Physiologic Changes in Pregnancy Flashcards
Uterus
Enlargement of existing myometrial cells
Increase in wt, strength, elasticity, and vascularity
Volume capacity increases from 10 mL to 5000 mL
When should you measure fundal height?
Starting at 20 weeks gestation
Public symphysis to top of fungus = # weeks gestation in centimeters
Cervix
Glandular tissues secretes thick sticky mucus to form mucous plug (from progesterone)
Increased vascularity
What does the mucous plug in the cervix do?
Prevents organisms from entering uterus
Increase in vaginal discharge - mucorrhea
Vagina
“Tunnel”
Increased thickness of mucosa
Increased vaginal secretions to prevent bacterial infections
Increased blood flow - can cause painful pelvic varicosities
Connective tissue relaxes
Breasts
Mammary glands increase in number and size
Superficial veins more prominent
Nipples more erect and areoles darken
When is colostrum produced?
During the third trimester
Respiratory System
Increased volume of air breathed each minute, from 30-40%
Abdominal breathing moves to thoracic breathing
Increase in nose bleeds and nasal stuffiness from estrogen-related edema
Cardiovascular System
Blood volume increased by 40-50%
CO increases 30-50%
Pulse increases by 10-15
Hyper-coagulable state
The size of an increased uterus interferes with what?
With blood return from lower extremities, leading to supine hypotensive syndrome, edema and varicose veins
Dilutional Anemia
RBC increase about 18% while plasma increase about 50% causing more fatigue
Supine Hypotensive Syndrome
Vena Caval Syndrome
When laying flat, the uterus puts pressure on the inferior vena cava and causes a relative hypotension
Supine Hypotensive Syndrome Interventions
Turn pt to side or to sitting position
Put pillow under hip
When Does Supine Hypotensive Syndrome start?
About 18 weeks due to weight of uterus, fetus, placenta, amniotic fluid
GI System
N/V - thick hCG and blood sugar instability
Increase of progesterone levels cause smooth muscle relaxation
Decreased peristalsis leading to bloating and/or constipation
Relaxation of cardiac sphincter may cause heart burn
GU System
Increased urinary frequency 1st & 3rd trimesters from pressure on bladder
Ureters elongate and dilate d/t progesterone - Pyelonephritis
Increased GFR resulting in glycosuria
Linea Nigra
Dark line on the abdomen that starts at the pubic symphonies and up to the belly button and can somtimes be higher
Skin
Linea Nigra
Facial chloasma or melasma gravidarum
Striae/Stretch marks
Musculoskeletal
Joints of pelvis relax - can be painful
Lumbar spinal curve becomes accentuated
Abdominal muscle may separate - Diastasis Recti
What happens when the lumbar spinal curve becomes accentuated?
Center of gravity changes
Compensates fro increase uterine weight in anterior aspect
Weight Gain
Increased demand only 300 kcal/day in 2nd & 3rd trimesters
Weight Gain: BMI <18.5
28-40 pounds
Weight Gain: BMI 18.5-24.9
25-35 pounds
Weight Gain: BMI 25-29.9
15-25 pounds
