLOGICAL
CHANGES
DURING PREGNANCY
PHYSIOLOGICAL CHANGES IN
PREGNANCY
Reproductive organs
I. Uterus:
The muscular organ holding the fetus during
pregnancy, nourishment of the fetus through the
placenta. It is divided into the body (Corpus, and
fundus)and the cervix.
During pregnancy, the uterus increases in weight
from 60 to 1000g. In size, it changes from 6.5 to 32
cm. In a non pregnant state, the uterus is situated in
the pelvic cavity. During pregnancy, it expands into
the abdominal cavity. In addition to the growing
foetus, uterine expansion is caused by an increase in
connective tissue and in the size and number of blood
vessels supplying the uterus
Uterine change during pregnancy
:
b) Ligamentous supports:
Cutaneous system
Due to overstretching of the skin, the elastic
fiber may rupture together with small blood
vessels and so red streaks appear; known as
striae gravida rum. They are usually more
marked below the umbilicus, on the breasts and
may appear on the buttocks and thighs. In some
women they are not marked or even don't
appear during pregnancy. After labour, the red
striae become pale silvery white due to fibrosis
and are known as (striae albicantes).
Linea nigra
Pigmentation: It is due to suprarenal changes, it
usually begins to appear after
the 4th month. The pigmentation may appear
anywhere but the commonest sites
are:
1. Linea nigra: which is a line of pigmentation
between the umbilicus and the
symphysis pubis.
2. Increased pigmentation of the nipple as primary
areola and appearance of the
secondary areola.
Stria gravidarum
3. Cloasma gravidarum or mask face of pregnancy
which is butterfly
pigmentation of the forehead, nose, upper lip and
the adjoining parts of the
checks. This pigmentation may persist but the
cloasma gravidarum usually
disappears.
Falling of hairs and brittleness of nails may occur
during pregnancy.
Butterfly pigmentation
MATERNAL WEIGHT GAIN
There are no reliable data available for weight gain in
the first 12 weeks of
pregnancy. But in normal pregnancy the average gain
0.3 Kg/week up to 18 is
weeks, 0.45 Kg/week from 18-28 weeks and a slight
reduction with a rate of 0.36-
0.41 Kg/week until term.
Failure to gain weight and sometimes slight weight loss
may occur in the last 2
weeks. The average weight gain for primigravidae for
the inhal pregnancy is 12.5
Kg. and is probably about 0.9 Kg. less for
multigravidae. Acute excessive weight
gain is commonly associated with abnormal fluid
retention.
Weight gain is produced by:
Fetus 3.63-3.88 Kg
Placenta 0.48-0.72 Kg
Amniotic fluid 0.72-0.97 Kg
Uterus and breasts 2.42-2.66 Kg
Blood and fluid 1.94-3.99 Kg
Muscle and fat 0.48-2.91 kg total= 9.70-14.55Kg
NERVOUS SYSTEM
Functional changes may appear especially in
neurotic women as :
-sleepy, depressed
-while others become irritable, excited and suffer
from insomnia.
-The nausea and vomiting may have a neurotic
element.
-Change of appetite such as refusal of some types
food. of
-Neuralgias