Table 3 - Changes During Pregnancy

Organ/System Changes During Pregnancy

· 50% increase in size (4 True) with increased secretion corticotropin,
Pituitary
thyrotropin and prolactin.
· Increase glucocorticoid secretion.
Adrenal
· 2 x aldosterone secretion.
· 50% increase in size and in production thyroxine as a result of
Thyroid stimulation by human chorionic gonadotropin and placental human
chorionic thyrotropin.
· Gland enlargement and increased parathyroid hormone.
Parathyroid
· More marked increase during lactation.
Ovaries and
· Produces oestrogens, progesterone and relaxin (3 True).
Placenta
· Uterus increases 22 fold.
· Breasts double in size.
Mother's body
· Vagina and introitus enlarge.
· General weight gain in excess of fetus and amniotic fluid.
· 15% increase basal metabolic rate in latter half pregnancy.
Metabolism · Increased absorption and storage of protein, calcium, phosphates and iron
through pregnancy.
· Cardiac output 30-40% above normal by 27th week but near normal in
final 8 weeks.
Circulation
· Blood volume increases during second half pregnancy (2 False) by about
30% (1-2 litres).
· Minute ventilation increases 50% and a fall in arterial pCO2.
Respiration · Respiratory rate increases as diaphragm less effective with enlarged
uterus.
· Slight increase in urine production.
Urinary · Near balance of increased glomerular filtration rate and increased re-
absorption of sodium, chloride and water.
Immune system · Decrease in maternal antibody production (1 True).

Table - Effects of Progesterone

Organ Effects of Progesterone

· Promotes secretory epithelium in endometrium.
Uterus · Decreases frequency and intensity of uterine contractions through decreased
excitability of myometrial cells (4 True).
Uterine cervix · Thickens mucus and makes it more tenacious and cellular.
Fallopian
· Promotes secretory changes of mucosa.
Tube
Breasts · Promotes development of lobules and alveoli to become secretory (2 True).
Vagina · Epithelial proliferation and thick viscous mucus production (3 True).
Endocrine · Inhibits LH secretin.
organs · Potentiates inhibitory effect of oestrogens.
Other effects · Thermogenic, probable cause of basal body temp rise at time of ovulation.

Table - Effects of Oestrogens

Organ Effect of Oestrogens

At puberty - two fold increase in size - increasing amount of uterine muscle
Uterus
and its content of contractile proteins (1 True).
Menstruating years- proliferation endometrial stroma and endometrial glands.
At puberty - vagina enlarges, as do labia majora and minora and deposition of
External
fat in mons pubis. Vaginal epithelium changes from cuboidal to the more
Genitalia
infection-resistant squamous.
Menstruating years - there is some cornification of vaginal epithelium. There
is a slight cyclical change in the vagina under changing levels of oestrogen and
progesterone.
Uterine Oestrogen makes cervical mucus thinner and more alkaline. Oestrogen-only
Cervix mucus is thin, elastic and dries into a 'fern-like' pattern.
Fallopian
Glandular proliferation and increase in the number and activity of ciliated cells.
tube
At puberty:
· Proliferation of mammary ducts.
Breasts · Development of stroma tissue.
· Deposition of fat.
Oestrogens are the growth hormones of the breasts (2 True).
· Increase osteoblastic activity.
Skeleton
· At puberty cause uniting of epiphyses to shafts of long bones.
· Decrease FSH.
Endocrine · Depending on circumstances may increase/decrease LH.
organs · Increase secretion angiotensinogen.
· Increased secretion thyroid-binding globulin (3 True).
· Slight increase in total body protein.
· Slight increase in metabolic rate.
Other effects · Increase deposition subcutaneous fat.
· Causes skin to become softer, smoother and more vascular (androgens are
primarily responsible for pubic and axillary hair at puberty) (4 False).