Obstetrics Simplified - Diaa M. EI-Mowafi Show
Maternal Changes Due to Pregnancy THE GENITAL SYSTEM The Ovaries
The Fallopian Tubes The musculature hypertrophies and the epithelium becomes flattened. The Uterus
The Cervix
The Vagina The vagina becomes soft, warm, moist with increased secretion and violet in colour (Chadwick’s sign) due to increased vascularity. The Vulva It becomes soft, violet in colour. Oedema and varicosities may develop. THE BREASTS
THE SKIN Pigmentation This is due to increased production of melanocyte stimulating hormone (MSH).
Striae gravidarum These are reddish, slightly depressed streaks appear in the later months of pregnancy in the abdomen and sometimes breasts and thighs. It may be due to mechanical stretching or increased glucocorticoids which results in rupture of the elastic fibres in the dermis and exposure of the vascular subcutaneous tissues. After delivery, they become white in colour but do not disappear and called "striae albicans". Vascular changes There is increase in the skin blood flow and temperature. Secretions Increase in sweat and sebaceous glands activity. HEMATOLOGIC CHANGES Blood Volume
Blood Indices
CARDIOVASCULAR SYSTEM Heart
Arteries
Veins Varicosities in the lower limbs and vulva may occur due to:
RESPIRATORY SYSTEM Dysponea may occur due to:
GASTROINTESTINAL TRACT Gingivitis There is increased vascularity and tendency for bleeding as well as hypertrophy of the interdental papilla. Ptyalism It is excessive salivation and more common in association with oral sepsis. Nausea and vomiting Nausea (morning sickness) and vomiting (emesis gravidarum) occur in early months. Appetite changes (longing or craving) The pregnant woman dislikes some foods and odours while desires others. Reduced sensitivity of the taste buds during pregnancy creates the desire for markedly sweet, sour or salt foods. Deviation may be so extreme to the extent of eating blackboard chalk, coal or mud (pica). Indigestion and flatulance This is probably due to:
Hurt burn Due to reflux of the acidic gastric contents to the oesophagus. Constipation Due to:
Gall stones More tendency to stone formation due to atony and delayed emptying of the gall bladder. Haemorroids Due to:
Appendix It is displaced upwards by the enlarged uterus. URINARY SYSTEM Kidney Renal blood flow and glomerular filtration rate increases by 50%. Ureters Dilatation of the ureters and renal pelvis due to:
Bladder Frequency of micturition in early pregnancy due to:
Urinary stress incontinence may develop for the first time during pregnancy and spontaneously relieved later on. MUSCULO-SKELETAL SYSTEM
ENDOCRINE SYSTEM Pituitary gland
Thyroid gland
Parathyroid glands Increase in size and activity to regulate the increased calcium metabolism. Adrenal glands Hypertrophy particularly the cortex resulting in increased mineralocorticoids (aldosterone) and glucocorticoids (cortisol). METABOLIC CHANGES Weight gain
Water metabolism There is tendency to water retention secondary to sodium retention. Protein metabolism There is tendency to nitrogen retention for foetal and maternal tissues formation. Carbohydrate metabolism
Fat metabolism There is increase in plasma lipids with tendency to acidosis. Mineral metabolism There is increased demand for iron, calcium, phosphate and magnesium. Which of the following changes take place during the second trimester of a woman's pregnancy?During the second trimester of pregnancy, you might experience physical changes, including: Growing belly and breasts. As your uterus expands to make room for the baby, your belly grows. Your breasts will also gradually continue to increase in size.
What is 2nd trimester of pregnancy?The second trimester represents the middle part of your pregnancy, from weeks 13 to 26. For many women, one of the best things about this trimester is that nausea might begin to settle.
Which if the following changes takes place during the first trimester of a woman's pregnancy?First Trimester (0 to 13 Weeks)
Your body also undergoes major changes during the first trimester. These changes often cause a variety of symptoms, including nausea, fatigue, breast tenderness and frequent urination. Although these are common pregnancy symptoms, every woman has a different experience.
Which of the following changes take place during the third trimester of a woman's pregnancy?During the third trimester, your fetus continues to grow in size and weight. The lungs are still maturing, and the fetus begins to position itself head down. By the end of the third trimester, the fetus is about 19 to 21 inches long and weighs, on average, 6 to 9 pounds.
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