Changes in Pregnancy

Physical and Physiologic changes

of Pregnancy
Pregnancy is a normal physiologic process that
affects all body systems and results in both
objective and subjective changes; it is a
stressful time requiring many adaptations and
may lead to minor discomforts.
 Physiological Changes
Uterus
>increase in size due to growing fetus
>Weight increases from 50 to 1,000 grams
>increase in fibrous and connective tissues, w/c strengthens the elasticity of
the uterine muscle wall.
>Braxton-Hicks- painless uterine contraction
>Softening of the cervix
>Formation of the mucus plug to prevent bacterial contamination from the
vagina.
Vagina
>Increase in vaginal secretions; Acidic (ph is 3.5 to 6) and thickish
white.
 Breast
>Increase in size accompanied by feeling of fullness, tingling, and
heaviness.
>Thin, watery secretions, precursor to colostrum, can be expressed
from the nipples by the end of the 10th week.
Cardiovascular
Blood Volume
 Increase progressively throughout pregnancy, beginning in the 1 st
trimester and peaking in the middle of the 3 rd trimester at about
45% above prepregnant levels.
 Extra volume of blood acts as a reserve for blood loss during
delivery.
Heart
 Increase in heart rate by 10 bpm by the end of 1st trimester.
 Increase in cardiac output.

Urinary/Renal systems
 Frequency of urination (1st and last trimester)
 Bladder capacity increases
 Kidney filtration rate increases as much as 50%
 Presence of protein indicates possible renal disease or PIH
 Red Blood Cells
Stimulation of the bone marrow leads to 20-
20% increase in RBC.
Plasma volume increase is greater than the
RBC increase which leads to hemodilution,
typically referred as physiologic anemia of
pregnancy (pseudoanemia)
Hematocrit is decreased by 7%
WBC – increase up to 25,000/cu mm during
labor and delivery.
 Musculoskeletal System
 Increase in the normal-lumbosacral curve leads to backward tilt
of the torso
 Center of gravity is changed, which often leads to leg and back
strain and predisposition to falling.
 Pelvis relaxes due to the effects of the hormone relaxin; leads
to the characteristics “duck waddling” gait.

Gastrointestinal System
 Pregnancy gingivitis – gums reddened, swollen and bleed easily
 Increased saliva (ptyalism); decreased gastric acidity.
 Decreased tone and motility of smooth muscles;
decreased emptying time of stomach; slowed
peristalsis due to increased progesterone leads to
complaints of bloating, heartburn, and constipation.
 Nausea and vomiting in 1st trimester due to rising
levels of HCG.
 Cravings or desires for strange food combinations
may occur.
 Emptying time for gallbladder may be prolonged;
increased incidence of gallstones.
 Integumentary
 Increased skin pigmentation in various areas of the
body: Chloasma, striae gravidarum, linea nigra
 Appearance of vascular nevi on the neck, arms and legs.
 Greater sweat and sebaceous gland activity.
Endocrine System
 Pituitary: FSH & LH greatly decreased; oxytocin secreted
during labor and after delivery; prolactin responsible for
initiation and continuation of lactation
 Progesterone secreted by corpus luteum until formation
of placenta.
Principal source of estrogen is placenta.
Ovaries secrete relaxin during
pregnancy
Slight increase in thyroid gland
Increase in aldosterone, which retains
sodium.
 Psychological Changes
1st Trimester
 Mother needs accurate diagnosis of pregnancy.
 Ambivalence
 Mother is self-centered, baby “part” of her
2nd Trimester
 Mother demonstrates growing realization of baby as separate
and needing person
 Fantasizes about unborn child
3rd Trimester
 “Nesting activity appears as due date approaches.
 Desire to be finished with pregnancy.
 Anxiety over “safe passage” for self and baby through labor and
delivery.
Preparation for Siblings.

Changes in the Father

 May feel left out of pregnancy
 Confused by partner’s mood swing
 Needs to confront and resolve his own conflicts
 Concerns and fears resurface.
 Couvade syndrome – refers to the presence of physical discomforts
in the man during their partner’s pregnancy that mimic her
symptoms.