Maternal Adaptations to Pregnancy Flashcards
Cervical Changes
Estrogen stimulates the glandular tissue of the cervix causing:
- Increases in cell number
- Forms the mucus plug
- Increased vascularization
- Softening of the cervix-Goodell’s sign
- Blue purple discoloration Chadwick’s sign
Breasts Changes
- Increases in size and nodularity
- End of second month- superficial veins are prominent, nipples are more erect, more pigmented
- Striae
- Colostrum: starts at the end of the third trimester
Cardiovascular System changes
- Blood Volume- Increases by 30%-45%
- Plasma Volume- Increases by 40%-60%
- RBC Volume increases but not as much as plasma
- this leads to dilution of RBC and causes physiologic anemia of pregnancy
— May cause anemia of pregnancy due to dilution of RBC from increased plasma - Cardiac Output increases by 30%-50%. Greater on left side
- Hypercoaguablity- clotting factors increase by 50%
— Higher risk of clotting
— Increased risk for HTN/ preeclampsia
Supine Hypotensive Syndrome
caused when the gravid uterus compresses the inferior vena cava when a pregnant woman is in a supine position, leading to decreased venous return centrally.
Gastrointestinal Changes
- Appetite-increased cravings
— Pica: cravings for non edible things - Mouth- increased vascularization leads to bleeding gums, ptyalism (increase in salivation).
- Esophagus-decreased sphincter tone (not as tight) due to progesterone- pyrosis (acid reflux-heart burn)
- Intestines- Increased emptying time & decreased motility due to progesterone= constipation /hemorrhoids/ nausea/ hyperemesis
- Gallbladder- hypotonic and prolonged emptying time. Bile thickens. = gall stones/ cholecystitis & pruitis (itchiness).
Skin Changes
- Cholasma
- Spider Nevi
- Straie
- Linea Nigra
Cholasma
hyperpigmentation (mask of pregnancy- cheeks to across nasal bridge): will go away
Spider Nevi:
breaks in the subcutaneous tissue will not go away
Straie
stretch marks: fade/ turn white or silverish: may not go away
Linea Nigra:
hyperpigmented line vertical across abdomen : will go away
Eye Changes
- Intraocular pressure decreases:
— Due to increased vitreous outflow - Slight thickening of the cornea (vision changes)
— Occurs due to fluid retention. If the woman wears contact lenses she may notice that her normally comfortable lens now are bothersome - Cornea changes disappear by 6 wks postpartum
— Changes that occur in the eye normally do not affect vision, other than transient loss of accommodation (the power of ther eye to alter convexity of the lense according to the narrowness or distance of an object)
Confirmation of Pregnancy: Presumptive Indicators (subjective)
- Amenorrhea (no period)
- Nausea and vomiting
- Fatigue
- Urinary frequency
- Breast and skin changes
- Vaginal and cervical color changes-Chadwick’s sign
- Fetal movement
Confirmation of Pregnancy: Probable Indicators (objective)
- Abdominal enlargement
- Ballottement
- Braxton Hicks contractions
- Cervical softening
- Changes in uterine consistency
- Goodell’s sign: ripening of the cervix (+)
- Hegar’s Sign: the compressibility and softening of the cervical isthmus
- Palpation of the fetal outline
- Pregnancy tests
- Uterine souffle : hear something in the uterus
Confirmation of Pregnancy: Positive Indicators (diagnostic)
- Auscultation of fetal heart sounds
- Fetal movements felt by examiner
- Visualization of the embryo or fetus (ultrasound)
Metabolism changes
- Weight gain
- Protein
- Carbohydrate
- Fat
- Calcium
- Iron
- Increased need for H2O
- Increased H2O retention
